Residents and first responders in an eastern Ohio town are reporting several health symptoms in the wake of a toxic train derailment that upended the town in early February, according to the results of an Ohio Department of Health (ODH) survey.

A Norfolk Southern train derailed on Feb. 3, leading to nearly 2,000 residents being temporarily evacuated before a controlled burn was conducted to alleviate pressure in the cars which released toxic chemicals into the environment. Residents and first responders have since reported various health concerns as the community grapples with ongoing cleanup efforts more than one month later.

The top five symptoms reported by residents include headaches, anxiety, coughing, fatigue or tiredness and skin irritation or pain, according to the survey results announced by Republican Gov. Mike DeWine on Monday. First respondersreported stuffy noses and congestion, runny noses, increased congestion and phlegm, burning noses or throats and hoarseness.

The ODH, in conjunction with local partners, began to survey East Palestine residents on Feb. 21 and began surveying first responders on March 5. The survey, known as an after chemical exposure (ACE) survey, differs for local responders and asks questions about the number of shifts worked and what personal protection equipment (PPE) is being used.

Nearly 200 first responders completed the survey, along with 446 residents. The survey can be administered at the ODH Health Assessment Clinic located in East Palestine or by a healthcare provider.

East Palestine Update: Around 6,800 tons of contaminated soil have now been removed from the derailment site.

Today’s full update: https://t.co/66v80jV2uE
Previous updates: https://t.co/QePrDyqhXH pic.twitter.com/sk9J3dpxhx

— Governor Mike DeWine (@GovMikeDeWine) March 20, 2023

Environmental activist Erin Brockovich advised residents to keep a record of their health levels during a community town hall on Feb. 24. She previously told the Daily Caller News Foundation that it could take “decades” for the town to recover.

“I can’t tell you how many communities feel these moments are the biggest gaslight of their life,” she said. “Because you experienced it, you have symptoms, you have issues, you want to be heard, but you’re going to be told it’s safe. You’re going to be told not to worry. But that’s just rubbish.”

The Environmental Protection Agency (EPA) reported on March 2 that the air and water quality are at safe levels, however residents are still concerned about what long-term impacts could result in the years to come. Independent researchers, however, report that officials are “inconsistently testing for chemicals of concern” which could prevent officials from completely understanding potential health risks.

The EPA is currently conducting air monitoring at 23 locations and performed 618 indoor air screenings, according to a Monday update.

“Everybody’s worried, myself included and my wife and family members, and everybody’s just worried about the lasting effects of this,” Chris Sigler, an East Palestine resident, previously told the DCNF. “You don’t know until every day goes by, and you start realizing that more and more.”

Another resident told the DCNF that her daughter became sick after playing in a local park after the derailment.

The ODH and DeWine did not immediately respond to the DCNF’s request for comment.

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