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1.
Curr Environ Health Rep ; 6(3): 174-187, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31376082

RESUMEN

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.


Asunto(s)
Planificación en Desastres/organización & administración , Desastres/prevención & control , Restauración y Remediación Ambiental/estadística & datos numéricos , Contaminación por Petróleo/estadística & datos numéricos , Humanos , Estudios de Casos Organizacionales , Salud Pública
2.
Environ Int ; 121(Pt 1): 695-702, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30317099

RESUMEN

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.


Asunto(s)
Contaminación Ambiental/efectos adversos , Volumen Espiratorio Forzado , Exposición Profesional/efectos adversos , Contaminación por Petróleo/efectos adversos , Capacidad Vital , Adulto , Desastres , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sudeste de Estados Unidos , Espirometría
3.
J Occup Environ Med ; 60(6): e312-e318, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29389810

RESUMEN

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.


Asunto(s)
Contaminantes Ocupacionales del Aire/toxicidad , Hidrocarburos/toxicidad , Exposición Profesional/efectos adversos , Industria del Petróleo y Gas , Adulto , Restauración y Remediación Ambiental , Femenino , Estudios de Seguimiento , Volumen Espiratorio Forzado , Golfo de México , Humanos , Masculino , Persona de Mediana Edad , Contaminación por Petróleo , Estudios Prospectivos , Espirometría , Capacidad Vital
4.
Epidemiology ; 29(3): 315-322, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29381492

RESUMEN

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.


Asunto(s)
Desastres , Exposición por Inhalación/análisis , Lesión Pulmonar/inducido químicamente , Lesión Pulmonar/fisiopatología , Industria del Petróleo y Gas , Contaminación por Petróleo , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sudeste de Estados Unidos , Espirometría
5.
J Expo Sci Environ Epidemiol ; 28(4): 358-370, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29288257

RESUMEN

To address concerns among Gulf Coast residents about ongoing exposures to volatile organic compounds, including benzene, toluene, ethylbenzene, o-xylene, and m-xylene/p-xylene (BTEX), we characterized current blood levels and identified predictors of BTEX among Gulf state residents. We collected questionnaire data on recent exposures and measured blood BTEX levels in a convenience sample of 718 Gulf residents. Because BTEX is rapidly cleared from the body, blood levels represent recent exposures in the past 24 h. We compared participants' levels of blood BTEX to a nationally representative sample. Among nonsmokers we assessed predictors of blood BTEX levels using linear regression, and predicted the risk of elevated BTEX levels using modified Poisson regression. Blood BTEX levels in Gulf residents were similar to national levels. Among nonsmokers, sex and reporting recent smoky/chemical odors predicted blood BTEX. The change in log benzene was -0.26 (95% CI: -0.47, -0.04) and 0.72 (0.02, 1.42) for women and those who reported odors, respectively. Season, time spent away from home, and self-reported residential proximity to Superfund sites (within a half mile) were statistically associated with benzene only, however mean concentration was nearly an order of magnitude below that of cigarette smokers. Among these Gulf residents, smoking was the primary contributor to blood BTEX levels, but other factors were also relevant.


Asunto(s)
Hidrocarburos Aromáticos/sangre , Fumar/sangre , Compuestos Orgánicos Volátiles/sangre , Adulto , Benceno , Monitoreo del Ambiente/métodos , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estaciones del Año , Sudeste de Estados Unidos , Encuestas y Cuestionarios , Tolueno , Adulto Joven
6.
Curr Environ Health Rep ; 3(4): 370-378, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27722880

RESUMEN

This review examines current research ascertaining the impact of the Deepwater Horizon oil spill on human health and ecosystems. Driven by the need to strategically focus research funding, the authors also assess the implications of those findings and promote a transdisciplinary research agenda addressing critical gaps.Epidemiologic studies conducted in workers and vulnerable communities in the spill's aftermath showed that non-chemical stressors affect resilience. Ecosystem-wise salt marsh species showed variability in structural and functional changes, attributed to species-specific tolerance, oil exposure, and belowground plant organs damage.Lacking baseline exposure assessment data hampers assessing the impact of chemical stressors. Research priorities include leveraging existing women/child dyads and worker cohorts to advance exposure characterization and counter early adverse effects in most vulnerable populations. Key policy gaps include mandated just-in-time emergency resources to ascertain immediate post-event exposures and contemporary legislation addressing human and ecosystem health in an integrated rather than silo fashion.


Asunto(s)
Ecosistema , Contaminación por Petróleo/efectos adversos , Petróleo/efectos adversos , Salud Pública , Golfo de México , Humanos , Petróleo/metabolismo , Plantas , Contaminantes Químicos del Agua/metabolismo , Humedales
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