A new report from the National Academies of Sciences, Engineering, and Medicine (NASEM), Clinical Follow-up and Care for Those Impacted by the JP-5 Releases at Red Hill, is urging clinicians to prioritize ongoing symptom evaluation and continuity of care for individuals potentially exposed in 2021 to jet fuel-contaminated drinking water in Honolulu, Hawaii.
Dr. Kurunthachalam Kannan of the Wadsworth Center’s Division of Environmental Health Sciences served on the NASEM committee that developed recommendations for the clinical follow-up and care of individuals impacted by the JP-5 (jet propellant-5) fuel releases at the Red Hill Bulk Fuel Storage Facility. The committee conducted a comprehensive review of the health risks associated with these exposures and provided guidance to the Department of Defense (DoD) and the Department of Veterans Affairs (VA). The report examines the widespread contamination event that affected the drinking water supply serving Joint Base Pearl Harbor-Hickam and surrounding communities, where as many as 93,000 individuals may have been exposed through ingestion, inhalation of vapors, or skin contact.
The committee found limited but suggestive evidence linking exposure to short-term respiratory, gastrointestinal, dermatological, and mental health symptoms. However, insufficient data exist to determine long-term health outcomes, and no validated clinical tests are currently available to confirm or quantify past exposure. As a result, the report emphasizes the importance of thorough clinical documentation, patient-centered care, and longitudinal monitoring of affected individuals.
To address critical gaps, the committee recommends that the Defense Health Agency and VA develop standardized clinical guidance for providers treating exposed populations. Additional recommendations include expanding environmental monitoring, developing biomarkers of exposure, standardizing water testing methodologies, and conducting long-term epidemiological studies. The report also encourages affected individuals to enroll in health registries, including the University of Hawaii Red Hill Independent Health Registry and, for DoD personnel, the Red Hill Defense Occupational and Environmental Health Readiness System (DOEHRS) Registry.
The committee’s work extended beyond literature review. Members conducted site visits to Red Hill and the Honolulu Board of Water Supply and engaged directly with affected communities through multiple in-person and virtual listening sessions. These interactions – spanning service members, military families, civilians, and other Oahu residents – highlighted a significant breakdown of trust between impacted communities and the medical system.
The Red Hill contamination event stands as a defining environmental health crisis for Hawaii and the nation, underscoring the critical intersection of environmental safety, public health, and institutional accountability. Contributions from the Wadsworth Center, including Dr. Kannan’s expertise in environmental chemical exposure, played an important role in shaping this national report and advancing understanding of the health impacts associated with such incidents.