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Norris CL, Sandler DP, Pratt GC, Stenzel MR, Stewart PA, Jackson WB, Gerr FE, Groth C, Banerjee S, Lawrence KG, Kwok RK, Werder EJ, Engel LS. Association between spill-related exposure to fine particulate matter and peripheral motor and sensory nerve function among oil spill response and cleanup workers following the Deepwater Horizon oil spill. J Expo Sci Environ Epidemiol 2023:10.1038/s41370-023-00558-6. [PMID: 37443296 DOI: 10.1038/s41370-023-00558-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/03/2023] [Accepted: 05/31/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Burning/flaring of oil/gas during the Deepwater Horizon oil spill response and cleanup (OSRC) generated high concentrations of fine particulate matter (PM2.5). Personnel working on the water during these activities may have inhaled combustion products. Neurologic effects of PM2.5 have been reported previously but few studies have examined lasting effects following disaster exposures. The association of brief, high exposures and adverse effects on sensory and motor nerve function in the years following exposure have not been examined for OSRC workers. OBJECTIVES We assessed the relationship between exposure to burning/flaring-related PM2.5 and measures of sensory and motor nerve function among OSRC workers. METHODS PM2.5 concentrations were estimated from Gaussian plume dispersion models and linked to self-reported work histories. Quantitative measures of sensory and motor nerve function were obtained 4-6 years after the disaster during a clinical exam restricted to those living close to two clinics in Mobile, AL or New Orleans, LA (n = 3401). We obtained covariate data from a baseline enrollment survey and a home visit, both in 2011-2013. The analytic sample included 1186 participants. RESULTS We did not find strong evidence of associations between exposure to PM2.5 and sensory or motor nerve function, although there was a suggestion of impairment based on single leg stance among individuals with high exposure to PM2.5. Results were generally consistent whether we examined average or cumulative maximum exposures or removed individuals with the highest crude oil exposures to account for co-pollutant confounding. There was no evidence of exposure-response trends. IMPACT STATEMENT Remediating environmental disasters is essential for long-term human and environmental health. During the Deepwater Horizon oil spill disaster, burning and flaring of oil and gas were used to remove these pollutants from the environment, but led to potentially high fine particulate matter exposures for spill response workers working on the water. We investigate the potential adverse effects of these exposures on peripheral nerve function; understanding the potential health harm of remediation tactics is necessary to inform future clean up approaches and protect human health.
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Affiliation(s)
- Christina L Norris
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Gregory C Pratt
- Division of Environmental Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA, USA
| | | | - W Braxton Jackson
- Social & Scientific Systems, Inc., a DLH Holding company, Durham, NC, USA
| | - Fredric E Gerr
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Caroline Groth
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, Morgantown, WV, USA
| | - Sudipto Banerjee
- Department of Biostatistics, University of California-Los Angeles Fielding School of Public Health, Los Angeles, CA, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
- Office of the Director, National Institute of Environmental Health Sciences, Bethesda, MD, USA
| | - Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
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Volckens J, Haynes EN, Croisant SP, Cui Y, Errett NA, Henry HF, Horney JA, Kwok RK, Magzamen S, Rappold AG, Ravichandran L, Reinlib L, Ryan PH, Shaughnessy DT. Health Research in the Wake of Disasters: Challenges and Opportunities for Sensor Science. Environ Health Perspect 2023; 131:65002. [PMID: 37389972 PMCID: PMC10312369 DOI: 10.1289/ehp12270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/24/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Disaster events adversely affect the health of millions of individuals each year. They create exposure to physical, chemical, biological, and psychosocial hazards while simultaneously exploiting community and individual-level vulnerabilities that allow such exposures to exert harm. Since 2013, the National Institute of Environmental Health Sciences (NIEHS) has led the development of the Disaster Research Response (DR2) program and infrastructure; however, research exploring the nature and effects of disasters on human health is lacking. One reason for this research gap is the challenge of developing and deploying cost-effective sensors for exposure assessment during disaster events. OBJECTIVES The objective of this commentary is to synergize the consensus findings and recommendations from a panel of experts on sensor science in support of DR2. METHODS The NIEHS convened the workshop, "Getting Smart about Sensors for Disaster Response Research" on 28 and 29 July 2021 to discuss current gaps and recommendations for moving the field forward. The workshop invited full discussion from multiple viewpoints, with the goal of identifying recommendations and opportunities for further development of this area of research. The panel of experts included leaders in engineering, epidemiology, social and physical sciences, and community engagement, many of whom had firsthand experience with DR2. DISCUSSION The primary finding of this workshop is that exposure science in support of DR2 is severely lacking. We highlight unique barriers to DR2, such as the need for time-sensitive exposure data, the chaos and logistical challenges that ensue from a disaster event, and the lack of a robust market for sensor technologies in support of environmental health science. We highlight a need for sensor technologies that are more scalable, reliable, and versatile than those currently available to the research community. We also recommend that the environmental health community renew efforts in support of DR2 facilitation, collaboration, and preparedness. https://doi.org/10.1289/EHP12270.
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Affiliation(s)
- John Volckens
- Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado, USA
| | - Erin N. Haynes
- Department of Epidemiology and Environmental Health, University of Kentucky, Lexington, Kentucky, USA
| | - Sharon P. Croisant
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - Yuxia Cui
- National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | - Nicole A. Errett
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Heather F. Henry
- National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | | | - Richard K. Kwok
- National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Ana G. Rappold
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Chapel Hill, North Carolina, USA
| | - Lingamanaidu Ravichandran
- National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | - Les Reinlib
- National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | - Patrick H. Ryan
- Department of Environmental Health, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Daniel T. Shaughnessy
- National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
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Chen D, Werder EJ, Stewart PA, Stenzel MR, Gerr FE, Lawrence KG, Groth CP, Huynh TB, Ramachandran G, Banerjee S, Jackson WB, Christenbury K, Kwok RK, Sandler DP, Engel LS. Exposure to volatile hydrocarbons and neurologic function among oil spill workers up to 6 years after the Deepwater Horizon disaster. Environ Res 2023; 231:116069. [PMID: 37149022 DOI: 10.1016/j.envres.2023.116069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND During the 2010 Deepwater Horizon (DWH) disaster, oil spill response and cleanup (OSRC) workers were exposed to toxic volatile components of crude oil. Few studies have examined exposure to individual volatile hydrocarbon chemicals below occupational exposure limits in relation to neurologic function among OSRC workers. OBJECTIVES To investigate the association of several spill-related chemicals (benzene, toluene, ethylbenzene, xylene, n-hexane, i.e., BTEX-H) and total petroleum hydrocarbons (THC) with neurologic function among DWH spill workers enrolled in the Gulf Long-term Follow-up Study. METHODS Cumulative exposure to THC and BTEX-H across the oil spill cleanup period were estimated using a job-exposure matrix that linked air measurement data to detailed self-reported DWH OSRC work histories. We ascertained quantitative neurologic function data via a comprehensive test battery at a clinical examination that occurred 4-6 years after the DWH disaster. We used multivariable linear regression and modified Poisson regression to evaluate relationships of exposures (quartiles (Q)) with 4 neurologic function measures. We examined modification of the associations by age at enrollment (<50 vs. ≥50 years). RESULTS We did not find evidence of adverse neurologic effects from crude oil exposures among the overall study population. However, among workers ≥50 years of age, several individual chemical exposures were associated with poorer vibrotactile acuity of the great toe, with statistically significant effects observed in Q3 or Q4 of exposures (range of log mean difference in Q4 across exposures: 0.13-0.26 μm). We also observed suggestive adverse associations among those ≥ age 50 years for tests of postural stability and single-leg stance, although most effect estimates did not reach thresholds of statistical significance (p < 0.05). CONCLUSIONS Higher exposures to volatile components of crude oil were associated with modest deficits in neurologic function among OSRC workers who were age 50 years or older at study enrollment.
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Affiliation(s)
- Dazhe Chen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | | | - Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA, USA
| | - Fredric E Gerr
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Fielding School of Public Health, University of California - Los Angeles, Los Angeles, CA, USA
| | - W Braxton Jackson
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, NC, USA
| | - Kate Christenbury
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, NC, USA
| | - Richard K Kwok
- Population Studies and Genetics Branch, National Institute on Aging, Bethesda, MD, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
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Chen D, Sandler DP, Keil AP, Heiss G, Whitsel EA, Edwards JK, Stewart PA, Stenzel MR, Groth CP, Ramachandran G, Banerjee S, Huynh TB, Jackson WB, Blair A, Lawrence KG, Kwok RK, Engel LS. Volatile Hydrocarbon Exposures and Incident Coronary Heart Disease Events: Up to Ten Years of Follow-up among Deepwater Horizon Oil Spill Workers. Environ Health Perspect 2023; 131:57006. [PMID: 37224072 PMCID: PMC10208425 DOI: 10.1289/ehp11859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 04/09/2023] [Accepted: 04/28/2023] [Indexed: 05/26/2023]
Abstract
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.
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Affiliation(s)
- Dazhe Chen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Alexander P. Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Eric A. Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jessie K. Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Mark R. Stenzel
- Exposure Assessment Applications, LLC, Arlington, Virginia, USA
| | - Caroline P. Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Fielding School of Public Health, University of California – Los Angeles, Los Angeles, California, USA
| | - Tran B. Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - W. Braxton Jackson
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, North Carolina, USA
| | - Aaron Blair
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Kaitlyn G. Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Richard K. Kwok
- Population Studies and Genetics Branch, National Institute on Aging, Bethesda, Maryland, USA
| | - Lawrence S. Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
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Holmgren S, Bell SM, Wignall J, Duncan CG, Kwok RK, Cronk R, Osborn K, Black S, Thessen A, Schmitt C. Workshop Report: Catalyzing Knowledge-Driven Discovery in Environmental Health Sciences through a Harmonized Language. Int J Environ Res Public Health 2023; 20:2317. [PMID: 36767684 PMCID: PMC9915042 DOI: 10.3390/ijerph20032317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Harmonized language is essential to finding, sharing, and reusing large-scale, complex data. Gaps and barriers prevent the adoption of harmonized language approaches in environmental health sciences (EHS). To address this, the National Institute of Environmental Health Sciences and partners created the Environmental Health Language Collaborative (EHLC). The purpose of EHLC is to facilitate a community-driven effort to advance the development and adoption of harmonized language approaches in EHS. EHLC is a forum to pinpoint language harmonization gaps, to facilitate the development of, raise awareness of, and encourage the use of harmonization approaches and tools, and to develop new standards and recommendations. To ensure that EHLC's focus and structure would be sustainable long-term and meet the needs of the field, EHLC launched an inaugural workshop in September 2021 focused on "Developing Sustainable Language Solutions" and "Building a Sustainable Community". When the attendees were surveyed, 91% said harmonized language solutions would be of high value/benefit, and 60% agreed to continue contributing to EHLC efforts. Based on workshop discussions, future activities will focus on targeted collaborative use-case working groups in addition to offering education and training on ontologies, metadata, and standards, and developing an EHS language resource portal.
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Affiliation(s)
- Stephanie Holmgren
- Office of Data Science, National Institute of Environmental Health Sciences (NIEHS), Durham, NC 27709, USA
| | | | | | - Christopher G. Duncan
- Genes, Environment, and Health Branch, Division of Extramural Research and Training, National Institute of Environmental Health Sciences (NIEHS), Durham, NC 27709, USA
| | - Richard K. Kwok
- Division of Neuroscience, National Institute on Aging (NIA), Bethesda, MD 20892, USA
| | - Ryan Cronk
- Health Sciences, ICF, Reston, VA 20190, USA
| | | | | | - Anne Thessen
- Center for Health Artificial Intelligence, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Charles Schmitt
- Office of Data Science, National Institute of Environmental Health Sciences (NIEHS), Durham, NC 27709, USA
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Chen D, Sandler DP, Keil AP, Heiss G, Whitsel EA, Pratt GC, Stewart PA, Stenzel MR, Groth CP, Banerjee S, Huynh TB, Edwards JK, Jackson WB, Engeda J, Kwok RK, Werder EJ, Lawrence KG, Engel LS. Fine particulate matter and incident coronary heart disease events up to 10 years of follow-up among Deepwater Horizon oil spill workers. Environ Res 2023; 217:114841. [PMID: 36403648 PMCID: PMC9825646 DOI: 10.1016/j.envres.2022.114841] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/05/2022] [Accepted: 11/15/2022] [Indexed: 05/31/2023]
Abstract
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.
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Affiliation(s)
- Dazhe Chen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Alexander P Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gregory C Pratt
- Division of Environmental Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Fielding School of Public Health, University of California - Los Angeles, Los Angeles, CA, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jessie K Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - W Braxton Jackson
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, NC, USA
| | - Joseph Engeda
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, NC, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA; Office of the Director, National Institute of Environmental Health Sciences, Bethesda, MD, USA
| | - Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
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7
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Jardel HV, Engel LS, Lawrence KG, Stewart PA, Stenzel MR, Curry MD, Kwok RK, Sandler DP. The association between oil spill cleanup-related total hydrocarbon exposure and diabetes. Environ Res 2022; 212:113591. [PMID: 35661735 PMCID: PMC9267393 DOI: 10.1016/j.envres.2022.113591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/21/2022] [Accepted: 05/29/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND Although evidence suggests relationships between some crude oil components and glycemic dysregulation, no studies have examined oil spill-related chemical exposures in relation to type 2 diabetes mellitus (DM) risk. This study examined the relationship between total hydrocarbon (THC) exposure among workers involved in the 2010 Deepwater Horizon (DWH) oil spill and risk of DM up to 6 years afterward. METHODS Participants comprised 2660 oil-spill cleanup or response workers in the prospective GuLF Study who completed a clinical exam and had no self-reported DM diagnosis prior to the spill. Maximum THC exposure was estimated with a job-exposure matrix based on interview data and personal measurements taken during cleanup operations. We defined incident DM by self-reported physician diagnosis of DM, antidiabetic medication use, or a measured hemoglobin A1c value ≥ 6.5%. We used log binomial regression to estimate risk ratios (RRs) for DM across ordinal categories of THC exposure. The fully adjusted model controlled for age, sex, race/ethnicity, education, employment status, and health insurance status. We also stratified on clinical body mass index categories. RESULTS We observed an exposure-response relationship between maximum daily ordinal THC exposure level and incident DM, especially among overweight participants. RRs among overweight participants were 0.99 (95% CI: 0.37, 2.69), 1.46 (95% CI: 0.54, 3.92), and 2.11 (95% CI: 0.78, 5.74) for exposure categories 0.30-0.99 ppm, 1.00-2.99 ppm, and ≥3.00 ppm, respectively (ptrend = 0.03). CONCLUSION We observed suggestively increasing DM risk with increasing THC exposure level among overweight participants, but not among normal weight or obese participants.
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Affiliation(s)
- H V Jardel
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - L S Engel
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA
| | - K G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA
| | - P A Stewart
- Stewart Exposure Assessments, LLC North Arlington, Virginia, USA
| | - M R Stenzel
- Exposure Assessment Applications LLC Arlington, Virginia, USA
| | - M D Curry
- Social and Scientific Systems, Inc., a DLH Holding Company Durham, NC, USA
| | - R K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA; Office of the Director, National Institute of Environmental Health Sciences, NIH, DHHS, Bethesda, MD, USA
| | - D P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA
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Rider LG, Parks CG, Wilkerson J, Schiffenbauer AI, Kwok RK, Noroozi Farhadi P, Nazir S, Ritter R, Sirotich E, Kennedy K, Larche MJ, Levine M, Sattui SE, Liew JW, Harrison CO, Moni TT, Miller AK, Putman M, Hausmann J, Simard JF, Sparks JA, Miller FW. Baseline Factors Associated with Self-reported Disease Flares Following COVID-19 Vaccination among Adults with Systemic Rheumatic Disease: Results from the COVID-19 Global Rheumatology Alliance Vaccine Survey. Rheumatology (Oxford) 2022; 61:SI143-SI150. [PMID: 35460240 DOI: 10.1093/rheumatology/keac249] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/30/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To examine the frequency of, and risk factors for, disease flare following COVID-19 vaccination in patients with systemic rheumatic disease (SRD). METHODS An international study was conducted from April 2 to August 16, 2021, using an online survey of 5619 adults with SRD for adverse events following COVID-19 vaccination, including flares of disease requiring a change in treatment. We examined risk factors identified a priori based on published associations with SRD activity and SARS-CoV-2 severity, including demographics, SRD type, comorbidities, vaccine type, cessation of immunosuppressive medications around vaccination, and history of reactions to non-COVID-19 vaccines, using multivariable logistic regression. RESULTS Flares requiring a change in treatment following COVID-19 vaccination were reported by 4.9% of patients. Compared with rheumatoid arthritis, certain SRD, including systemic lupus erythematosus (OR 1.51, 95%CI 1.03, 2.20), psoriatic arthritis (OR 1.95, 95%CI 1.20, 3.18), and polymyalgia rheumatica (OR 1.94, 95%CI 1.08, 2.48) were associated with higher odds of flare, while idiopathic inflammatory myopathies were associated with lower odds for flare (OR 0.54, 95%CI 0.31-0.96). The Oxford-AstraZeneca vaccine was associated with higher odds of flare relative to the Pfizer-BioNTech vaccine (OR 1.44, 95%CI 1.07, 1.95), as were a prior reaction to a non-COVID-19 vaccine (OR 2.50, 95%CI 1.76, 3.54) and female sex (OR 2.71, 95%CI 1.55, 4.72). CONCLUSION SRD flares requiring changes in treatment following COVID-19 vaccination were uncommon in this large international study. Several potential risk factors, as well as differences by disease type, warrant further examination in prospective cohorts.
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Affiliation(s)
- Lisa G Rider
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS, National Institutes of Health (NIH), Bethesda, MD, USA)
| | | | | | - Adam I Schiffenbauer
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS, National Institutes of Health (NIH), Bethesda, MD, USA)
| | - Richard K Kwok
- Office of the Director, NIEHS, NIH, Research Triangle Park, NC, USA
| | - Payam Noroozi Farhadi
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS, National Institutes of Health (NIH), Bethesda, MD, USA)
| | - Sarvar Nazir
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS, National Institutes of Health (NIH), Bethesda, MD, USA)
| | | | | | - Kevin Kennedy
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | | | - Mitchell Levine
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Sebastian E Sattui
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jean W Liew
- Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA
| | | | - Tarin T Moni
- Department of Biochemistry and Biomedical Sciences, McMaster University Faculty of Science, Hamilton, ON, Canada
| | - Aubrey K Miller
- Office of the Director, NIEHS, NIH, Research Triangle Park, NC, USA
| | | | - Jonathan Hausmann
- Program in Rheumatology, Boston Children's Hospital, Division of Rheumatology and Clinical Immunology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA
| | - Julia F Simard
- Department of Epidemiology and Population Health, and Immunology and Rheumatology (Department of Medicine), Stanford University School of Medicine, USA
| | - Jeffrey A Sparks
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Frederick W Miller
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS, National Institutes of Health (NIH), Bethesda, MD, USA)
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9
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Stenzel MR, Groth CP, Huynh TB, Ramachandran G, Banerjee S, Kwok RK, Engel LS, Blair A, Sandler DP, Stewart PA. Exposure Group Development in Support of the NIEHS GuLF Study. Ann Work Expo Health 2022; 66:i23-i55. [PMID: 35390128 PMCID: PMC8989038 DOI: 10.1093/annweh/wxab093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/03/2021] [Accepted: 10/06/2021] [Indexed: 11/14/2022] Open
Abstract
In the GuLF Study, a study investigating possible adverse health effects associated with work on the oil spill response and clean-up (OSRC) following the Deepwater Horizon disaster in the Gulf of Mexico, we used a job-exposure matrix (JEM) approach to estimate exposures. The JEM linked interview responses of study participants to measurement data through exposure groups (EGs). Here we describe a systematic process used to develop transparent and precise EGs that allowed characterization of exposure levels among the large number of OSRC activities performed across the Gulf of Mexico over time and space. EGs were identified by exposure determinants available to us in our measurement database, from a substantial body of other spill-related information, and from responses provided by study participants in a detailed interview. These determinants included: job/activity/task, vessel and type of vessel, weathering of the released oil, area of the Gulf of Mexico, Gulf coast state, and time period. Over 3000 EGs were developed for inhalation exposure and applied to each of 6 JEMs of oil-related substances (total hydrocarbons, benzene, toluene, ethylbenzene, total xylene, and n-hexane). Subsets of those EGs were used for characterization of exposures to dispersants, particulate matter, and oil mist. The EGs allowed assignment to study participants of exposure estimates developed from measurement data or from estimation models through linkage in the JEM for the investigation of exposure-response relationships.
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Affiliation(s)
- Mark R Stenzel
- Exposure Assessment Applications, LLC, 6045 N. 27th. St., Arlington, VA, 22207, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, WVU School of Public Health, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, 3215 Market St, Philadelphia, PA 19104, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California-Los Angeles, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive-MD A3-05, Research Triangle Park, NC 27709, USA.,Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, 31 Center Drive, Bethesda, MD 20892, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive-MD A3-05, Research Triangle Park, NC 27709, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 35 Dauer Drive, Chapel Hill, NC, 27599, USA
| | - Aaron Blair
- Division of Caner Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Building 9609, MSC 9760, Bethesda, MD 20892-9760, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive-MD A3-05, Research Triangle Park, NC 27709, USA
| | - Patricia A Stewart
- Stewart Exposure Assessments, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA
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10
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Pratt GC, Stenzel MR, Kwok RK, Groth CP, Banerjee S, Arnold SF, Engel LS, Sandler DP, Stewart PA. Modeled Air Pollution from In Situ Burning and Flaring of Oil and Gas Released Following the Deepwater Horizon Disaster. Ann Work Expo Health 2022; 66:i172-i187. [PMID: 32936300 PMCID: PMC8989033 DOI: 10.1093/annweh/wxaa084] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/27/2020] [Accepted: 08/18/2020] [Indexed: 12/19/2023] Open
Abstract
The GuLF STUDY, initiated by the National Institute of Environmental Health Sciences, is investigating the health effects among workers involved in the oil spill response and clean-up (OSRC) after the Deepwater Horizon (DWH) explosion in April 2010 in the Gulf of Mexico. Clean-up included in situ burning of oil on the water surface and flaring of gas and oil captured near the seabed and brought to the surface. We estimated emissions of PM2.5 and related pollutants resulting from these activities, as well as from engines of vessels working on the OSRC. PM2.5 emissions ranged from 30 to 1.33e6 kg per day and were generally uniform over time for the flares but highly episodic for the in situ burns. Hourly emissions from each source on every burn/flare day were used as inputs to the AERMOD model to develop average and maximum concentrations for 1-, 12-, and 24-h time periods. The highest predicted 24-h average concentrations sometimes exceeded 5000 µg m-3 in the first 500 m downwind of flaring and reached 71 µg m-3 within a kilometer of some in situ burns. Beyond 40 km from the DWH site, plumes appeared to be well mixed, and the predicted 24-h average concentrations from the flares and in situ burns were similar, usually below 10 µg m-3. Structured averaging of model output gave potential PM2.5 exposure estimates for OSRC workers located in various areas across the Gulf. Workers located nearest the wellhead (hot zone/source workers) were estimated to have a potential maximum 12-h exposure of 97 µg m-3 over the 2-month flaring period. The potential maximum 12-h exposure for workers who participated in in situ burns was estimated at 10 µg m-3 over the ~3-month burn period. The results suggest that burning of oil and gas during the DWH clean-up may have resulted in PM2.5 concentrations substantially above the U.S. National Ambient Air Quality Standard for PM2.5 (24-h average = 35 µg m-3). These results are being used to investigate possible adverse health effects in the GuLF STUDY epidemiologic analysis of PM2.5 exposures.
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Affiliation(s)
- Gregory C Pratt
- University of Minnesota, School of Public Health, Division of Environmental Health, 420 Delaware St. S.E., Minneapolis, MN 55455, USA
| | - Mark R Stenzel
- Exposure Assessment Applications, LLC, 6045 27th St N, Arlington, VA 22207, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, P.O. Box 12233, MD A3-05, 111 T.W. Alexander Drive, Research Triangle Park, NC 22709, USA
| | - Caroline P Groth
- Department of Biostatistics, West Virginia University School of Public Health, 64 Medical Center Drive, P.O. Box 9190, Morgantown, WV 26506-9190, USA
| | - Sudipto Banerjee
- University of California-Los Angeles, School of Public Health, Department of Biostatistics, Suite: 51-254 CHS, 650 charles E. Young Drive South, Los Angeles, CA 90095, USA
| | - Susan F Arnold
- University of Minnesota, School of Public Health, Division of Environmental Health, 420 Delaware St. S.E., Minneapolis, MN 55455, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, P.O. Box 12233, MD A3-05, 111 T.W. Alexander Drive, Research Triangle Park, NC 22709, USA
- Department of Epidemiology, McGavran-Greenberg Hall, Campus Box 7435, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, P.O. Box 12233, MD A3-05, 111 T.W. Alexander Drive, Research Triangle Park, NC 22709, USA
| | - Patricia A Stewart
- Stewart Exposure Assessments, LLC, 6045 27th St N, Arlington, VA 22207, USA
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11
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Arnold S, Stewart PA, Pratt GC, Ramachandran G, Kwok RK, Engel LS, Sandler DP, Stenzel MR. Estimation of Aerosol Concentrations of Oil Dispersants COREXIT™ EC9527A and EC9500A during the Deepwater Horizon Oil Spill Response and Clean-up Operations. Ann Work Expo Health 2022; 66:i188-i202. [PMID: 35390130 PMCID: PMC8989030 DOI: 10.1093/annweh/wxab108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/26/2021] [Accepted: 11/28/2021] [Indexed: 11/14/2022] Open
Abstract
The April 2010 Deepwater Horizon drilling unit explosion at the Macondo oil well resulted in the release of approximately 779 million l of oil into the Gulf of Mexico. As part of the response effort to break up oil slicks on the water's surface, 6.81 million l of chemical dispersants COREXIT™ EC9500A and COREXIT™ EC9527A were applied by plane or vessel or injected near the seabed. The GuLF Long-term Follow-up Study is investigating possible adverse health effects of workers involved in the oil spill response and clean-up (OSRC). In this paper, we describe potential dispersant-related air concentrations generated from aerial spraying of dispersants to provide insight as to what concentrations OSRC workers may have been exposed under worst-case conditions. Personal exposure measurement data were not collected. Modeling, therefore, was conducted to estimate airborne concentrations of total aerosol to COREXIT™ EC9527A and EC9500A. Using the AgDISP model, we estimated air concentrations to dispersant total aerosols, defined as all components of the dispersant including active ingredients, surfactants, and water, resulting from aerial and vessel applications, as average 1-h and 2-min concentrations. For comparison, 1-h air concentrations associated with aerial spraying were estimated using another model, AERMOD. At 152 m horizontal to the flight path, average 1-h total aerosol concentrations associated with aerial applications were estimated to be as high as 49.3 µg m-3 (9527A) and 45.4 µg m-3 (9500A), and both decreased with increased distance from the flight line. The estimates for spraying 9500A from vessels indicated that total aerosol concentrations were potentially as high as 0.33 µg m-3 at 10 m from the nozzles. These results suggest that personal exposures to dispersant aerosols were negligible.
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Affiliation(s)
- Susan Arnold
- University of Minnesota, School of Public Health, Division of Environmental Health, 420 Delaware St SE, Minneapolis, MN 55455, USA
| | - Patricia A Stewart
- Stewart Exposure Assessments, LLC, 6045 N. 27th. St, Arlington, VA 22207, USA
| | - Gregory C Pratt
- University of Minnesota, School of Public Health, Division of Environmental Health, 420 Delaware St SE, Minneapolis, MN 55455, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, , 615 N. Wolfe St, Baltimore, MD 21205, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive - MD A3-05, Research Triangle Park, NC 27709, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive - MD A3-05, Research Triangle Park, NC 27709, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 35 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Dale P Sandler
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, , 615 N. Wolfe St, Baltimore, MD 21205, USA
| | - Mark R Stenzel
- Exposure Assessment Applications, LLC, 6045 N. 27th. St, Arlington, VA 22207, USA
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12
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Gorman Ng M, Cherrie JW, Sleeuwenhoek A, Stenzel M, Kwok RK, Engel LS, Cavallari JM, Blair A, Sandler DP, Stewart P. GuLF DREAM: A Model to Estimate Dermal Exposure Among Oil Spill Response and Clean-up Workers. Ann Work Expo Health 2022; 66:i218-i233. [PMID: 31334553 PMCID: PMC8989037 DOI: 10.1093/annweh/wxz037] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 02/14/2019] [Accepted: 04/29/2019] [Indexed: 12/17/2023] Open
Abstract
Tens of thousands of individuals performed oil spill response and clean-up (OSRC) activities following the 'Deepwater Horizon' oil drilling rig explosion in 2010. Many were exposed to oil residues and dispersants. The US National Institute of Environmental Health Sciences assembled a cohort of nearly 33 000 workers to investigate potential adverse health effects of oil spill exposures. Estimates of dermal and inhalation exposure are required for those individuals. Ambient breathing-zone measurements taken at the time of the spill were used to estimate inhalation exposures for participants in the GuLF STUDY (Gulf Long-term Follow-up Study), but no dermal measurements were collected. Consequently, a modelling approach was used to estimate dermal exposures. We sought to modify DREAM (DeRmal Exposure Assessment Method) to optimize the model for assessing exposure to various oil spill-related substances and to incorporate advances in dermal exposure research. Each DREAM parameter was reviewed in the context of literature published since 2000 and modified where appropriate. To reflect the environment in which the OSRC work took place, the model treatment of evaporation was expanded to include vapour pressure and wind speed, and the effect of seawater on exposure was added. The modified model is called GuLF DREAM and exposure is estimated in GuLF DREAM units (GDU). An external validation to assess the performance of the model for oils, tars, and fuels was conducted using available published dermal wipe measurements of heavy fuel oil (HFO) and dermal hand wash measurements of asphalt. Overall, measured exposures had moderate correlations with GDU estimates (r = 0.59) with specific correlations of -0.48 for HFO and 0.68 for asphalt. The GuLF DREAM model described in this article has been used to generate dermal exposure estimates for the GuLF STUDY. Many of the updates made were generic, so the updated model may be useful for other dermal exposure scenarios.
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Affiliation(s)
- Melanie Gorman Ng
- Centre for Human Exposure Science, Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - John W Cherrie
- Centre for Human Exposure Science, Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK
- Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh EH14 4AS, UK
| | - Anne Sleeuwenhoek
- Centre for Human Exposure Science, Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK
| | - Mark Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA 22207, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Jennifer M Cavallari
- Department of Community Medicine, University of Connecticut School of Medicine, Farmington, CT 06032, USA
| | - Aaron Blair
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD 27709, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA
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13
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Stewart P, Groth CP, Huynh TB, Gorman Ng M, Pratt GC, Arnold SF, Ramachandran G, Banerjee S, Cherrie JW, Christenbury K, Kwok RK, Blair A, Engel LS, Sandler DP, Stenzel MR. Assessing Exposures from the Deepwater Horizon Oil Spill Response and Clean-up. Ann Work Expo Health 2022; 66:i3-i22. [PMID: 35390131 PMCID: PMC8989041 DOI: 10.1093/annweh/wxab107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/31/2021] [Accepted: 11/10/2021] [Indexed: 01/05/2023] Open
Abstract
The GuLF Study is investigating adverse health effects from work on the response and clean-up after the Deepwater Horizon explosion and oil release. An essential and necessary component of that study was the exposure assessment. Bayesian statistical methods and over 135 000 measurements of total hydrocarbons (THC), benzene, ethylbenzene, toluene, xylene, and n-hexane (BTEX-H) were used to estimate inhalation exposures to these chemicals for >3400 exposure groups (EGs) formed from three exposure determinants: job/activity/task, location, and time period. Recognized deterministic models were used to estimate airborne exposures to particulate matter sized 2.5 µm or less (PM2.5) and dispersant aerosols and vapors. Dermal exposures were estimated for these same oil-related substances using a model modified especially for this study from a previously published model. Exposures to oil mist were assessed using professional judgment. Estimated daily THC arithmetic means (AMs) were in the low ppm range (<25 ppm), whereas BTEX-H exposures estimates were generally <1000 ppb. Potential 1-h PM2.5 air concentrations experienced by some workers may have been as high as 550 µg m-3. Dispersant aerosol air concentrations were very low (maximum predicted 1-h concentrations were generally <50 µg m-3), but vapor concentrations may have exceeded occupational exposure excursion guidelines for 2-butoxyethanol under certain circumstances. The daily AMs of dermal exposure estimates showed large contrasts among the study participants. The estimates are being used to evaluate exposure-response relationships in the GuLF Study.
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Affiliation(s)
- Patricia Stewart
- Stewart Exposure Assessments, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA,Author to whom correspondence should be addressed. Tel: +0/703-534-2956; e-mail:
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, 3215 Market St., Philadelphia, PA 19104, USA
| | - Melanie Gorman Ng
- School of Population and Public Health, Faculty of Medicine, 3rd Floor, 2206 East Mall, Vancouver, BC V6T 1Z3Canada
| | - Gregory C Pratt
- Division of Environmental Health, University of Minnesota, School of Public Health, 420 Delaware St. S.E., Minneapolis, MN 55455, USA
| | - Susan F Arnold
- Division of Environmental Health, University of Minnesota, School of Public Health, 420 Delaware St. S.E., Minneapolis, MN 55455, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St., Baltimore, MD 21205, USA,Department of Biostatistics, Suite: 51-254 CHS. UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Suite: 51-254 CHS. UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA
| | - John W Cherrie
- Insitute of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh, Midlothian EH14 4AP, UK
| | - Kate Christenbury
- Public Health Sciences, Social and Scientific Systems Inc., a DLH Holdings Company, 4505 Emperor Blvd, Suite 400, Durham, NC 27703, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA,Office of the Director, National Institute of Environmental Health Sciences, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Aaron Blair
- National Cancer Institute, 9609 Medical Center Drive, Building 9609 MSC 9760, Bethesda, MD 20892-9760, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 35 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA
| | - Mark R Stenzel
- Exposure Assessment Applications, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA
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14
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Kwok RK, Jackson WB, Curry MD, Stewart PA, McGrath JA, Stenzel M, Huynh TB, Groth CP, Ramachandran G, Banerjee S, Pratt GC, Miller AK, Zhang X, Engel LS, Sandler DP. Association of Deepwater Horizon Oil Spill Response and Cleanup Work With Risk of Developing Hypertension. JAMA Netw Open 2022; 5:e220108. [PMID: 35195699 PMCID: PMC8867245 DOI: 10.1001/jamanetworkopen.2022.0108] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
IMPORTANCE Exposure to hydrocarbons, fine particulate matter (PM2.5), and other chemicals from the April 20, 2010, Deepwater Horizon disaster may be associated with increased blood pressure and newly detected hypertension among oil spill response and cleanup workers. OBJECTIVE To determine whether participation in cleanup activities following the disaster was associated with increased risk of developing hypertension. DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted via telephone interviews and in-person home exams. Participants were 6846 adults who had worked on the oil spill cleanup (workers) and 1505 others who had completed required safety training but did not do cleanup work (nonworkers). Eligible participants did not have diagnosed hypertension at the time of the oil spill. Statistical analyses were performed from June 2018 to December 2021. EXPOSURES Engagement in cleanup activities following the Deepwater Horizon oil spill disaster, job classes, quintiles of cumulative total hydrocarbons exposure level, potential exposure to burning or flaring oil, and estimated PM2.5 were examined. MAIN OUTCOMES AND MEASURES Systolic and diastolic blood pressure measurements were collected during home exams from 2011 to 2013 using automated oscillometric monitors. Newly detected hypertension was defined as antihypertensive medication use or elevated blood pressure since the spill. Log binomial regression was used to calculate prevalence ratios (PR) and 95% CIs for associations between cleanup exposures and hypertension. Multivariable linear regression was used to estimate exposure effects on continuous blood pressure levels. RESULTS Of 8351 participants included in this study, 6484 (77.6%) were male, 517 (6.2%) were Hispanic, 2859 (34.2%) were non-Hispanic Black, and 4418 (52.9%) were non-Hispanic White; the mean (SD) age was 41.9 (12.5) years at enrollment. Among workers, the prevalence of newly detected hypertension was elevated in all quintiles (Q) of cumulative total hydrocarbons above the first quintile (PR for Q3, 1.29 [95% CI, 1.13-1.46], PR for Q4, 1.25 [95% CI, 1.10-1.43], and PR for Q5, 1.31 [95% CI, 1.15-1.50]). Both exposure to burning and/or flaring oil and gas (PR, 1.16 [95% CI, 1.02-1.33]) and PM2.5 from burning (PR, 1.26 [95% CI, 0.89-1.71]) for the highest exposure category were associated with increased risk of newly detected hypertension, as were several types of oil spill work including cleanup on water (PR, 1.34 [95% CI, 1.08-1.66]) and response work (PR, 1.51 [95% CI, 1.20-1.90]). CONCLUSIONS AND RELEVANCE Oil spill exposures were associated with newly detected hypertension after the Deepwater Horizon disaster. These findings suggest that blood pressure screening should be considered for workers with occupational hydrocarbon exposures.
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Affiliation(s)
- Richard K. Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
- Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - W. Braxton Jackson
- Social & Scientific Systems, Inc, a DLH holdings company, Durham, North Carolina
| | | | | | - John A. McGrath
- Social & Scientific Systems, Inc, a DLH holdings company, Durham, North Carolina
| | - Mark Stenzel
- Exposure Assessment Applications, LLC, Arlington, Virginia
| | - Tran B. Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Caroline P. Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California, Los Angeles
| | - Gregory C. Pratt
- Division of Environmental Health, School of Public Health, University of Minnesota, Minneapolis
| | - Aubrey K. Miller
- Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Xian Zhang
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill
| | - Lawrence S. Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
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15
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Chen D, Lawrence KG, Pratt GC, Stenzel MR, Stewart PA, Groth CP, Banerjee S, Christenbury K, Curry MD, Jackson WB, Kwok RK, Blair A, Engel LS, Sandler DP. Fine Particulate Matter and Lung Function among Burning-Exposed Deepwater Horizon Oil Spill Workers. Environ Health Perspect 2022; 130:27001. [PMID: 35103485 PMCID: PMC8805798 DOI: 10.1289/ehp8930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 11/01/2021] [Accepted: 01/03/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND During the 2010 Deepwater Horizon (DWH) disaster, controlled burning was conducted to remove oil from the water. Workers near combustion sites were potentially exposed to increased fine particulate matter [with aerodynamic diameter ≤2.5μm (PM2.5)] levels. Exposure to PM2.5 has been linked to decreased lung function, but to our knowledge, no study has examined exposure encountered in an oil spill cleanup. OBJECTIVE We investigated the association between estimated PM2.5 only from burning/flaring of oil/gas and lung function measured 1-3 y after the DWH disaster. METHODS We included workers who participated in response and cleanup activities on the water during the DWH disaster and had lung function measured at a subsequent home visit (n=2,316). PM2.5 concentrations were estimated using a Gaussian plume dispersion model and linked to work histories via a job-exposure matrix. We evaluated forced expiratory volume in 1 s (FEV1; milliliters), forced vital capacity (FVC; milliliters), and their ratio (FEV1/FVC; %) in relation to average and cumulative daily maximum exposures using multivariable linear regressions. RESULTS We observed significant exposure-response trends associating higher cumulative daily maximum PM2.5 exposure with lower FEV1 (p-trend=0.04) and FEV1/FVC (p-trend=0.01). In comparison with the referent group (workers not involved in or near the burning), those with higher cumulative exposures had lower FEV1 [-166.8mL, 95% confidence interval (CI): -337.3, 3.7] and FEV1/FVC (-1.7, 95% CI: -3.6, 0.2). We also saw nonsignificant reductions in FVC (high vs. referent: -120.9, 95% CI: -319.4, 77.6; p-trend=0.36). Similar associations were seen for average daily maximum PM2.5 exposure. Inverse associations were also observed in analyses stratified by smoking and time from exposure to spirometry and when we restricted to workers without prespill lung disease. CONCLUSIONS Among oil spill workers, exposure to PM2.5 specifically from controlled burning of oil/gas was associated with significantly lower FEV1 and FEV1/FVC when compared with workers not involved in burning. https://doi.org/10.1289/EHP8930.
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Affiliation(s)
- Dazhe Chen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kaitlyn G. Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Gregory C. Pratt
- Division of Environmental Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Mark R. Stenzel
- Exposure Assessment Applications, LLC, Arlington, Virginia, USA
| | | | - Caroline P. Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Fielding School of Public Health, University of California–Los Angeles, Los Angeles, California, USA
| | | | | | | | - Richard K. Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
- Office of the Director, National Institute of Environmental Health Sciences, Bethesda, Maryland, USA
| | - Aaron Blair
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Lawrence S. Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
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16
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Takeshita R, Bursian SJ, Colegrove KM, Collier TK, Deak K, Dean KM, De Guise S, DiPinto LM, Elferink CJ, Esbaugh AJ, Griffitt RJ, Grosell M, Harr KE, Incardona JP, Kwok RK, Lipton J, Mitchelmore CL, Morris JM, Peters ES, Roberts AP, Rowles TK, Rusiecki JA, Schwacke LH, Smith CR, Wetzel DL, Ziccardi MH, Hall AJ. A review of the toxicology of oil in vertebrates: what we have learned following the Deepwater Horizon oil spill. J Toxicol Environ Health B Crit Rev 2021; 24:355-394. [PMID: 34542016 DOI: 10.1080/10937404.2021.1975182] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In the wake of the Deepwater Horizon (DWH) oil spill, a number of government agencies, academic institutions, consultants, and nonprofit organizations conducted lab- and field-based research to understand the toxic effects of the oil. Lab testing was performed with a variety of fish, birds, turtles, and vertebrate cell lines (as well as invertebrates); field biologists conducted observations on fish, birds, turtles, and marine mammals; and epidemiologists carried out observational studies in humans. Eight years after the spill, scientists and resource managers held a workshop to summarize the similarities and differences in the effects of DWH oil on vertebrate taxa and to identify remaining gaps in our understanding of oil toxicity in wildlife and humans, building upon the cross-taxonomic synthesis initiated during the Natural Resource Damage Assessment. Across the studies, consistency was found in the types of toxic response observed in the different organisms. Impairment of stress responses and adrenal gland function, cardiotoxicity, immune system dysfunction, disruption of blood cells and their function, effects on locomotion, and oxidative damage were observed across taxa. This consistency suggests conservation in the mechanisms of action and disease pathogenesis. From a toxicological perspective, a logical progression of impacts was noted: from molecular and cellular effects that manifest as organ dysfunction, to systemic effects that compromise fitness, growth, reproductive potential, and survival. From a clinical perspective, adverse health effects from DWH oil spill exposure formed a suite of signs/symptomatic responses that at the highest doses/concentrations resulted in multi-organ system failure.
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Affiliation(s)
- Ryan Takeshita
- Conservation Medicine, National Marine Mammal Foundation, San Diego, California, United States
| | - Steven J Bursian
- Department of Animal Science, Michigan State University, East Lansing, Michigan, United States
| | - Kathleen M Colegrove
- College of Veterinary Medicine, Illinois at Urbana-Champaign, Brookfield, Illinois, United States
| | - Tracy K Collier
- Zoological Pathology Program, Huxley College of the Environment, Western Washington University, Bellingham, Washington, United States
| | - Kristina Deak
- College of Marine Sciences, University of South Florida, St. Petersburg, Florida, United States
| | | | - Sylvain De Guise
- Department of Pathobiology and Veterinary Sciences, University of Connecticut, Storrs, Connecticut, United States
| | - Lisa M DiPinto
- Office of Response and Restoration, NOAA, Silver Spring, Maryland, United States
| | - Cornelis J Elferink
- Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas, United States
| | - Andrew J Esbaugh
- Marine Science Institute, University of Texas at Austin, Port Aransas, Texas, United States
| | - Robert J Griffitt
- Division of Coastal Sciences, School of Ocean Science and Engineering, University of Southern Mississippi, Gulfport, Mississippi, United States
| | - Martin Grosell
- RSMAS, University of Miami, Miami, Florida, United States
| | | | - John P Incardona
- NOAA Environmental Conservation Division, Northwest Fisheries Science Center, Seattle, Washington, United States
| | - Richard K Kwok
- Department of Health and Human Services, National Institute of Environmental Health Sciences, National Institutes of Health, North Carolina, United States
| | | | - Carys L Mitchelmore
- University of Maryland Center of Environmental Science, Chesapeake Biological Laboratory, Solomons, Maryland, United States
| | - Jeffrey M Morris
- Health and Environment Division, Abt Associates, Boulder, Colorado, United States
| | - Edward S Peters
- Department of Epidemiology, LSU School of Public Health, New Orleans, Louisiana, United States
| | - Aaron P Roberts
- Advanced Environmental Research Institute and Department of Biological Sciences, University of North Texas, Denton, Texas, United States
| | - Teresa K Rowles
- NOAA Office of Protected Resources, National Marine Fisheries Service, Silver Spring, Maryland, United States
| | - Jennifer A Rusiecki
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, Maryland, United States
| | - Lori H Schwacke
- Conservation Medicine, National Marine Mammal Foundation, San Diego, California, United States
| | - Cynthia R Smith
- Conservation Medicine, National Marine Mammal Foundation, San Diego, California, United States
| | - Dana L Wetzel
- Environmental Laboratory of Forensics, Mote Marine Laboratory, Sarasota, Florida, United States
| | - Michael H Ziccardi
- School of Veterinary Medicine, One Health Institute, University of California, Davis, California, United States
| | - Ailsa J Hall
- Sea Mammal Research Unit, Scottish Oceans Institute, University of St Andrews, St Andrews, UK
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17
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Xu J, Engel LS, Rhoden J, Jackson WB, Kwok RK, Sandler DP. The association between blood metals and hypertension in the GuLF study. Environ Res 2021; 202:111734. [PMID: 34303682 PMCID: PMC8578391 DOI: 10.1016/j.envres.2021.111734] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/14/2021] [Accepted: 07/17/2021] [Indexed: 05/19/2023]
Abstract
BACKGROUND Both essential and non-essential metals come from natural and anthropogenic sources. Metals can bioaccumulate in humans and may impact human health, including hypertension. METHODS Blood metal (cadmium, lead, mercury, manganese, and selenium) concentrations were measured at baseline for a sample of participants in the Gulf Long-Term Follow-up (GuLF) Study. The GuLF Study is a prospective cohort study focused on potential health effects following the 2010 Deepwater Horizon oil spill. Hypertension was defined as high systolic (≥140 mm Hg) or diastolic (≥90 mm Hg) blood pressure or taking anti-hypertensive medications. A total of 957 participants who had blood measurement for at least one metal, baseline blood pressure measurements, information on any anti-hypertensive medication use, and relevant covariates were included in this cross-sectional analysis. We used Poisson regression to explore the association between individual blood metal levels and hypertension. Quantile-based g-computation was used to investigate the association between the metal mixture and hypertension. We also explored the association between individual blood metal levels and continuous blood pressure measurements using general linear regression. RESULTS Comparing the highest quartile of blood metals with the lowest (Q4vs1), the hypertension prevalence ratio (PR) was 0.92 (95 % confidence interval (CI) = 0.73,1.15) for cadmium, 0.86 (95%CI = 0.66,1.12) for lead, 0.89 (95%CI = 0.71,1.12) for mercury, 1.00 (95%CI = 0.80,1.26) for selenium, and 1.22 (95%CI = 0.95,1.57) for manganese. We observed some qualitative differences across race and BMI strata although none of these differences were statistically significant. In stratified analyses, the PR (Q4vs1) for mercury was 0.69 (95%CI = 0.53, 0.91) in White participants and 1.29 (95%CI = 0.86,1.92) in Black participants (p for interaction = 0.5). The PR (Q4vs1) for manganese was relatively higher in Black participants (PR = 1.37, 95%CI = 0.92,2.05) than in White participants (PR = 1.15, 95%CI = 0.83,1.60, p for interaction = 0.5), with a suggestive dose-response among Blacks. After stratifying by obesity (BMI ≥30 and < 30), positive associations of of hypertension with cadmium (PR [Q4vs1] = 1.19, 95%CI = 0.91,1.56, p for interaction = 0.5), lead (PR [Q4vs1] = 1.14, 95%CI = 0.84,1.55, p for interaction = 1.0) and manganese (PR = 1.25, 95%CI = 0.93,1.68, p for interaction = 0.8) were observed in participants with BMI≥30, but not in participants with BMI<30. The joint effect of the metal mixture was 0.96 (95%CI = 0.73,1.27). We did not observe clear associations between blood metal levels and continuous blood pressure measurements. CONCLUSION We did not find overall cross-sectional associations between blood cadmium, lead, mercury, selenium levels and hypertension or blood pressure. We found some evidence suggesting that manganese might be positively associated with risk of hypertension. Associations varied somewhat by race and BMI.
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Affiliation(s)
- Jing Xu
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA; Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Joyce Rhoden
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - W Braxton Jackson
- Social & Scientific Systems, Inc., DLH Holdings Company, Durham, NC, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA; Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA.
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18
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Stewart PA, Gorman Ng M, Cherrie JW, Jones A, Kwok RK, Blair A, Engel LS, Sandler DP, Stenzel MR. Estimation of Dermal Exposure to Oil Spill Response and Clean-up Workers after the Deepwater Horizon Disaster. Ann Work Expo Health 2021; 66:i234-i246. [PMID: 34642740 PMCID: PMC8989031 DOI: 10.1093/annweh/wxab073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/28/2021] [Accepted: 08/23/2021] [Indexed: 01/05/2023] Open
Abstract
The GuLF STUDY is investigating health outcomes associated with oil spill-related chemical exposures among workers involved in the spill response and clean-up following the Deepwater Horizon disaster. Due to the lack of dermal exposure measurements, we estimated dermal exposures using a deterministic model, which we customized from a previously published model. Workers provided information on the frequency of contact with oil, tar, chemical dispersants applied to the oil spill and sea water, as well as the use of protective equipment, by job/activity/task. Professional judgment by industrial hygienists served as a source of information for other model variables. The model estimated dermal exposures to total hydrocarbons (THC), benzene, ethylbenzene, toluene, xylene, n-hexane (BTEX-H), polycyclic aromatic hydrocarbons (PAHs), and dispersants in GuLF DREAM units (GDUs). Arithmetic means (AMs) of THC exposure estimates across study participants ranged from <0.02 to 5.50 GDUs for oil and <0.02 to 142.14 GDUs for tar. Statistical differences in the estimates were observed among the AMs of the estimates for some broad groups of worker activities over time and for some time periods across the broad groups of activities. N-Hexane had ranges similar to THC for oil exposures (e.g. AMs up to 2.22 GDUs) but not for tar (up to 5.56 GDUs). Benzene, ethylbenzene, toluene, and xylene, in contrast, were characterized by higher exposure levels than THC for oil (AMs up to 12.77, 12.17, 17.45, and 36.77 GDUs, respectively) but lower levels than THC to tar (AMs up to 3.69, 11.65, 42.37, and 88.18 GDUs, respectively). For PAHs, the AMs were as high as 219.31 and 587.98 for oil and tar, respectively. Correlations of these seven substances to each other were high (>0.9) for most of the substances in oil but were lower for some of the substances in tar. These data were linked to the study participants to allow investigation of adverse health effects that may be related to dermal exposures.
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Affiliation(s)
- Patricia A Stewart
- Stewart Exposure Assessments, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA,Author to whom correspondence should be addressed. Tel: +1-703-534-2956; e-mail:
| | - Melanie Gorman Ng
- School of Population and Public Health, Faculty of Medicine, 3rd Floor, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
| | - John W Cherrie
- Insititue of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh EH14 4AP, UK
| | - Anna Jones
- Public Health Sciences, Social & Scientific Systems, Inc., a DLH Holdings Company, 4505 Emperor Blvd, Suite 400, Durham, NC 27703, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA,Office of the Director, National Institute of Environmental Health Sciences, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Aaron Blair
- National Cancer Institute, Bethesda, MD 20892, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA
| | - Mark R Stenzel
- Exposure Assessment Applications, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA
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19
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Lawrence KG, Werder EJ, Kwok RK, Engel LS, Sandler DP. Mental health indicators and lung function following a large oil spill. Eur Respir J 2021; 58:2100712. [PMID: 34326186 PMCID: PMC10947419 DOI: 10.1183/13993003.00712-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/03/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
- Office of the Director, National Institute of Environmental Health Sciences, Bethesda, MD, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
- Dept of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
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20
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Lawrence KG, Jackson WB, Ramsey S, Kwok RK, Engel LS, Curry MD, Sandler DP. Spirometry quality predictors in a large multistate prospective study. Respir Med 2021; 188:106618. [PMID: 34571455 DOI: 10.1016/j.rmed.2021.106618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Gulf Long-Term Follow-up (GuLF) Study is a prospective cohort study of health effects associated with oil spill response and clean-up following the 2010 Deepwater Horizon Disaster (DWH). As part of the study, spirometry testing of lung function was carried out in home visits across multiple states. Few studies have described factors associated with spirometry test failure in field-based settings. OBJECTIVE Our objective was to identify what factors, if any, predict test failure among GuLF Study participants who completed spirometry testing in a non-traditional setting. METHODS Trained examiners administered spirometry (May 2011-May 2013) to 10,019 participants living in US Gulf States (LA, MS, TX, AL, FL) using an Easy-on ultrasonic spirometer. We applied American Thoracic Society/European Respiratory Society quality criteria to determine quality test failure and identified factors predictive of failure using both a Stepwise and a LASSO model. We calculated odds ratios and 95% confidence intervals (CIs) for associations of selected factors with test failure. RESULTS Among GuLF Study participants who conducted spirometry, self-reported African American/Black participants (OR: 1.39, 95% CI: 1.23,1.56); men (OR:1.61, 95% CI: 1.41,1.83); and those making less than $20,000 per year (OR: 1.45, 95% CI: 1.26,1.67) were more likely to fail quality testing, while those who were obese were less likely to fail (OR: 0.61, 95% CI: 0.42,0.89). CONCLUSION Field-based studies involving spirometry should identify and account for participant factors that may influence test failure. Coaching that is tailored to those less likely to have experience with spirometry may help reduce test failure rates.
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Affiliation(s)
- Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - W Braxton Jackson
- Social & Scientific Systems, Inc., a DLH Holding Company, Durham, NC, USA
| | - Steven Ramsey
- Social & Scientific Systems, Inc., a DLH Holding Company, Durham, NC, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA; Office of the Director, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA; Dept. of Epidemiology, Gillings School of Global Public Health, UNC Chapel Hill, Chapel Hill, NC, USA
| | - Matthew D Curry
- Social & Scientific Systems, Inc., a DLH Holding Company, Durham, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.
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21
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Ramachandran G, Groth CP, Huynh TB, Banerjee S, Stewart PA, Engel LS, Kwok RK, Sandler DP, Stenzel M. Using Real-Time Area VOC Measurements to Estimate Total Hydrocarbons Exposures to Workers Involved in the Deepwater Horizon Oil Spill. Ann Work Expo Health 2021; 66:i156-i171. [PMID: 34516617 PMCID: PMC8989043 DOI: 10.1093/annweh/wxab066] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 01/05/2023] Open
Abstract
Even though the Deepwater Horizon oil spill response and clean-up (OSRC) had one of the largest exposure monitoring efforts of any oil spill, a number of exposure groups did not have sufficient personal data available or there were gaps in days measured to adequately characterize exposures for the GuLF STUDY, an epidemiologic study investigating the health of the OSRC workers. Area measurements were available from real-time air monitoring instruments and used to supplement the personal exposure measurements. OBJECTIVES The objective was to present a method that used real-time volatile organic compounds (VOCs) area measurements transformed to daily total hydrocarbons (THC) time-weighted averages (TWAs) to supplement THC personal full-shift measurements collected using passive charcoal badges. A second objective was to develop exposure statistics using these data for workers on vessels piloting remotely operated vehicle (ROV) vessels and other marine vessels (MVs) not at the job title level, but at the vessel level. METHODS From hourly vessel averages derived from ~26 million real-time VOC measurements, we estimated full-shift VOC TWAs. Then, we determined the relationship between these TWAs and corresponding full-shift THC personal measurements taken on the same vessel-day. We used this relationship to convert the full-shift VOC measurements to full-shift 'THC' TWA estimates when no personal THC measurements existed on a vessel-day. We then calculated arithmetic means (AMs) and other statistics of THC exposures for each vessel. RESULTS The VOC-derived estimates substantially supplemented the THC personal measurements, with the number of vessel-days for which we have exposure estimates increasing by ~60%. The estimates of the AMs are some of the highest observed in the GuLF STUDY. As expected, the AMs decreased over time, consistent with our findings on other vessels. CONCLUSIONS Despite the inherent limitations of using real-time area measurements, we were able to develop additional daily observations of personal THC exposures for workers on the ROV vessels and other MVs over time. The estimates likely resulted in more representative estimates of the AMs in the GuLF STUDY. The method used here can be applied in other occupational settings and industries for personal exposure estimation where large amounts of area measurements and more limited numbers of personal measurements are available.
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Affiliation(s)
- Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe Street, Baltimore, MD 21205, USA,Author to whom correspondence should be addressed. Tel: +1-612-619-6702; e-mail:
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, WVU School of Public Health, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA 19104, USA
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California—Los Angeles, 650 Charles E. Young Drive, Los Angeles, CA 90095, USA
| | - Patricia A Stewart
- Stewart Exposure Assessments, LLC, 6045 N 27th Street, Arlington, VA 22207, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive—MD A3-05, Research Triangle Park, NC 27709, USA,Department of Epidemiology, University of North Carolina at Chapel Hill, 35 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive—MD A3-05, Research Triangle Park, NC 27709, USA,Office of the Director, National Institute of Environmental Health Sciences, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive—MD A3-05, Research Triangle Park, NC 27709, USA
| | - Mark Stenzel
- Exposure Assessment Applications, LLC, 6045 N 27th Street, Arlington, VA 22207, USA
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Groth CP, Huynh TB, Banerjee S, Ramachandran G, Stewart PA, Quick H, Sandler DP, Blair A, Engel LS, Kwok RK, Stenzel MR. Linear Relationships Between Total Hydrocarbons and Benzene, Toluene, Ethylbenzene, Xylene, and n-Hexane during the Deepwater Horizon Response and Clean-up. Ann Work Expo Health 2021; 66:i71-i88. [PMID: 34473212 PMCID: PMC8989044 DOI: 10.1093/annweh/wxab064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 06/20/2021] [Accepted: 07/29/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Our objectives were to (i) determine correlations between measurements of THC and of BTEX-H, (ii) apply these linear relationships to predict BTEX-H from measured THC, (iii) use these correlations as informative priors in Bayesian analyses to estimate exposures. METHODS We used a Bayesian left-censored bivariate framework for all 3 objectives. First, we modeled the relationships (i.e. correlations) between THC and each BTEX-H chemical for various overarching groups of measurements using linear regression to determine if correlations derived from linear relationships differed by various exposure determinants. We then used the same linear regression relationships to predict (or impute) BTEX-H measurements from THC when only THC measurements were available. Finally, we used the same linear relationships as priors for the final exposure models that used real and predicted data to develop exposure estimate statistics for each individual exposure group. RESULTS Correlations between measurements of THC and each of the BTEX-H chemicals (n = 120 for each of BTEX, 36 for n-hexane) differed substantially by area of the Gulf of Mexico and by time period that reflected different oil-spill related exposure opportunities. The correlations generally exceeded 0.5. Use of regression relationships to impute missing data resulted in the addition of >23 000 n-hexane and 541 observations for each of BTEX. The relationships were then used as priors for the calculation of exposure statistics while accounting for censored measurement data. CONCLUSIONS Taking advantage of observed relationships between THC and BTEX-H allowed us to develop robust exposure estimates where a large amount of data were missing, strengthening our exposure estimation process for the epidemiologic study.
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Affiliation(s)
- Caroline P Groth
- Department of Epidemiology and Biostatistics, WVU School of Public Health, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA,Author to whom correspondence should be addressed. Tel: (304) 581 - 1835; e-mail:
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, 3215 Market St, Philadelphia, PA 19104, USA
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California –Los Angeles, 650 Charles E. Young Drive, Los Angeles, CA 90095, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Patricia A Stewart
- Stewart Exposure Assessments, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA
| | - Harrison Quick
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, 3215 Market St, Philadelphia, PA 19104, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive MD A3-05, P.O. Box 12233, Research Triangle Park, NC 27709, USA
| | - Aaron Blair
- National Cancer Institute, 9609 Medical Center Drive, Building 9609 MSC 9760, Bethesda, MD 20892-9760, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive MD A3-05, P.O. Box 12233, Research Triangle Park, NC 27709, USA,Department of Epidemiology, University of North Carolina at Chapel Hill, 35 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive MD A3-05, P.O. Box 12233, Research Triangle Park, NC 27709, USA,Office of the Director, National Institute of Environmental Health Sciences, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Mark R Stenzel
- Exposure Assessment Applications, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA
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23
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Hu MD, Lawrence KG, Gall M, Emrich CT, Bodkin MR, Jackson WB, MacNell N, Kwok RK, Engel LS, Sandler DP. Natural hazards and mental health among US Gulf Coast residents. J Expo Sci Environ Epidemiol 2021; 31:842-851. [PMID: 33603095 PMCID: PMC8371064 DOI: 10.1038/s41370-021-00301-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 01/02/2021] [Accepted: 01/21/2021] [Indexed: 05/23/2023]
Abstract
BACKGROUND Individuals affected by disasters are at risk for adverse mental health sequelae. Individuals living in the US Gulf Coast have experienced many recent major disasters, but few studies have explored the cumulative burden of experiencing multiple disasters on mental health. OBJECTIVE The objective of this study was to evaluate the relationship between disaster burden and mental health. METHODS We used data from 9278 Gulf Long-term Follow-up Study participants who completed questionnaires on perceived stress, anxiety, depression, and post-traumatic stress disorder (PTSD) in 2011-2013. We linked 2005-2010 county-level data from the Spatial Hazard Events and Losses Database for the United States, a database of loss-causing events, to participant's home address. Exposure measures included total count of loss events as well as severity quantified as property/crop losses per capita from all hazards. We used multilevel modeling to estimate odds ratios (OR) and 95% confidence intervals (CI) for each exposure-outcome relationship. RESULTS Total count of loss events was positively associated with perceived stress (ORQ4:1.40, 95% CI:1.21-1.61) and was inversely associated with PTSD (ORQ4:0.66, 95% CI:0.45-0.96). Total duration of exposure was also associated with stress (ORQ4:1.16, 95% CI:1.01-1.33) but not with other outcomes. Severity based on cumulative fatalities/injuries was associated with anxiety (ORQ4:1.31, 95% CI:1.05-1.63) and stress (ORQ4:1.34, 95% CI:1.15-1.57), and severity based on cumulative property/crop losses was associated with anxiety (ORQ4:1.42, 95% CI:1.12-1.81), depression (ORQ4:1.22, 95% CI:0.95-1.57) and PTSD (ORQ4:1.99, 95% CI:1.44-2.76).
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Affiliation(s)
- Michael D Hu
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC, USA
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC, USA
| | - Melanie Gall
- Center for Emergency Management and Homeland Security, Arizona State University, Phoenix, AZ, USA
| | - Christopher T Emrich
- College of Community Innovation and Education, University of Central Florida, Orlando, FL, USA
| | | | | | | | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC, USA
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC, USA.
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24
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Holmgren SD, Boyles RR, Cronk RD, Duncan CG, Kwok RK, Lunn RM, Osborn KC, Thessen AE, Schmitt CP. Catalyzing Knowledge-Driven Discovery in Environmental Health Sciences through a Community-Driven Harmonized Language. Int J Environ Res Public Health 2021; 18:8985. [PMID: 34501574 PMCID: PMC8430534 DOI: 10.3390/ijerph18178985] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 01/10/2023]
Abstract
Harmonized language is critical for helping researchers to find data, collecting scientific data to facilitate comparison, and performing pooled and meta-analyses. Using standard terms to link data to knowledge systems facilitates knowledge-driven analysis, allows for the use of biomedical knowledge bases for scientific interpretation and hypothesis generation, and increasingly supports artificial intelligence (AI) and machine learning. Due to the breadth of environmental health sciences (EHS) research and the continuous evolution in scientific methods, the gaps in standard terminologies, vocabularies, ontologies, and related tools hamper the capabilities to address large-scale, complex EHS research questions that require the integration of disparate data and knowledge sources. The results of prior workshops to advance a harmonized environmental health language demonstrate that future efforts should be sustained and grounded in scientific need. We describe a community initiative whose mission was to advance integrative environmental health sciences research via the development and adoption of a harmonized language. The products, outcomes, and recommendations developed and endorsed by this community are expected to enhance data collection and management efforts for NIEHS and the EHS community, making data more findable and interoperable. This initiative will provide a community of practice space to exchange information and expertise, be a coordination hub for identifying and prioritizing activities, and a collaboration platform for the development and adoption of semantic solutions. We encourage anyone interested in advancing this mission to engage in this community.
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Affiliation(s)
- Stephanie D. Holmgren
- Office of Data Science, National Institute of Environmental Health Sciences (NIEHS), Durham, NC 27709, USA;
| | | | | | - Christopher G. Duncan
- Genes, Environment, and Health Branch, Division of Extramural Research and Training, NIEHS, Durham, NC 27709, USA;
| | - Richard K. Kwok
- Epidemiology Branch, Division of Intramural Research, NIEHS, Durham, NC 27709, USA;
- Office of the Director, NIEHS, Bethesda, MD 20892, USA
| | - Ruth M. Lunn
- Integrative Health Assessment Branch, Division of the National Toxicology Program, NIEHS, Durham, NC 27709, USA;
| | | | - Anne E. Thessen
- Environmental and Molecular Toxicology Department, Oregon State University, Corvallis, OR 97331, USA;
| | - Charles P. Schmitt
- Office of Data Science, National Institute of Environmental Health Sciences (NIEHS), Durham, NC 27709, USA;
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25
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Stenzel MR, Groth CP, Banerjee S, Ramachandran G, Kwok RK, Engel LS, Sandler DP, Stewart PA. Exposure Assessment Techniques Applied to the Highly Censored Deepwater Horizon Gulf Oil Spill Personal Measurements. Ann Work Expo Health 2021; 66:i56-i70. [PMID: 34417597 DOI: 10.1093/annweh/wxab060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 06/07/2021] [Accepted: 07/13/2021] [Indexed: 11/14/2022] Open
Abstract
The GuLF Long-term Follow-up Study (GuLF STUDY) is investigating potential adverse health effects of workers involved in the Deepwater Horizon (DWH) oil spill response and cleanup (OSRC). Over 93% of the 160 000 personal air measurements taken on OSRC workers were below the limit of detection (LOD), as reported by the analytic labs. At this high level of censoring, our ability to develop exposure estimates was limited. The primary objective here was to reduce the number of measurements below the labs' reported LODs to reflect the analytic methods' true LODs, thereby facilitating the use of a relatively unbiased and precise Bayesian method to develop exposure estimates for study exposure groups (EGs). The estimates informed a job-exposure matrix to characterize exposure of study participants. A second objective was to develop descriptive statistics for relevant EGs that did not meet the Bayesian criteria of sample size ≥5 and censoring ≤80% to achieve the aforementioned level of bias and precision. One of the analytic labs recalculated the measurements using the analytic method's LOD; the second lab provided raw analytical data, allowing us to recalculate the data values that fell between the originally reported LOD and the analytical method's LOD. We developed rules for developing Bayesian estimates for EGs with >80% censoring. The remaining EGs were 100% censored. An order-based statistical method (OBSM) was developed to estimate exposures that considered the number of measurements, geometric standard deviation, and average LOD of the censored samples for N ≥ 20. For N < 20, substitution of ½ of the LOD was assigned. Recalculation of the measurements lowered overall censoring from 93.2 to 60.5% and of the THC measurements, from 83.1 to 11.2%. A total of 71% of the EGs met the ≤15% relative bias and <65% imprecision goal. Another 15% had censoring >80% but enough non-censored measurements to apply Bayesian methods. We used the OBSM for 3% of the estimates and the simple substitution method for 11%. The methods presented here substantially reduced the degree of censoring in the dataset and increased the number of EGs meeting our Bayesian method's desired performance goal. The OBSM allowed for a systematic and consistent approach impacting only the lowest of the exposure estimates. This approach should be considered when dealing with highly censored datasets.
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Affiliation(s)
- Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, WVU School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California-Los Angeles, Los Angeles, CA, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.,Office of the Director, National Institute of Environmental Health Sciences, Bethesda, MD, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.,Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
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26
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Stenzel MR, Arnold SF, Ramachandran G, Kwok RK, Engel LS, Sandler DP, Stewart PA. Estimation of Airborne Vapor Concentrations of Oil Dispersants COREXIT™ EC9527A and EC9500A, Volatile Components Associated with the Deepwater Horizon Oil Spill Response and Clean-up Operations. Ann Work Expo Health 2021; 66:i202-i217. [PMID: 34409429 DOI: 10.1093/annweh/wxab056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 07/01/2021] [Accepted: 07/12/2021] [Indexed: 11/12/2022] Open
Abstract
The Deepwater Horizon (DWH) drilling unit explosion above the Macondo oil well on 20 April 2010 caused the release of approximately 4.9 million barrels (779 million L) of oil into the Gulf of Mexico. As part of a larger spill response and clean-up effort, approximately 1.84 million gallons (6.81 million L) of chemical dispersants COREXIT™ EC9500A and COREXIT™ EC9527A were applied to the resultant oil slicks through spraying on the water surface by plane and by vessel and through injection at the release source near the seabed. The GuLF STUDY is investigating the health effects of workers involved in the oil spill response and clean-up after the DWH explosion, and estimates of possible exposure to chemical dispersants were needed. Exposures were estimated to the volatile components of COREXIT™ EC9500A [petroleum distillates, hydrotreated light, and propylene glycol (PG)] and of COREXIT™ EC9527A [2-butoxyethanol (2-BE) and PG] using two of AIHA IHMOD2.0© mathematical modeling tools along with the dispersants' chemical and physical properties. Monte Carlo simulations were used to reflect uncertainty in input parameters with both the two-box, constant emission model and the near and mid field plume model for indoor and outdoor activities, respectively. Possible exposure scenarios considered various evaporation rates, sizes of the dispersant pool, wind speeds, and ventilation rates. For the two-box model, mean near field exposure estimates to 2-BE ranged from 0.9 to 5.7 ppm, while mean far field estimated exposures ranged from 0.3 to 3.5 ppm. Estimates of mean near field plume model exposures ranged from 0.01 to 3.7 ppm at 2.5 ft from the source, and <0.01 to 0.3 ppm at 10 ft from the source. Estimated exposures to PG were approximately 10% of the calculated 2-BE exposures and exposures to petroleum distillates about 40% higher than the 2-BE estimates. Results indicate that compared with current occupational exposure guidelines, overexposure to petroleum distillates and PG probably did not occur in our study, but under some conditions, for short periods, exposure to 2-BE may have exceeded the limits for peak exposures. These estimates were developed for use in job-exposure matrices to estimate exposures of workers having contact with dispersant vapors for the GuLF STUDY.
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Affiliation(s)
- Mark R Stenzel
- Exposure Assessment Applications, LLC, 6045 N. 27th St., Arlington, VA 22207, USA
| | - Susan F Arnold
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, 420 Delaware St. SE, Minneapolis, MN 55455, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St., Baltimore, MD 21205, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, MD A3-05, PO Box 12233, Research Triangle Park, NC 27709, USA.,Office of the Director, National Institute of Environmental Health Sciences, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Lawrence S Engel
- Office of the Director, National Institute of Environmental Health Sciences, 9000 Rockville Pike, Bethesda, MD 20892, USA.,Department of Epidemiology, University of North Carolina at Chapel Hill, 35 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, MD A3-05, PO Box 12233, Research Triangle Park, NC 27709, USA
| | - Patricia A Stewart
- Stewart Exposure Assessments, LLC, 6045 N. 27th St., Arlington, VA 22207, USA
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27
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Huynh TB, Groth CP, Ramachandran G, Banerjee S, Stenzel M, Blair A, Sandler DP, Engel LS, Kwok RK, Stewart PA. Estimates of Inhalation Exposures among Land Workers during the Deepwater Horizon Oil Spill Clean-up Operations. Ann Work Expo Health 2021; 66:i124-i139. [PMID: 34368831 PMCID: PMC8989042 DOI: 10.1093/annweh/wxab028] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 03/09/2021] [Accepted: 03/31/2021] [Indexed: 01/05/2023] Open
Abstract
Following the Deepwater Horizon oil spill disaster, thousands of workers and volunteers cleaned the shoreline across four coastal states of the Gulf of Mexico. For the GuLF STUDY, we developed quantitative estimates of oil-related chemical exposures [total petroleum hydrocarbons (THC), benzene, toluene, ethylbenzene, xylene, and n-hexane (BTEX-H)] from personal measurements on workers performing various spill clean-up operations on land. These operations included decontamination of vessels, equipment, booms, and personnel; handling of oily booms; hazardous waste management; beach, marsh, and jetty clean-up; aerial missions; wildlife rescue and rehabilitation; and administrative support activities. Exposure estimates were developed for unique groups of workers by (i) activity, (ii) state, and (iii) time period. Estimates of the arithmetic means (AMs) for THC ranged from 0.04 to 3.67 ppm. BTEX-H estimates were substantially lower than THC (in the parts per billion range). Both THC and BTEX-H estimates were substantially lower than their respective occupational exposure limits. The work group, 'Fueled engines' consistently was one of the higher exposed groups to THC and BTEX-H. Notable differences in the AM exposures were observed by activity, time and, to a lesser degree, by state. These exposure estimates were used to develop job-exposure matrices for the GuLF STUDY.
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Affiliation(s)
- Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, 3215 Market St., Philadelphia, PA 19004, USA,Author to whom correspondence should be addressed. Tel: +1-612-669-8234; e-mail:
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21218, USA
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California—Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA 90095, USA
| | - Mark Stenzel
- Exposure Assessment Applications, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA
| | - Aaron Blair
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Gaithersburg, MD 20892, USA
| | - Dale P Sandler
- Chronic Disease Epidemiology Group, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA
| | - Lawrence S Engel
- Chronic Disease Epidemiology Group, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA,Department of Epidemiology, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Richard K Kwok
- Chronic Disease Epidemiology Group, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA,Office of the Director, National Institute of Environmental Health Sciences, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Patricia A Stewart
- Stewart Exposure Assessments, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA
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Groth CP, Banerjee S, Ramachandran G, Stewart PA, Sandler DP, Blair A, Engel LS, Kwok RK, Stenzel MR. Methods for the Analysis of 26 Million VOC Area Measurements during the Deepwater Horizon Oil Spill Clean-up. Ann Work Expo Health 2021; 66:i140-i155. [PMID: 34184747 PMCID: PMC8989035 DOI: 10.1093/annweh/wxab038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 05/06/2021] [Accepted: 05/13/2021] [Indexed: 01/05/2023] Open
Abstract
The NIEHS GuLF STUDY is an epidemiologic study of the health of workers who participated in the 2010 Deepwater Horizon oil spill response and clean-up effort. Even with a large database of approximately 28 000 personal samples that were analyzed for total hydrocarbons (THCs) and other oil-related chemicals, resulting in nearly 160 000 full-shift personal measurements, there were still exposure scenarios where the number of measurements was too limited to rigorously assess exposures. Also available were over 26 million volatile organic compounds (VOCs) area air measurements of approximately 1-min duration, collected from direct-reading instruments on 38 large vessels generally located near the leaking well. This paper presents a strategy for converting the VOC database into hourly average air concentrations by vessel as the first step of a larger process designed to use these data to supplement full-shift THC personal exposure measurements. We applied a Bayesian method to account for measurements with values below the analytic instrument's limit of detection while processing the large database into average instrument-hour concentrations and then hourly concentrations across instruments on each day of measurement on each of the vessels. To illustrate this process, we present results on the drilling rig ship, the Discoverer Enterprise. The methods reduced the 26 million measurements to 21 900 hourly averages, which later contributed to the development of additional full-shift THC observations. The approach used here can be applied by occupational health professionals with large datasets of direct-reading instruments to better understand workplace exposures.
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Affiliation(s)
- Caroline P Groth
- Department of Epidemiology and Biostatistics, WVU School of Public Health, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA,Author to whom correspondence should be addressed. Tel: (304)-581-1835; e-mail:
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California–Los Angeles, 650 Charles E. Young Drive, Los Angeles, CA 90095, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Patricia A Stewart
- Stewart Exposure Assessments, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive.–MD A3-05, P.O. Box 12233, Research Triangle Park, NC 27709, USA
| | - Aaron Blair
- National Cancer Institute, 9609 Medical Center Drive, Building 9609 MSC 9760, Bethesda, MD 20892-9760, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive.–MD A3-05, P.O. Box 12233, Research Triangle Park, NC 27709, USA,Department of Epidemiology, University of North Carolina at Chapel Hill, 35 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive.–MD A3-05, P.O. Box 12233, Research Triangle Park, NC 27709, USA,Office of the Director, National Institute of Environmental Health Sciences, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Mark R Stenzel
- Exposure Assessment Applications, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA
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29
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Huynh TB, Groth CP, Ramachandran G, Banerjee S, Stenzel M, Blair A, Sandler DP, Engel LS, Kwok RK, Stewart PA. Estimates of Inhalation Exposures to Oil-Related Components on the Supporting Vessels During the Deepwater Horizon Oil Spill. Ann Work Expo Health 2021; 66:i111-i123. [PMID: 33791771 PMCID: PMC8989039 DOI: 10.1093/annweh/wxaa113] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/26/2020] [Accepted: 10/29/2020] [Indexed: 01/05/2023] Open
Abstract
The Deepwater Horizon oil spill response and clean-up (OSRC) involved over 9000 large and small vessels deployed in waters of the Gulf of Mexico across four states (Alabama, Florida, Louisiana, and Mississippi). For the GuLF STUDY, we developed exposure estimates of oil-related components for many work groups to capture a wide range of OSRC operations on these vessels, such as supporting the four rig vessels charged with stopping the spill at the wellhead; skimming oil; in situ burning of oil; absorbing and containing oil by boom; and environmental monitoring. Work groups were developed by: (i) vessel activity; (ii) location (area of the Gulf or state); and (iii) time period. Using Bayesian methods, we computed exposure estimates for these groups for: total hydrocarbons measured as total petroleum hydrocarbons (THC), benzene, toluene, ethylbenzene, xylene, and n-hexane (BTEX-H). Estimates of the arithmetic means for THC ranged from 0.10 ppm [95% credible interval (CI) 0.04, 0.38 ppm] in time periods 2 and 3 (16 July-30 September 2010) to 15.06 ppm (95% CI 10.74, 22.41 ppm) in time period 1a (22 April-15 May 2010). BTEX-H estimates were substantially lower (in the parts per billion range). Exposure levels generally fell over time and differed statistically by activity, location, and time for some groups. These exposure estimates have been used to develop job-exposure matrices for the GuLF STUDY.
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Affiliation(s)
- Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, 3215 Market St, Philadelphia PA 19004, USA
- Author to whom correspondence should be addressed. Tel: 612-669-8234; e-mail:
| | - Caroline P Groth
- Department of Biostatistics, School of Public Health, West Virginia University, One Medical Center Drive, Morgantown, WV 26506-9190, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21218, USA
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California—Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA 90095, USA
| | - Mark Stenzel
- Exposure Assessment Applications, 6045 N, 27th St, Arlington, LLC, Arlington, VA 22207, USA
| | - Aaron Blair
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Gaithersburg, MD 20892, USA
| | - Dale P Sandler
- Chronic Disease Epidemiology Group, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA
| | - Lawrence S Engel
- Chronic Disease Epidemiology Group, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Richard K Kwok
- Chronic Disease Epidemiology Group, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA
| | - Patricia A Stewart
- Stewart Exposure Assessments, 6045 N, 27th St, Arlington, LLC, Arlington, VA 22207, USA
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Hu MD, Lawrence KG, Bodkin MR, Kwok RK, Engel LS, Sandler DP. Neighborhood Deprivation, Obesity, and Diabetes in Residents of the US Gulf Coast. Am J Epidemiol 2021; 190:295-304. [PMID: 33524122 DOI: 10.1093/aje/kwaa206] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 09/20/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022] Open
Abstract
Socioeconomic status has been associated with cardiovascular disease risk factors. However, few studies have examined this relationship among populations in the US Gulf Coast region. We assessed neighborhood deprivation in relation to obesity and diabetes in 9,626 residents participating in the Gulf Long-Term Follow-Up Study (2011-present) who completed a home visit (2011-2013) with height, weight, waist, and hip measurements. Obesity was categorized as body mass index of at least 30, and diabetes was defined by doctor's diagnosis or prescription medication. Participant home addresses were linked to an established Area Deprivation Index and categorized into 4 levels (1 = least deprived). In adjusted, modified Poisson regression models, participants with greatest deprivation were more likely to have obesity compared with those with least deprivation (adjusted prevalence ratio (aPR) = 1.21, 95% confidence interval (CI): 1.08, 1.35), central obesity (aPR = 1.11, 95% CI: 1.04, 1.19), and diabetes (aPR = 1.49, 95% CI: 1.03, 2.14). Repeated analyses among a subgroup of participants (n = 3,016) whose hemoglobin A1C values were measured 3 years later indicated the association with diabetes (defined as diagnosis, medications, or hemoglobin A1C ≥ 6.5) was similar (aPR = 1.46, 95% CI: 1.14, 1.86). Results suggest neighborhood deprivation is associated with obesity and diabetes in a US region with high baseline prevalence.
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Huynh TB, Groth CP, Ramachandran G, Banerjee S, Stenzel M, Quick H, Blair A, Engel LS, Kwok RK, Sandler DP, Stewart PA. Estimates of Occupational Inhalation Exposures to Six Oil-Related Compounds on the Four Rig Vessels Responding to the Deepwater Horizon Oil Spill. Ann Work Expo Health 2020; 66:i89-i110. [PMID: 33009797 PMCID: PMC8989034 DOI: 10.1093/annweh/wxaa072] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/27/2020] [Accepted: 06/22/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The 2010 Deepwater Horizon (DWH) oil spill involved thousands of workers and volunteers to mitigate the oil release and clean-up after the spill. Health concerns for these participants led to the initiation of a prospective epidemiological study (GuLF STUDY) to investigate potential adverse health outcomes associated with the oil spill response and clean-up (OSRC). Characterizing the chemical exposures of the OSRC workers was an essential component of the study. Workers on the four oil rig vessels mitigating the spill and located within a 1852 m (1 nautical mile) radius of the damaged wellhead [the Discoverer Enterprise (Enterprise), the Development Driller II (DDII), the Development Driller III (DDIII), and the HelixQ4000] had some of the greatest potential for chemical exposures. OBJECTIVES The aim of this paper is to characterize potential personal chemical exposures via the inhalation route for workers on those four rig vessels. Specifically, we presented our methodology and descriptive statistics of exposure estimates for total hydrocarbons (THCs), benzene, toluene, ethylbenzene, xylene, and n-hexane (BTEX-H) for various job groups to develop exposure groups for the GuLF STUDY cohort. METHODS Using descriptive information associated with the measurements taken on various jobs on these rig vessels and with job titles from study participant responses to the study questionnaire, job groups [unique job/rig/time period (TP) combinations] were developed to describe groups of workers with the same or closely related job titles. A total of 500 job groups were considered for estimation using the available 8139 personal measurements. We used a univariate Bayesian model to analyze the THC measurements and a bivariate Bayesian regression framework to jointly model the measurements of THC and each of the BTEX-H chemicals separately, both models taking into account the many measurements that were below the analytic limit of detection. RESULTS Highest THC exposures occurred in TP1a and TP1b, which was before the well was mechanically capped. The posterior medians of the arithmetic mean (AM) ranged from 0.11 ppm ('Inside/Other', TP1b, DDII; and 'Driller', TP3, DDII) to 14.67 ppm ('Methanol Operations', TP1b, Enterprise). There were statistical differences between the THC AMs by broad job groups, rigs, and time periods. The AMs for BTEX-H were generally about two to three orders of magnitude lower than the THC AMs, with benzene and ethylbenzene measurements being highly censored. CONCLUSIONS Our results add new insights to the limited literature on exposures associated with oil spill responses and support the current epidemiologic investigation of potential adverse health effects of the oil spill.
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Affiliation(s)
- Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
| | - Caroline P Groth
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV 26506-9190, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA,Author to whom correspondence should be addressed. Tel: +1-410-502-0182; e-mail:
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California—Los Angeles, Los Angeles, CA 90095, USA
| | - Mark Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA 22207, USA
| | - Harrison Quick
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
| | - Aaron Blair
- National Cancer Institute, Occupational and Environmental Epidemiology Branch, Gaithersburg, MN 20892, USA
| | - Lawrence S Engel
- National Institute of Environmental Health Sciences, Epidemiology Branch, Research Triangle Park, NC 27709, USA,University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, NC 27599, USA
| | - Richard K Kwok
- National Institute of Environmental Health Sciences, Epidemiology Branch, Research Triangle Park, NC 27709, USA
| | - Dale P Sandler
- National Institute of Environmental Health Sciences, Epidemiology Branch, Research Triangle Park, NC 27709, USA
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Lawrence KG, Keil AP, Garantziotis S, Umbach DM, Stewart PA, Stenzel MR, McGrath JA, Jackson WB, Kwok RK, Curry MD, Engel LS, Sandler DP. Lung function in oil spill responders 4-6 years after the Deepwater Horizon disaster. J Toxicol Environ Health A 2020; 83:233-248. [PMID: 32249687 PMCID: PMC7837370 DOI: 10.1080/15287394.2020.1745111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Oil spill response and clean-up (OSRC) workers were exposed to hazardous airborne chemicals following the 2010 Deepwater Horizon disaster. The aim of this study was to evaluate lung function in workers 4-6 years following the disaster using a prospective cohort. Participants who completed two spirometry test sessions 1-3 years, and 4-6 years after the spill (N = 1,838) were included and forced expiratory volume in 1 s (FEV1; ml), forced vital capacity (FVC; ml), and ratio (FEV1/FVC; %) determined. Linear mixed models were utilized to estimate relationships between OSRC exposures and lung function 4-6 years after the spill and changes since the prior measurement. Despite suggestive reduced lung function at 1-3 years, at the 4-6-year exam workers with total hydrocarbon (THC) exposure 1-2.99 ppm and ≥3 ppm compared to those with ≤0.29 ppm exhibited higher FEV1 (β: 108 ml, 95% CI: 17, 198) and (β: 118 ml, 95% CI: 5, 232), respectively. Compared with support workers, those in higher exposed jobs displayed greater improvement in FEV1 between visits: cleanup on water (β: 143 ml, 95% CI: 35, 250), operations (β: 132 ml, 95% CI: 30, 234) and response (β: 149 ml, 95% CI: 43, 256). Greater FEV1 improvement was also associated with higher versus the lowest level THC exposure: 1-2.99 ppm (β: 134 ml, 95% CI: 57, 210) and ≥3 ppm (β: 205 ml, 95% CI: 109, 301). Lung function decrements seen shortly after the spill were no longer apparent 4-6 years later, with the greatest improvement among those with the highest exposures.
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Affiliation(s)
- Kaitlyn G. Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Alexander P. Keil
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Stavros Garantziotis
- Clinical Research Unit, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - David M. Umbach
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | | | | | | | | | - Richard K. Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | | | - Lawrence S. Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
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Quist AJL, Rohlman DS, Kwok RK, Stewart PA, Stenzel MR, Blair A, Miller AK, Curry MD, Sandler DP, Engel LS. Deepwater Horizon oil spill exposures and neurobehavioral function in GuLF study participants. Environ Res 2019; 179:108834. [PMID: 31703974 PMCID: PMC6878206 DOI: 10.1016/j.envres.2019.108834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/26/2019] [Accepted: 10/16/2019] [Indexed: 05/04/2023]
Abstract
INTRODUCTION The 2010 Deepwater Horizon (DWH) disaster exposed tens of thousands of oil spill response and cleanup (OSRC) workers to hydrocarbons and other hazardous chemicals. Some hydrocarbons, such as toluene and hexane, have been found to have acute adverse effects on the central nervous system in occupational settings. However, no studies have examined the association between oil spill exposures and neurobehavioral function. METHODS We used data from the Gulf Long-term Follow-up Study, a cohort of adults who worked on the DWH response and cleanup. Total hydrocarbon (THC) exposure attributed to oil spill cleanup work was estimated from a job-exposure matrix linking air measurement data to detailed cleanup work histories. Participants were also categorized into 6 job categories, or OSRC classes, based on their activity with the highest exposure. Neurobehavioral performance was assessed at a clinical exam 4-6 years after the spill. We used multivariable linear regression to evaluate relationships of ordinal THC levels and OSRC classes with 16 neurobehavioral outcomes. RESULTS We found limited evidence of associations between THC levels or OSRC classes and decreased neurobehavioral function, including attention, memory, and executive function. Workers exposed to ≥3 ppm THC scored significantly worse (difference1.0-2.9ppm = -0.39, 95% confidence interval (CI) = -0.74, -0.04) than workers exposed to <0.30 ppm THC for the digit span forward count test. There was also a possible threshold effect above 1 ppm THC for symbol digit test total errors (difference1.0-2.9ppm = -0.56 (95% CI = -1.13, -0.003), difference≥3.0ppm = -0.55 (95% CI = -1.20, 0.10)). Associations appeared to be stronger in men than in women. A summary latency measure suggested an association between more highly exposed jobs (especially support of operations workers) and decreased neurobehavioral function. CONCLUSION OSRC-related exposures were associated with modest decreases in neurobehavioral function, especially attention, memory, and executive function.
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Affiliation(s)
- Arbor J L Quist
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
| | - Diane S Rohlman
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Richard K Kwok
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | | | - Mark R Stenzel
- Exposure Assessment Applications LLC, Arlington, VA, USA
| | - Aaron Blair
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Aubrey K Miller
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | | | - Dale P Sandler
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA; National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
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Werder EJ, Sandler DP, Richardson DB, Emch ME, Kwok RK, Engel LS. Determinants of environmental styrene exposure in Gulf coast residents. J Expo Sci Environ Epidemiol 2019; 29:831-841. [PMID: 30546124 PMCID: PMC6763388 DOI: 10.1038/s41370-018-0098-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 09/25/2018] [Accepted: 10/19/2018] [Indexed: 05/26/2023]
Abstract
BACKGROUND In a previous study of exposure to oil-related chemicals in Gulf coast residents, we measured blood levels of volatile organic compounds. Levels of styrene were substantially elevated compared to a nationally representative sample. We sought to identify factors contributing to these levels, given the opportunities for styrene exposure in this community. METHODS We measured blood styrene levels in 667 Gulf coast residents and compared participants' levels of blood styrene to a nationally representative sample. We assessed personal and environmental predictors of blood styrene levels using linear regression and predicted the risk of elevated blood styrene (defined as above the National Health and Nutrition Examination Survey 95th percentile) using modified Poisson regression. We assessed exposure to styrene using questionnaire data on recent exposure opportunities and leveraged existing databases to assign ambient styrene exposure based on geocoded residential location. RESULTS These Gulf coast residents were 4-6 times as likely as the nationally representative sample to have elevated blood styrene levels. The change in styrene (log ng/mL) was 0.42 (95% CI: 0.34, 0.51) for smoking, 0.34 (0.09, 0.59) for time spent in vehicles and 1.10 (0.31, 1.89) for boats, and -0.41 (-0.73, -0.10) for fall/winter blood draws. Residential proximity to industrial styrene emissions did not predict blood styrene levels. Ambient styrene predicted elevated blood styrene in subgroups. CONCLUSIONS Personal predictors of increasing blood styrene levels included smoking, vehicle emissions, and housing characteristics. There was a suggestive association between ambient and blood styrene. Our measures of increased regional exposure opportunity do not fully explain the observed elevated blood styrene levels in this population.
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Affiliation(s)
- Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - David B Richardson
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Michael E Emch
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.
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Kwok RK, Berridge BR, Bucher JR, Collman GW, Hall JE, Jacobson ME, Long WC, Miller AK, Miller MF, Woychik RP, Zeldin DC. The Distinguished Legacy of Linda S. Birnbaum, an Environmental Health Champion. Environ Health Perspect 2019; 127:101001. [PMID: 31638836 PMCID: PMC6910772 DOI: 10.1289/ehp6332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Richard K Kwok
- Office of the Director, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, North Carolina, USA
- Epidemiology Branch, Division of Intramural Research, NIEHS, NIH, DHHS, Research Triangle Park, North Carolina, USA
| | - Brian R Berridge
- Division of National Toxicology Program, NIEHS, NIH, DHHS, Research Triangle Park, North Carolina, USA
| | - John R Bucher
- Division of National Toxicology Program, NIEHS, NIH, DHHS, Research Triangle Park, North Carolina, USA
| | - Gwen W Collman
- Division of Extramural Research and Training, NIEHS, NIH, DHHS, Research Triangle Park, North Carolina, USA
| | - Janet E Hall
- Clinical Research Branch, Division of Intramural Research, NIEHS, NIH, Research Triangle Park, North Carolina, USA
| | - Mary E Jacobson
- Office of the Director, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, North Carolina, USA
| | - W Chris Long
- Office of Management, NIEHS, NIH, DHHS, Research Triangle Park, North Carolina, USA
| | - Aubrey K Miller
- Office of the Director, NIEHS, NIH, DHHS, Bethesda, Maryland, USA
| | - Mark F Miller
- Office of the Director, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, North Carolina, USA
- U.S. Public Health Service Commissioned Corps, Research Triangle Park, North Carolina, USA
| | - Rick P Woychik
- Office of the Deputy Director, NIEHS, NIH, DHHS, Research Triangle Park, North Carolina, USA
| | - Darryl C Zeldin
- Division of Intramural Research, NIEHS, NIH, DHHS, Research Triangle Park, North Carolina, USA
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Kwok RK, Miller AK, Gam KB, Curry MD, Ramsey SK, Blair A, Engel LS, Sandler DP. Developing Large-Scale Research in Response to an Oil Spill Disaster: a Case Study. Curr Environ Health Rep 2019; 6:174-187. [PMID: 31376082 PMCID: PMC6699641 DOI: 10.1007/s40572-019-00241-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Research conducted in the wake of a disaster can provide information to help mitigate health consequences, support future recovery efforts, and improve resilience. However, a number of barriers have prevented time-sensitive research responses following previous disasters. Furthermore, large-scale disasters present their own special challenges due to the number of people exposed to disaster conditions, the number of groups engaged in disaster response, and the logistical challenges of rapidly planning and implementing a large study. In this case study, we illustrate the challenges in planning and conducting a large-scale post-disaster research study by drawing on our experience in establishing the Gulf Long-term Follow-up (GuLF) Study following the 2010 Deepwater Horizon disaster. We describe considerations in identifying at-risk populations and appropriate comparison groups, garnering support for the study from different stakeholders, obtaining timely scientific and ethics review, measuring and characterizing complex exposures, and addressing evolving community health concerns and unmet medical needs. We also describe the NIH Disaster Research Response (DR2) Program, which provides a suite of resources, including data collection tools, research protocols, institutional review board guidance, and training materials to enable the development and implementation of time-critical studies following disasters and public health emergencies. In describing our experiences related to the GuLF Study and the ongoing efforts through the NIH DR2 Program, we aim to help improve the timeliness, quality, and value of future disaster-related data collection and research studies.
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Affiliation(s)
- Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), NIH, Research Triangle Park, North Carolina, USA.
| | | | - Kaitlyn B Gam
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), NIH, Research Triangle Park, North Carolina, USA
| | - Matthew D Curry
- Social & Scientific Systems, Inc., Durham, North Carolina, USA
| | - Steven K Ramsey
- Social & Scientific Systems, Inc., Durham, North Carolina, USA
| | - Aaron Blair
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, Maryland, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), NIH, Research Triangle Park, North Carolina, USA
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), NIH, Research Triangle Park, North Carolina, USA
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Werder EJ, Engel LS, Blair A, Kwok RK, McGrath JA, Sandler DP. Blood BTEX levels and neurologic symptoms in Gulf states residents. Environ Res 2019; 175:100-107. [PMID: 31108353 PMCID: PMC6571161 DOI: 10.1016/j.envres.2019.05.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 05/12/2023]
Abstract
BACKGROUND The chemicals benzene, toluene, ethylbenzene, and xylenes (BTEX) are neuroactive. Exposures often co-occur because they share common sources. We examined neurologic effects of environmental BTEX exposure among U.S. Gulf coast residents taking into account concomitant exposures. METHODS We measured blood concentrations of BTEX in 690 Gulf state residents. Neurologic symptoms were ascertained via telephone interview. We used log-binomial regression to estimate associations between blood BTEX levels and self-reported neurologic symptoms independently for the presence of any neurologic, central (CNS), or peripheral nervous system (PNS) symptoms. We estimated associations in single chemical models mutually adjusted for co-occurring BTEX and used weighted quantile sum regression to model associations between the combined BTEX mixture and neurologic symptoms. RESULTS Half (49%) of participants reported at least one neurologic symptom. Each BTEX chemical was associated with increased CNS and PNS symptoms in single-chemical models comparing the highest to lowest quartile of exposure. After adjusting for coexposures, benzene was associated with CNS symptoms among all participants (PR = 2.13, 95% CI: 1.27, 3.57) and among nonsmokers (PR = 2.30, 95% CI: 1.35, 3.91). After adjusting for coexposures, associations with toluene were apparent only for reporting multiple PNS symptoms (PR = 2.00, 95% CI: 0.96, 4.16). In mixture analyses, a one-quartile increase in BTEX exposure was associated with neurologic symptoms (OR = 1.47, 95% CI: 1.11, 1.98). The weighted quantile sum index weighted benzene most heavily, which was consistent with single chemical analyses. CONCLUSIONS Increasing blood benzene concentration was associated with increased prevalence of CNS symptoms. In this sample, BTEX-associated neurologic effects are likely driven by exposure to benzene and, to a lesser extent, toluene.
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Affiliation(s)
- Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, NC, USA; Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Aaron Blair
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, NC, USA
| | | | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, NC, USA.
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Nethery RC, Sandler DP, Zhao S, Engel LS, Kwok RK. A joint spatial factor analysis model to accommodate data from misaligned areal units with application to Louisiana social vulnerability. Biostatistics 2019; 20:468-484. [PMID: 29659722 DOI: 10.1093/biostatistics/kxy016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 02/25/2018] [Indexed: 11/13/2022] Open
Abstract
With the threat of climate change looming, the public health community has an interest in identifying communities at the highest risk of devastation based not only on geographic features but also on social characteristics. Indices of community social vulnerability can be created by applying a spatial factor analysis to a set of relevant social variables measured for each community; however, current spatial factor analysis methodology is ill-equipped to handle spatially misaligned data. We introduce a joint spatial factor analysis model that can accommodate spatial data from two distinct partitions of a geographic space and identify a common set of latent factors underlying them. By defining the latent factors over the intersection of the two partitions, the model minimizes loss of information. Using simulated data constructed to mimic the spatial structure of our real data, we confirm the reliability of the model and demonstrate its superiority over competing ad hoc methods for dealing with misaligned data in spatial factor analysis. Finally, we construct an index of community social vulnerability for each census tract in Louisiana, a state prone to environmental disasters, which could be exacerbated by climate change, by applying the joint spatial factor analysis model to a set of misaligned social indicator data from the state. To demonstrate the utility of this index, we integrate it with Louisiana flood insurance claims data to identify communities that may be at particularly high risk during natural disasters, based on both social and geographic features.
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Affiliation(s)
- Rachel C Nethery
- Department of Biostatistics, Harvard University, T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, USA
| | - Shanshan Zhao
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, USA and Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, USA
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Gaston SA, Galea S, Cohen GH, Kwok RK, Rung AL, Peters ES, Jackson CL. Potential Impact of 2020 US Decennial Census Data Collection on Disaster Preparedness and Population Mental Health. Am J Public Health 2019; 109:1079-1083. [PMID: 31219714 DOI: 10.2105/ajph.2019.305150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Increasing in frequency and impact in the United States and worldwide, disasters can lead to serious mental health consequences. Although US census data are essential for disaster preparedness and the identification of community-level risk factors for adverse postdisaster mental health outcomes, the US Census Bureau faces many challenges as we approach 2020 Decennial Census data collection. Despite the utility of the information provided by the Census and American Community Survey (ACS), the 2020 US Census and subsequent ACS data face threats to validity. As a result, public health funding could be misallocated, and disaster preparedness and response efforts misinformed; this can also contribute to the worsening of mental health inequities, particularly in the context of disaster. Undercutting the Census and the ACS, rich data sources that allow representation of all people in the United States, is a step backward in our effort to mitigate the population mental health consequences of disasters.
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Affiliation(s)
- Symielle A Gaston
- Symielle A. Gaston, Richard K. Kwok, and Chandra L. Jackson are with the National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC. Sandro Galea and Gregory H. Cohen are with the School of Public Health, Boston University, Boston, MA. Ariane L. Rung and Edward S. Peters are with the Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans
| | - Sandro Galea
- Symielle A. Gaston, Richard K. Kwok, and Chandra L. Jackson are with the National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC. Sandro Galea and Gregory H. Cohen are with the School of Public Health, Boston University, Boston, MA. Ariane L. Rung and Edward S. Peters are with the Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans
| | - Gregory H Cohen
- Symielle A. Gaston, Richard K. Kwok, and Chandra L. Jackson are with the National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC. Sandro Galea and Gregory H. Cohen are with the School of Public Health, Boston University, Boston, MA. Ariane L. Rung and Edward S. Peters are with the Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans
| | - Richard K Kwok
- Symielle A. Gaston, Richard K. Kwok, and Chandra L. Jackson are with the National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC. Sandro Galea and Gregory H. Cohen are with the School of Public Health, Boston University, Boston, MA. Ariane L. Rung and Edward S. Peters are with the Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans
| | - Ariane L Rung
- Symielle A. Gaston, Richard K. Kwok, and Chandra L. Jackson are with the National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC. Sandro Galea and Gregory H. Cohen are with the School of Public Health, Boston University, Boston, MA. Ariane L. Rung and Edward S. Peters are with the Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans
| | - Edward S Peters
- Symielle A. Gaston, Richard K. Kwok, and Chandra L. Jackson are with the National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC. Sandro Galea and Gregory H. Cohen are with the School of Public Health, Boston University, Boston, MA. Ariane L. Rung and Edward S. Peters are with the Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans
| | - Chandra L Jackson
- Symielle A. Gaston, Richard K. Kwok, and Chandra L. Jackson are with the National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC. Sandro Galea and Gregory H. Cohen are with the School of Public Health, Boston University, Boston, MA. Ariane L. Rung and Edward S. Peters are with the Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans
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Runkle J, Svendsen ER, Hamann M, Kwok RK, Pearce J. Population Health Adaptation Approaches to the Increasing Severity and Frequency of Weather-Related Disasters Resulting From our Changing Climate: A Literature Review and Application to Charleston, South Carolina. Curr Environ Health Rep 2019; 5:439-452. [PMID: 30406894 DOI: 10.1007/s40572-018-0223-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Recent changes in our planetary climate have and will continue to challenge historical knowledge and risk assumptions for weather-related disasters. While the public health community is rapidly working to develop epidemiological approaches and tools to mitigate and adapt to these weather-related disasters, recent high-profile events have exposed gaps in knowledge and response efforts. Limited work has been done to assess the climate readiness of the local public health and healthcare community as it pertains to local response planning and adaptation measures in the event of a weather-related disaster. The purpose of this paper is to review the existing literature related to climate change, weather-related disasters, and population health approaches to adapt to climate-related changes in weather-related disasters at the local level. We highlight a brief case study to illustrate an example of a local approach to adaptation planning in a coastal community. RECENT FINDINGS Few studies have put forth quantitative disaster epidemiology tools to aid public health officials in preparing for and responding to these weather-related disaster events. There is a general lack of understanding within the public health community about the epidemiological tools which are available to assist local communities in their preparation for, response to, and recovery from weather-related disasters. Cities around the nation are already working to assess their vulnerability and resilience to weather-related disasters by including climate change in emergency preparedness plans and developing adaptation strategies, as well as equipping local hospitals, health departments and other critical public health systems with climate information. But more work is needed and public health funding is lagging to support local and state-level efforts in preparing for and adapting to weather-related disasters in the context of a changing climate. Our population health disaster preparedness programs need to be adapted to address the increasing risks to local public health resulting from our changing climate.
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Affiliation(s)
- Jennifer Runkle
- North Carolina State University, Raleigh, NC, USA. .,Cooperative Institute for Climate and Satellites-North Carolina (CICS-NC) at NOAA's National Centers for Environmental Information (NCEI), North Carolina State University, 151 Patton Avenue, Asheville, NC, 28801, USA.
| | - Erik R Svendsen
- Environmental Health Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Mark Hamann
- Department of Drug Discovery and Biomedical Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - John Pearce
- Environmental Health Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
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Strelitz J, Sandler DP, Keil AP, Richardson DB, Heiss G, Gammon MD, Kwok RK, Stewart PA, Stenzel MR, Engel LS. Exposure to Total Hydrocarbons During Cleanup of the Deepwater Horizon Oil Spill and Risk of Heart Attack Across 5 Years of Follow-up. Am J Epidemiol 2019; 188:917-927. [PMID: 30698634 DOI: 10.1093/aje/kwz017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/10/2019] [Accepted: 01/16/2019] [Indexed: 11/13/2022] Open
Abstract
Exposure to total hydrocarbons (THC) and volatile organic compounds from air pollution is associated with risk of coronary heart disease. THC exposure from oil spills might be similarly associated, but no research has examined this. We assessed the relationship between THC exposure during the response and cleanup of the Deepwater Horizon oil spill (Gulf of Mexico) and heart attack risk among 24,375 oil spill workers enrolled in the Gulf Long-Term Follow-up Study. There were 312 first heart attacks (self-reported physician-diagnosed myocardial infarction, or fatal coronary heart disease) ascertained during the study period (2010-2016). THC exposures were estimated using a job-exposure matrix incorporating self-reported activities and personal air measurements. We used Cox proportional hazards regression to estimate hazard ratios, with inverse-probability weights to account for confounding and censoring. Maximum THC levels of ≥0.30 parts per million (ppm) were associated with heart attack risk, with a 1.8-fold risk for exposure of ≥3.00 ppm versus <0.30 ppm (hazard ratio = 1.81, 95% confidence interval: 1.11, 2.95). The risk difference for highest versus lowest THC level was 10 excess cases per 1,000 workers. This is the first study of the persistent health impacts of THC exposure during oil spill work, and results support increased protection against oil exposure during cleanup of future spills.
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Affiliation(s)
- Jean Strelitz
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
| | - Alexander P Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Marilie D Gammon
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
| | | | - Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, Virginia
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
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Jelsema CM, Kwok RK, Peddada SD. Threshold Knot Selection for Large-Scale Spatial Models With Applications to the Deepwater Horizon Disaster. J STAT COMPUT SIM 2019; 89:2121-2137. [PMID: 32139950 PMCID: PMC7058149 DOI: 10.1080/00949655.2019.1610884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 04/19/2019] [Indexed: 10/26/2022]
Abstract
Large spatial datasets are typically modeled through a small set of knot locations; often these locations are specified by the investigator by arbitrary criteria. Existing methods of estimating the locations of knots assume their number is known a priori, or are otherwise computationally intensive. We develop a computationally efficient method of estimating both the location and number of knots for spatial mixed effects models. Our proposed algorithm, Threshold Knot Selection (TKS), estimates knot locations by identifying clusters of large residuals and placing a knot in the centroid of those clusters. We conduct a simulation study showing TKS in relation to several comparable methods of estimating knot locations. Our case study utilizes data of particulate matter concentrations collected during the course of the response and clean-up effort from the 2010 Deepwater Horizon oil spill in the Gulf of Mexico.
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Affiliation(s)
- Casey M Jelsema
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, 26505, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, 27709, USA
| | - Shyamal D Peddada
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, USA
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Lowe SR, McGrath JA, Young MN, Kwok RK, Engel LS, Galea S, Sandler DP. Cumulative Disaster Exposure and Mental and Physical Health Symptoms Among a Large Sample of Gulf Coast Residents. J Trauma Stress 2019; 32:196-205. [PMID: 30913348 PMCID: PMC6476642 DOI: 10.1002/jts.22392] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 12/11/2018] [Accepted: 12/18/2018] [Indexed: 11/06/2022]
Abstract
A large body of research has linked disaster exposure to adverse mental and physical health outcomes. Few studies, however, have explored the cumulative impact of exposure to multiple disasters. Participants (N = 8,366) from the National Institute of Environmental Health Sciences Gulf Long-Term Follow-Up Study were classified as having been exposed to both, either, or neither Hurricane Katrina and the Deepwater Horizon oil spill (DHOS). Participants also reported on a range of mental and physical health symptoms. Logistic regression models found that participants who were exposed to both disasters had significantly higher odds of probable generalized anxiety disorder, odds ratio (OR) = 1.72, 95% CI [1.52, 1.96]; major depression, OR = 1.53, 95% CI [1.32, 1.77]; and posttraumatic stress disorder, OR = 2.51, 95% CI [2.03, 3.10], than participants who were exposed to only one disaster, ps < .001. Additionally, a linear regression model found that participants who were exposed to both disasters had significantly more physical health symptoms at the time of the spill than those who were exposed to only one disaster, B = 0.99, SE = .20, p < .001. The results indicate that cumulative disaster exposure confers enhanced risk for adverse mental and physical health outcomes. The findings demonstrate that screening for prior exposure among disaster-affected individuals might identify those at greatest risk for adverse health outcomes.
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Affiliation(s)
- Sarah R. Lowe
- Department of Psychology, Montclair State University, Montclair, New Jersey, USA
| | - John A. McGrath
- Social & Scientific Systems, Inc., Silver Spring, Maryland, USA
| | - Megan N. Young
- Department of Psychology, Montclair State University, Montclair, New Jersey, USA
| | - Richard K. Kwok
- Social & Scientific Systems, Inc., Silver Spring, Maryland, USA
| | - Lawrence S. Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA,Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sandro Galea
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts USA
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
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Werder EJ, Sandler DP, Richardson DB, Emch ME, Kwok RK, Gerr FE, Engel LS. Environmental Styrene Exposure and Sensory and Motor Function in Gulf Coast Residents. Environ Health Perspect 2019; 127:47006. [PMID: 31009265 PMCID: PMC6785236 DOI: 10.1289/ehp3954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 03/01/2019] [Accepted: 03/05/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Although styrene is an established neurotoxicant at occupational exposure levels, its neurotoxicity has not been characterized in relation to general population exposures. Further, occupational research to date has focused on central nervous system impairment. OBJECTIVE We assessed styrene-associated differences in sensory and motor function among Gulf coast residents. METHODS We used 2011 National Air Toxics Assessment estimates of ambient styrene to determine exposure levels for 2,956 nondiabetic Gulf state residents enrolled in the Gulf Long-term Follow-up Study, and additionally measured blood styrene concentration in a subset of participants 1 to 2 y after enrollment ([Formula: see text]). Participants completed an enrollment telephone interview and a comprehensive test battery to assess sensory and motor function during a clinical follow-up exam 2 to 4 y later. Detailed covariate information was ascertained at enrollment via telephone interview. We used multivariate linear regression to estimate continuous differences in sensory and motor function, and log-binomial regression to estimate prevalence ratios for dichotomous outcomes. We estimated associations of both ambient and blood styrene exposures with sensory and motor function, independently for five unique tests. RESULTS Those participants in the highest 25% vs. lowest 75% of ambient exposure and those in the highest 10% vs. lowest 90% of blood styrene had slightly diminished visual contrast sensitivity. Mean vibrotactile thresholds were lower among those in the highest vs. lowest quartile of ambient styrene and the highest 10% vs. lowest 90% of blood styrene ([Formula: see text] log microns; 95% CI: [Formula: see text], [Formula: see text] and [Formula: see text] log microns; 95% CI: [Formula: see text], [Formula: see text], respectively). The highest vs. lowest quartile of ambient styrene was associated with significantly poorer postural stability, and (unexpectedly) with significantly greater grip strength. DISCUSSION We observed associations between higher styrene exposure and poorer visual, sensory, and vestibular function, though we did not detect associations with reduced voluntary motor system performance. Associations were more consistent for ambient exposures, but we also found notable associations with measured blood styrene. https://doi.org/10.1289/EHP3954.
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Affiliation(s)
- Emily J. Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Epidemiology Department, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - David B. Richardson
- Epidemiology Department, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Michael E. Emch
- Epidemiology Department, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Richard K. Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Fredric E. Gerr
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, Iowa
| | - Lawrence S. Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Epidemiology Department, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
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Gam KB, Kwok RK, Engel LS, Curry MD, Stewart PA, Stenzel MR, McGrath JA, Jackson WB, Jensen RL, Keil AP, Lichtveld MY, Miller AK, Sandler DP. Lung Function in Oil Spill Response Workers 1-3 Years After the Deepwater Horizon Disaster. Epidemiology 2019; 29:315-322. [PMID: 29381492 DOI: 10.1097/ede.0000000000000808] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Little is known about the effects of inhalation exposures on lung function among workers involved in the mitigation of oil spills. Our objective was to determine the relationship between oil spill response work and lung function 1-3 years after the Deepwater Horizon (DWH) disaster. METHODS We evaluated spirometry for 7,775 adults living in the Gulf states who either participated in DWH response efforts (workers) or received safety training but were not hired (nonworkers). At an enrollment interview, we collected detailed work histories including information on potential exposure to dispersants and burning oil/gas. We assessed forced expiratory volume in 1 second (FEV1; mL), forced vital capacity (FVC; mL), and the ratio (FEV1/FVC%) for differences by broad job classes and exposure to dispersants or burning oil/gas using multivariable linear and modified Poisson regression. RESULTS We found no differences between workers and nonworkers. Among workers, we observed a small decrement in FEV1 (Beta, -71 mL; 95% confidence interval [CI], -127 to -14) in decontamination workers compared with support workers. Workers with high potential exposure to burning oil/gas had reduced lung function compared with unexposed workers: FEV1 (Beta, -183 mL; 95% CI, -316 to -49) and FEV1/FVC (Beta, -1.93%; 95% CI, -3.50 to -0.36), and an elevated risk of having a FEV1/FVC in the lowest tertile (prevalence ratio, 1.38; 95% CI, 0.99 to 1.92). CONCLUSIONS While no differences in lung function were found between workers and nonworkers, lung function was reduced among decontamination workers and workers with high exposure to burning oil/gas compared with unexposed workers.
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Strelitz J, Keil AP, Richardson DB, Heiss G, Gammon MD, Kwok RK, Sandler DP, Engel LS. Self-reported myocardial infarction and fatal coronary heart disease among oil spill workers and community members 5 years after Deepwater Horizon. Environ Res 2019; 168:70-79. [PMID: 30278364 PMCID: PMC6263782 DOI: 10.1016/j.envres.2018.09.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 05/31/2023]
Abstract
BACKGROUND Chemical, physical and psychological stressors due to the 2010 Deepwater Horizon oil spill may impact coronary heart disease (CHD) among exposed populations. Using longitudinal information from two interviews in the Gulf Long Term Follow-up (GuLF) STUDY, we assessed CHD among oil spill workers and community members. OBJECTIVE To assess the associations between duration of oil spill clean-up work, residential proximity to the oil spill, and incidence of self-reported myocardial infarction or fatal CHD. METHODS Among respondents with two GuLF STUDY interviews (n = 21,256), there were 395 first incident heart disease events (self-reported myocardial infarction or fatal CHD) across 5 years. We estimated hazard ratios (HR) and 95% confidence intervals (95%CI) for associations with duration of oil spill clean-up work and residential proximity to the oil spill. To assess potential impacts of non-response, we compared covariate distributions for those who did (n = 21,256) and did not (n = 10,353) complete the second interview and used inverse probability (IP) of censoring weights to correct for potential non-response bias. RESULTS Living in proximity to the oil spill (vs. living further away) was associated with heart disease, with [HR(95%CI) = 1.30(1.01-1.67)] and without [1.29(1.00-1.65)] censoring weights. For work duration, hazard of heart disease appeared to be higher for those who worked > 180 days (vs. 1-30 days), with and without censoring weights [1.43(0.91-2.25) and 1.36(0.88-2.11), respectively]. Associations persisted throughout the 5-year follow-up. CONCLUSIONS Residential proximity to the spill and duration of clean-up work were associated with a suggested 29-43% higher hazard of heart disease events. Associations were robust to censoring.
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Affiliation(s)
- Jean Strelitz
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, Chapel Hill, NC 27599, USA.
| | - Alexander P Keil
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, Chapel Hill, NC 27599, USA
| | - David B Richardson
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, Chapel Hill, NC 27599, USA
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, Chapel Hill, NC 27599, USA
| | - Marilie D Gammon
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, Chapel Hill, NC 27599, USA
| | - Richard K Kwok
- National Institute of Environmental Health Sciences, NIH, DHHS, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA
| | - Dale P Sandler
- National Institute of Environmental Health Sciences, NIH, DHHS, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA
| | - Lawrence S Engel
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, Chapel Hill, NC 27599, USA; National Institute of Environmental Health Sciences, NIH, DHHS, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA
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Gam KB, Engel LS, Kwok RK, Curry MD, Stewart PA, Stenzel MR, McGrath JA, Jackson WB, Lichtveld MY, Sandler DP. Association between Deepwater Horizon oil spill response and cleanup work experiences and lung function. Environ Int 2018; 121:695-702. [PMID: 30317099 PMCID: PMC6400458 DOI: 10.1016/j.envint.2018.09.058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/29/2018] [Accepted: 09/30/2018] [Indexed: 05/15/2023]
Abstract
INTRODUCTION Oil spill response and cleanup (OSRC) workers had potentially stressful experiences during mitigation efforts following the 2010 Deepwater Horizon disaster. Smelling chemicals; skin or clothing contact with oil; heat stress; handling oily plants/wildlife or dead animal recovery; and/or being out of regular work may have posed a risk to worker respiratory health through psychological stress mechanisms. OBJECTIVE To evaluate the association between six potentially stressful oil spill experiences and lung function among OSRC workers 1-3 years following the Deepwater Horizon disaster, while controlling for primary oil spill inhalation hazards and other potential confounders. METHODS Of 6811 GuLF STUDY participants who performed OSRC work and completed a quality spirometry test, 4806 provided information on all exposures and confounders. We carried out complete case analysis and used multiple imputation to assess risk among the larger sample. Potentially stressful work experiences were identified from an earlier study of these workers. The lung function parameters of interest include the forced expiratory volume in 1 s (FEV1, mL), the forced vital capacity (FVC, mL) and the ratio (FEV1/FVC, %). RESULTS On average, participants in the analytic sample completed spirometry tests 1.7 years after the spill. Among workers with at least 2 acceptable FEV1 and FVC curves, workers with jobs that involved oily plants/wildlife or dead animal recovery had lower values for FEV1 (Mean difference: -53 mL, 95% CI: -84, -22), FVC (Mean difference: -45 mL, 95% CI: -81, -9) and FEV1/FVC (Mean difference: -0.44%, 95% CI: -0.80, -0.07) compared to unexposed workers in analyses using multiple imputation. CONCLUSIONS Workers involved in handling oily plants/wildlife or dead animal recovery had lower lung function than unexposed workers after accounting for other OSRC inhalation hazards.
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Affiliation(s)
- Kaitlyn B Gam
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States of America; Department of Global Environmental Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States of America; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States of America
| | - Matthew D Curry
- Social & Scientific Systems Inc., Durham, NC, United States of America
| | - Patricia A Stewart
- Stewart Exposure Assessments, LLC, Arlington, VA, United States of America
| | - Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA, United States of America
| | - John A McGrath
- Social & Scientific Systems Inc., Durham, NC, United States of America
| | - W Braxton Jackson
- Social & Scientific Systems Inc., Durham, NC, United States of America
| | - Maureen Y Lichtveld
- Department of Global Environmental Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States of America
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States of America.
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Werder EJ, Engel LS, Richardson DB, Emch ME, Gerr FE, Kwok RK, Sandler DP. Environmental styrene exposure and neurologic symptoms in U.S. Gulf coast residents. Environ Int 2018; 121:480-490. [PMID: 30278311 PMCID: PMC6712572 DOI: 10.1016/j.envint.2018.09.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/04/2018] [Accepted: 09/14/2018] [Indexed: 05/26/2023]
Abstract
BACKGROUND Styrene is an established neurotoxicant at occupational levels, but effects at levels relevant to the general population have not been studied. We examined the neurologic effects of environmental styrene exposure among U.S. Gulf coast residents. METHODS We used National Air Toxics Assessment (NATA) 2011 estimates of ambient styrene concentrations to assign exposure levels for 21,962 non-diabetic Gulf state residents, and additionally measured blood styrene concentration in a subset of participants (n = 874). Neurologic symptoms, as well as detailed covariate information, were ascertained via telephone interview. We used log-binomial regression to estimate prevalence ratios (PR) and 95% confidence intervals (95% CI) for cross-sectional associations between both ambient and blood styrene levels and self-reported neurologic symptoms. We estimated associations independently for ten unique symptoms, as well as for the presence of any neurologic, central nervous system (CNS), or peripheral nervous system (PNS) symptoms. We also examined heterogeneity of associations with estimated ambient styrene levels by race and sex. RESULTS One-third of participants reported at least one neurologic symptom. The highest quartile of estimated ambient styrene was associated with one or more neurologic (PR, 1.12; 95% CI: 1.07,1.18), CNS (PR, 1.17; 95% CI: 1.11,1.25), and PNS (PR, 1.16; 95% CI: 1.09,1.25) symptom. Results were less consistent for biomarker analyses, but blood styrene level was suggestively associated with nausea (PR, 1.78; 95% CI: 1.04, 3.03). In stratified analyses, we observed the strongest effects among non-White participants. CONCLUSIONS Increasing estimated ambient styrene concentration was consistently associated with increased prevalence of neurologic symptoms. Associations between blood styrene levels and some neurologic symptoms were suggestive. Environmental styrene exposure levels may be sufficient to elicit symptomatic neurotoxic effects.
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Affiliation(s)
- Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States of America; Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, United States of America
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States of America; Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, United States of America
| | - David B Richardson
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, United States of America
| | - Michael E Emch
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, United States of America
| | - Fredric E Gerr
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, IA, United States of America
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States of America
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States of America.
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Strelitz J, Engel LS, Kwok RK, Miller AK, Blair A, Sandler DP. Deepwater Horizon oil spill exposures and nonfatal myocardial infarction in the GuLF STUDY. Environ Health 2018; 17:69. [PMID: 30144816 PMCID: PMC6109340 DOI: 10.1186/s12940-018-0408-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 07/19/2018] [Indexed: 05/31/2023]
Abstract
BACKGROUND Workers involved in the response and clean-up of the 2010 Deepwater Horizon oil spill faced possible exposures to crude oil, burning oil, dispersants and other pollutants in addition to physical and emotional stress. These exposures may have increased risk of myocardial infarction (MI) among oil spill workers. METHODS Gulf Long-term Follow-up (GuLF) STUDY participants comprise individuals who either participated in the Deepwater Horizon response efforts or registered for safety training but were not hired. Oil spill-related exposures were assessed during enrollment interviews conducted in 2011-2013. We estimated risk ratios (RR) and 95% confidence intervals for the associations of clean-up work characteristics with self-reported nonfatal MI up to three years post-spill. RESULTS Among 31,109 participants without history of MI prior to the spill, 77% worked on the oil spill. There were 192 self-reported MI during the study period; 151 among workers. Among the full cohort, working on the oil spill clean-up (vs not working on the clean-up) and living in proximity to the oil spill (vs further away) were suggestively associated with a possible increased risk of nonfatal MI [RR: 1.22 (0.86, 1.73) and 1.15 (0.82, 1.60), respectively]. Among oil spill workers, working for > 180 days was associated with MI [RR for > 180 days (vs 1-30 days): 2.05 (1.05, 4.01)], as was stopping working due to heat [RR: 1.99 (1.43, 2.78)]. There were suggestive associations of maximum total hydrocarbon exposure ≥3.00 ppm (vs < 0.30 ppm) [RR: 1.69 (0.90, 3.19)] and working on decontaminating oiled equipment (vs administrative support) [1.72 (0.96, 3.09)] with nonfatal MI. CONCLUSION This is the first study to assess the associations between oil spill exposures and MI. Results suggest that working on the spill for > 180 days and stopping work due to heat increased risk of nonfatal MI. Future research should evaluate whether the observed associations are related to specific chemical exposures or other stressors associated with the spill.
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Affiliation(s)
- Jean Strelitz
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Lawrence S. Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC USA
| | - Richard K. Kwok
- National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC USA
| | - Aubrey K. Miller
- National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC USA
| | - Aaron Blair
- National Cancer Institute, NIH, DHHS, Bethesda, MD USA
| | - Dale P. Sandler
- National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC USA
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Gam KB, Kwok RK, Engel LS, Curry MD, Stewart PA, Stenzel MR, McGrath JA, Jackson WB, Jensen RL, Lichtveld MY, Miller AK, Sandler DP. Exposure to Oil Spill Chemicals and Lung Function in Deepwater Horizon Disaster Response Workers. J Occup Environ Med 2018; 60:e312-e318. [PMID: 29389810 PMCID: PMC5995629 DOI: 10.1097/jom.0000000000001292] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to assess the relationship between total hydrocarbon (THC) exposures attributed to oil spill clean-up work and lung function 1 to 3 years after the Deepwater Horizon (DWH) disaster. METHODS We used data from the GuLF STUDY, a large cohort of adults who worked on response to the DWH disaster and others who were safety trained but did not work. We analyzed data from 6288 workers with two acceptable spirometry tests. We estimated THC exposure levels with a job exposure matrix. We evaluated lung function using the forced expiratory volume in 1 second (FEV1; mL), the forced vital capacity (FVC; mL), and the FEV1/FVC ratio (%). RESULTS Lung function measures did not differ by THC exposure levels among clean-up workers. CONCLUSION We did not observe an association between THC exposure and lung function among clean-up workers 1 to 3 years following the DWH disaster.
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Affiliation(s)
- Kaitlyn B. Gam
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Department of Global Environmental Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Richard K. Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Lawrence S. Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | | | | | | | | | | | - Robert L. Jensen
- Pulmonary Division, University of Utah and Intermountain Medical Center, Salt Lake City, Utah
| | - Maureen Y. Lichtveld
- Department of Global Environmental Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Aubrey K. Miller
- Office of the Director, National Institute of Environmental Health Sciences, Bethesda, Maryland
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
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