by: Michael Kaufman, Medical Journalist

Katy Roemer, RN, remembers the fire that took place in 2012 at the Chevron oil refinery in Richmond, Calif., a 12-mile drive from the Kaiser Permanente Oakland Medical Center, where she works as a maternity nurse. The fire burned out of control for more than five hours, spewing a huge black cloud of toxic chemicals, including sulfur dioxide and nitrogen oxide, into the air. Bay Area residents were advised to stay inside, close windows and doors, turn off air conditioners and heating units, and have duck tape on hand in case it was needed to further seal the windows and doors. Pets and children were to be kept inside.

It was a wakeup call for Roemer, who forwarded a copy of an op-ed article by Antonia Juhasz, author of several books about the oil industry, published in the Los Angeles Times after the fire.

“Some 160,000 residents live in the areas directly affected by the warning,” wrote Juhasz. “More than 5,700 people sought medical treatment.” She noted that homes, businesses, an elementary school, and playgrounds are all located within a mile of the refinery, some even adjacent to it. She also cited a 2008 study by UC Berkeley and Brown University researchers that found that air inside some Richmond homes was more toxic than that outside because harmful pollutants from the refinery were trapped indoors.

Incidence of breast, ovarian, and prostate cancer in Contra Costa County, which includes Richmond, is the second highest in California, continued Juhasz. And Richmond residents are among the "most at-risk groups" in the county. They are hospitalized for chronic diseases at significantly higher rates than the county average, including for female reproductive cancers, which are more than double the county rate. People who live near any one of the four oil refineries located in the county have higher rates of childhood and adult asthma, as well as asthma-related deaths.

"This is evidence absolutely related to our work as nurses," says Roemer, noting that about 60% of hospitalized pediatric patients at her center in Oakland are cancer patients. The center has a medical/surgical oncology unit and also provides outpatient oncology infusion.

Roemer is a member of National Nurses United (NNU), the largest organization of nurses in the United States, and serves on the board of the NNU-affiliated California Nurses Association. She and other NNU members recently attended a press conference convened in Washington, D.C., by Senator Barbara Boxer (D-CA), chair of the Senate Committee on Environment and Public Works, calling on Secretary of State John Kerry and the Obama Administration to conduct an immediate health impact study on the proposed Keystone XL Pipeline and tar sands oil before giving its approval to the project.

The NNU announced its opposition to the project last year, citing potential health hazards associated with extracting, refining, and transporting oil from tar sands. More reports have surfaced since then, according to NNU co-president Karen Higgins, RN. She says tar sands-mining pollutants have been linked to cancer, leukemia, genetic damage, and birth defects. Tar sands pipeline spills in Michigan and Arkansas, she adds “have beset local residents with cardiovascular, gastrointestinal, neurological, and respiratory impacts, as well as persistent coughs, headaches, nausea, eye, and skin problems.”

Roemer says she finds it “appalling” that the Keystone project is being considered “when we know what is happening in these communities.” She wonders why most of the impact studies that have been done have emphasized the overall environmental effects without considering the impact on health. She hopes the evidence of increased cancer risk will lead oncology nurses across the country to speak out, as individuals and through their professional organizations, to ensure that the Keystone XL will not be approved until evidence determines that it will not imperil the health and safety of the American people.