Gulf Longitudinal Follow-up (GuLF) Study

海湾纵向随访（GuLF）研究

• 批准号: 9550167
• 负责人: Dale P Sandler
• 金额: $ 120.99万
• 依托单位: NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9550167
• 关键词: Acute; Address; Area; Behavioral; Benzene; Biological; Biological Markers; Blood; Cardiovascular system; Censuses; Cessation of life; Chemicals; Clinic; Clinical; Collection; County; Crime; DNA Damage; Data; Development; Disasters; Economics; Educational workshop; Enrollment; Environmental and Occupational Exposure; Epigenetic Process; Exposure to; Follow-Up Studies; Foundations; Future; Gene Expression; Goals; Health; Heat Stress Disorders; Hemoglobin; Hepatic; Home visitation; Hormones; Human; Hydrocarbons; Immunologics; Individual; International; Interview; Kidney; Life Style; Longitudinal Studies; Manuscripts; Measures; Mental Health; Mental Health Services; Methods; Mexico; Modeling; Monitor; Monograph; National Institute of Environmental Health Sciences; Neighborhoods; Nervous System Physiology; Occupations; Oils; Outcome; Paper; Participant; Patient Self-Report; Persons; Petroleum; Physiological; Population; Preparation; Publications; Publishing; Pulmonary function tests; Questionnaires; Renal function; Reporting; Reproductive Health; Research; Research Personnel; Resources; Risk; Safety; Saliva; Sampling; Socioeconomic Factors; Statistical Methods; Statistical Models; Stress; Subgroup; Substance abuse problem; Symptoms; Telephone Interviews; Testing; Time; Training; United States National Institutes of Health; Urine; Work; base; biobank; cohort; dermal exposure; design; experience; follow-up; immune function; indexing; interest; malignant neurologic neoplasms; meetings; member; physical conditioning; physical symptom; programs; pulmonary function; repository; respiratory; respiratory health; response; service utilization; statistics; study population; toxicant; traumatic event; volatile organic compound

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.

NIEHS正在进行一项长期研究，着眼于深水地平线漏油事件对不同反应人群的潜在健康影响。在2017财年，海湾研究(海湾长期跟踪研究)完成了对参与者的后续访谈(约在他们登记后2年)，回复率接近70%。2014年的死亡人数是通过与国家死亡指数的联系确定的。此外，居住在洛杉矶新奥尔良或AL莫比尔诊所60英里范围内的3403名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、尿液和唾液样本以供进一步研究。收集生物样本以评估免疫、肾脏和肾脏功能，并允许对在较早的家访和诊所提供样本的亚组进行纵向比较。较小的临床子研究，例如通过收集重复的唾液样本来评估应激激素的时间变化，也包括在内。最后，参与者完成了一项全面的临床精神健康评估，其中包括评估创伤事件和药物滥用的问卷模块，以及旨在评估参与者对精神健康服务利用情况的问题。第二次后续采访的计划已经开始，目标是在2018财年启动。 NIEHS调查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。开发了一个顺序的工作暴露矩阵，该矩阵表征了暴露于总烃的特征，作为漏油经历的一个标志。问卷数据被用来描述接触与燃烧石油和分散剂有关的毒物的特征。一些基本的手稿正在印刷中，初步曝光--使用这些曝光指标和在登记电话面试中自我报告的数据的结果论文已提交出版。正在进行的统计建模将导致制定特定于化学品的、依赖于时间的工作暴露指标，例如BTEX化学品和与漏油清理有关的其他暴露。正在开发空间模型，以考虑PM2.5和分散剂的暴露，并考虑小区域的社区特征，如社会经济因素或县内或人口普查区域一级的犯罪统计数据。在国家和国际会议和讲习班上介绍了确定暴露特征的方法和初步结果。 正在进行的基线数据分析侧重于心理健康、肺功能、心血管结果、呼吸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使用的方法的论文。还发表了一篇介绍墨西哥湾研究生物库和如何获取样本的论文，一篇描述顺序暴露指标的论文正在出版中。已发表的论文还介绍了根据泄漏发生时的环境采样数据和问卷答复为参与者制定暴露措施时使用的统计方法；已计划出版一本关于其他暴露评估指标(如皮肤暴露)和统计发展的论文专著。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精神健康症状的风险，以及环境暴露于挥发性有机化合物(如苯)可能与血液学效应(如降低血红蛋白浓度)有关。一篇发表在报纸上的论文描述了可能接触分散剂的工人的急性影响；这是第一份与这些化学物质有关的对人类健康影响的报告。最后，发表了论文，描述了从启动海湾研究的经验中吸取的教训，以及它如何可以作为未来灾害研究的典范，如国家卫生研究院灾害研究响应计划。