Gulf Longitudinal Follow-up (GuLF) Study

NIEHS正在进行一项长期研究，研究深水地平线石油泄漏对不同响应人群的潜在健康影响。在2017财年，GuLF研究（海湾长期随访研究）完成了对参与者的随访采访（大约在他们入学后2年），回复率接近70%。截至2014年的死亡人数是通过与国家死亡指数挂钩确定的。 此外，3,403名居住在新奥尔良，洛杉矶或移动的，AL诊所60英里内的讲英语的队列成员完成了临床检查。参与者接受了全面的肺功能测试，完成了一系列行为和生理测试以评估神经功能，并提供了血液，尿液和唾液样本用于进一步研究。收集生物样本，以评估免疫，肾脏和肾功能，并允许纵向比较的子集的人谁提供的样品在早期的家庭访视和诊所。较小的临床子研究，如通过收集重复唾液样本评估应激激素的时间变化，也包括在内。最后，参与者完成了一个全面的临床心理健康评估，其中包括问卷模块，以评估创伤事件和药物滥用，以及旨在评估参与者的心理健康服务利用的问题。第二次后续访谈的计划已经开始，目标是在2018财年启动。 NIEHS研究人员正在继续努力评估所有可用的环境和职业暴露监测数据，以便更全面地描述研究人群中的暴露特征。一个有序的工作接触矩阵的特点，暴露于总碳氢化合物作为一个标志的石油泄漏的经验。问卷调查数据被用来描述与燃烧石油和分散剂有关的有毒物质的接触情况。几篇基础手稿正在出版中，使用这些暴露指标和在招募电话访谈中自我报告的数据的初步确定结果论文已提交出版。正在进行的统计建模将导致化学品特定的，时间依赖的工作接触指标的发展，例如，BTEX化学品和其他接触有关的石油泄漏清理。正在开发空间模型，以说明PM2.5和分散剂的暴露情况，并说明小面积的社区特征，如社会经济因素或县内或人口普查区水平的犯罪统计数据。在国家和国际会议及讲习班上介绍了接触特征描述工作的方法和初步结果。 对基线数据的持续分析侧重于心理健康、肺功能、心血管结局、呼吸系统健康以及参与者在应对和清理工作中报告的一系列特定和非特定症状。已经发表了一篇描述队列和所用方法的论文。一份介绍GuLF研究生物储存库和如何获取样本的文件也已出版，一份介绍顺序暴露指标的文件正在印刷中。已发表的论文还描述了根据泄漏和问卷答复时的环境采样数据为参与者制定接触措施所使用的统计方法;已计划出版一本论文专著，介绍其他接触评估指标（如皮肤接触）和统计发展。已发表的论文描述了身体健康症状和社会经济因素如何导致工人出现心理健康症状的风险，以及环境暴露于挥发性有机化合物（如苯）如何可能与血液学效应（如血红蛋白浓度降低）相关。一篇即将出版的论文描述了可能接触分散剂的工人的急性影响;这是与这些化学品有关的人类健康影响的第一份报告。最后，发表了一些论文，介绍了从发起GuLF研究的经验中吸取的教训，以及它如何成为未来灾害研究的模型，如NIH灾害研究响应计划。

NIEHS is carrying out a long term study looking at the potential health effects of the Deepwater Horizon oil spill in various responder populations. During FY 2017, the GuLF STUDY (Gulf Long-term Follow-Up Study) completed follow-up interviews with participants (approximately 2 years after they enrolled), with a response rate of nearly 70%. Deaths through 2014 were identified through linkage with the National Death Index. Additionally, 3,403 English-speaking cohort members living within 60 miles of clinics in New Orleans, LA or Mobile, AL completed clinical examinations. Participants underwent comprehensive lung function testing, completed a battery of behavioral and physiological tests to assess neurological function, and provided blood, urine, and saliva samples for further study. Biological samples were collected to assess immune, renal, and kidney function and to allow for longitudinal comparisons for the subset of persons who provided samples at an earlier home visit and at the clinic. Smaller clinical sub-studies, such as assessing temporal changes in stress hormones through collection of repeat saliva samples, were also included. Finally, participants completed a comprehensive clinical mental health assessment which included questionnaire modules to assess traumatic events and substance abuse as well as questions designed to assess mental health services utilization by participants. Planning for a second follow-up interview has begun with the goal of launching in FY2018. NIEHS investigators are continuing efforts to evaluate all of the available environmental and occupational exposure monitoring data in order to more completely characterize exposures in the study population. An ordinal job-exposure matrix was developed that characterizes exposure to total hydrocarbons as a marker for oil spill experiences. Questionnaire data were used to characterize exposure to toxicants associated with burning oil and to dispersants. Several foundational manuscripts are in press and preliminary exposure-outcome papers using these exposure metrics and data self-reported at the enrollment telephone interview have been submitted for publication. Ongoing statistical modeling will lead to the development of chemical specific, time dependent job-exposure metrics, e.g. for the BTEX chemicals and other exposures related to oil spill cleanup. Spatial models are being developed to account for exposure to PM2.5 and dispersants, and to account for small-area neighborhood features such as socioeconomic factors or crime statistics within a county or at the census tract level. Approaches and preliminary results from exposure characterization efforts were presented at national and international meetings and workshops. Ongoing analysis of baseline data is focusing on mental health, pulmonary function, cardiovascular outcomes, respiratory health and a range of specific and non-specific symptoms reported by participants while working on the response and clean-up. A paper describing the cohort and methods used has been published. A paper describing the GuLF STUDY biorepository and how to access samples has also been published and a paper describing the ordinal exposure metrics is in press. Published papers also describe statistical methods used in developing exposure measures for participants based on environmental sampling data from the time of the spill and questionnaire responses; plans have been made to publish a monograph of papers with on additional exposure assessment metrics (e.g. dermal exposures) and statistical development. Published papers have described how physical health symptoms and socioeconomic factors contribute to workers risk for mental health symptoms and how ambient exposure to volatile organic compounds such as benzene may be associated with hematologic effects such as decreased hemoglobin concentration. A paper in press describes acute effects in workers with likely exposure to dispersants; this is the first report of human health effects associated with these chemicals. Finally, papers describing the lessons learned from the experience of launching the GuLF STUDY and how it can serve as a model for future disaster research such as the NIH Disaster Research Response program were published.