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Abstract

Background: The East Palestine, Ohio, train derailment on February 3rd, 2023, resulted in the exposure of residents and the surrounding area to numerous hazardous chemicals, which included known acute irritants and human carcinogens. Despite evacuation and cleanup, both residents and responders reported high occurrences of symptoms associated with exposure in the months following, such as eye, skin, and respiratory irritation, headaches, and fatigue. The long-term health consequences for residents remain uncertain.

Objective: To assess the potential for immune perturbations resulting from the exposure, we performed a broad investigation of circulating immune cells and mediators from residents of East Palestine, OH, 5 months following the derailment.

Methods: We performed exploratory immunophenotyping via flow cytometry and immune mediator profiling via Luminex on peripheral blood mononuclear cells and plasma collected from 19 participants who resided within an approximately one-mile radius of the derailment. These results were compared to sex and age-matched controls from an unexposed location.

Results: Immunophenotyping of East Palestine residents revealed decreased overall proportions of T and B lymphocytes and a shift towards memory subsets. Natural killer cell percentages were increased, particularly the cytotoxic CD56dim subset. Cytokine assays demonstrated heightened levels of cytokines and growth factors associated with hematopoietic differentiation and tissue repair.

Significance: Collectively, our observations demonstrate potential immunomodulation indicative of a response to an inflammatory insult within this cohort of exposed participants. This investigation indicates the necessity of expanded retrospective studies to continue immune monitoring of residents for evaluation of long-term health impacts.

Impact: This study evaluates immune perturbations in East Palestine, OH, residents five months after the February 3rd, 2023, train derailment, revealing altered lymphocyte frequencies, increased cytotoxic NK cells, and elevated cytokines linked to regulation of hematopoiesis and tissue repair. Findings suggest persistent immunomodulation consistent with prior inflammatory exposure and underscore the need for expanded long-term immune monitoring to understand potential chronic health effects in this exposed community.

Document Type

Article

Publication Date

2026

Notes/Citation Information

© The Author(s) 2026

Funding Information

This study was supported in part by NIH/NIEHS P30ES026529; R21ES036036; 0T2ES038696 and NIH/NCATS UL1TR001998. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH/NIEHS.

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