Health Effects of Hurricane Ian

飓风伊恩对健康的影响

• 批准号: 10743484
• 负责人: Naresh Kumar
• 金额: $ 43.47万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-13 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10743484
• 关键词: Accident and Emergency department; Accidental Injury; Affect; Air Pollutants; Asthma; Attention; Biochemical; Birth; Businesses; Carbon Monoxide; Characteristics; Chemicals; Chronic Obstructive Pulmonary Disease; Clinical; Clinical Research; Collection; Communities; Data; Data Set; Diabetes Mellitus; Disease; Electricity; Emergency department visit; Employment; Endotoxins; Environment; Environmental Monitoring; Environmental Pollutants; Environmental Wind; Experimental Designs; Exposure to; Floods; Florida; Gasoline; Health; Health care facility; Heat Stress Disorders; High Performance Computing; Home; Hospital Records; Hospitals; Household; Housing; Hurricane; Hypersensitivity; Immune System Diseases; Individual; Infrastructure; Institutional Review Boards; Knowledge; Laboratories; Light; Location; Low Birth Weight Infant; Molds; Monitor; Morbidity - disease rate; Motivation; Natural Disasters; Natural experiment; Neighborhoods; Normalcy; Paralysed; Particulate Matter; Policies; Pollen; Pregnancy Outcome; Premature Birth; Property; Psychological Stress; Public Health; Records; Recovery; Reproduction spores; Research; Research Personnel; Resource Allocation; Resources; Services; Severities; Surveys; Symptoms; Time; Universities; Water; adverse birth outcomes; burden of illness; contaminated water; demographics; design; effective intervention; environmental stressor; health care availability; health management; improved; large datasets; mortality; nutrition; pollutant; recruit; repository; restoration; social; sociodemographics; stressor; water mold

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.

飓风极大地改变了自然景观，并引发了社会物理和生态环境的变化。 环境的生物化学特性（下文称为环境应激源）。这暴露了 新的环境压力源在飓风后持续数周至数月。 例如，失去家园、生意/就业、基础设施造成社会心理压力; 水损坏的建筑物增加了对生物气溶胶的暴露;一氧化碳和颗粒物（PM） 汽油发电机增加了对化学应激源的暴露。本项目旨在梳理出 飓风伊恩（2022年）的不利健康影响及其随时间的持续性。我们将评估 飓风伊恩的物理影响，研究环境压力源的变化及其 对发病率、死亡率和妊娠结局的相关影响。我们将使用陆地卫星8/9， MODIS卫星数据，以及来自佛罗里达电力和照明公司的数据。和联邦应急管理局来评估 飓风伊恩的影响我们会进行实地监测，以筛选环境压力因素， 飓风后6、9和12个月的移动的实验室。我们将招募240名受试者，按强度分层 监测室内和室外环境压力源，例如空气污染物、生物气溶胶 (mold和花粉孢子和内毒素）、基础设施和家庭公用设施的损害、损失持续时间 电力和其他设施，并筛选他们的健康（症状）和人口统计。我们有一个 批准IRB（20190217）从佛罗里达州的 OneFlorida临床研究联盟的健康（FLDH）、医院和急诊室记录 （OneFL）（2020-2024年）。OneFL由共同PI Shenkman指导，是全州最大的 医院记录，代表75%的佛罗里达人。我们已经获得了2015年的死亡率和出生数据 到2022年9月我们也将在2024年之前获得这些数据。我们将进行两组分析。一是 将评估特定原因的死亡率、发病率和不良出生结果，包括早产和低出生率。 出生体重，相对于时间和距离滞后暴露于飓风的影响，使用横截面 设计（即基于飓风的物理影响强度），然后使用自然实验 设计（即飓风前两年和飓风后两年，间隔3个月）， 社会人口统计学和邻里特征。其次，我们将研究不同的 疾病症状（过敏、糖尿病、哮喘和COPD等）使用调查数据，这将允许 评估漏报的疾病发病率负担，否则无法使用临床记录进行量化。 该项目将提高我们对飓风造成的疾病负担的认识， 制定有效干预战略，及时收集不良暴露数据和资源 因此，需要为管理飓风对健康的影响提供资金。