Health Effects of Hurricane Ian

飓风极大地改变了自然景观，并引发了社会物理和社会环境的变化 环境的生化特征(下称环境应激源)。这暴露了 受影响社区应对新的环境压力源，这种压力在飓风过后持续数周至数月。 例如，失去住房、商业/就业、基础设施导致社会心理压力； 水损坏的建筑物增加了生物气溶胶的暴露；一氧化碳和颗粒物(PM)来自 汽油发电机会增加化学应激源的暴露。这个项目的目的是梳理出 飓风伊恩(2022年)对健康的不利影响及其随时间的持续。我们将评估严重程度 关于飓风伊恩的身体影响，检查环境应激源的变化及其 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和 MODIS卫星数据，以及佛罗里达电力和照明公司的数据。和联邦应急管理局评估体力活动的强度 飓风伊恩的影响。我们将进行现场监测，以筛选环境应激源 移动实验室在飓风过后6个月、9个月和12个月。我们将招募240名受试者，按强度分层 监测飓风影响，监测室内和室外环境应激源，例如空气污染物、生物气溶胶 (霉菌和花粉孢子，以及内毒素)，对基础设施和家庭公用事业的破坏，损失的持续时间 对电力和其他设施进行监测，并对他们的健康(症状)和人口统计进行筛查。我们有一个 批准IRB(20190217)从佛罗里达州卫生部获得特定地点和时间的死亡率和出生数据 健康(FLDH)，以及来自One佛罗里达临床研究联盟的医院和急诊室记录 (OneFL)(2020-2024)。OneFL由共同导演Pi，Shenkman执导，是全州范围内最大的 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 至2022年9月。我们还将在2024年之前获得这些数据。我们将进行两组分析。首先，我们 将评估特定原因的死亡率、发病率和不良分娩结局，包括早产和低产 出生体重相对于时间和距离滞后的飓风影响暴露使用横截面 设计(即基于飓风物理影响的强度)，然后使用自然实验 设计(即飓风前两年和飓风后最多两年，每隔3个月调整一次) 社会人口学和邻里特征。第二，我们将考察不同 疾病症状(过敏、糖尿病、哮喘和慢性阻塞性肺病等)使用调查数据，这将允许 评估未报告的疾病发病率负担，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疾病负担的了解，并指导 制定有效干预战略，及时收集不良暴露数据和资源 管理飓风过后的健康影响所需的拨款。

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.