The oil spewing into the Gulf of Mexico is clearly harming wildlife and the economy of the region, but just how is it affecting human health?

It's a question coastal residents and visitors want answered -- but so far, those answers are hard to come by.

Although health professionals in Alabama and beyond are monitoring reports of illnesses in the Gulf, they say it could be months or years before the full impact is understood.

"A lot of it depends on how long it continues and to what degree," said Tom Miller, assistant state health officer at the Alabama Department of Public Health. "There are a lot of unknowns, to be honest."

The health department is tracking reports of oil exposure from people seeking treatment in emergency rooms or urgent care centers in Mobile and Baldwin Counties. As of the beginning of this week, 37 people had been tallied since the monitoring began May 14, Miller said.

Of those, 22 had inhaled oil fumes or vapors; 11 had skin contact; three had swallowed the oil and one had both touched and inhaled it.

For now, Miller said, the best bet is for residents or visitors to stay away from the oil in the water or on the beaches. The department has reinstated advisories against swimming at and near Dauphin Island and is particularly warning pregnant women, asthmatics, children and the elderly about avoiding contact with the oil, dispersants and vapors.

"You don't want to touch it and walk in it, and you don't want to take home a souvenir," Miller said. "We've been getting stories of people taking tarballs home as souvenirs."

In addition to the health department, the Environmental Protection Agency is tracking air quality along the Gulf coast and has found ozone and particulate levels ranging from "good" to "unhealthy for sensitive groups." Although the odor-causing pollutants associated with the oil are generally at low levels, they may cause headaches, nausea or irritation to the eyes, nose and throat, the agency says.

CDC monitors

The Centers for Disease Control is also monitoring the spill in cooperation with state health departments and the national poison control centers, paying special attention to upper respiratory conditions, cardiovascular problems, eye issues and stomach complaints such as nausea. It's following both workers -- who have more intense exposure to the oil, as well as other issues like heat exhaustion -- and the general public.

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But so far, the numbers are so small that it's impossible to draw any conclusions about what might happen, Miller said.

In addition, scientists say little is known about past oil spills, and there's no way to guess what could happen with a spill of this magnitude so close to shore.

The U.S. surgeon general, former Bayou La Batre resident Regina Benjamin, emphasized that last week when she spoke at a conference in New Orleans called by the federal Institute of Medicine, which pulled scientists from around the country to discuss the issue. "The current scientific literature is inconclusive with regards to the potential hazards resulting from this spill," Benjamin said. "Some scientists predict little or no toxic effects, while others express serious concerns about the potential for short and long-term health impacts."

Down the road

Nalini Sathiakumar, a physician and public health professor at the University of Alabama at Birmingham, was one of the experts invited to that meeting. She has done research on a Greek supertanker that ran aground in 2003 off the coast of Pakistan, and says oil contains compounds and heavy metals that can damage organs like the lungs and kidneys and also may harm DNA.

But she said there's little understanding of what could show up 10 or 15 years down the road, especially with a spill of this unprecedented magnitude. She said that only eight of the 38 supertanker spills that have occurred since the 1960s have been studied so far, with little long-term follow up. To compare, the Gulf spill is releasing the equivalent of a supertanker a week, she said.

"As long as oil rig operations are going on in the deep sea, these accidents could occur again," said Sathiakumar, who is a pediatric nephrologist in the epidemiology department at UAB. "So I think we need to understand more both in terms of the technology to prevent these leaks, and also the lessons as far as health is concerned, because we don't know a lot of these things."

In fact, a 2008 study of a tanker spill published in the journal Mutation Research urged more such investigation, calling it "a relevant but overlooked public health field that involves a large number of people all over the world."

Earlier this month, members of the American Medical Association voted at their annual meeting to adopt a resolution urging Congress to support long-term studies of the health effects of the oil spill. It also strives to provide more information to doctors and the public about the risks of oil and dispersants.

And Sathiakumar said the National Institute of Medicine and a CDC advisory board she's part of are looking at ways to gather baseline health information ranging from respiratory tests of cleanup workers to blood samples from babies born in Gulf hospitals.

In addition, she said, there will need to be studies of the psychological effects of the spill and how social changes in the Gulf community affect health there.

Jeanne Birkenhauer, a physician in Gulf Shores, said that her patients haven't complained of direct physical effects of the spill, but have been pouring in with stress-related symptoms like anxiety, insomnia and panic attacks.

"They live and die on the water, so they have a different relationship to it," she said. "It's having a greater emotional impact, and I don't know that a lot of people have the coping skills that you would need to deal with something like this."

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