Exposure to volatile organic compounds and glycemic dysregulation among oil spill cleanup workers

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Project Abstract Diabetes, the clinical manifestation of glycemic dysregulation, leads to devastating complications as well as high medical costs for both the individual and society. Diabetes is increasing in prevalence and is disproportionately high among certain minority populations, and particularly among those of low socioeconomic status within those populations. Limited evidence suggests a role of environmental factors in the etiology of glycemic dysregulation and highlights the need for further research to better understand these relationships. Exposure to the BTEX-H (benzene, toluene, ethylbenzene, xylenes, and hexane) mixture is ubiquitous and is associated with glycemic dysregulation in epidemiologic and toxicological studies, but there are clear gaps in the literature. One gap is in the assessment and analysis of exposures; previous work primarily addresses the BTEX-H chemicals singly, and not all of the BTEX-H chemicals have been investigated as such. In contrast the BTEX-H chemicals are often experienced jointly and must be analyzed accordingly. Additionally, previous work has not incorporated individuals with large magnitude and varied exposures, making it difficult to isolate exposure effects. The proposed research will address these gaps by analyzing these associations in a well- characterized, prospective cohort of oil-spill workers with a wide range of exposures using mixtures analysis methods. The goals of this proposal are a) to examine real-world exposure effects of BTEX-H mixtures on incident diabetes up to 10 years post-exposure among a cohort of oil spill workers, b) to determine racial/ethnic and socioeconomic category specific exposure burden, outcome burden, and BTEX-H mixture to clinical diabetes associations, and c) to examine the effect of BTEX-H mixture exposure on glycemic dysregulation by relating the mixture to i) glycosylated hemoglobin levels and ii) change in glycosylated hemoglobin levels between two time points up to 5 years apart. My training plan will allow me to further develop the skills necessary to complete the proposed research and to pursue a successful career as an independent researcher. These skills are a) to become fluent in exposure mixtures theory and analysis methods; b) to develop skills in operationalizing socioeconomic and racial disparities processes in quantitative research; c) to further develop skills necessary for a strong scientific career by refining my written communication, expanding my professional network for collaboration, and further evolving my presentation strategies; and d) to obtain additional training in the responsible conduct of research, especially in the context of disaster and environmental epidemiology research. This training will propel me toward my goal of studying long-term health outcomes at the intersection of disasters, environmental exposures, and social disparities processes.