Nursing students who surveyed 76 people along the Ogeechee River since last May’s fish die-off found that the closer people live to the river, the more health symptoms they reported.
But no cause-and-effect relationship has been established. Further, the five Georgia Southern University nursing students, who did the study as a class project, found no correlation between the reported symptoms and two other questions on their survey: time spent swimming in the river and the number of fish consumed from its waters. Presenting the results Saturday afternoon, the student researchers emphasized their study’s limitations and said that what it points to, more than anything else, is a need for further research.
About 60 people filled Statesboro Regional Library’s community room for the presentation Saturday afternoon. The study’s lead author, senior nursing student Lynsey Johnson, said students knew they were picking a topic of intense public interest. But she was still surprised by the level of attention.
“It has gotten a lot of attention, and we just hope that further research will be done and this will be used as inspiration to follow up because this is a pilot study. It is a student, pilot study” she said.
She added that the survey was based on subjective surveys. Students distributed the surveys at Ogeechee Riverkeeper meetings and other community events and door-to-door in neighborhoods near the river. They were answered anonymously.
 “This was strictly a correlational study,” said Chelsea Allen, who introduced the presentation. “We didn’t have the time or resources to do a really in-depth cause-and-effect.”
Johnson began the slideshow with a reminder of the sightings May 19, 2011, of Georgia’s largest fish kill on record, with more 38,000 fish dead. Initially, she noted, the state Environmental Protection Division found that the fish died of infections with columnaris bacteria. But EPD officials said that stress factors such as low flows and chemicals in the water had weakened the fish and triggered the outbreak.
A June 3 EPD report noted the discovery of formaldehyde, ammonia and hydrogen peroxide in the river downstream from King America Finishing, a plant at Dover that applies dyes and coatings to fabrics. Formaldehyde levels were five times the chronic exposure limit for aquatic live and approaching the acute exposure limit for aquatic life, according to numbers included in the nursing student’s presentation.
Observing that the fish kill occurred downstream from King America Finishing at Dover, the EPD eventually issued a consent order than required King America to fund $1 million of environmental projects on the river.
Human health effects
Leaving the effects on aquatic life to other researchers, the nursing students sought to test whether exposure to the river was affecting human health, as measured by a health history survey.
The presentation noted, from previous scientific studies, that formaldehyde has been shown to cause skin sensitization, an increased risk of myeloid leukemia, and – when inhaled – eye, nose and throat irritation.
The survey was directed to Bulloch County residents over age 18 who either live along or had visited the river. They were asked about acute symptoms and specifically, whether they had been diagnosed or treated for any conditions since last May 19. Of the 76 respondents, 53 were male, 23 were female, and the age range was 21-78, with an average age of 48. Pregnant women and people under age 18 were intentionally excluded.
Johnson showed a graph of the number of acute symptoms people reported versus the distances of their homes from the river. Many of those reporting the most symptoms were grouped near the zero axis for distance from the river, and a curve showed symptoms tending to taper off with distance.
“In other words, the closer the subjects live to the river, the more acute symptoms were reported,” Johnson read, explaining what researchers called a negative correlation.
Pulmonary symptoms, ear, nose and throat symptoms and neurological symptoms were the most commonly reported.
No control group
Among the study’s limitations, also listed on a slide, were the small sample size, the fact that a mostly male population responded, and that children and pregnant women were excluded. Another admitted limitation was the lack of a control group. In other words, the survey did not, for comparison, look at people upstream or at Bulloch County residents who did not live near or visit the river.
The nursing students made these shortcomings the basis of their recommendations for further research. They also provided some “community education,” advising people not to eat fish or swim in water “unless deemed safe,” to keep up with river water testing results at the EPD website, to have their well water tested periodically and to report any symptoms to a healthcare provider or health department.
After concluding their presentation, the students took questions and comments from the audience.
Citizen concerns
Spencer and Betty Moore live at Pembroke in Bryan County but own 13 acres at Gobar Landing in Bulloch. Their son, Steven, 53, lives there and was diagnosed in November with brain cancer. His parents said he is dying, and they named several other people who lived in the area who have died of cancer over the years.
“My son has driven me crazy with, ‘Mama, do something about this river. It’s killing me. Mama, you’ve got to do something,’ and I said, ‘What in the world can I do?’” said Betty Moore.
She said she still doesn’t know what to do, but she now believes what her son had been saying even before his diagnosis.
“He says, ‘Mama, it doesn’t matter what you do now, it’s too late for me,’ and I said, ‘Son, it might not be too late for somebody,’” she continued.
Another person who expressed worries that chemicals in the river are affecting people is Ben H. Anderson. He is one of the lead plaintiffs in a class action lawsuit landowners along the river filed against King America last June. The suit is now awaiting a judge’s decision on whether it will be heard in Fulton County Superior Court, where it was filed, or transferred to a federal court.
“I’m worried about myself and my family about the formaldehyde,” Anderson said Saturday. “I don’t even sleep anymore.”
Separately from the class action suit, the Ogeechee Riverkeeper in October filed a legal challenge to the EPD’s handling of the consent order. Attending the nursing students’ presentation, Riverkeeper Dianna Wedincamp urged citizens to watch for notices of an upcoming EPD hearing on King America Finishing’s draft of a new discharge permit.
All five student researchers are seniors in GSU’s Bachelor of Science program in nursing. Besides Johnson and Allen, they include Danny West, Ben Strozzo and Ryan Dyson. Johnson already has bachelor’s degrees in biology and psychology, and West has a bachelor’s in chemistry.
They began the study in 2011 as their project for a nursing research course taught by Dr. Marian Tabi and continued it this semester in the community health nursing course taught by Dr. Ursula Pritham. The presentation fulfilled a requirement for a community awareness project.