Flint Rash Investigation

Background

During the time that the City of Flint switched water sources from Lake Huron to the Flint River and then back to Lake Huron, people in the area reported getting rashes (or worsening rashes) to their health care providers. In response, the Michigan Department of Health and Human Services (MDHHS) launched an investigation on February 3, 2016.

The objectives of the rash investigation were to:

• better understand and characterize the rashes,
• explore the causes of the rashes and determine if the Flint water supply may have caused them, and
• make recommendations for public health interventions.

On February 25, 2016, MDHHS requested help from federal and state government agencies to support this investigation. The Centers for Disease Control and Prevention (CDC), the Agency for Toxic Substances and Disease Registry (ATSDR), the U.S. Environmental Protection Agency (EPA), the U.S. Department of Health and Human Services (HHS), MDHHS, and others formed a unified coordination group (UCG) to investigate the problem.

How were rash and water quality concerns investigated?

The investigation took about 6 months and had three different parts:

1. Between late January and March of 2016, investigators contacted Flint residents who participated in the investigation and asked them questions from a survey designed specifically for this study. Investigators were able to interview 390 people.
2. In January 2016, four dermatologists from the Flint area volunteered to give the investigation participants free dermatology evaluations. They examined 122 people.
3. Between January and May of 2016, investigators conducted water-quality tests. They did this by taking water samples from 170 homes in Flint where people reported rashes. The investigators also reviewed historic water-quality data that the Flint water treatment plant produced when the Flint River was the city’s source for municipal water.

What are the conclusions of the investigation?  Did the water in Flint cause rashes?

Investigators were not able to identify any current water-quality parameters that might be causing or exacerbating rashes. Investigators found no pattern of water contaminants or water-quality parameters in the homes sampled for this investigation. 

This conclusion should be interpreted with caution because of the limitations of the data and the fact that samples were all taken at a single time from each household. Water quality and concentration of metals can change over time. It is possible that a substance was present in the water at the time the participants’ rashes began but was no longer in the water at the time of testing.

Water-quality data specific to the actual timing of rash/skin irritation are not available, so the investigation conclusions also take into account a review of historic water-quality data.  It is possible that an unknown and unmeasured water-quality parameter or combination of parameters may be present that are or were affecting skin conditions in Flint. It is not possible, based on the information collected in this investigation, to assess the interaction between water quality and community stress on skin conditions.

What are the recommendations of the investigation?

Investigators provided the following recommendations at the end of their study:

1. If you have a rash or are concerned that you may have a metal allergy, schedule an appointment with your primary care provider for evaluation, treatment, or referral to a specialists such as a dermatologist or allergist.
2. Take care of your skin, particularly if it is sensitive. Follow the tips from local dermatologists: http://www.michigan.gov/documents/flintwater/Dos_and_Donts_of_Rashes_Dr_Barkey_Final_530621_7.pdf [PDF - 303KB].
3. If water in your home is discolored or has an unusual odor, flush water until the discoloration disappears.If you want your water tested, contact the City of Flint or the MDEQ.
4. Flint residents are encouraged to discuss any adaptive strategies with their doctors, such as changes in showering frequency or source of water, changes in showering products, and general skin care changes.

For more information about the Flint response, please visit the Contaminated Water in Flint web site.