RACELAND, Louisiana — Jamie Simon worked on a barge in the oily waters for six months following the BP spill last year, cooking for the cleanup workers, washing their clothes and tidying up after them.
One year later, the 32-year-old said she still suffers from a range of debilitating health problems, including racing heartbeat, vomiting, dizziness, ear infections, swollen throat, poor sight in one eye and memory loss.
She blames toxic elements in the crude oil and the dispersants sprayed to dissolve it after the BP-leased Deepwater Horizon oil rig exploded in the Gulf of Mexico about 50 miles (80 kilometers) off the coast of Louisiana on April 20, 2010.
"I was exposed to those chemicals, which I questioned, and they told me it was just as safe as Dawn dishwashing liquid and there was nothing for me to worry about," she said of the BP bosses at the job site.
The local doctor, Mike Robichaux, said he has seen as many as 60 patients like Simon in recent weeks, as this small southern town of 10,000 bordered by swamp land and sugar cane fields grapples with a mysterious sickness that some believe is all BP's fault.
Andy LaBoeuf, 51, said he was paid $1,500 per day to use his boat to go out on the water and lay boom to contain some of the 4.9 million barrels of oil that spewed from the bottom of the ocean after the BP well ruptured.
But four months of that job left him ill and unable to work, and he said he recently had to refinance his home loan because he could not pay his taxes.
"I have just been sick for a long time. I just got sick and I couldn't get better," LaBoeuf said, describing memory problems and a sore throat that has nagged him for a year.
Robichaux, an ear, nose and throat specialist whose office an hour's drive southwest of New Orleans is nestled on a roadside marked with handwritten signs advertising turtle meat for sale, says he is treating many of the local patients in their homes.
"Their work ethic is so strong, they are so stoic, they don't want people to know when they're sick," he said.
"Ninety percent of them are getting worse... Nobody has a clue as to what it is."
According to a roster compiled by the National Institute for Occupational Safety and Health, a total of 52,000 workers were responding to the Gulf oil spill as of August 2010.
The state of Louisiana has reported 415 cases of health problems linked to the spill, with symptoms including sore throats, irritated eyes, respiratory tract infections, headaches and nausea.
But Bernard Goldstein, an environmental toxicologist and professor at the University of Pittsburgh, said the US government's method of collecting health data on the workers is flawed.
For instance, a major study of response workers by the National Institute of Environmental Health Sciences was not funded until six months after the spill, a critical delay that affects both the biology and the recall ability of the workers.
"It is too late if you go six months later," he told AFP.
Benzene, a known carcinogen present in crude oil, disappears from a person's blood within four months, Goldstein said.
Polycyclic aromatic hydrocarbons, or PAHs, are pollutants that can cause genetic mutations and cancer. They are of particular interest in studying long-term health, but without a baseline for comparison it is difficult to know where they came from -- the oil spill or somewhere else in the environment.
"They last in the body for a longer period of time but they also get confounded by, if you will, obscured by, other sources of PAHs," like eating barbecued meat or smoking cigarettes, said Goldstein.
Further blurring the situation, Louisiana already ranks very low in the overall health of its residents compared to the rest of the United States -- between 44th and 49th out of the 50 states according to government data.
Some similar symptoms, including eye irritation, breathing problems, nausea and psychological stress, have been seen among responders to the Prestige oil tanker spill off Spain in 2002 and the Exxon Valdez spill in 1989 off Alaska.
Local chemist Wilma Subra has been helping test people's blood for volatile solvents, and said levels of benzene among cleanup workers, divers, fishermen and crabbers are as high as 36 times that of the general population.
"As the event progresses we are seeing more and more people who are desperately ill," she said.
"Clearly it is showing that this is ongoing exposure," Subra said, noting that pathways include contact with the skin, eating contaminated seafood or breathing polluted air.
"We have been asking the federal agencies to please provide medical care from physicians who are trained in toxic exposure."
She said she has received no response.
Asked for comment, BP said in an email that "protection of response workers was a top priority" and that it had conducted "extensive monitoring of response workers" in coordination with several government agencies.
"Illness and injury reports were tracked and documented during the response, and the medical data indicate they did not differ appreciably from what would be expected among a workforce of this size under normal circumstances," it added.
Any compensation for sick workers would fall under state law, and "BP does not make these determinations, which must be supported by acceptable medical evidence."
For Simon, her way of life has been completely altered. She said she takes pain relievers every day just to function.
A couple of weeks ago, she read in a local newspaper that other ex-cleanup workers were feeling sick too, and her grandmother urged her to see a doctor.
"I never put the two together. I am just realizing that this is possibly related," she said.