Environmental influences on pregnancy outcomes after Hurricane Michael

迈克尔飓风后环境对妊娠结局的影响

• 批准号: 9918368
• 负责人: Emily Wheeler Harville
• 金额: $ 22.93万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-18 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9918368
• 关键词: Address; Affect; Area; Awareness; Birth; Birth Certificates; Carbon Monoxide; Caring; Continuing Education; County; Data; Disaster Planning; Disasters; Environmental Exposure; Environmental Health; Environmental Pollutants; Environmental Pollution; Environmental Wind; Exposure to; Florida; Future; General Population; Goals; Health; Health Personnel; Health care facility; Healthcare; Human; Hurricane; Individual; Infant; Knowledge; Low Birth Weight Infant; Maps; Measurement; Methodology; Mothers; Neighborhood Health Center; Outcome; Pattern; Physicians; Poison Control Centers; Population; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Primary Health Care; Radar; Reporting; Research; Risk; Sampling; Speed; Time; Toxic Environmental Substances; Translations; Work; adverse birth outcomes; adverse outcome; base; design; harmful algal blooms; innovation; land cover; prenatal; prevent; primary outcome; programs; psychological stressor; response; skills; stressor; surveillance data

The natural world and human influences work together to create the devastation that follows a major disaster such as a hurricane. Although many studies have examined broad patterns of effects on pregnancy outcomes after disasters, the causes of adverse outcomes are not always clear, as there are interrelated environmental pollutant exposures, psychological stressors, and lack of health care. Without understanding which aspects of disaster exposure are the strongest contributors to adverse outcomes, it will not be possible to establish disaster responses that efficiently target the most important factors. The objective of this application is to examine effects of environmental (harmful algal bloom, carbon monoxide) exposures and generally encountered disaster exposures (power outages, storm damage) on pregnancy-related outcomes. Our central hypothesis is that severe exposure (defined by both magnitude and duration) to any of these stressors will be associated with worse outcomes. Our specific aims are to 1) Examine the relationship between environmental exposures (HAB and CO) and birth outcomes; 2) Assess the relationship between general disaster-related exposures (extent of damage, health care closings) and birth outcomes; 3) Determine which disaster- related exposures most strongly predict birth outcomes, and the combined effect of environmental and general disaster exposure; 4) Engage primary care practitioners to build EOH knowledge and skills by developing CME content on HAB and CO. We will accomplish these specific aims by comparing birth outcomes in areas exposed to these environmental predictors to areas and times that are unexposed. We will map exposure patterns based on ecological sampling and satellite-based estimates (HAB), CO surveillance data and poison control centers data, and hurricane damage reports (state of the art satellite measurements, disaster declarations, power outage data, health facility closing) and physical impacts measurements (storm surge inundation, wind speed, land cover change). Comparisons will be made across and within areas exposed to different levels of environmental contaminants, as well as pre-post hurricane. To promote translation and dissemination, we will develop CME content targeting the potential risks adverse pregnancy and birth outcomes associated with exposures to HAB and CO. At the end of the project, our expected outcome is to have identified the aspects of Hurricane Michael most associated with adverse birth outcomes. The proposed research represents a three-pronged innovative design- conceptually, by determining the potential cumulative risk of two integrated exposure domains - environmental contaminants and traditional disaster; methodologically, by using Synthetic Aperture Radar data to examine exposures to HAB during pregnancy in humans; and 3) translational, by utilizing time sensitive disaster-related environmental health findings for frontline CME.

自然界和人类的影响共同作用，创造了一个重大的破坏， 像飓风这样的灾难。 虽然许多研究已经检查了对 灾难后的怀孕结果，不良后果的原因并不总是清楚的，因为 是相互关联的环境污染物暴露，心理压力和缺乏健康 在乎如果不了解灾害风险的哪些方面是最大的贡献者， 如果不采取措施，将不可能建立有效针对 最重要的因素。本申请的目的是检查 环境（有害藻华、一氧化碳）暴露并通常遇到灾难 暴露（停电、风暴破坏）对妊娠相关结果的影响。 我们的核心假设是 严重暴露于这些压力源（由强度和持续时间定义）将是 与更糟糕的结果相关。 我们的具体目标是：（1）检查 环境暴露（HAB和CO）和出生结果; 2）评估一般 与灾害有关的风险（损害程度、医疗机构关闭）和生育结果; 3） 确定哪些与灾害有关的暴露最能预测出生结果， 环境和一般灾害暴露的影响; 4）让初级保健从业人员参与， 通过在HAB和CO上开发CME内容，建立EOH知识和技能。我们将实现这些目标 通过比较暴露于这些环境预测因素的地区的出生结果， 未曝光的区域和时间。我们将根据生态取样绘制暴露模式， 基于卫星的估计（HAB），CO监测数据和中毒控制中心数据，以及 飓风损失报告（最先进的卫星测量、灾害申报、电力 停电数据，卫生设施关闭）和物理影响测量（风暴潮淹没， 风速、土地覆盖变化）。 将在暴露于以下风险的地区之间和地区内进行比较： 不同程度的环境污染，以及飓风前后。 促进 翻译和传播，我们将制定针对CME内容的潜在风险不利 与接触有害藻华和一氧化碳有关的怀孕和分娩结果。在项目结束时， 我们的预期成果是确定飓风迈克尔与以下因素最相关的方面： 不良生育后果。 拟议的研究代表了一个三管齐下的创新设计- 从概念上讲，通过确定两个综合暴露领域的潜在累积风险- 环境污染物和传统灾害;方法上，通过使用合成孔径 雷达数据，以检查人类怀孕期间接触有害藻华的情况;以及3）转化， 利用对时间敏感的灾害相关环境卫生调查结果进行前线继续医学教育。

项目成果

Remotely sensed measures of Hurricane Michael damage and adverse perinatal outcomes and access to prenatal care services in the Florida panhandle.

• DOI: 10.1186/s12940-022-00924-1
• 发表时间: 2022-11-29
• 期刊: ENVIRONMENTAL HEALTH
• 影响因子: 6
• 作者: Pan, Ke;Gonsoroski, Elaina;Uejio, Christopher K.;Beitsch, Leslie;Sherchan, Samendra P.;Lichtveld, Maureen Y.;Harville, Emily W.
• 通讯作者: Harville, Emily W.

Effects of Hurricane Michael on Access to Care for Pregnant Women and Associated Pregnancy Outcomes.

• DOI: 10.3390/ijerph18020390
• 发表时间: 2021-01-06
• 期刊: International journal of environmental research and public health
• 作者: Pan K;Beitsch L;Gonsoroski E;Sherchan SP;Uejio CK;Lichtveld MY;Harville EW
• 通讯作者: Harville EW

Hurricane Michael and Adverse Birth Outcomes in the Florida Panhandle: Analysis of Vital Statistics Data.

• DOI: 10.1017/dmp.2021.367
• 发表时间: 2022-03-03
• 期刊: DISASTER MEDICINE AND PUBLIC HEALTH PREPAREDNESS
• 影响因子: 2.7
• 作者: Harville, Emily W.;Pan, Ke;Beitsch, Leslie;Sherchan, Samendra P.;Gonsoroski, Elaina;Uejio, Christopher;Lichtveld, Maureen Y.
• 通讯作者: Lichtveld, Maureen Y.