1
|
Sweeney MR, Nichols HB, Jones RR, Olshan AF, Keil AP, Engel LS, James P, Sandler DP, White AJ, Jackson CL. Exposure to indoor light at night in relation to multiple dimensions of sleep health: findings from the Sister Study. Sleep 2024; 47:zsad100. [PMID: 37018759 PMCID: PMC10851850 DOI: 10.1093/sleep/zsad100] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/23/2023] [Indexed: 04/07/2023] Open
Abstract
STUDY OBJECTIVE To examine the association between light at night (LAN) and multiple sleep health dimensions. METHODS Among 47 765 Sister Study participants, indoor LAN (TV on in the room, light(s) on in room, light from outside the room, nightlight, no light) and sleep dimensions were self-reported at baseline (2003-2009). We used Poisson regression with robust variance to estimate adjusted prevalence ratios (PR) and 95% confidence intervals (CI) for the cross-sectional associations between LAN and short sleep duration (<7 hours/night), insomnia symptoms (difficulty falling or staying asleep), frequent napping (≥3 naps/week), inconsistent sleep/wake time (differed day-to-day and week-to-week), sleep debt (≥2 hours between longest and shortest duration), recent sleep medication use, and a cumulative poor sleep score (≥3 poor sleep dimensions). Population-attributable risks (PARs) were determined for any light exposure vs. none by race/ethnicity. RESULTS Compared to sleeping with no light in the bedroom, sleeping with a TV on was associated with a higher prevalence of most dimensions of poor sleep (e.g. short sleep duration: PR = 1.38, 95% CI: 1.32 to 1.45; inconsistent sleep/wake time: PR = 1.55, 95% CI: 1.44 to 1.66; sleep debt: PR = 1.36, 95% CI: 1.29 to 1.44; poor sleep score: PR = 1.58, 95% CI: 1.48-1.68). PARs tended to be higher for non-Hispanic black women compared to non-Hispanic white women. CONCLUSIONS Sleeping with a TV on was associated with poor sleep health among US women, and non-Hispanic black women may be disproportionately burdened.
Collapse
Affiliation(s)
- Marina R Sweeney
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Hazel B Nichols
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Alexander P Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| |
Collapse
|
2
|
Hammel SC, Eftekhari A, Eichler CMA, Liu CW, Nylander-French LA, Engel LS, Lu K, Morrison GC. Reducing Transdermal Uptake of Semivolatile Plasticizers from Indoor Environments: A Clothing Intervention. Environ Sci Technol 2023; 57:20678-20688. [PMID: 38019971 DOI: 10.1021/acs.est.3c06142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Models and laboratory studies suggest that everyday clothing influences the transdermal uptake of semivolatile organic compounds, including phthalate plasticizers, from indoor environments. However, this effect has not been documented in environmental exposure settings. In this pilot study, we quantified daily excretion of 17 urinary metabolites (μg/day) for phthalates and phthalate alternatives in nine participants during 5 days. On Day 0, baseline daily excretion was determined in participants' urine. Starting on Day 1, participants refrained from eating phthalate-heavy foods and using personal care products. On Days 3 and 4, participants wore precleaned clothing as an exposure intervention. We observed a reduction in the daily excretion of phthalates during the intervention; mono-n-butyl phthalate, monoisobutyl phthalate (MiBP), and monobenzyl phthalate were significantly reduced by 35, 38, and 56%, respectively. Summed metabolites of di(2-ethylhexyl)phthalate (DEHP) were also reduced (27%; not statistically significant). A similar reduction among phthalate alternatives was not observed. The daily excretion of MiBP during the nonintervention period strongly correlated with indoor air concentrations of diisobutyl phthalate (DiBP), suggesting that inhalation and transdermal uptake of DiBP from the air in homes are dominant exposure pathways. The results indicate that precleaned clothing can significantly reduce environmental exposure to phthalates and phthalate alternatives.
Collapse
Affiliation(s)
- Stephanie C Hammel
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark
| | - Azin Eftekhari
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Clara M A Eichler
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Chih-Wei Liu
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Leena A Nylander-French
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Lawrence S Engel
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Kun Lu
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Glenn C Morrison
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| |
Collapse
|
3
|
Lin JJY, Koffman LJ, Tehrani MW, Chen R, Han SG, Sandler DP, Lawrence KG, Jackson WB, Dickerson AS, Ramachandran G, Engel LS, Rule AM. Reliability of low mass toenail samples as biomarkers of chronic metal exposure. J Expo Sci Environ Epidemiol 2023; 33:945-953. [PMID: 37296232 PMCID: PMC10709526 DOI: 10.1038/s41370-023-00560-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Toenails are a promising matrix for chronic metal exposure assessment, but there are currently no standard methods for collection and analysis. Questions remain about sample mass requirements and the extent to which metals measured in this matrix are representative of chronic body burden. OBJECTIVE This study proposes a method to maximize sample conservation for toenail metals analysis using inductively coupled plasma mass spectrometry (ICP-MS). We demonstrate the reliability of an ~25 mg toenail sample (typically 1-2 clippings) for metals analysis and evaluate the intra-individual variability of multiple metals in this matrix over time in men from the Gulf Long-term Follow-up (GuLF) Study. METHODS Toenail samples from 123 GuLF Study participants were collected at two visits 3 years apart and analyzed for 18 elements using ICP-MS. Participants with samples exceeding 200 mg at the first visit (n = 29) were selected for triplicate sub-sample analysis. Kendall's coefficient of concordance (W) was used to assess sub-sample reliability and Spearman's correlation coefficients (ρ) were used to evaluate fluctuations in elemental concentrations over time. RESULTS Results were not reported for Cd, Co, Mo, Sb, and V (detected in <60% of the samples). There was strong agreement among triplicate samples (Kendall's W: 0.72 (Cu)-0.90 (Cu)) across all elements evaluated, moderate correlations of elemental concentrations (Spearman's ρ: 0.21-0.42) over 3 years for As, Ca, Cr, Fe, Pb, Mn, and Zn, and strong correlations (>0.50) for Se, Cu, and Hg. IMPACT STATEMENT This toenail reliability study found that a low-mass (~25 mg) toenail sample (1-2 clippings) is suitable for the determination of most elements using ICP-MS and helps to increase the analytical capacity of limited toenail biospecimens collected in cohort studies. The results highlight differences in the suitability of toenails for chronic metal exposure assessment by element and underscore the need to consider intra-person variability, especially when comparing results across studies. We also provide recommendations for analytical standardization and the partitioning of the total collected toenail sample into multiple analytic sub-samples for future studies using toenail biospecimen for multiple assays.
Collapse
Affiliation(s)
- Joyce J Y Lin
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Lily J Koffman
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mina W Tehrani
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rui Chen
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Seok Gyu Han
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | | | - Aisha S Dickerson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Ana M Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
4
|
Lin JJ, Werder E, Lawrence KG, Jackson WB, Sandler DP, Dickerson AS, Engel LS, Rule AM. Residential proximity to metal emitting industries and toenail metal concentration in the US Gulf States. Res Sq 2023:rs.3.rs-3210942. [PMID: 37609314 PMCID: PMC10441474 DOI: 10.21203/rs.3.rs-3210942/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Objective The US Gulf region is heavily reliant on metal-emitting petrochemical and manufacturing industries. We characterized the effect of residential proximity to metal-emitting sites and metal body burden in Gulf states residents with particular attention to potential differential exposure burden by race. Methods We measured toenail concentrations of arsenic, chromium, lead, manganese, mercury, and selenium using inductively coupled plasma mass spectrometry in 413 non-smoking men from the Gulf Long-term Follow-Up Study. Point sources of industrial metal emissions were identified using the US EPA's National Emissions Inventory (NEI) database and geocoded to participant residential addresses. For each metal, we assessed associations of toenail metal concentrations with the inverse-distance weighted number of emissions sites and volume of air-metal emissions within 30 km radial buffers of participant residences using multivariable linear regression. Results were stratified by race. Results Compared to self-identified Non-Hispanic (NH) White participants, NH Black participants lived closer to NEI sites but had 23-70% lower toenail metal concentrations adjusting for other personal/behavioral factors. Residential proximity to lead-emitting NEI sites was positively associated with toenail Pb concentration while proximity to mercury-emitting NEI sites was inversely associated with toenail Hg concentration. Findings for lead were significantly attenuated after adjustment for neighborhood-level socioeconomic factors. Conclusion Residential proximity to lead-emitting NEI sites in the US Gulf region is associated with a higher body burden of lead. However, this relationship may be driven in part by non-NEI factors related to residence in industry-adjacent neighborhoods.
Collapse
Affiliation(s)
- Joyce Jy Lin
- Johns Hopkins University Bloomberg School of Public Health
| | - Emily Werder
- National Institute of Environmental Health Sciences Laboratory of Pharmacology and Chemistry: National Institute of Environmental Health Sciences
| | | | | | | | | | - Lawrence S Engel
- The University of North Carolina at Chapel Hill Gillings School of Global Public Health
| | - Ana M Rule
- Johns Hopkins University Bloomberg School of Public Health
| |
Collapse
|
5
|
Norris CL, Sandler DP, Pratt GC, Stenzel MR, Stewart PA, Jackson WB, Gerr FE, Groth C, Banerjee S, Lawrence KG, Kwok RK, Werder EJ, Engel LS. Association between spill-related exposure to fine particulate matter and peripheral motor and sensory nerve function among oil spill response and cleanup workers following the Deepwater Horizon oil spill. J Expo Sci Environ Epidemiol 2023:10.1038/s41370-023-00558-6. [PMID: 37443296 DOI: 10.1038/s41370-023-00558-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/03/2023] [Accepted: 05/31/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Burning/flaring of oil/gas during the Deepwater Horizon oil spill response and cleanup (OSRC) generated high concentrations of fine particulate matter (PM2.5). Personnel working on the water during these activities may have inhaled combustion products. Neurologic effects of PM2.5 have been reported previously but few studies have examined lasting effects following disaster exposures. The association of brief, high exposures and adverse effects on sensory and motor nerve function in the years following exposure have not been examined for OSRC workers. OBJECTIVES We assessed the relationship between exposure to burning/flaring-related PM2.5 and measures of sensory and motor nerve function among OSRC workers. METHODS PM2.5 concentrations were estimated from Gaussian plume dispersion models and linked to self-reported work histories. Quantitative measures of sensory and motor nerve function were obtained 4-6 years after the disaster during a clinical exam restricted to those living close to two clinics in Mobile, AL or New Orleans, LA (n = 3401). We obtained covariate data from a baseline enrollment survey and a home visit, both in 2011-2013. The analytic sample included 1186 participants. RESULTS We did not find strong evidence of associations between exposure to PM2.5 and sensory or motor nerve function, although there was a suggestion of impairment based on single leg stance among individuals with high exposure to PM2.5. Results were generally consistent whether we examined average or cumulative maximum exposures or removed individuals with the highest crude oil exposures to account for co-pollutant confounding. There was no evidence of exposure-response trends. IMPACT STATEMENT Remediating environmental disasters is essential for long-term human and environmental health. During the Deepwater Horizon oil spill disaster, burning and flaring of oil and gas were used to remove these pollutants from the environment, but led to potentially high fine particulate matter exposures for spill response workers working on the water. We investigate the potential adverse effects of these exposures on peripheral nerve function; understanding the potential health harm of remediation tactics is necessary to inform future clean up approaches and protect human health.
Collapse
Affiliation(s)
- Christina L Norris
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Gregory C Pratt
- Division of Environmental Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA, USA
| | | | - W Braxton Jackson
- Social & Scientific Systems, Inc., a DLH Holding company, Durham, NC, USA
| | - Fredric E Gerr
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Caroline Groth
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, Morgantown, WV, USA
| | - Sudipto Banerjee
- Department of Biostatistics, University of California-Los Angeles Fielding School of Public Health, Los Angeles, CA, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
- Office of the Director, National Institute of Environmental Health Sciences, Bethesda, MD, USA
| | - Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
| |
Collapse
|
6
|
Wu Z, Petrick JL, Florio AA, Guillemette C, Beane Freeman LE, Buring JE, Bradwin G, Caron P, Chen Y, Eliassen AH, Engel LS, Freedman ND, Gaziano JM, Giovannuci EL, Hofmann JN, Huang WY, Kirsh VA, Kitahara CM, Koshiol J, Lee IM, Liao LM, Newton CC, Palmer JR, Purdue MP, Rohan TE, Rosenberg L, Sesso HD, Sinha R, Stampfer MJ, Um CY, Van Den Eeden SK, Visvanathan K, Wactawski-Wende J, Zeleniuch-Jacquotte A, Zhang X, Graubard BI, Campbell PT, McGlynn KA. Endogenous sex steroid hormones and risk of liver cancer among US men: Results from the Liver Cancer Pooling Project. JHEP Rep 2023; 5:100742. [PMID: 37425211 PMCID: PMC10326694 DOI: 10.1016/j.jhepr.2023.100742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/28/2023] [Accepted: 03/03/2023] [Indexed: 07/11/2023] Open
Abstract
Background & Aims Incidence rates of liver cancer in most populations are two to three times higher among men than women. The higher rates among men have led to the suggestion that androgens are related to increased risk whereas oestrogens are related to decreased risk. This hypothesis was investigated in the present study via a nested case-control analysis of pre-diagnostic sex steroid hormone levels among men in five US cohorts. Methods Concentrations of sex steroid hormones and sex hormone-binding globulin were quantitated using gas chromatography-mass spectrometry and a competitive electrochemiluminescence immunoassay, respectively. Multivariable conditional logistic regression was used to calculate odds ratios (ORs) and 95% CIs for associations between hormones and liver cancer among 275 men who subsequently developed liver cancer and 768 comparison men. Results Higher concentrations of total testosterone (OR per one-unit increase in log2 = 1.77, 95% CI = 1.38-2.29), dihydrotestosterone (OR = 1.76, 95% CI = 1.21-2.57), oestrone (OR = 1.74, 95% CI = 1.08-2.79), total oestradiol (OR = 1.58, 95% CI=1.22-20.05), and sex hormone-binding globulin (OR = 1.63, 95% CI = 1.27-2.11) were associated with increased risk. Higher concentrations of dehydroepiandrosterone (DHEA), however, were associated with a 53% decreased risk (OR = 0.47, 95% CI = 0.33-0.68). Conclusions Higher concentrations of both androgens (testosterone, dihydrotestosterone) and their aromatised oestrogenic metabolites (oestrone, oestradiol) were observed among men who subsequently developed liver cancer compared with men who did not. As DHEA is an adrenal precursor of both androgens and oestrogens, these results may suggest that a lower capacity to convert DHEA to androgens, and their subsequent conversion to oestrogens, confers a lower risk of liver cancer, whereas a greater capacity to convert DHEA confers a greater risk. Impact and implications This study does not fully support the current hormone hypothesis as both androgen and oestrogen levels were associated with increased risk of liver cancer among men. The study also found that higher DHEA levels were associated with lower risk, thus suggesting the hypothesis that greater capacity to convert DHEA could be associated with increased liver cancer risk among men.
Collapse
Affiliation(s)
- Zeni Wu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Andrea A. Florio
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Chantal Guillemette
- Pharmacogenomics Laboratory, Centre Hospitalier Universitaire de Québec-(CHU de Québec) Research Center–Université Laval, Québec, QC, Canada
- Faculty of Pharmacy and Cancer Research Center, Laval University, Québec, QC, Canada
| | - Laura E. Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Julie E. Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Gary Bradwin
- Clinical and Epidemiologic Research Laboratory, Department of Laboratory Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Patrick Caron
- Pharmacogenomics Laboratory, Centre Hospitalier Universitaire de Québec-(CHU de Québec) Research Center–Université Laval, Québec, QC, Canada
| | - Yu Chen
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - A. Heather Eliassen
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lawrence S. Engel
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - Neal D. Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - J. Michael Gaziano
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Edward L. Giovannuci
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Jonathan N. Hofmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Victoria A. Kirsh
- Ontario Institute for Cancer Research, Toronto, ON, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - I-Min Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Linda M. Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Julie R. Palmer
- Slone Epidemiology Center, Boston University, Boston, MA, USA
| | - Mark P. Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Thomas E. Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA
| | - Lynn Rosenberg
- Slone Epidemiology Center, Boston University, Boston, MA, USA
| | - Howard D. Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Meir J. Stampfer
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Caroline Y. Um
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | | | - Kala Visvanathan
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | | | - Xuehong Zhang
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Barry I. Graubard
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Katherine A. McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| |
Collapse
|
7
|
Chen D, Werder EJ, Stewart PA, Stenzel MR, Gerr FE, Lawrence KG, Groth CP, Huynh TB, Ramachandran G, Banerjee S, Jackson WB, Christenbury K, Kwok RK, Sandler DP, Engel LS. Exposure to volatile hydrocarbons and neurologic function among oil spill workers up to 6 years after the Deepwater Horizon disaster. Environ Res 2023; 231:116069. [PMID: 37149022 DOI: 10.1016/j.envres.2023.116069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND During the 2010 Deepwater Horizon (DWH) disaster, oil spill response and cleanup (OSRC) workers were exposed to toxic volatile components of crude oil. Few studies have examined exposure to individual volatile hydrocarbon chemicals below occupational exposure limits in relation to neurologic function among OSRC workers. OBJECTIVES To investigate the association of several spill-related chemicals (benzene, toluene, ethylbenzene, xylene, n-hexane, i.e., BTEX-H) and total petroleum hydrocarbons (THC) with neurologic function among DWH spill workers enrolled in the Gulf Long-term Follow-up Study. METHODS Cumulative exposure to THC and BTEX-H across the oil spill cleanup period were estimated using a job-exposure matrix that linked air measurement data to detailed self-reported DWH OSRC work histories. We ascertained quantitative neurologic function data via a comprehensive test battery at a clinical examination that occurred 4-6 years after the DWH disaster. We used multivariable linear regression and modified Poisson regression to evaluate relationships of exposures (quartiles (Q)) with 4 neurologic function measures. We examined modification of the associations by age at enrollment (<50 vs. ≥50 years). RESULTS We did not find evidence of adverse neurologic effects from crude oil exposures among the overall study population. However, among workers ≥50 years of age, several individual chemical exposures were associated with poorer vibrotactile acuity of the great toe, with statistically significant effects observed in Q3 or Q4 of exposures (range of log mean difference in Q4 across exposures: 0.13-0.26 μm). We also observed suggestive adverse associations among those ≥ age 50 years for tests of postural stability and single-leg stance, although most effect estimates did not reach thresholds of statistical significance (p < 0.05). CONCLUSIONS Higher exposures to volatile components of crude oil were associated with modest deficits in neurologic function among OSRC workers who were age 50 years or older at study enrollment.
Collapse
Affiliation(s)
- Dazhe Chen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | | | - Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA, USA
| | - Fredric E Gerr
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Fielding School of Public Health, University of California - Los Angeles, Los Angeles, CA, USA
| | - W Braxton Jackson
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, NC, USA
| | - Kate Christenbury
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, NC, USA
| | - Richard K Kwok
- Population Studies and Genetics Branch, National Institute on Aging, Bethesda, MD, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
| |
Collapse
|
8
|
Chen D, Sandler DP, Keil AP, Heiss G, Whitsel EA, Edwards JK, Stewart PA, Stenzel MR, Groth CP, Ramachandran G, Banerjee S, Huynh TB, Jackson WB, Blair A, Lawrence KG, Kwok RK, Engel LS. Volatile Hydrocarbon Exposures and Incident Coronary Heart Disease Events: Up to Ten Years of Follow-up among Deepwater Horizon Oil Spill Workers. Environ Health Perspect 2023; 131:57006. [PMID: 37224072 PMCID: PMC10208425 DOI: 10.1289/ehp11859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 04/09/2023] [Accepted: 04/28/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND During the 2010 Deepwater Horizon (DWH) disaster, response and cleanup workers were potentially exposed to toxic volatile components of crude oil. However, to our knowledge, no study has examined exposure to individual oil spill-related chemicals in relation to cardiovascular outcomes among oil spill workers. OBJECTIVES Our aim was to investigate the association of several spill-related chemicals [benzene, toluene, ethylbenzene, xylene, n-hexane (BTEX-H)] and total hydrocarbons (THC) with incident coronary heart disease (CHD) events among workers enrolled in a prospective cohort. METHODS Cumulative exposures to THC and BTEX-H across the cleanup period were estimated via a job-exposure matrix that linked air measurement data with self-reported DWH spill work histories. We ascertained CHD events following each worker's last day of cleanup work as the first self-reported physician-diagnosed myocardial infarction (MI) or a fatal CHD event. We estimated hazard ratios (HR) and 95% confidence intervals for the associations of exposure quintiles (Q) with risk of CHD. We applied inverse probability weights to account for bias due to confounding and loss to follow-up. We used quantile g-computation to assess the joint effect of the BTEX-H mixture. RESULTS Among 22,655 workers with no previous MI diagnoses, 509 experienced an incident CHD event through December 2019. Workers in higher quintiles of each exposure agent had increased CHD risks in comparison with the referent group (Q1) of that agent, with the strongest associations observed in Q5 (range of HR = 1.14 - 1.44 ). However, most associations were nonsignificant, and there was no evidence of exposure-response trends. We observed stronger associations among ever smokers, workers with ≤ high school education, and workers with body mass index < 30 kg / m 2 . No apparent positive association was observed for the BTEX-H mixture. CONCLUSIONS Higher exposures to volatile components of crude oil were associated with modest increases in risk of CHD among oil spill workers, although we did not observe exposure-response trends. https://doi.org/10.1289/EHP11859.
Collapse
Affiliation(s)
- Dazhe Chen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Alexander P. Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Eric A. Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jessie K. Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Mark R. Stenzel
- Exposure Assessment Applications, LLC, Arlington, Virginia, USA
| | - Caroline P. Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Fielding School of Public Health, University of California – Los Angeles, Los Angeles, California, USA
| | - Tran B. Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - W. Braxton Jackson
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, North Carolina, USA
| | - Aaron Blair
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Kaitlyn G. Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Richard K. Kwok
- Population Studies and Genetics Branch, National Institute on Aging, Bethesda, Maryland, USA
| | - Lawrence S. Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| |
Collapse
|
9
|
Malik H, Goel R, Melito W, Malik A, Engel LS, Boulmay B. A difficult task: determining oral anticoagulation efficacy (OAC) in patients with HIT type II. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00240-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
10
|
Yount P, Robin K, Yesbeck L, deLeon L, Engel LS, Ziada ME. Multiple myeloma presenting as fluid overload. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00271-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
11
|
Misky AM, Lo B, Engel LS. Utility of fructosamine to assess glycemic control. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00143-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
12
|
Knowles S, Khan ST, Malik H, Helmstetter NB, Engel LS, Kamboj S. Functional weakness incongruent with acute myasthenia crisis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00088-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
13
|
Rome C, Fondong M, Millar H, Lormeus F, Fuentes SC, Phillips M, Engel LS. A Case of lymphogranuloma venereum. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00317-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
14
|
Riley E, Garcia Y, Brew EA, Van DA, Engel LS, Imsais W. Primary adrenal insufficiency in a 56-year-old patient with well-controlled HIV. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00145-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
15
|
Rodriguez T, Nguyen T, Hall M, Difranco MA, Engel LS. Retropharyngeal abscess simulating meningitis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00316-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
16
|
Van DA, Engel LS, Kamboj S. Angioedema of undetermined etiology. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00637-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
17
|
El Hajj EC, Zia AW, Bilalis M, Ataei A, Lo B, Engel LS. Hepatitis C recurrence after complete resolution. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00292-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
18
|
Beyer D, Loghmani A, Correa F, Yesbeck L, Purcell O, Engel LS, Modica M. Takotsubo cardiomyopathy: a stress-induced “broken heart”. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00114-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
19
|
Grube AM, Coleman CK, LaMontagne CD, Miller ME, Kothegal NP, Holcomb DA, Blackwood AD, Clerkin TJ, Serre ML, Engel LS, Guidry VT, Noble RT, Stewart JR. Detection of SARS-CoV-2 RNA in wastewater and comparison to COVID-19 cases in two sewersheds, North Carolina, USA. Sci Total Environ 2023; 858:159996. [PMID: 36356771 PMCID: PMC9639408 DOI: 10.1016/j.scitotenv.2022.159996] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
Wastewater surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be useful for monitoring population-wide coronavirus disease 2019 (COVID-19) infections, especially given asymptomatic infections and limitations in diagnostic testing. We aimed to detect SARS-CoV-2 RNA in wastewater and compare viral concentrations to COVID-19 case numbers in the respective counties and sewersheds. Influent 24-hour composite wastewater samples were collected from July to December 2020 from two municipal wastewater treatment plants serving different population sizes in Orange and Chatham Counties in North Carolina. After a concentration step via HA filtration, SARS-CoV-2 RNA was detected and quantified by reverse transcription droplet digital polymerase chain reaction (RT-ddPCR) and quantitative PCR (RT-qPCR), targeting the N1 and N2 nucleocapsid genes. SARS-CoV-2 RNA was detected by RT-ddPCR in 100 % (24/24) and 79 % (19/24) of influent wastewater samples from the larger and smaller plants, respectively. In comparison, viral RNA was detected by RT-qPCR in 41.7 % (10/24) and 8.3 % (2/24) of samples from the larger and smaller plants, respectively. Positivity rates and method agreement further increased for the RT-qPCR assay when samples with positive signals below the limit of detection were counted as positive. The wastewater data from the larger plant generally correlated (⍴ ~0.5, p < 0.05) with, and even anticipated, the trends in reported COVID-19 cases, with a notable spike in measured viral RNA preceding a spike in cases when students returned to a college campus in the Orange County sewershed. Correlations were generally higher when using estimates of sewershed-level case data rather than county-level data. This work supports use of wastewater surveillance for tracking COVID-19 disease trends, especially in identifying spikes in cases. Wastewater-based epidemiology can be a valuable resource for tracking disease trends, allocating resources, and evaluating policy in the fight against current and future pandemics.
Collapse
Affiliation(s)
- Alyssa M Grube
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, United States
| | - Collin K Coleman
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, United States
| | - Connor D LaMontagne
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, United States
| | - Megan E Miller
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, United States
| | - Nikhil P Kothegal
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, United States
| | - David A Holcomb
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, United States; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, United States
| | - A Denene Blackwood
- Institute of Marine Sciences, Department of Earth, Marine, and Environmental Sciences, University of North Carolina at Chapel Hill, 3431 Arendell Street, Morehead City, NC 28557, United States
| | - Thomas J Clerkin
- Institute of Marine Sciences, Department of Earth, Marine, and Environmental Sciences, University of North Carolina at Chapel Hill, 3431 Arendell Street, Morehead City, NC 28557, United States
| | - Marc L Serre
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, United States
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, United States
| | - Virginia T Guidry
- Occupational and Environmental Epidemiology Branch, NC Department of Health and Human Services, 5505 Six Forks Road, Raleigh, NC 27609, United States
| | - Rachel T Noble
- Institute of Marine Sciences, Department of Earth, Marine, and Environmental Sciences, University of North Carolina at Chapel Hill, 3431 Arendell Street, Morehead City, NC 28557, United States
| | - Jill R Stewart
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, United States.
| |
Collapse
|
20
|
Van Dreumel C, Marler AC, Loghmani A, Dubuc J, Moise HO, Engel LS, Walvekar S. Pneumonitis in a patient treated with chemotherapy, radiation, and immune checkpoint inhibitors for SCC of the lung. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00266-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
21
|
Misky AM, Hutchins L, Bornstein K, Engel LS. An unusual presentation of diabetes mellitus. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00144-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
22
|
Beyer D, Sridhar S, Singh M, Nikdast J, Engel LS, Boudreaux K. BRASH syndrome: a close “BRASH” with death? Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00070-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
23
|
Patel OP, Lawrence KG, Parks CG, Bodkin M, Jackson WB, Engel LS, Sandler DP. Neighborhood disadvantage and immune-related illnesses among residents living in the US Gulf States. Ann Epidemiol 2023; 78:44-46. [PMID: 36586457 PMCID: PMC10077875 DOI: 10.1016/j.annepidem.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE Neighborhood disadvantage has been associated with increased risk for pneumonia and influenza-associated hospitalizations. Few studies, however, have investigated how neighborhood disadvantage may influence immune-related illnesses. The aim of this study was to examine the association between neighborhooddisadvantage and immune-related illnesses. METHODS We used data from the Gulf Long-term Follow-up (GuLF) Study (n = 32,608). Our analytic sample included home visit participants (n = 11,193) who had complete information on exposure and covariates (n = 10,543). Neighborhood disadvantage was assessed using the 2013 Area Deprivation Index (ADI), which assigns a ranking of 1 to 100 for lowest to highest disadvantage. We linked ADI to participants' geocoded enrollment addresses at the census block group level. ADI was categorized into quartiles based on the national distribution with the first quartile as the referent. Immune-related illnesses self-reported at the home visit (May 2011-May 2013) included occurrence of shingles, pneumonia, cold sores, flu, and colds since the Deepwater Horizon oil spill (April 2010). Frequent colds and frequent flu were defined as ≥4 colds and ≥2 episodes of flu since the spill. An aggregated outcome, based on occurrence of any pneumonia, cold sores, flu, and ≥4 colds since the spill, was also examined. We assessed the association of each outcome with ADI using multivariable log-binomial regression adjusting for individual-level demographics, behavioral factors, kids at home, and season of interview completion. RESULTS We found elevated prevalence ratios (PR) and 95% confidence intervals (CI) for pneumonia associated with ADI in the third (PR: 2.04, 95% CI: 1.04, 4.02) and fourth (PR: 2.00; 95% CI: 1.00, 3.98) quartiles. PRs for frequent colds were also elevated for increasing ADI quartiles, but with confidence intervals including the null value. CONCLUSIONS The observed associations of frequent colds and pneumonia with increasing neighborhood disadvantage may warrant further research on this topic.
Collapse
Affiliation(s)
- Opal P Patel
- Department of Epidemiology, UNC Gillings School of Public Health, Chapel Hill, NC
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
| | - Christine G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
| | - Mark Bodkin
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC
| | | | - Lawrence S Engel
- Department of Epidemiology, UNC Gillings School of Public Health, Chapel Hill, NC; Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
| |
Collapse
|
24
|
Ritchie A, Barbara B, Engel LS, Amoss J. Severe generalized myositis after COVID-19. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00093-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
25
|
Van DA, Knowles S, Engel LS, Kamboj S. The link between bananas and rhinitis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00096-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
26
|
Ataei A, Benes G, Destin G, Etienne J, Marler AC, Bank M, Engel LS, Modica M. Unusual presentation of a stanford type A aortic dissection. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00547-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
27
|
Gawey L, Naik T, Shaw C, Pinner A, Woodall C, Engel LS, Amoss J. Post-myocardial infarction ventricular septal defect due to interventricular septal rupture. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00067-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
28
|
Van Dreumel C, Hall H, Prejean C, Engel LS, Walvekar S. Non-traumatic hemothorax in a 43-year-old woman. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00490-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
29
|
Gawey L, Denys I, Van A, Naik T, Woodall C, Engel LS, Amoss J. Diamond-blackfan anemia in an adult. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00226-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
30
|
Bordes J, Cunningham C, Engel LS, Amoss J. A case of cardiac tamponade secondary to CMV pericardial effusion. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00116-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
31
|
Denic-Roberts H, Engel LS, Buchanich JM, Miller RG, Talbott EO, Thomas DL, Cook GA, Costacou T, Rusiecki JA. Risk of longer-term neurological conditions in the Deepwater Horizon Oil Spill Coast Guard Cohort Study - Five years of follow-up. Environ Health 2023; 22:12. [PMID: 36694171 PMCID: PMC9875433 DOI: 10.1186/s12940-022-00941-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/14/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND Long-term neurological health risks associated with oil spill cleanup exposures are largely unknown. We aimed to investigate risks of longer-term neurological conditions among U.S. Coast Guard (USCG) responders to the 2010 Deepwater Horizon (DWH) oil spill. METHODS We used data from active duty members of the DWH Oil Spill Coast Guard Cohort Study (N=45224). Self-reported oil spill exposures were ascertained from post-deployment surveys. Incident neurological outcomes were classified using International Classification of Diseases, 9th Revision, codes from military health encounter records up to 5.5 years post-DWH. We used Cox Proportional Hazards regression to calculate adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for various incident neurological diagnoses (2010-2015). Oil spill responder (n=5964) vs. non-responder (n= 39260) comparisons were adjusted for age, sex, and race, while within-responder comparisons were additionally adjusted for smoking. RESULTS Compared to those not responding to the spill, spill responders had reduced risks for headache (aHR=0.84, 95% CI: 0.74-0.96), syncope and collapse (aHR=0.74, 95% CI: 0.56-0.97), and disturbance of skin sensation (aHR=0.81, 95% CI: 0.68-0.96). Responders reporting ever (n=1068) vs. never (n=2424) crude oil inhalation exposure were at increased risk for several individual and grouped outcomes related to headaches and migraines (aHR range: 1.39-1.83). Crude oil inhalation exposure was also associated with elevated risks for an inflammatory nerve condition, mononeuritis of upper limb and mononeuritis multiplex (aHR=1.71, 95% CI: 1.04-2.83), and tinnitus (aHR=1.91, 95% CI: 1.23-2.96), a condition defined by ringing in one or both ears. Risk estimates for those neurological conditions were higher in magnitude among responders reporting exposure to both crude oil and oil dispersants than among those reporting crude oil only. CONCLUSION In this large study of active duty USCG responders to the DWH disaster, self-reported spill cleanup exposures were associated with elevated risks for longer-term neurological conditions.
Collapse
Affiliation(s)
- Hristina Denic-Roberts
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Room E-2009, Bethesda, MD, 20814, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jeanine M Buchanich
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rachel G Miller
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Evelyn O Talbott
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dana L Thomas
- United States Coast Guard Headquarters, Directorate of Health, Safety, and Work Life, Washington, D.C., USA
| | - Glen A Cook
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Tina Costacou
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jennifer A Rusiecki
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Room E-2009, Bethesda, MD, 20814, USA.
| |
Collapse
|
32
|
Chen D, Sandler DP, Keil AP, Heiss G, Whitsel EA, Pratt GC, Stewart PA, Stenzel MR, Groth CP, Banerjee S, Huynh TB, Edwards JK, Jackson WB, Engeda J, Kwok RK, Werder EJ, Lawrence KG, Engel LS. Fine particulate matter and incident coronary heart disease events up to 10 years of follow-up among Deepwater Horizon oil spill workers. Environ Res 2023; 217:114841. [PMID: 36403648 PMCID: PMC9825646 DOI: 10.1016/j.envres.2022.114841] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/05/2022] [Accepted: 11/15/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND During the 2010 Deepwater Horizon (DWH) disaster, in-situ burning and flaring were conducted to remove oil from the water. Workers near combustion sites were potentially exposed to burning-related fine particulate matter (PM2.5). Exposure to PM2.5 has been linked to increased risk of coronary heart disease (CHD), but no study has examined the relationship among oil spill workers. OBJECTIVES To investigate the association between estimated PM2.5 from burning/flaring of oil/gas and CHD risk among the DWH oil spill workers. METHODS We included workers who participated in response and cleanup activities on the water during the DWH disaster (N = 9091). PM2.5 exposures were estimated using a job-exposure matrix that linked modelled PM2.5 concentrations to detailed DWH spill work histories provided by participants. We ascertained CHD events as the first self-reported physician-diagnosed CHD or a fatal CHD event that occurred after each worker's last day of burning exposure. We estimated hazard ratios (HR) and 95% confidence intervals (95%CI) for the associations between categories of average or cumulative daily maximum PM2.5 exposure (versus a referent category of water workers not near controlled burning) and subsequent CHD. We assessed exposure-response trends by examining continuous exposure parameters in models. RESULTS We observed increased CHD hazard among workers with higher levels of average daily maximum exposure (low vs. referent: HR = 1.26, 95% CI: 0.93, 1.70; high vs. referent: HR = 2.11, 95% CI: 1.08, 4.12; per 10 μg/m3 increase: HR = 1.10, 95% CI: 1.02, 1.19). We also observed suggestively elevated HRs among workers with higher cumulative daily maximum exposure (low vs. referent: HR = 1.19, 95% CI: 0.68, 2.08; medium vs. referent: HR = 1.38, 95% CI: 0.88, 2.16; high vs. referent: HR = 1.44, 95% CI: 0.96, 2.14; per 100 μg/m3-d increase: HR = 1.03, 95% CI: 1.00, 1.05). CONCLUSIONS Among oil spill workers, exposure to PM2.5 from flaring/burning of oil/gas was associated with increased risk of CHD.
Collapse
Affiliation(s)
- Dazhe Chen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Alexander P Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gregory C Pratt
- Division of Environmental Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Fielding School of Public Health, University of California - Los Angeles, Los Angeles, CA, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jessie K Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - W Braxton Jackson
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, NC, USA
| | - Joseph Engeda
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, NC, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA; Office of the Director, National Institute of Environmental Health Sciences, Bethesda, MD, USA
| | - Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
| |
Collapse
|
33
|
Kotlarz N, Holcomb DA, Tanvir Pasha ABM, Reckling S, Kays J, Lai YC, Daly S, Palani S, Bailey E, Guidry VT, Christensen A, Berkowitz S, Hoppin JA, Mitasova H, Engel LS, Reyes FLDL, Harris A. Timing and Trends for Municipal Wastewater, Lab-Confirmed Case, and Syndromic Case Surveillance of COVID-19 in Raleigh, North Carolina. Am J Public Health 2023; 113:79-88. [PMID: 36356280 PMCID: PMC9755929 DOI: 10.2105/ajph.2022.307108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 11/12/2022]
Abstract
Objectives. To compare 4 COVID-19 surveillance metrics in a major metropolitan area. Methods. We analyzed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in wastewater influent and primary solids in Raleigh, North Carolina, from April 10 through December 13, 2020. We compared wastewater results with lab-confirmed COVID-19 cases and syndromic COVID-like illness (CLI) cases to answer 3 questions: (1) Did they correlate? (2) What was the temporal alignment of the different surveillance systems? (3) Did periods of significant change (i.e., trends) align? Results. In the Raleigh sewershed, wastewater influent, wastewater primary solids, lab-confirmed cases, and CLI were strongly or moderately correlated. Trends in lab-confirmed cases and wastewater influent were observed earlier, followed by CLI and, lastly, wastewater primary solids. All 4 metrics showed sustained increases in COVID-19 in June, July, and November 2020 and sustained decreases in August and September 2020. Conclusions. In a major metropolitan area in 2020, the timing of and trends in municipal wastewater, lab-confirmed case, and syndromic case surveillance of COVID-19 were in general agreement. Public Health Implications. Our results provide evidence for investment in SARS-CoV-2 wastewater and CLI surveillance to complement information provided through lab-confirmed cases. (Am J Public Health. 2023;113(1):79-88. https://doi.org/10.2105/AJPH.2022.307108).
Collapse
Affiliation(s)
- Nadine Kotlarz
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - David A Holcomb
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - A B M Tanvir Pasha
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Stacie Reckling
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Judith Kays
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Yi-Chun Lai
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Sean Daly
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Sivaranjani Palani
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Erika Bailey
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Virginia T Guidry
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Ariel Christensen
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Steven Berkowitz
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Jane A Hoppin
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Helena Mitasova
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Lawrence S Engel
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Francis L de Los Reyes
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| | - Angela Harris
- Nadine Kotlarz and Jane A. Hoppin are with the Department of Biological Sciences, North Carolina State University, Raleigh. David A. Holcomb and Lawrence S. Engel are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. A. B. M. Tanvir Pasha, Judith Kays, Yi-Chun Lai, Sean Daly, Francis L. de los Reyes III, and Angela Harris are with the Department of Civil, Construction, and Environmental Engineering, North Carolina State University. Stacie Reckling and Helena Mitasova are with the Center for Geospatial Analytics, North Carolina State University. Sivaranjani Palani is with the Department of Plant and Microbial Biology, North Carolina State University. Erika Bailey is with Raleigh Water, Raleigh, NC. Virginia T. Guidry, Ariel Christensen, and Steven Berkowitz are with the Division of Public Health, North Carolina Department of Health and Human Services, Raleigh
| |
Collapse
|
34
|
Kshirsagar AV, Zeitler EM, Weaver A, Franceschini N, Engel LS. Environmental Exposures and Kidney Disease. Kidney360 2022; 3:2174-2182. [PMID: 36591345 PMCID: PMC9802544 DOI: 10.34067/kid.0007962021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/04/2022] [Indexed: 12/31/2022]
Abstract
Accumulating evidence underscores the large role played by the environment in the health of communities and individuals. We review the currently known contribution of environmental exposures and pollutants on kidney disease and its associated morbidity. We review air pollutants, such as particulate matter; water pollutants, such as trace elements, per- and polyfluoroalkyl substances, and pesticides; and extreme weather events and natural disasters. We also discuss gaps in the evidence that presently relies heavily on observational studies and animal models, and propose using recently developed analytic methods to help bridge the gaps. With the expected increase in the intensity and frequency of many environmental exposures in the decades to come, an improved understanding of their potential effect on kidney disease is crucial to mitigate potential morbidity and mortality.
Collapse
Affiliation(s)
- Abhijit V. Kshirsagar
- UNC Kidney Center and Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, North Carolina
| | - Evan M. Zeitler
- UNC Kidney Center and Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, North Carolina
| | - Anne Weaver
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Chapel Hill, North Carolina
| | - Nora Franceschini
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Lawrence S. Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| |
Collapse
|
35
|
Holcomb DA, Quist AJL, Engel LS. Exposure to industrial hog and poultry operations and urinary tract infections in North Carolina, USA. Sci Total Environ 2022; 853:158749. [PMID: 36108846 PMCID: PMC9613609 DOI: 10.1016/j.scitotenv.2022.158749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/15/2023]
Abstract
An increasing share of urinary tract infections (UTIs) are caused by extraintestinal pathogenic Escherichia coli (ExPEC) lineages that have also been identified in poultry and hogs with high genetic similarity to human clinical isolates. We investigated industrial food animal production as a source of uropathogen transmission by examining relationships of hog and poultry density with emergency department (ED) visits for UTIs in North Carolina (NC). ED visits for UTI in 2016-2019 were identified by ICD-10 code from NC's ZIP code-level syndromic surveillance system and livestock counts were obtained from permit data and aerial imagery. We calculated separate hog and poultry spatial densities (animals/km2) by Census block with a 5 km buffer on the block perimeter and weighted by block population to estimate mean ZIP code densities. Associations between livestock density and UTI incidence were estimated using a reparameterized Besag-York-Mollié (BYM2) model with ZIP code population offsets to account for spatial autocorrelation. We excluded metropolitan and offshore ZIP codes and assessed effect measure modification by calendar year, ZIP code rurality, and patient sex, age, race/ethnicity, and health insurance status. In single-animal models, hog exposure was associated with increased UTI incidence (rate ratio [RR]: 1.21, 95 % CI: 1.07-1.37 in the highest hog-density tertile), but poultry exposure was associated with reduced UTI rates (RR: 0.86, 95 % CI: 0.81-0.91). However, the reference group for single-animal poultry models included ZIP codes with only hogs, which had some of the highest UTI rates; when compared with ZIP codes without any hogs or poultry, there was no association between poultry exposure and UTI incidence. Hog exposure was associated with increased UTI incidence in areas that also had medium to high poultry density, but not in areas with low poultry density, suggesting that intense hog production may contribute to increased UTI incidence in neighboring communities.
Collapse
Affiliation(s)
- David A Holcomb
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Arbor J L Quist
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| |
Collapse
|
36
|
Sweeney MR, Nichols HB, Jones RR, Olshan AF, Keil AP, Engel LS, James P, Jackson CL, Sandler DP, White AJ. Light at night and the risk of breast cancer: Findings from the Sister study. Environ Int 2022; 169:107495. [PMID: 36084405 PMCID: PMC9561075 DOI: 10.1016/j.envint.2022.107495] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/19/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Light at night (LAN) may alter estrogen regulation through circadian disruption. High levels of outdoor LAN may increase breast cancer risk, but studies have largely not considered possible residual confounding from correlated environmental exposures. We evaluated the association between indoor and outdoor LAN and incident breast cancer. METHODS In 47,145 participants in the prospective Sister Study cohort living in the contiguous U.S., exposure to outdoor LAN was determined using satellite-measured residential data and indoor LAN was self-reported (light/TV on, light from outside the room, nightlight, no light). We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between outdoor and indoor LAN and breast cancer risk. Models were adjusted for age, race/ethnicity, educational attainment, annual household income, neighborhood disadvantage, latitude, and population density as a proxy for urbanicity. To evaluate the potential for residual confounding of the outdoor LAN and breast cancer relationship by factors associated with urbanicity, we considered further adjustment for exposures correlated with outdoor LAN including NO2 [Spearman correlation coefficient, rho (ρ) = 0.78], PM2.5 (ρ = 0.36), green space (ρ = - 0.41), and noise (ρ = 0.81). RESULTS During 11 years of follow-up, 3,734 breast cancer cases were identified. Outdoor LAN was modestly, but non-monotonically, associated with a higher risk of breast cancer (Quintile 4 vs 1: HR = 1.10, 95% CI: 0.99-1.22; Quintile 5 vs 1: HR = 1.04, 95% CI: 0.93-1.16); however, no association was evident after adjustment for correlated ambient exposures (Quintile 4 vs 1: HR = 0.99, 95% CI: 0.86-1.14; Quintile 5 vs 1: HR = 0.89, 95% CI: 0.74-1.06). Compared to those with no indoor LAN exposure, sleeping with a light or TV on was associated with a HR = 1.09 (95% CI: 0.97-1.23) in the adjusted model. CONCLUSIONS Outdoor LAN does not appear to increase the risk of breast cancer after adjustment for correlated environmental exposures.
Collapse
Affiliation(s)
- Marina R Sweeney
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Hazel B Nichols
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Alexander P Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA; Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA.
| |
Collapse
|
37
|
Lawrence KG, Niehoff NM, Keil AP, Braxton Jackson W, Christenbury K, Stewart PA, Stenzel MR, Huynh TB, Groth CP, Ramachandran G, Banerjee S, Pratt GC, Curry MD, Engel LS, Sandler DP. Associations between airborne crude oil chemicals and symptom-based asthma. Environ Int 2022; 167:107433. [PMID: 35921771 PMCID: PMC9378681 DOI: 10.1016/j.envint.2022.107433] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
RATIONALE The 2010 Deepwater Horizon (DWH) oil spill response and cleanup (OSRC) workers were exposed to airborne total hydrocarbons (THC), benzene, toluene, ethylbenzene, o-, m-, and p-xylenes and n-hexane (BTEX-H) from crude oil and PM2.5 from burning/flaring oil and natural gas. Little is known about asthma risk among oil spill cleanup workers. OBJECTIVES We assessed the relationship between asthma and several oil spill-related exposures including job classes, THC, individual BTEX-H chemicals, the BTEX-H mixture, and PM2.5 using data from the Gulf Long-Term Follow-up (GuLF) Study, a prospective cohort of 24,937 cleanup workers and 7,671 nonworkers following the DWH disaster. METHODS Our analysis largely focused on the 19,018 workers without asthma before the spill who had complete exposure, outcome, and covariate information. We defined incident asthma 1-3 years following exposure using both self-reported wheeze and self-reported physician diagnosis of asthma. THC and BTEX-H were assigned to participants based on measurement data and work histories, while PM2.5 used modeled estimates. We used modified Poisson regression to estimate risk ratios (RR) and 95% confidence intervals (CIs) for associations between spill-related exposures and asthma and a quantile-based g-computation approach to explore the joint effect of the BTEX-H mixture on asthma risk. RESULTS OSRC workers had greater asthma risk than nonworkers (RR: 1.60, 95% CI: 1.38, 1.85). Higher estimated THC exposure levels were associated with increased risk in an exposure-dependent manner (linear trend test p < 0.0001). Asthma risk also increased with increasing exposure to individual BTEX-H chemicals and the chemical mixture: A simultaneous quartile increase in the BTEX-H mixture was associated with an increased asthma risk of 1.45 (95% CI: 1.35,1.55). With fewer cases, associations were less apparent for physician-diagnosed asthma alone. CONCLUSIONS THC and BTEX-H were associated with increased asthma risk defined using wheeze symptoms as well as a physician diagnosis.
Collapse
Affiliation(s)
- Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Nicole M Niehoff
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Alexander P Keil
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA; Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - W Braxton Jackson
- Social and Scientific Systems Inc, a DLH Holdings company, Durham, NC, USA
| | - Kate Christenbury
- Social and Scientific Systems Inc, a DLH Holdings company, Durham, NC, USA
| | | | - Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, WV, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Gregory C Pratt
- Division of Environmental Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Matthew D Curry
- Social and Scientific Systems Inc, a DLH Holdings company, Durham, NC, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA; Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA.
| |
Collapse
|
38
|
Jardel HV, Engel LS, Lawrence KG, Stewart PA, Stenzel MR, Curry MD, Kwok RK, Sandler DP. The association between oil spill cleanup-related total hydrocarbon exposure and diabetes. Environ Res 2022; 212:113591. [PMID: 35661735 PMCID: PMC9267393 DOI: 10.1016/j.envres.2022.113591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/21/2022] [Accepted: 05/29/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND Although evidence suggests relationships between some crude oil components and glycemic dysregulation, no studies have examined oil spill-related chemical exposures in relation to type 2 diabetes mellitus (DM) risk. This study examined the relationship between total hydrocarbon (THC) exposure among workers involved in the 2010 Deepwater Horizon (DWH) oil spill and risk of DM up to 6 years afterward. METHODS Participants comprised 2660 oil-spill cleanup or response workers in the prospective GuLF Study who completed a clinical exam and had no self-reported DM diagnosis prior to the spill. Maximum THC exposure was estimated with a job-exposure matrix based on interview data and personal measurements taken during cleanup operations. We defined incident DM by self-reported physician diagnosis of DM, antidiabetic medication use, or a measured hemoglobin A1c value ≥ 6.5%. We used log binomial regression to estimate risk ratios (RRs) for DM across ordinal categories of THC exposure. The fully adjusted model controlled for age, sex, race/ethnicity, education, employment status, and health insurance status. We also stratified on clinical body mass index categories. RESULTS We observed an exposure-response relationship between maximum daily ordinal THC exposure level and incident DM, especially among overweight participants. RRs among overweight participants were 0.99 (95% CI: 0.37, 2.69), 1.46 (95% CI: 0.54, 3.92), and 2.11 (95% CI: 0.78, 5.74) for exposure categories 0.30-0.99 ppm, 1.00-2.99 ppm, and ≥3.00 ppm, respectively (ptrend = 0.03). CONCLUSION We observed suggestively increasing DM risk with increasing THC exposure level among overweight participants, but not among normal weight or obese participants.
Collapse
Affiliation(s)
- H V Jardel
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - L S Engel
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA
| | - K G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA
| | - P A Stewart
- Stewart Exposure Assessments, LLC North Arlington, Virginia, USA
| | - M R Stenzel
- Exposure Assessment Applications LLC Arlington, Virginia, USA
| | - M D Curry
- Social and Scientific Systems, Inc., a DLH Holding Company Durham, NC, USA
| | - R K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA; Office of the Director, National Institute of Environmental Health Sciences, NIH, DHHS, Bethesda, MD, USA
| | - D P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA
| |
Collapse
|
39
|
Wang JH, Denic-Roberts H, Goodie JL, Thomas DL, Engel LS, Rusiecki JA. Risk factors for acute mental health symptoms and tobacco initiation in Coast Guard Responders to the Deepwater Horizon oil spill. J Trauma Stress 2022; 35:1099-1114. [PMID: 35290683 PMCID: PMC9355914 DOI: 10.1002/jts.22817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/19/2021] [Accepted: 12/27/2021] [Indexed: 11/08/2022]
Abstract
Acute mental health symptoms experienced during oil spill response work are understudied, especially among nonlocal responders. We assessed potential risk factors for acute mental health symptoms and tobacco initiation among U.S. Coast Guard responders to the 2010 Deepwater Horizon (DWH) oil spill who completed a deployment exit survey. Cross-sectional associations among responder characteristics, deployment-related stressors (deployment duration, timing, crude oil exposure, physical symptoms, injuries), and professional help-seeking for stressors experienced with concurrent depression/anxiety and tobacco initiation were examined. Log-binomial regression was used to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals. Sensitivity analyses excluded responders with a history of mental health conditions using health encounter data from the Military Health System Data Repository. Of the 4,855 responders, 75.5% were deployed from nonlocal/non-Gulf home stations, 5.8% reported concurrent depression and anxiety, and 2.8% reported the initiation of any tobacco product during oil spill response. Self-report of concurrent depression and anxiety was more prevalent among female responders and positively associated with longer deployments, crude oil exposure via inhalation, physical symptoms and injuries, and professional help-seeking during deployment, aPRs = 1.54-6.55. Tobacco initiation was inversely associated with older age and officer rank and positively associated with deployment-related stressors and depression/anxiety during deployment, aPRs = 1.58-4.44. Associations remained robust after excluding responders with a history of mental health- and tobacco-related health encounters up to 3 years before deployment. Depression, anxiety, and tobacco initiation were cross-sectionally associated with oil spill response work experiences among DWH responders, who largely originated outside of the affected community.
Collapse
Affiliation(s)
- Jeanny H. Wang
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, Maryland, USA
| | - Hristina Denic-Roberts
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, Maryland, USA
- Oak Ridge Institute for Science and Education, Maryland, USA
| | - Jeffrey L. Goodie
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, Maryland, USA
| | - Dana L. Thomas
- United States Coast Guard Headquarters, Directorate of Health, Safety, and Work Life, Washington, D.C., USA
| | - Lawrence S. Engel
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jennifer A. Rusiecki
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, Maryland, USA
| |
Collapse
|
40
|
Quist AJL, Holcomb DA, Fliss MD, Delamater PL, Richardson DB, Engel LS. Exposure to industrial hog operations and gastrointestinal illness in North Carolina, USA. Sci Total Environ 2022; 830:154823. [PMID: 35341848 PMCID: PMC9133154 DOI: 10.1016/j.scitotenv.2022.154823] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
With 9 million hogs, North Carolina (NC) is the second leading hog producer in the United States. Most hogs are housed at concentrated animal feeding operations (CAFOs), where millions of tons of hog waste can pollute air and water with fecal pathogens that can cause diarrhea, vomiting, and/or nausea (known as acute gastrointestinal illness (AGI)). We used NC's ZIP code-level emergency department (ED) data to calculate rates of AGI ED visits (2016-2019) and swine permit data to estimate hog exposure. Case exposure was estimated as the inverse distances from each hog CAFO to census block centroids, weighting with Gaussian decay and by manure amount per CAFO, then aggregated to ZIP code using population weights. We compared ZIP codes in the upper quartile of hog exposure ("high hog exposed") to those without hog exposure. Using inverse probability of treatment weighting, we created a control with similar demographics to the high hog exposed population and calculated rate ratios using quasi-Poisson models. We examined effect measure modification of rurality and race using adjusted models. In high hog exposed areas compared to areas without hog exposure, we observed a 11% increase (95% CI: 1.06, 1.17) in AGI rate and 21% increase specifically in rural areas (95% CI: 0.98, 1.43). When restricted to rural areas, we found an increased AGI rate among American Indian (RR = 4.29, 95% CI: 3.69, 4.88) and Black (RR = 1.45, 95% CI: 0.98, 1.91) residents. The association was stronger during the week after heavy rain (RR = 1.41, 95% CI: 1.19, 1.62) and in areas with both poultry and swine CAFOs (RR = 1.52, 95% CI: 1.48, 1.57). Residing near CAFOs may increase rates of AGI ED visits. Hog CAFOs are disproportionally built near rural Black and American Indian communities in NC and are associated with increased AGI most strongly in these populations.
Collapse
Affiliation(s)
- Arbor J L Quist
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA.
| | - David A Holcomb
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Mike Dolan Fliss
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Paul L Delamater
- Department of Geography, University of North Carolina, Chapel Hill, NC 27514, USA
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| |
Collapse
|
41
|
Gribble MO, Keshav T, Denic-Roberts H, Engel LS, Rusiecki JA. Exposure patterns among Coast Guard responders to the Deepwater Horizon Oil Spill: A latent class analysis. Environ Epidemiol 2022; 6:e211. [PMID: 35702499 PMCID: PMC9187181 DOI: 10.1097/ee9.0000000000000211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 04/04/2022] [Indexed: 11/26/2022] Open
Abstract
Background The Deepwater Horizon Oil Spill was an environmental crisis for which multiple groups, including the United States Coast Guard (USCG), provided emergency response services. A cohort of 5,665 USCG oil spill responders completed postdeployment surveys eliciting information on a variety of topics, including oil spill-related exposures and experiences. Our objective was to determine the most common exposure patterns among USCG responders. Methods We used latent class analysis based on six indicator variables reflecting different aspects of the responders' experiences: exposure to oil, exposure to engine exhaust fumes or carbon monoxide, hand sanitizer use, sunblock use, mosquito bites, and level of anxiety. We validated our interpretation of these latent classes using ancillary variables. Results The model distinguished four distinct exposure profiles, which we interpreted as "low overall exposure" (prevalence estimate = 0.18), "low crude oil/exhaust and moderate time outdoors/anxiety (prevalence estimate = 0.18), "high crude oil/exhaust and moderate time outdoors/anxiety" (prevalence estimate = 0.25), and "high overall exposure" (prevalence estimate = 0.38). The validation analysis was consistent with our interpretation of the latent classes. Conclusions The exposure patterns identified in this analysis can help inform future studies of the health impacts of exposure mixtures among USCG oil spill responders.
Collapse
Affiliation(s)
- Matthew O. Gribble
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Taj Keshav
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, Maryland
| | - Hristina Denic-Roberts
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, Maryland
- Oak Ridge Institute for Science and Education, Bethesda, Maryland
| | - Lawrence S. Engel
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Jennifer A. Rusiecki
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, Maryland
| |
Collapse
|
42
|
Stenzel MR, Groth CP, Huynh TB, Ramachandran G, Banerjee S, Kwok RK, Engel LS, Blair A, Sandler DP, Stewart PA. Exposure Group Development in Support of the NIEHS GuLF Study. Ann Work Expo Health 2022; 66:i23-i55. [PMID: 35390128 PMCID: PMC8989038 DOI: 10.1093/annweh/wxab093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/03/2021] [Accepted: 10/06/2021] [Indexed: 11/14/2022] Open
Abstract
In the GuLF Study, a study investigating possible adverse health effects associated with work on the oil spill response and clean-up (OSRC) following the Deepwater Horizon disaster in the Gulf of Mexico, we used a job-exposure matrix (JEM) approach to estimate exposures. The JEM linked interview responses of study participants to measurement data through exposure groups (EGs). Here we describe a systematic process used to develop transparent and precise EGs that allowed characterization of exposure levels among the large number of OSRC activities performed across the Gulf of Mexico over time and space. EGs were identified by exposure determinants available to us in our measurement database, from a substantial body of other spill-related information, and from responses provided by study participants in a detailed interview. These determinants included: job/activity/task, vessel and type of vessel, weathering of the released oil, area of the Gulf of Mexico, Gulf coast state, and time period. Over 3000 EGs were developed for inhalation exposure and applied to each of 6 JEMs of oil-related substances (total hydrocarbons, benzene, toluene, ethylbenzene, total xylene, and n-hexane). Subsets of those EGs were used for characterization of exposures to dispersants, particulate matter, and oil mist. The EGs allowed assignment to study participants of exposure estimates developed from measurement data or from estimation models through linkage in the JEM for the investigation of exposure-response relationships.
Collapse
Affiliation(s)
- Mark R Stenzel
- Exposure Assessment Applications, LLC, 6045 N. 27th. St., Arlington, VA, 22207, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, WVU School of Public Health, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, 3215 Market St, Philadelphia, PA 19104, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California-Los Angeles, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive-MD A3-05, Research Triangle Park, NC 27709, USA.,Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, 31 Center Drive, Bethesda, MD 20892, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive-MD A3-05, Research Triangle Park, NC 27709, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 35 Dauer Drive, Chapel Hill, NC, 27599, USA
| | - Aaron Blair
- Division of Caner Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Building 9609, MSC 9760, Bethesda, MD 20892-9760, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive-MD A3-05, Research Triangle Park, NC 27709, USA
| | - Patricia A Stewart
- Stewart Exposure Assessments, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA
| |
Collapse
|
43
|
Pratt GC, Stenzel MR, Kwok RK, Groth CP, Banerjee S, Arnold SF, Engel LS, Sandler DP, Stewart PA. Modeled Air Pollution from In Situ Burning and Flaring of Oil and Gas Released Following the Deepwater Horizon Disaster. Ann Work Expo Health 2022; 66:i172-i187. [PMID: 32936300 PMCID: PMC8989033 DOI: 10.1093/annweh/wxaa084] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/27/2020] [Accepted: 08/18/2020] [Indexed: 12/19/2023] Open
Abstract
The GuLF STUDY, initiated by the National Institute of Environmental Health Sciences, is investigating the health effects among workers involved in the oil spill response and clean-up (OSRC) after the Deepwater Horizon (DWH) explosion in April 2010 in the Gulf of Mexico. Clean-up included in situ burning of oil on the water surface and flaring of gas and oil captured near the seabed and brought to the surface. We estimated emissions of PM2.5 and related pollutants resulting from these activities, as well as from engines of vessels working on the OSRC. PM2.5 emissions ranged from 30 to 1.33e6 kg per day and were generally uniform over time for the flares but highly episodic for the in situ burns. Hourly emissions from each source on every burn/flare day were used as inputs to the AERMOD model to develop average and maximum concentrations for 1-, 12-, and 24-h time periods. The highest predicted 24-h average concentrations sometimes exceeded 5000 µg m-3 in the first 500 m downwind of flaring and reached 71 µg m-3 within a kilometer of some in situ burns. Beyond 40 km from the DWH site, plumes appeared to be well mixed, and the predicted 24-h average concentrations from the flares and in situ burns were similar, usually below 10 µg m-3. Structured averaging of model output gave potential PM2.5 exposure estimates for OSRC workers located in various areas across the Gulf. Workers located nearest the wellhead (hot zone/source workers) were estimated to have a potential maximum 12-h exposure of 97 µg m-3 over the 2-month flaring period. The potential maximum 12-h exposure for workers who participated in in situ burns was estimated at 10 µg m-3 over the ~3-month burn period. The results suggest that burning of oil and gas during the DWH clean-up may have resulted in PM2.5 concentrations substantially above the U.S. National Ambient Air Quality Standard for PM2.5 (24-h average = 35 µg m-3). These results are being used to investigate possible adverse health effects in the GuLF STUDY epidemiologic analysis of PM2.5 exposures.
Collapse
Affiliation(s)
- Gregory C Pratt
- University of Minnesota, School of Public Health, Division of Environmental Health, 420 Delaware St. S.E., Minneapolis, MN 55455, USA
| | - Mark R Stenzel
- Exposure Assessment Applications, LLC, 6045 27th St N, Arlington, VA 22207, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, P.O. Box 12233, MD A3-05, 111 T.W. Alexander Drive, Research Triangle Park, NC 22709, USA
| | - Caroline P Groth
- Department of Biostatistics, West Virginia University School of Public Health, 64 Medical Center Drive, P.O. Box 9190, Morgantown, WV 26506-9190, USA
| | - Sudipto Banerjee
- University of California-Los Angeles, School of Public Health, Department of Biostatistics, Suite: 51-254 CHS, 650 charles E. Young Drive South, Los Angeles, CA 90095, USA
| | - Susan F Arnold
- University of Minnesota, School of Public Health, Division of Environmental Health, 420 Delaware St. S.E., Minneapolis, MN 55455, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, P.O. Box 12233, MD A3-05, 111 T.W. Alexander Drive, Research Triangle Park, NC 22709, USA
- Department of Epidemiology, McGavran-Greenberg Hall, Campus Box 7435, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, P.O. Box 12233, MD A3-05, 111 T.W. Alexander Drive, Research Triangle Park, NC 22709, USA
| | - Patricia A Stewart
- Stewart Exposure Assessments, LLC, 6045 27th St N, Arlington, VA 22207, USA
| |
Collapse
|
44
|
Arnold S, Stewart PA, Pratt GC, Ramachandran G, Kwok RK, Engel LS, Sandler DP, Stenzel MR. Estimation of Aerosol Concentrations of Oil Dispersants COREXIT™ EC9527A and EC9500A during the Deepwater Horizon Oil Spill Response and Clean-up Operations. Ann Work Expo Health 2022; 66:i188-i202. [PMID: 35390130 PMCID: PMC8989030 DOI: 10.1093/annweh/wxab108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/26/2021] [Accepted: 11/28/2021] [Indexed: 11/14/2022] Open
Abstract
The April 2010 Deepwater Horizon drilling unit explosion at the Macondo oil well resulted in the release of approximately 779 million l of oil into the Gulf of Mexico. As part of the response effort to break up oil slicks on the water's surface, 6.81 million l of chemical dispersants COREXIT™ EC9500A and COREXIT™ EC9527A were applied by plane or vessel or injected near the seabed. The GuLF Long-term Follow-up Study is investigating possible adverse health effects of workers involved in the oil spill response and clean-up (OSRC). In this paper, we describe potential dispersant-related air concentrations generated from aerial spraying of dispersants to provide insight as to what concentrations OSRC workers may have been exposed under worst-case conditions. Personal exposure measurement data were not collected. Modeling, therefore, was conducted to estimate airborne concentrations of total aerosol to COREXIT™ EC9527A and EC9500A. Using the AgDISP model, we estimated air concentrations to dispersant total aerosols, defined as all components of the dispersant including active ingredients, surfactants, and water, resulting from aerial and vessel applications, as average 1-h and 2-min concentrations. For comparison, 1-h air concentrations associated with aerial spraying were estimated using another model, AERMOD. At 152 m horizontal to the flight path, average 1-h total aerosol concentrations associated with aerial applications were estimated to be as high as 49.3 µg m-3 (9527A) and 45.4 µg m-3 (9500A), and both decreased with increased distance from the flight line. The estimates for spraying 9500A from vessels indicated that total aerosol concentrations were potentially as high as 0.33 µg m-3 at 10 m from the nozzles. These results suggest that personal exposures to dispersant aerosols were negligible.
Collapse
Affiliation(s)
- Susan Arnold
- University of Minnesota, School of Public Health, Division of Environmental Health, 420 Delaware St SE, Minneapolis, MN 55455, USA
| | - Patricia A Stewart
- Stewart Exposure Assessments, LLC, 6045 N. 27th. St, Arlington, VA 22207, USA
| | - Gregory C Pratt
- University of Minnesota, School of Public Health, Division of Environmental Health, 420 Delaware St SE, Minneapolis, MN 55455, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, , 615 N. Wolfe St, Baltimore, MD 21205, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive - MD A3-05, Research Triangle Park, NC 27709, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive - MD A3-05, Research Triangle Park, NC 27709, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 35 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Dale P Sandler
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, , 615 N. Wolfe St, Baltimore, MD 21205, USA
| | - Mark R Stenzel
- Exposure Assessment Applications, LLC, 6045 N. 27th. St, Arlington, VA 22207, USA
| |
Collapse
|
45
|
Gorman Ng M, Cherrie JW, Sleeuwenhoek A, Stenzel M, Kwok RK, Engel LS, Cavallari JM, Blair A, Sandler DP, Stewart P. GuLF DREAM: A Model to Estimate Dermal Exposure Among Oil Spill Response and Clean-up Workers. Ann Work Expo Health 2022; 66:i218-i233. [PMID: 31334553 PMCID: PMC8989037 DOI: 10.1093/annweh/wxz037] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 02/14/2019] [Accepted: 04/29/2019] [Indexed: 12/17/2023] Open
Abstract
Tens of thousands of individuals performed oil spill response and clean-up (OSRC) activities following the 'Deepwater Horizon' oil drilling rig explosion in 2010. Many were exposed to oil residues and dispersants. The US National Institute of Environmental Health Sciences assembled a cohort of nearly 33 000 workers to investigate potential adverse health effects of oil spill exposures. Estimates of dermal and inhalation exposure are required for those individuals. Ambient breathing-zone measurements taken at the time of the spill were used to estimate inhalation exposures for participants in the GuLF STUDY (Gulf Long-term Follow-up Study), but no dermal measurements were collected. Consequently, a modelling approach was used to estimate dermal exposures. We sought to modify DREAM (DeRmal Exposure Assessment Method) to optimize the model for assessing exposure to various oil spill-related substances and to incorporate advances in dermal exposure research. Each DREAM parameter was reviewed in the context of literature published since 2000 and modified where appropriate. To reflect the environment in which the OSRC work took place, the model treatment of evaporation was expanded to include vapour pressure and wind speed, and the effect of seawater on exposure was added. The modified model is called GuLF DREAM and exposure is estimated in GuLF DREAM units (GDU). An external validation to assess the performance of the model for oils, tars, and fuels was conducted using available published dermal wipe measurements of heavy fuel oil (HFO) and dermal hand wash measurements of asphalt. Overall, measured exposures had moderate correlations with GDU estimates (r = 0.59) with specific correlations of -0.48 for HFO and 0.68 for asphalt. The GuLF DREAM model described in this article has been used to generate dermal exposure estimates for the GuLF STUDY. Many of the updates made were generic, so the updated model may be useful for other dermal exposure scenarios.
Collapse
Affiliation(s)
- Melanie Gorman Ng
- Centre for Human Exposure Science, Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - John W Cherrie
- Centre for Human Exposure Science, Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK
- Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh EH14 4AS, UK
| | - Anne Sleeuwenhoek
- Centre for Human Exposure Science, Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK
| | - Mark Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA 22207, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Jennifer M Cavallari
- Department of Community Medicine, University of Connecticut School of Medicine, Farmington, CT 06032, USA
| | - Aaron Blair
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD 27709, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA
| | | |
Collapse
|
46
|
Stewart P, Groth CP, Huynh TB, Gorman Ng M, Pratt GC, Arnold SF, Ramachandran G, Banerjee S, Cherrie JW, Christenbury K, Kwok RK, Blair A, Engel LS, Sandler DP, Stenzel MR. Assessing Exposures from the Deepwater Horizon Oil Spill Response and Clean-up. Ann Work Expo Health 2022; 66:i3-i22. [PMID: 35390131 PMCID: PMC8989041 DOI: 10.1093/annweh/wxab107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/31/2021] [Accepted: 11/10/2021] [Indexed: 01/05/2023] Open
Abstract
The GuLF Study is investigating adverse health effects from work on the response and clean-up after the Deepwater Horizon explosion and oil release. An essential and necessary component of that study was the exposure assessment. Bayesian statistical methods and over 135 000 measurements of total hydrocarbons (THC), benzene, ethylbenzene, toluene, xylene, and n-hexane (BTEX-H) were used to estimate inhalation exposures to these chemicals for >3400 exposure groups (EGs) formed from three exposure determinants: job/activity/task, location, and time period. Recognized deterministic models were used to estimate airborne exposures to particulate matter sized 2.5 µm or less (PM2.5) and dispersant aerosols and vapors. Dermal exposures were estimated for these same oil-related substances using a model modified especially for this study from a previously published model. Exposures to oil mist were assessed using professional judgment. Estimated daily THC arithmetic means (AMs) were in the low ppm range (<25 ppm), whereas BTEX-H exposures estimates were generally <1000 ppb. Potential 1-h PM2.5 air concentrations experienced by some workers may have been as high as 550 µg m-3. Dispersant aerosol air concentrations were very low (maximum predicted 1-h concentrations were generally <50 µg m-3), but vapor concentrations may have exceeded occupational exposure excursion guidelines for 2-butoxyethanol under certain circumstances. The daily AMs of dermal exposure estimates showed large contrasts among the study participants. The estimates are being used to evaluate exposure-response relationships in the GuLF Study.
Collapse
Affiliation(s)
- Patricia Stewart
- Stewart Exposure Assessments, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA,Author to whom correspondence should be addressed. Tel: +0/703-534-2956; e-mail:
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, One Medical Center Drive, Morgantown, WV 26506, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, 3215 Market St., Philadelphia, PA 19104, USA
| | - Melanie Gorman Ng
- School of Population and Public Health, Faculty of Medicine, 3rd Floor, 2206 East Mall, Vancouver, BC V6T 1Z3Canada
| | - Gregory C Pratt
- Division of Environmental Health, University of Minnesota, School of Public Health, 420 Delaware St. S.E., Minneapolis, MN 55455, USA
| | - Susan F Arnold
- Division of Environmental Health, University of Minnesota, School of Public Health, 420 Delaware St. S.E., Minneapolis, MN 55455, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St., Baltimore, MD 21205, USA,Department of Biostatistics, Suite: 51-254 CHS. UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Suite: 51-254 CHS. UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA
| | - John W Cherrie
- Insitute of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh, Midlothian EH14 4AP, UK
| | - Kate Christenbury
- Public Health Sciences, Social and Scientific Systems Inc., a DLH Holdings Company, 4505 Emperor Blvd, Suite 400, Durham, NC 27703, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA,Office of the Director, National Institute of Environmental Health Sciences, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Aaron Blair
- National Cancer Institute, 9609 Medical Center Drive, Building 9609 MSC 9760, Bethesda, MD 20892-9760, USA
| | - Lawrence S Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 35 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive – MD A3-05, Research Triangle Park, NC 27709, USA
| | - Mark R Stenzel
- Exposure Assessment Applications, LLC, 6045 N. 27th. St., Arlington, VA 22207, USA
| |
Collapse
|
47
|
Barua VB, Juel MAI, Blackwood AD, Clerkin T, Ciesielski M, Sorinolu AJ, Holcomb DA, Young I, Kimble G, Sypolt S, Engel LS, Noble RT, Munir M. Tracking the temporal variation of COVID-19 surges through wastewater-based epidemiology during the peak of the pandemic: A six-month long study in Charlotte, North Carolina. Sci Total Environ 2022; 814:152503. [PMID: 34954186 PMCID: PMC8697423 DOI: 10.1016/j.scitotenv.2021.152503] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 05/05/2023]
Abstract
The global spread of SARS-CoV-2 has continued to be a serious concern after WHO declared the virus to be the causative agent of the coronavirus disease 2019 (COVID-19) a global pandemic. Monitoring of wastewater is a useful tool for assessing community prevalence given that fecal shedding of SARS-CoV-2 occurs in high concentrations by infected individuals, regardless of whether they are asymptomatic or symptomatic. Using tools that are part of wastewater-based epidemiology (WBE) approach, combined with molecular analyses, wastewater monitoring becomes a key piece of information used to assess trends and quantify the scale and dynamics of COVID-19 infection in a specific community, municipality, or area of service. This study investigates a six-month long SARS-CoV-2 RNA quantification in influent wastewater from four municipal wastewater treatment plants (WWTP) serving the Charlotte region of North Carolina (NC) using both RT-qPCR and RT-ddPCR platforms. Influent wastewater was analyzed for the nucleocapsid (N) genes N1 and N2. Both RT-qPCR and RT-ddPCR performed well for detection and quantification of SARS-CoV-2 using the N1 target, while for the N2 target RT-ddPCR was more sensitive. SARS-CoV-2 concentration ranged from 103 to 105 copies/L for all four plants. Both RT-qPCR and RT-ddPCR showed a significant positive correlation between SARS-CoV-2 concentrations and the 7-day rolling average of clinically reported COVID-19 cases when lagging 5 to 12 days (ρ = 0.52-0.92, p < 0.001-0.02). A major finding of this study is that RT-qPCR and RT-ddPCR generated SARS-CoV-2 data that was positively correlated (ρ = 0.569, p < 0.0001) and can be successfully used to monitor SARS-CoV-2 signals across the WWTP of different sizes and metropolitan service functions without significant anomalies.
Collapse
Affiliation(s)
- Visva Bharati Barua
- Department of Civil and Environmental Engineering, University of North Carolina Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA
| | - Md Ariful Islam Juel
- Department of Civil and Environmental Engineering, University of North Carolina Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA
| | - A Denene Blackwood
- Institute of Marine Sciences, The University of North Carolina at Chapel Hill, Morehead City, NC 28557, USA
| | - Thomas Clerkin
- Institute of Marine Sciences, The University of North Carolina at Chapel Hill, Morehead City, NC 28557, USA
| | - Mark Ciesielski
- Institute of Marine Sciences, The University of North Carolina at Chapel Hill, Morehead City, NC 28557, USA
| | - Adeola Julian Sorinolu
- Department of Civil and Environmental Engineering, University of North Carolina Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA
| | - David A Holcomb
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Isaiah Young
- Department of Civil and Environmental Engineering, University of North Carolina Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA
| | - Gina Kimble
- Charlotte Water, 5100 Brookshire Blvd., Charlotte, NC 28216, USA
| | - Shannon Sypolt
- Charlotte Water, 5100 Brookshire Blvd., Charlotte, NC 28216, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Rachel T Noble
- Institute of Marine Sciences, The University of North Carolina at Chapel Hill, Morehead City, NC 28557, USA
| | - Mariya Munir
- Department of Civil and Environmental Engineering, University of North Carolina Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA.
| |
Collapse
|
48
|
Quist AJL, Fliss MD, Wade TJ, Delamater PL, Richardson DB, Engel LS. Hurricane flooding and acute gastrointestinal illness in North Carolina. Sci Total Environ 2022; 809:151108. [PMID: 34688737 PMCID: PMC8770555 DOI: 10.1016/j.scitotenv.2021.151108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/15/2021] [Accepted: 10/16/2021] [Indexed: 05/28/2023]
Abstract
Hurricanes often flood homes and industries, spreading pathogens. Contact with pathogen-contaminated water can result in diarrhea, vomiting, and/or nausea, known collectively as acute gastrointestinal illness (AGI). Hurricanes Matthew and Florence caused record-breaking flooding in North Carolina (NC) in October 2016 and September 2018, respectively. To examine the relationship between hurricane flooding and AGI in NC, we first calculated the percent of each ZIP code flooded after Hurricanes Matthew and Florence. Rates of all-cause AGI emergency department (ED) visits were calculated from NC's ED surveillance system data. Using controlled interrupted time series, we compared AGI ED visit rates during the three weeks after each hurricane in ZIP codes with a third or more of their area flooded to the predicted rates had these hurricanes not occurred, based on AGI 2016-2019 ED trends, and controlling for AGI ED visit rates in unflooded areas. We examined alternative case definitions (bacterial AGI) and effect measure modification by race and age. We observed an 11% increase (rate ratio (RR): 1.11, 95% CI: 1.00, 1.23) in AGI ED visit rates after Hurricanes Matthew and Florence. This effect was particularly strong among American Indian patients and patients aged 65 years and older after Florence and elevated among Black patients for both hurricanes. Florence's effect was more consistent than Matthew's effect, possibly because little rain preceded Florence and heavy rain preceded Matthew. When restricted to bacterial AGI, we found an 85% (RR: 1.85, 95% CI: 1.37, 2.34) increase in AGI ED visit rate after Florence, but no increase after Matthew. Hurricane flooding is associated with an increase in AGI ED visit rate, although the strength of effect may depend on total storm rainfall or antecedent rainfall. American Indians and Black people-historically pushed to less desirable, flood-prone land-may be at higher risk for AGI after storms.
Collapse
Affiliation(s)
- Arbor J L Quist
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA.
| | - Mike Dolan Fliss
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Timothy J Wade
- Public Health and Environmental Systems Division, United States Environmental Protection Agency, Chapel Hill, NC 27514, USA
| | - Paul L Delamater
- Department of Geography, University of North Carolina, Chapel Hill, NC 27514, USA
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| |
Collapse
|
49
|
Kwok RK, Jackson WB, Curry MD, Stewart PA, McGrath JA, Stenzel M, Huynh TB, Groth CP, Ramachandran G, Banerjee S, Pratt GC, Miller AK, Zhang X, Engel LS, Sandler DP. Association of Deepwater Horizon Oil Spill Response and Cleanup Work With Risk of Developing Hypertension. JAMA Netw Open 2022; 5:e220108. [PMID: 35195699 PMCID: PMC8867245 DOI: 10.1001/jamanetworkopen.2022.0108] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
IMPORTANCE Exposure to hydrocarbons, fine particulate matter (PM2.5), and other chemicals from the April 20, 2010, Deepwater Horizon disaster may be associated with increased blood pressure and newly detected hypertension among oil spill response and cleanup workers. OBJECTIVE To determine whether participation in cleanup activities following the disaster was associated with increased risk of developing hypertension. DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted via telephone interviews and in-person home exams. Participants were 6846 adults who had worked on the oil spill cleanup (workers) and 1505 others who had completed required safety training but did not do cleanup work (nonworkers). Eligible participants did not have diagnosed hypertension at the time of the oil spill. Statistical analyses were performed from June 2018 to December 2021. EXPOSURES Engagement in cleanup activities following the Deepwater Horizon oil spill disaster, job classes, quintiles of cumulative total hydrocarbons exposure level, potential exposure to burning or flaring oil, and estimated PM2.5 were examined. MAIN OUTCOMES AND MEASURES Systolic and diastolic blood pressure measurements were collected during home exams from 2011 to 2013 using automated oscillometric monitors. Newly detected hypertension was defined as antihypertensive medication use or elevated blood pressure since the spill. Log binomial regression was used to calculate prevalence ratios (PR) and 95% CIs for associations between cleanup exposures and hypertension. Multivariable linear regression was used to estimate exposure effects on continuous blood pressure levels. RESULTS Of 8351 participants included in this study, 6484 (77.6%) were male, 517 (6.2%) were Hispanic, 2859 (34.2%) were non-Hispanic Black, and 4418 (52.9%) were non-Hispanic White; the mean (SD) age was 41.9 (12.5) years at enrollment. Among workers, the prevalence of newly detected hypertension was elevated in all quintiles (Q) of cumulative total hydrocarbons above the first quintile (PR for Q3, 1.29 [95% CI, 1.13-1.46], PR for Q4, 1.25 [95% CI, 1.10-1.43], and PR for Q5, 1.31 [95% CI, 1.15-1.50]). Both exposure to burning and/or flaring oil and gas (PR, 1.16 [95% CI, 1.02-1.33]) and PM2.5 from burning (PR, 1.26 [95% CI, 0.89-1.71]) for the highest exposure category were associated with increased risk of newly detected hypertension, as were several types of oil spill work including cleanup on water (PR, 1.34 [95% CI, 1.08-1.66]) and response work (PR, 1.51 [95% CI, 1.20-1.90]). CONCLUSIONS AND RELEVANCE Oil spill exposures were associated with newly detected hypertension after the Deepwater Horizon disaster. These findings suggest that blood pressure screening should be considered for workers with occupational hydrocarbon exposures.
Collapse
Affiliation(s)
- Richard K. Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
- Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - W. Braxton Jackson
- Social & Scientific Systems, Inc, a DLH holdings company, Durham, North Carolina
| | | | | | - John A. McGrath
- Social & Scientific Systems, Inc, a DLH holdings company, Durham, North Carolina
| | - Mark Stenzel
- Exposure Assessment Applications, LLC, Arlington, Virginia
| | - Tran B. Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Caroline P. Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Sudipto Banerjee
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California, Los Angeles
| | - Gregory C. Pratt
- Division of Environmental Health, School of Public Health, University of Minnesota, Minneapolis
| | - Aubrey K. Miller
- Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Xian Zhang
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill
| | - Lawrence S. Engel
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
| |
Collapse
|
50
|
Chen D, Lawrence KG, Pratt GC, Stenzel MR, Stewart PA, Groth CP, Banerjee S, Christenbury K, Curry MD, Jackson WB, Kwok RK, Blair A, Engel LS, Sandler DP. Fine Particulate Matter and Lung Function among Burning-Exposed Deepwater Horizon Oil Spill Workers. Environ Health Perspect 2022; 130:27001. [PMID: 35103485 PMCID: PMC8805798 DOI: 10.1289/ehp8930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 11/01/2021] [Accepted: 01/03/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND During the 2010 Deepwater Horizon (DWH) disaster, controlled burning was conducted to remove oil from the water. Workers near combustion sites were potentially exposed to increased fine particulate matter [with aerodynamic diameter ≤2.5μm (PM2.5)] levels. Exposure to PM2.5 has been linked to decreased lung function, but to our knowledge, no study has examined exposure encountered in an oil spill cleanup. OBJECTIVE We investigated the association between estimated PM2.5 only from burning/flaring of oil/gas and lung function measured 1-3 y after the DWH disaster. METHODS We included workers who participated in response and cleanup activities on the water during the DWH disaster and had lung function measured at a subsequent home visit (n=2,316). PM2.5 concentrations were estimated using a Gaussian plume dispersion model and linked to work histories via a job-exposure matrix. We evaluated forced expiratory volume in 1 s (FEV1; milliliters), forced vital capacity (FVC; milliliters), and their ratio (FEV1/FVC; %) in relation to average and cumulative daily maximum exposures using multivariable linear regressions. RESULTS We observed significant exposure-response trends associating higher cumulative daily maximum PM2.5 exposure with lower FEV1 (p-trend=0.04) and FEV1/FVC (p-trend=0.01). In comparison with the referent group (workers not involved in or near the burning), those with higher cumulative exposures had lower FEV1 [-166.8mL, 95% confidence interval (CI): -337.3, 3.7] and FEV1/FVC (-1.7, 95% CI: -3.6, 0.2). We also saw nonsignificant reductions in FVC (high vs. referent: -120.9, 95% CI: -319.4, 77.6; p-trend=0.36). Similar associations were seen for average daily maximum PM2.5 exposure. Inverse associations were also observed in analyses stratified by smoking and time from exposure to spirometry and when we restricted to workers without prespill lung disease. CONCLUSIONS Among oil spill workers, exposure to PM2.5 specifically from controlled burning of oil/gas was associated with significantly lower FEV1 and FEV1/FVC when compared with workers not involved in burning. https://doi.org/10.1289/EHP8930.
Collapse
Affiliation(s)
- Dazhe Chen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kaitlyn G. Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Gregory C. Pratt
- Division of Environmental Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Mark R. Stenzel
- Exposure Assessment Applications, LLC, Arlington, Virginia, USA
| | | | - Caroline P. Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Fielding School of Public Health, University of California–Los Angeles, Los Angeles, California, USA
| | | | | | | | - Richard K. Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
- Office of the Director, National Institute of Environmental Health Sciences, Bethesda, Maryland, USA
| | - Aaron Blair
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Lawrence S. Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| |
Collapse
|