Health Effects of Hurricane Ian

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Hurricanes dramatically modify the physical landscape and trigger changes in the socio-physical and biochemical characteristics of the environment (environmental stressors hereafter). This exposes the affected communities to new environmental stressors, which persist for weeks to months after the hurricane. For example, loss of home, business/employment, infrastructure results in socio-psychological stress; mold in water damaged building elevates exposure to bioaerosols; carbon monoxide and particulate matter (PM) from gasoline-powered generators elevate exposure to chemical stressors. This project aims to tease out the adverse health impacts of Hurricane Ian (2022) and their persistence over time. We will assess the severity of the physical impacts of Hurricane Ian, examine changes in environmental stressors and their associated impacts on morbidity, mortality and pregnancy outcomes. We will use Landsat 8/9 and MODIS satellite data, and the data from Florida Power and Light. And FEMA to assess the intensity of physical impact of Hurricane Ian. We will conduct field monitoring to screen for environmental stressors using our mobile laboratory 6, 9 and 12 months after the hurricane. We will recruit 240 subjects stratified by the intensity of hurricane impact, and monitor indoor and outdoor environmental stressors, e.g. air pollutants, bioaerosols (mold and pollen spores, and endotoxins), damage to infrastructure and household utilities, duration of the loss of electricity and other facilities, and screen them for health (symptoms) and demographics. We have an approved IRB (20190217) to acquire location-time specific mortality and birth data from Florida Department of Health (FLDH), and hospital and emergency room record from OneFlorida Clinical Research Consortium (OneFL) (from 2020-2024). OneFL, directed by co-PI, Shenkman, is the largest statewide repository of hospital records, representing 75% of Floridians. We have already acquired mortality and birth data from 2015 to September 2022. We will also acquire these data until 2024. We will conduct two sets of analyses. First, we will assess cause-specific mortality, morbidity and adverse birth outcomes, including pre-term birth and low birth weight, with respect to time- and distance-lagged exposure to hurricane impacts using a cross-sectional design (i.e. based on the intensity of the physical impacts of hurricanes) and then using a natural experiment design (i.e. two years before and up to two years after the hurricane at an interval of 3 months) adjusting for socio-demographic and neighborhood characteristics. Second, we will examine the persistence of different disease symptoms (allergies, diabetes, asthma and COPD etc.) using the survey data, which will allow to assess underreported morbidity burden of disease, which otherwise cannot be quantified using clinical records. The project will improve our understanding of the disease burden of hurricanes and guide policies for developing strategies for effective interventions, timely collection of adverse exposure data and resource allocation needed to manage the health effects in the aftermath of hurricanes.