Deepwater Horizon oil spill exposures and nonfatal myocardial infarction in the GuLF STUDY

Cardiovascular health and proximity to urban oil drilling in Los Angeles, California

BACKGROUND

Although ~18 million people live within a mile from active oil and gas development (OGD) sites in the United States, epidemiological research on how OGD affects the health of nearby urban residents is sparse. Thousands of OGD sites are spread across Los Angeles (LA) County, California, home to the largest urban oil production in the country. Air pollution and noise from OGD may contribute to cardiovascular morbidity.

OBJECTIVE

We examined the association between proximity to OGD and blood pressure in a diverse cohort of residents in LA.

METHODS

We recruited residents in South LA who lived <1 km from an OGD site. We collected three blood pressure measurements for each participant and used the second and third measurements to calculate averages for systolic blood pressure (SBP) and diastolic blood pressure (DBP) separately. We conducted multivariable linear regression to examine the relationship between distance to OGD sites and continuous SBP and DBP, adjusting for BMI, smoking status, distance to freeway, sex, age, and use of antihypertension medications, with a random effect for household. We examined effect measure modification by BMI category and smoking category.

RESULTS

Among the 623 adult participants, we found that for every 100 meter increase in distance from the OGD site, DBP was reduced by an average of 0.73 mmHg (95% CI: -1.26, -0.21) in this population. We observed stronger effects of proximity to OGD site on DBP among never smokers and among participants with a healthy BMI. The associations observed between proximity to OGD site and SBP were weaker but followed the same patterns as those for DBP.

IMPACT

Our study suggests that living near urban oil drilling sites is significantly associated with greater diastolic blood pressure in urban Los Angeles communities. This research improves understanding of impacts from living nearby drilling operations on the health and welfare of this community, which is critical to inform public health relevant strategies.

Sustainable polyurethane for the remediation of oil spills: a review

Catastrophic oil spill is one of the major issues to the environment. Various methods have been used to treat oil spillage including in situ burning, the use of skimmers, dispersants, bioremediation, dispersing agents, oil sorbents, and biological agents. Application of oil sorbent is one of the effective solutions in oil spill clean-up. Polymers are sustainable extraordinary materials for the treatment of oil spillage due to their special physicochemical characteristics such as high porosity, good hydrophobicity, and reusability. Polymers are modified using suitable chemical reagents and their hydrophobicity is enhanced, making them suitable for oil spill clean-up. The present manuscript is an attempt to summarize the study of chemical modifications done on a polymer polyurethane (PU) for achieving the desirable properties, for efficient oil spill clean-up. A patent analysis has been carried out for the leading countries, top inventors, leading assignees, trends of patent publications, citation analysis, and summary of granted patents in the area of the use of a polymer Polyurethane (PU) for oil spill clean-up.

Long-term effects of the Hebei Spirit oil spill on the prevalence and incidence of allergic disorders

The Hebei Spirit oil spill accident occurred in December 2007, approximately 10 km off the coast of Taean, South Korea, a location notably close to residential areas. Crude oil substances have been detected in various environmental mediums since the accident, yet previous studies have primarily focused on the acute effects of oil exposure due to the short latency period of allergic diseases. Therefore, this study evaluated the long-term effects of oil spill exposure on allergic disorders. Our study included adult residents who had participated in the Health Effects Research on Hebei Spirit Oil Spill (HEROS) study up to five years post-incident, which was a prospective cohort to monitor the health status of Taean residents. We used two indicators to assess oil spill exposure, namely the distance from the initial contaminated coastline to each participant's residence and the number of days participants had engaged in oil clean-up work. Current symptoms such as asthma, allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and multimorbidity were considered allergic disorders. In the baseline survey, the prevalence of asthma, allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and allergic multimorbidity symptoms was associated with both exposure indicators; however, these associations were not observed in the two consecutive surveys. Significant longitudinal associations between oil spill exposure indicators and the four allergic disorders, as well as multimorbidity incidences, were observed during a five-year follow-up period. Our results suggest that oil spill exposure can affect acute and long-term allergic symptoms in residents near the accident site.

Volatile Hydrocarbon Exposures and Incident Coronary Heart Disease Events: Up to Ten Years of Follow-up among Deepwater Horizon Oil Spill Workers

BACKGROUND

During the 2010 Deepwater Horizon (DWH) disaster, response and cleanup workers were potentially exposed to toxic volatile components of crude oil. However, to our knowledge, no study has examined exposure to individual oil spill-related chemicals in relation to cardiovascular outcomes among oil spill workers.

OBJECTIVES

Our aim was to investigate the association of several spill-related chemicals [benzene, toluene, ethylbenzene, xylene, n-hexane (BTEX-H)] and total hydrocarbons (THC) with incident coronary heart disease (CHD) events among workers enrolled in a prospective cohort.

METHODS

Cumulative exposures to THC and BTEX-H across the cleanup period were estimated via a job-exposure matrix that linked air measurement data with self-reported DWH spill work histories. We ascertained CHD events following each worker's last day of cleanup work as the first self-reported physician-diagnosed myocardial infarction (MI) or a fatal CHD event. We estimated hazard ratios (HR) and 95% confidence intervals for the associations of exposure quintiles (Q) with risk of CHD. We applied inverse probability weights to account for bias due to confounding and loss to follow-up. We used quantile g-computation to assess the joint effect of the BTEX-H mixture.

RESULTS

Among 22,655 workers with no previous MI diagnoses, 509 experienced an incident CHD event through December 2019. Workers in higher quintiles of each exposure agent had increased CHD risks in comparison with the referent group (Q1) of that agent, with the strongest associations observed in Q5 (range of HR = 1.14 - 1.44 ). However, most associations were nonsignificant, and there was no evidence of exposure-response trends. We observed stronger associations among ever smokers, workers with ≤ high school education, and workers with body mass index < 30   kg / m 2 . No apparent positive association was observed for the BTEX-H mixture.

CONCLUSIONS

Higher exposures to volatile components of crude oil were associated with modest increases in risk of CHD among oil spill workers, although we did not observe exposure-response trends. https://doi.org/10.1289/EHP11859.

Fine particulate matter and incident coronary heart disease events up to 10 years of follow-up among Deepwater Horizon oil spill workers

BACKGROUND

During the 2010 Deepwater Horizon (DWH) disaster, in-situ burning and flaring were conducted to remove oil from the water. Workers near combustion sites were potentially exposed to burning-related fine particulate matter (PM2.5). Exposure to PM2.5 has been linked to increased risk of coronary heart disease (CHD), but no study has examined the relationship among oil spill workers.

OBJECTIVES

To investigate the association between estimated PM2.5 from burning/flaring of oil/gas and CHD risk among the DWH oil spill workers.

METHODS

We included workers who participated in response and cleanup activities on the water during the DWH disaster (N = 9091). PM2.5 exposures were estimated using a job-exposure matrix that linked modelled PM2.5 concentrations to detailed DWH spill work histories provided by participants. We ascertained CHD events as the first self-reported physician-diagnosed CHD or a fatal CHD event that occurred after each worker's last day of burning exposure. We estimated hazard ratios (HR) and 95% confidence intervals (95%CI) for the associations between categories of average or cumulative daily maximum PM2.5 exposure (versus a referent category of water workers not near controlled burning) and subsequent CHD. We assessed exposure-response trends by examining continuous exposure parameters in models.

RESULTS

We observed increased CHD hazard among workers with higher levels of average daily maximum exposure (low vs. referent: HR = 1.26, 95% CI: 0.93, 1.70; high vs. referent: HR = 2.11, 95% CI: 1.08, 4.12; per 10 μg/m3 increase: HR = 1.10, 95% CI: 1.02, 1.19). We also observed suggestively elevated HRs among workers with higher cumulative daily maximum exposure (low vs. referent: HR = 1.19, 95% CI: 0.68, 2.08; medium vs. referent: HR = 1.38, 95% CI: 0.88, 2.16; high vs. referent: HR = 1.44, 95% CI: 0.96, 2.14; per 100 μg/m3-d increase: HR = 1.03, 95% CI: 1.00, 1.05).

CONCLUSIONS

Among oil spill workers, exposure to PM2.5 from flaring/burning of oil/gas was associated with increased risk of CHD.

Acute and longer-term cardiovascular conditions in the Deepwater Horizon Oil Spill Coast Guard Cohort

INTRODUCTION

In 2010, the U.S. Coast Guard (USCG) led a clean-up response to the Deepwater Horizon (DWH) oil spill. Human studies evaluating acute and longer-term cardiovascular conditions associated with oil spill-related exposures are sparse. Thus, we aimed to investigate prevalent and incident cardiovascular symptoms/conditions in the DHW Oil Spill Coast Guard Cohort.

METHODS

Self-reported oil spill exposures and cardiovascular symptoms were ascertained from post-deployment surveys (n = 4,885). For all active-duty cohort members (n = 45,193), prospective cardiovascular outcomes were classified via International Classification of Diseases, 9th Edition from military health encounter records up to 5.5 years post-DWH. We used log-binomial regression to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) in the cross-sectional analyses and Cox Proportional Hazards regression to calculate adjusted hazard ratios (aHR) and 95% CIs for incident cardiovascular diagnoses during 2010-2015 and stratifying by earlier (2010-2012) and later (2013-2015) time periods.

RESULTS

Prevalence of chest pain was associated with increasing levels of crude oil exposure via inhalation (aPR_{high vs. none} = 2.00, 95% CI = 1.16-3.42, p-trend = 0.03) and direct skin contact (aPR_{high vs. none} = 2.72, 95% CI = 1.30-5.16, p-trend = 0.03). Similar associations were observed for sudden heartbeat changes and for being in the vicinity of burning oil exposure. In prospective analyses, responders (vs. non-responders) had an elevated risk for mitral valve disorders during 2013-2015 (aHR = 2.12, 95% CI = 1.15-3.90). Responders reporting ever (vs. never) crude oil inhalation exposure were at increased risk for essential hypertension, particularly benign essential hypertension during 2010-2012 (aHR = 2.00, 95% CI = 1.08-3.69). Responders with crude oil inhalation exposure also had an elevated risk for palpitations during 2013-2015 (aHR = 2.54, 95% CI = 1.36-4.74). Cardiovascular symptoms/conditions aPR and aHR estimates were generally stronger among responders reporting exposure to both crude oil and oil dispersants than among those reporting neither.

CONCLUSIONS

In this large study of the DWH oil spill USCG responders, self-reported spill clean-up exposures were associated with acute and longer-term cardiovascular symptoms/conditions.

Cardiac assessments of bottlenose dolphins (Tursiops truncatus) in the Northern Gulf of Mexico following exposure to Deepwater Horizon oil

The Deepwater Horizon (DWH) oil spill profoundly impacted the health of bottlenose dolphins (Tursiops truncatus) in Barataria Bay, LA (BB). To comprehensively assess the cardiac health of dolphins living within the DWH oil spill footprint, techniques for in-water cardiac evaluation were refined with dolphins cared for by the U.S. Navy Marine Mammal Program in 2018 and applied to free-ranging bottlenose dolphins in BB (n = 34) and Sarasota Bay, Florida (SB) (n = 19), a non-oiled reference population. Cardiac auscultation detected systolic murmurs in the majority of dolphins from both sites (88% BB, 89% SB) and echocardiography showed most of the murmurs were innocent flow murmurs attributed to elevated blood flow velocity [1]. Telemetric six-lead electrocardiography detected arrhythmias in BB dolphins (43%) and SB dolphins (31%), all of which were considered low to moderate risk for adverse cardiac events. Echocardiography showed BB dolphins had thinner left ventricular walls, with significant differences in intraventricular septum thickness at the end of diastole (p = 0.002), and left ventricular posterior wall thickness at the end of diastole (p = 0.033). BB dolphins also had smaller left atrial size (p = 0.004), higher prevalence of tricuspid valve prolapse (p = 0.003), higher prevalence of tricuspid valve thickening (p = 0.033), and higher prevalence of aortic valve thickening (p = 0.008). Two dolphins in BB were diagnosed with pulmonary arterial hypertension based on Doppler echocardiography-derived estimates and supporting echocardiographic findings. Histopathology of dolphins who stranded within the DWH oil spill footprint showed a significantly higher prevalence of myocardial fibrosis (p = 0.003), regardless of age, compared to dolphins outside the oil spill footprint. In conclusion, there were substantial cardiac abnormalities identified in BB dolphins which may be related to DWH oil exposure, however, future work is needed to rule out other hypotheses and further elucidate the connection between oil exposure, pulmonary disease, and the observed cardiac abnormalities.

Self-reported oil spill exposure and birth outcomes among southern Louisiana women at the time of the Gulf oil spill: The GROWH study

BACKGROUND

The chemical, physical, economic, and social effects of a major oil spill might adversely affect pregnancy health.

OBJECTIVES

To examine the relationship between oil spill exposure and birth outcomes in a cohort of women living near the Gulf of Mexico at the time of the 2010 oil spill.

METHODS

Between 2012 and 2016, 1375 women reported their exposure to the oil spill, and at least one livebirth. Five hundred and three had births both before and after the oil spill. Indicators of oil spill exposure included self-reported financial consequences, direct contact with oil, traumatic experiences, loss of use of the coast, and involvement in litigation. Birth outcomes were low birthweight (LBW; birthweight <2500 g) and preterm birth (PTB; >3 weeks early). Women who were not pregnant at the time of the interview (n = 1001) self-reported outcomes, while women who were pregnant (n = 374) primarily had them abstracted from medical records (n = 374). All pregnancies prior to the oil spill were considered unexposed; those after the oil spill were considered exposed or unexposed depending on interview responses. Generalized estimating equations were used to control for clustering within women, with control for confounders.

RESULTS

The most common type of exposure was economic (49%), but 302 women (22.0%) reported some degree of direct contact with the oil. Associations between most indicators of oil spill exposure and pregnancy outcomes were null, although when all pregnancies were examined, associations were seen with high levels of contact with oil for LBW (adjusted Odds Ratio [aOR] 2.19, 95% CI, 1.29-3.71) and PTB (aOR 2.27, 1.34-3.87).

DISCUSSION

In this community-based cohort, we did not find associations between report of exposure to the oil spill, with the possible exception of high oil contact in some analyses, and birth outcomes. Research incorporating specific biomarkers of oil spill exposure and stress biomarkers would be valuable, to allow for assessing both perceived and actual exposure, especially when direct toxicant exposure is minimal.

Standardization of Dolphin Cardiac Auscultation and Characterization of Heart Murmurs in Managed and Free-Ranging Bottlenose Dolphins (Tursiops truncatus)

Cardiac auscultation is an important, albeit underutilized tool in aquatic animal medicine due to the many challenges associated with in-water examinations. The aims of this prospective study were to (1) establish an efficient and repeatable in-water cardiac auscultation technique in bottlenose dolphins (Tursiops truncatus), (2) describe the presence and characterization of heart murmurs detected in free-ranging and managed dolphins, and (3) characterize heart murmur etiology through echocardiography in free-ranging dolphins. For technique development, 65 dolphins cared for by the Navy Marine Mammal Program (Navy) were auscultated. The techniques were then applied to two free-ranging dolphin populations during capture-release health assessments: Sarasota Bay, Florida (SB), a reference population, and Barataria Bay, LA (BB), a well-studied population of dolphins impacted by the Deepwater Horizon oil spill. Systolic heart murmurs were detected at a frequent and similar prevalence in all dolphin populations examined (Navy 92%, SB 89%, and BB 88%), and characterized as fixed or dynamic. In all three populations, sternal cranial and left cranial were the most common locations for murmur point of maximal intensity (PMI). An in-water transthoracic echocardiogram technique was refined on a subset of Navy dolphins, and full echocardiographic exams were performed on 17 SB dolphins and 29 BB dolphins, of which, 40 had murmurs. Spectral Doppler was used to measure flow velocities across the outflow tracts, and almost all dolphins with audible murmurs had peak outflow velocities ≥1.6 m/s (95%, 38/40); three dolphins also had medium mitral regurgitation which could be the source of their murmurs. The presence of audible murmurs in most of the free-ranging dolphins (88%) was attributed to high velocity blood flow as seen on echocardiography, similar to a phenomenon described in other athletic species. These innocent murmurs were generally characterized as Grade I-III systolic murmurs with PMI in the left or sternal cranial region. This study is the first to describe an efficient technique for in-water dolphin cardiac auscultation, and to present evidence that heart murmurs are common in bottlenose dolphins.

An association between oil spill clean-up work and cardiovascular disease

BACKGROUND

In December 2007, Taean, South Korea, experienced the largest oil spill in Korean history. After about 10 years of follow-up, we evaluated the long-term effect of the disaster on the cardiovascular health of residents and clean-up workers/volunteers.

OBJECTIVE

We examined the relationship between the duration of oil clean-up work and the risk of incident angina and myocardial infarction (MI).

METHODS

We used data from a prospective cohort study, the Health Effects Research of Oil Spill (HEROS); we included adult cohort members free from cardiovascular disease who completed at least the first two surveys (n = 1737). At baseline, members reported the number of days they participated in oil clean-up work; during the subsequent surveys, they reported newly diagnosed cases of angina or MI. We fitted a time-varying interval-censored proportional hazard model, controlling for age, sex, body mass index, smoking status, monthly household income, and distance from the affected seashore to residence.

RESULTS

The risk of incident angina or MI was greater in those with more than 15 days' exposure; those with 15-59 days showed a hazard ratio (HR) of 1.34 (95% confidence interval [CI]: 0.87, 2.06) those with 60-179 days had an HR of 1.31 (0.95, 1.79), and those worked longest (180 or more days) showed the strongest association with a HR of 1.75 (95% CI: 1.17, 2.61).

CONCLUSION

We found that a greater duration of clean-up work was associated with an increased risk of incident angina or MI.

Long-term Cardiovascular Disease Risk Among Firefighters After the World Trade Center Disaster

IMPORTANCE

Published studies examining the association between World Trade Center (WTC) exposure on and after September 11, 2001, and longer-term cardiovascular disease (CVD) outcomes have reported mixed findings.

OBJECTIVE

To assess whether WTC exposure was associated with elevated CVD risk in Fire Department of the City of New York (FDNY) firefighters.

DESIGN, SETTINGS, AND PARTICIPANTS

In this cohort study, the association between WTC exposure and the risk of CVD was assessed between September 11, 2001, and December 31, 2017, in FDNY male firefighters. Multivariable Cox regression analyses were used to estimate CVD risk in association with 2 measures of WTC exposure: arrival time to the WTC site and duration of work at the WTC site. Data analyses were conducted from May 1, 2018, to March 8, 2019.

MAIN OUTCOMES AND MEASURES

The primary CVD outcome included myocardial infarction, stroke, unstable angina, coronary artery surgery or angioplasty, or CVD death. The secondary outcome (all CVD) included all primary outcome events or any of the following: transient ischemic attack; stable angina, defined as either use of angina medication or cardiac catheterization without intervention; cardiomyopathy; and other CVD (aortic aneurysm, peripheral arterial vascular intervention, and carotid artery surgery).

RESULTS

There were 489 primary outcome events among 9796 male firefighters (mean [SD] age on September 11, 2001, was 40.3 [7.4] years and 7210 individuals [73.6%] were never smokers). Age-adjusted incident rates of CVD were higher for firefighters with greater WTC exposure. The multivariable adjusted hazard ratio (HR) for the primary CVD outcome was 1.44 (95% CI, 1.09-1.90) for the earliest arrival group compared with those who arrived later. Similarly, those who worked at the WTC site for 6 or more months vs those who worked less time at the site were more likely to have a CVD event (HR, 1.30; 95% CI, 1.05-1.60). Well-established CVD risk factors, including hypertension (HR, 1.41; 95% CI, 1.10-1.80), hypercholesterolemia (HR, 1.56; 95% CI, 1.28-1.91), diabetes (HR, 1.99; 95% CI, 1.33-2.98), and smoking (current: HR, 2.13; 95% CI, 1.68-2.70; former: HR, 1.55; 95% CI, 1.23-1.95), were significantly associated with CVD in the multivariable models. Analyses with the all-CVD outcome were similar.

CONCLUSIONS AND RELEVANCE

The findings of the study suggest a significant association between greater WTC exposure and long-term CVD risk. The findings appear to reinforce the importance of long-term monitoring of the health of survivors of disasters.

Health effect research on Hebei Spirit Oil Spill (HEROS) in Korea: a cohort profile

PURPOSE

The Hebei Spirit Oil Spill occurred on 7 December 2007 and resulted in the spillage of 12 547 kl of crude oil on the coastline near Taean. Historically, this was the largest oil spill in Korean water. The health effect research on Hebei Spirit Oil Spill (HEROS) is a prospective cohort study that aimed to evaluate the long-term health effects of oil spill exposure on residents in the affected community.

PARTICIPANTS

The Taean Environmental Health Center initially enrolled adults, adolescents and children living in Taean in 2009 and 2010. Follow-up surveys of participating adults and children were conducted every other year. By 2017, a total of 9585 adults and 2216 children and adolescents were enrolled. Of these, 294 adults and 102 children and adolescents were included in all subsequent surveys.

FINDINGS TO DATE

Children who lived closer to the oil spill site exhibited a lower level of pulmonary function and higher prevalence of allergic rhinitis, than those who lived further away from the oil spill site. Adults who lived in a highly exposed area or participated in clean-up work had higher urine levels of the oxidative stress biomarkers malondialdehyde and 8-hydroxydeoxyguanosine. Changes in haematological parameters during a 3-year period were observed in residents of both sexes in highly exposed areas, in addition to increases in respiratory diseases and mental health problems in female and male participants, respectively.

FUTURE PLANS

The findings of this study will better enable policy makers to develop environmental health policies intended to prevent adverse health effects in residents of communities affected by oil spills, as well as policies regarding the management of future oil accidents. The HEROS study will continue to follow participants in future and will be updated to enable an investigation of long-term health effects.