Health Effects of the Deepwater Horizon Disaster:the Coast Guard Responder Cohort

深水地平线灾难对健康的影响：海岸警卫队响应者队列

基本信息

批准号：
8222313
负责人：
Jennifer Ann Rusiecki
金额：
$ 35.65万
依托单位：
HENRY M. JACKSON FDN FOR THE ADV MIL/MED
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-03-01 至 2016-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8222313
关键词：
Accounting Acute Benzene Biological Biological Markers CYP2E1 gene Carcinogens Cardiovascular system Caring Clinical Clinical Data Coast Guard Code Cohort Analysis Cohort Studies Control Groups Coughing DNA Data Dermatologic Disasters Disease EPHX1 gene Electronic Health Record Endocrine Enrollment Epidemiology Event Frequencies Future GSTM1 gene GSTT1 gene Genes Genetic Polymorphism Genotype Health Heat Stress Disorders Hepatic Human ICD-9 Immunologics Individual Investigation Kidney Literature Longitudinal Studies Lower respiratory tract structure Medical Medical Surveillance Mental Health Metabolism Mexico Military Personnel Monitor NQO1 gene National Institute of Environmental Health Sciences Nested Case-Control Study Neurologic Newly Diagnosed Occupational Groups Occupations Oils Outcome Patient Self-Report Petroleum Population Recording of previous events Reporting Research Sampling Serum Severities Shortness of Breath Source Specimen Surveillance Program Surveys Symptoms Validation Work base clinical care cohort follow-up high risk interest member prevent psychologic respiratory response surveillance data

项目摘要

DESCRIPTION (provided by applicant): Little is known about the health effects from oil spills on response workers, despite the frequency of these events worldwide. The Deepwater Horizon (DWH) disaster, which released approximately 200 million gallons of crude oil into the Gulf of Mexico, was the largest oil spill in U.S. history. The unprecedented interagency response, led by the U.S. Coast Guard, involved over 7,000 Coast Guard workers, who carried out a wide range of response/clean-up activities. Of the few studies which have evaluated the human health consequences of oil spills, almost all have been cross-sectional. Respiratory symptoms, including cough and shortness of breath have been consistently reported among these studies. The longest follow- up to date of clean-up workers found lower respiratory tract symptoms persisting two years after response work ended. Other studies have found neurological, hematologic, psychological, genotoxic and endocrine effects. Additionally, benzene, a major component of crude oil, is a known hematotoxin and carcinogen, even at low exposure levels. Long-term studies of oil-spill responders are urgently needed. We propose a study of a cohort of Coast Guard DWH responders to elucidate the health consequences of oil spill exposures by capitalizing on valuable, existing military data. The key sources of existing data for this study include an exit survey completed by each responder, which provides self-reported exposure and health data; personal monitoring data on a subset of responders; objective clinical data in the form of Coast Guard electronic health records (EHRs) and ICD-9 coded surveillance data, which will enable pre- and post-spill comparisons; and serum samples of Coast Guard responders, which will provide DNA for genotyping. In addition, members of certain high risk occupations are enrolled in a surveillance program with more intensive periodic examinations, thus providing more detailed and comprehensive EHR data. These sources of objective health/bio-specimen data are collected and used by the military solely for individual clinical care or surveillance, but they will be invaluable for the proposed epidemiologic analyses. The objective of the proposed study is to identify health effects in the Coast Guard DWH responder cohort by analyzing data from the exit survey and by comparing pre- and post-DWH disease rates based on objective health data such as Coast Guard EHR entries and ICD-9 codes. The proposed Coast Guard cohort study has the ability that no other study to our knowledge will have to compare objective health data, post-spill to pre-spill. Additionally, it will efficiently lay the groundwork for future nested case-control studies of selected outcomes and for the targeted study of biomarkers of adverse biological effect using valuable pre- and post-spill serial serum samples. By carefully following up this cohort we may be able to prevent or mitigate long-term health consequences among these workers and provide much-needed information to help prevent adverse health effects in future oil spills. PUBLIC HEALTH RELEVANCE: The Deepwater Horizon disaster in 2010 was the largest oil spill in U.S. history. The proposed study of a cohort of Coast Guard Deepwater Horizon responders presents an extraordinary opportunity for elucidating the health consequences of oil spill exposures. Our proposed study will take advantage of existing data, including objective pre- and post-spill clinical information and serum samples, to investigate a wide range of health outcomes, based on the very limited epidemiologic literature on oil spills.

描述（由申请人提供）：尽管这些事件在全球范围内发生了频率，但对漏油对响应工人的健康影响知之甚少。 Deepwater Horizon（DWH）灾难是美国历史上最大的石油漏油事件，该灾难向墨西哥湾释放了约2亿加仑的原油。由美国海岸警卫队领导的前所未有的机构间反应涉及7,000多名海岸警卫队工人，他们进行了广泛的响应/清理活动。在少数评估了溢油的人类健康后果的研究中，几乎都是横断面的。在这些研究中，始终报道了呼吸道症状，包括咳嗽和呼吸急促。最新的最新的清理工人的随访发现，在反应工作结束两年后，下呼吸道症状持续存在。其他研究发现神经，血液学，心理，遗传毒性和内分泌作用。此外，即使在低暴露水平下，苯是原油的主要组成部分，是一种已知的血毒素和致癌物。迫切需要对溢油响应者进行长期研究。我们提出了一项研究海岸警卫队DWH响应者队列的研究，以通过利用有价值的现有军事数据来阐明溢油暴露的健康后果。这项研究的现有数据的主要来源包括每个响应者完成的退出调查，该调查提供了自我报告的暴露和健康数据；个人监控数据的一部分响应者；海岸警卫队电子健康记录（EHRS）和ICD-9编码的监视数据的形式的客观临床数据，这将实现爆发前后的比较；以及海岸警卫队反应者的血清样品，这将为基因分型提供DNA。此外，某些高风险职业的成员还参加了一项监视计划，并进行了更深入的周期性检查，从而提供了更详细和更全面的EHR数据。这些客观健康/生物特异性数据的来源仅由军方仅用于个人临床护理或监视，但对于拟议的流行病学分析将是无价的。拟议的研究的目的是通过分析退出调查中的数据并根据客观健康数据（例如海岸警卫队EHR EHR条目和ICD-9代码）进行比较，通过分析退出调查中的数据和DWH疾病率来鉴定海岸警卫队DWH响应者队列中的健康影响。拟议中的海岸警卫队队列研究具有我们所知的其他研究将不得不比较客观健康数据的能力，即溢出后溢出。此外，它将有效地为所选结果的未来嵌套病例对照研究和使用有价值的漏皮前和后跨后串行血清样品样品对生物学效应的生物标志物进行靶向研究。通过仔细跟踪该队列，我们可能能够预防或减轻这些工人的长期健康后果，并提供急需的信息，以帮助防止未来的漏油事件中的不良健康影响。公共卫生相关性：2010年的Deepwater Horizon灾难是美国历史上最大的漏油事件。对海岸警卫队深水地平线响应者队列的拟议研究为阐明漏油事件的健康后果提供了一个非凡的机会。我们提出的研究将利用现有数据，包括客观的临床前后临床信息和血清样本，以基于非常有限的漏油性流行病学文献来研究广泛的健康结果。