Four days after a chemical spill contaminated drinking water with 4-methylcyclohexane methanol in Charleston, W.Va., Jennifer Kayrouz, who is 38 weeks pregnant, was given the go-ahead, as were others in Charleston, to resume drinking out of the tap.
Residents were told the water was safe to drink on Jan. 13, but late on Jan. 15, the West Virginia Department of Health and Human Resources issued an advisory for pregnant women based on the U.S. Center for Disease Control and Prevention's guidelines that recommended "out of an abundance of caution" that "pregnant women drink bottled water until there are no longer detectable levels of 4-methylcyclohexane methanol, or MCHM, in the water distribution system."
"It's very upsetting," said Kayrouz, 38, who lives in Knawha City, one of the first neighborhoods to see the water ban lifted. "I am not ingesting it, but I felt safe enough to shower in it ... and was still washing dishes by hand. ... I have a master's in public health, and I know people are very polarized on this issue, but I put my faith in our local health department that said the water was safe. I feel like it wasn't right."
Kayrouz, who has a 6-year-old daughter, and other pregnant women, along with some health care providers, wondered why the CDC delayed its warning and whether pregnant women living in affected counties had been lured in to a false sense of security that the tap water was safe.
"If it is not safe for me to drink pregnant, is it safe for my 55-pound daughter to drink or our pets?" Kayrouz asked. "It's very misleading. We got the green light, and three days later were told this one population really shouldn't drink it. It kind of flies in the face of my training. What are we supposed to believe?'"
Brandy Russell, community director for the West Virginia March of Dimes, which fights against birth defects, said, "Everyone is freaking out," and not just pregnant women.
She said there had been an uptick of calls to its Charleston office over the past weekend. And since the ban was lifted, residents continue to express worry.
"People are bringing private testing facilities into their homes," she said. "There was a gal in Zone 1 who tested, and they were still showing levels [of the chemical] in her water, although it was below the recommendations."
"It's kind of scary," she said. "A few years back there was a leak at Dupont in the Ohio Valley, and they said the same thing: 'Everything is back to normal. And a few years later there were multiple issues."
The West Virginia American Water spill has affected 300,000 people in nine counties in the southern part of the state. But this week, 200,000 started to drink the water again.
Not much is known about the chemical -- 4-methylcyclohexane methanol or crude MCHM – and how it might affect people, particularly a developing fetus. Because MCHM was grandfathered in to the 1976 Toxic Substances Control Act, there are no laws requiring industry to prove it is safe.
But the CDC has said it believes water with levels of one part per million was safe to drink.
A triage nurse at the Family Care health and birth center in Charleston, said, "Our phone rang off the hook" on the first day of the spill.
"At the time, we told [pregnant women] to use bottled water and not take in any more [tap water]," she said. "Several had had a glass of tea or maybe ice in a drink the day before. But we told them to just avoid everything until it was cleared."
Dr. Stephen Bush, chairman of the obstetrics and gynecology department at West Virginia University in Charleston, said he, too, was confused by the delay in the CDC's warning, but "we have to take what they are telling us as truthful.
"All of my patients have been erring on the side of caution anyway," he said. "With them, it's not been a problem, but it could potentially cause others to have fear. But we have to rely on what the CDC has come up with and take them at their word that it is not a truly dangerous toxin at less than one part per million concentrate."
Of course, there is always concern about whether the chemical could cause miscarriages or anomalies to the baby, said Bush. "But according to the CDC it is safe, although it's only in animal studies, and who knows what will happen in 30 years," he said.
But Lesley Rathbun, a nurse-midwife and president of the American Association of Birth Centers, said she would "be very concerned' about the effects of this spill on pregnant women and their unborn fetuses.
"The big thing is it's an unknown," said Rathbun, who founded the Charleston Birth Place in South Carolina. "Nobody knows what this chemical is or what it can do, or how much is not good. Pregnant women have all sorts of things they can be worried about when pregnant, and they have to have some sort of trust in the state and federal agencies."
In the meantime, Kayrouz said she would continue to drink bottled water, and would shower only in warm temperatures to minimize how much of the chemical she might inhale.
"I am sure thousands of people -- bright, educated people -- have started drinking and showering in it when they could no longer smell it in their homes," she said. "But I had friends who collected rain water all weekend. ... We know so little."