In late November 2021, the Hawaii Department of Health (HDOH) received reports from Oahu residents of a fuel-like odor coming from their drinking water, which was later determined to be related to a November 20, 2021, petroleum (jet fuel) leak at the Red Hill Bulk Fuel Storage Facility. The petroleum leak contaminated the Joint Base Pearl Harbor-Hickam water system.

HDOH developed a survey which could be self-administered to collect information about potential exposure to contaminated water, health symptoms experienced, and medical care sought. The survey was promoted through electronic and in-person outreach.

A total of 2,289 eligible participants submitted surveys, with at least one household member participating from 1,389 (14%) of 9,694 estimated affected households. Most participants reported experiencing one or more new or worsened symptoms after the incident (1,980; 87%), many of whom reported symptoms lasting ≥30 days (1,493; 75%). The largest percentages of reported symptoms were those related to the nervous system (62%), followed by the gastrointestinal system (58%), skin (58%), ear, nose, and throat (47%), mental health (46%), eyes (42%), and respiratory system (31%). Medical care was sought by 853 (37%) of participants after the incident, including 17 who were hospitalized overnight. Among symptomatic participants, 1,591 of 1,980 symptomatic participants (80%) reported improvement in symptoms after switching to an alternative water source.