The human health effects of harmful algal blooms in Florida: The importance of high resolution data

Harmful algal blooms (HABs) have been found to cause increases in healthcare visits for a variety of illnesses to humans if exposure and contact is sufficient. We use a more comprehensive dataset than previously implemented in prior literature to better isolate visits by healthcare facility type and proximity to bloom. Using a difference-in-differences model, our results suggest HABs cause an increase of 23.67 healthcare admissions per zip code per month across four HAB-related diagnoses. This impact is a 3,000% increase over baseline non-bloom times and an increase in monthly healthcare costs of about $250,000 for the entire impacted area. Our data include inpatient non-emergency and outpatient healthcare visits, which account for over 60% of all HAB-related healthcare visits, meaning that prior literature that has not measured those facilities has greatly underestimated HAB health impacts.

The effects of moderate concentrations of Karenia brevis on stone crab reproduction

The stone crab, Menippe mercenaria, supports a commercial fishery along Florida's Gulf coast where harmful algae blooms, known as red tides (Karenia brevis) develop. Red tides occur nearly annually and can overlap with the stone crab reproductive season. We determined the impact of moderate red tide (K. brevis) concentrations (∼105 cells L-1) on stone crab embryo development, hatching success, female stress, hatch duration, and larval survival. Crabs and larvae were exposed to a control (no K. brevis) or moderate concentrations of K. brevis. No difference in embryo development or hatching success was observed. Stress was elevated in the K. brevis treatment, resulting in prolonged hatching relative to the control. Larval survival was reduced in K. brevis relative to the control. Moderate concentrations of K. brevis results in sublethal effects on stone crabs and reduces larval survival, suggesting that mitigation that reduces bloom concentrations could provide relief to stone crab populations.

The effects of prolonged exposure to hypoxia and Florida red tide (Karenia brevis) on the survival and activity of stone crabs

Florida red tides are harmful algae blooms caused by the dinoflagellate Karenia brevis, which occur along Florida's gulf coast almost annually. In recent years Florida red tide blooms have become more common, frequent, and intense. Florida's southwest coast, from Manatee to Collier County, has experienced repeated and prolonged K. brevis blooms since 2011 with the most recent bloom in 2017 lasting 17 months and resulting in both hypoxic and anoxic events. We therefore determined the survival and level of lethargy (e.g., lack of responsiveness or reduction in behavioral reactions) of sublegal stone crabs to K. brevis and hypoxia as both singular and simultaneous stressors. Crabs were randomly assigned to one of six treatments that included: 1) high concentration of toxic K. brevis (> 1 million cells L^-1) maintained at normoxic levels (7.2 mg L^-1 ± S.D. 0.47 dissolved oxygen), 2) moderate hypoxia (1.6 mg L^-1 ± S.D. 0.42 dissolved oxygen) with no K. brevis, 3) moderate hypoxia (1.5 mg L^-1 ± S.D. 0.43 dissolved oxygen) with a high concentration of K. brevis, 4) severe hypoxia with no K. brevis (0.69 mg L^-1 ± S.D. 0.36 dissolved oxygen), 5) severe hypoxia (0.63 mg L^-1 ± S.D. 0.40 dissolved oxygen) with a high concentration of K. brevis, and 6) a normoxic control (7.3 mg L^-1 ± S.D. 0.61 dissolved oxygen) with no K. brevis. Survival and stone crab lethargy or responsiveness was monitored every 10-12 h for six days. Crabs simultaneously exposed to K. brevis and severe hypoxia exhibited a 43% decrease in survival and experienced increased lethargy within 24 h relative to the control (7% decrease in survival, no increase in lethargy). The increase in stress level and sluggish behavior during exposure to hypoxia was evident by a general lack of responsiveness or movement which indicates that nearshore populations of stone crabs are unlikely to emigrate away from such conditions suggesting that future harvests may be reduced following prolonged K. brevis blooms and hypoxic events.

The effects of red tide (Karenia brevis) on reflex impairment and mortality of sublegal Florida stone crabs, Menippe mercenaria

The Florida stone crab, Menippe mercenaria, is a major commercial fishery that occurs primarily along Florida's west coast, where harmful algal blooms of Karenia brevis frequently develop. To determine sublethal and lethal effects of K. brevis on M. mercenaria, we exposed sublegal stone crabs to three seawater treatments in laboratory conditions: no K. brevis (control), a low-toxin K. brevis strain (Wilson LT), and a toxic K. brevis (New Pass strain). Total food consumed, reflex impairment and survivorship of each crab was monitored throughout the nine-day experiment. Crabs in the toxic treatment consumed 67% less food. The probability of an individual losing a reflex significantly increased with time (days), and there was a 42% decrease in survivorship in the toxic treatment. This is the first study to demonstrate negative effects of K. brevis on the stone crab, presenting the critical need of further investigation to fully understand how red tide may impact sustainability of the fishery.

Human responses to Florida red tides: policy awareness and adherence to local fertilizer ordinances

To mitigate the damages of natural hazards, policy responses can be beneficial only if they are effective. Using a self-administered survey approach, this paper focuses on the adherence to local fertilizer ordinances (i.e., county or municipal rules regulating the application of fertilizer to private lawns or facilities such as golf courses) implemented in jurisdictions along the Southwest Florida coast in response to hazardous blooms of Florida red tides (Karenia brevis). These ordinances play a role in the context of evolving programs of water pollution control at federal, state, water basin, and local levels. With respect to policy effectiveness, while the strength of physical linkages is of critical importance, the extent to which humans affected are aware of and adhere to the relevant rules, is equally critical. We sought to understand the public's depth of understanding about the rationales for local fertilizer ordinances. Respondents in Sarasota, Florida, were asked about their fertilizer practices in an area that has experienced several major blooms of Florida red tides over the past two decades. A highly educated, older population of 305 residents and "snowbirds" reported relatively little knowledge about a local fertilizer ordinance, its purpose, or whether it would change the frequency, size, or duration of red tides. This finding held true even among subpopulations that were expected to have more interest in or to be more knowledgeable about harmful algal blooms. In the face of uncertain science and environmental outcomes, and with individual motivations at odds with evolving public policies, the effectiveness of local community efforts to decrease the impacts of red tides may be compromised. Targeted social-science research on human perceptions about the risks of Florida red tides and education about the rationales for potential policy responses are warranted.

The human health effects of Florida red tide (FRT) blooms: an expanded analysis

Human respiratory and digestive illnesses can be caused by exposures to brevetoxins from blooms of the marine alga Karenia brevis, also known as Florida red tide (FRT). K. brevis requires macro-nutrients to grow; although the sources of these nutrients have not been resolved completely, they are thought to originate both naturally and anthropogenically. The latter sources comprise atmospheric depositions, industrial effluents, land runoffs, or submerged groundwater discharges. To date, there has been only limited research on the extent of human health risks and economic impacts due to FRT. We hypothesized that FRT blooms were associated with increases in the numbers of emergency room visits and hospital inpatient admissions for both respiratory and digestive illnesses. We sought to estimate these relationships and to calculate the costs of associated adverse health impacts. We developed environmental exposure-response models to test the effects of FRT blooms on human health, using data from diverse sources. We estimated the FRT bloom-associated illness costs, using extant data and parameters from the literature. When controlling for resident population, a proxy for tourism, and seasonal and annual effects, we found that increases in respiratory and digestive illnesses can be explained by FRT blooms. Specifically, FRT blooms were associated with human health and economic effects in older cohorts (≥55 years of age) in six southwest Florida counties. Annual costs of illness ranged from $60,000 to $700,000 annually, but these costs could exceed $1.0 million per year for severe, long-lasting FRT blooms, such as the one that occurred during 2005. Assuming that the average annual illness costs of FRT blooms persist into the future, using a discount rate of 3%, the capitalized costs of future illnesses would range between $2 and 24 million.

Florida Red Tide Knowledge and Risk Perception: Is there a need for tailored messaging?

Harmful algal blooms of the toxic dinoflagellate, Karenia brevis, occur throughout the Gulf of Mexico. Recent research efforts sponsored by the National Institute of Environmental Health Sciences (NIEHS) and others found that Florida red tide causes both acute and possibly chronic health effects from the toxic aerosols. Florida red tide also demonstrated significant social and economic impacts to both coastal residents and visitors. In conjunction with the research, persistent outreach efforts were conducted over the 11 year period. The goal of this project was to assess potential needs for tailored messaging needed among different red tide information user groups. Survey participants included 303 local residents, both with asthma and without, and 'snowbirds (seasonal residents that reside in the Sarasota area for more than 3 months but less than 6 months/year), also both with asthma and without. The questionnaire assessed Florida red tide knowledge and risk perception regarding Florida red tide using items drawn from two previously published surveys to allow comparison. Our results reveal that overall knowledge of Florida red tide has not changed. We found that knowledge was consistent across our selected groups and also did not vary by age, gender and education level. However, knowledge regarding consumption of seafood during Florida red tide has declined. Risk perception increased significantly for people who have asthma. Individuals responsible for public health communication regarding Florida red tide and human health concerns need to continue to pursue more effective outreach messages and delivery methods.

Evaluation of harmful algal bloom outreach activities

With an apparent increase of harmful algal blooms (HABs) worldwide, healthcare providers, public health personnel and coastal managers are struggling to provide scientifically-based appropriately-targeted HAB outreach and education. Since 1998, the Florida Poison Information Center-Miami, with its 24 hour/365 day/year free Aquatic Toxins Hotline (1-888-232-8635) available in several languages, has received over 25,000 HAB-related calls. As part of HAB surveillance, all possible cases of HAB-related illness among callers are reported to the Florida Health Department. This pilot study evaluated an automated call processing menu system that allows callers to access bilingual HAB information, and to speak directly with a trained Poison Information Specialist. The majority (68%) of callers reported satisfaction with the information, and many provided specific suggestions for improvement. This pilot study, the first known evaluation of use and satisfaction with HAB educational outreach materials, demonstrated that the automated system provided useful HAB-related information for the majority of callers, and decreased the routine informational call workload for the Poison Information Specialists, allowing them to focus on callers needing immediate assistance and their healthcare providers. These results will lead to improvement of this valuable HAB outreach, education and surveillance tool. Formal evaluation is recommended for future HAB outreach and educational materials.