Associations Between Oil Spill Exposure Patterns and Acute Symptoms in United States Coast Guard Responders During the Deepwater Horizon Response.

As the Deepwater Horizon disaster unfolds in the Gulf of Mexico, public health practitioners are having a sinking deja vu feeling. Once again, environmental disaster has struck, and tens of thousands of emergency responders—some professionals, but many more volunteers—have swung into action, potentially risking their health as they work to clean up the worst oil spill in U.S. history. Veterans of similar disasters are wondering if historical lessons learned can help keep the damage to a bare minimum. But a paucity of hard data on emergency responder health makes it difficult even to ask the right questions. “Emergency responders have not been adequately studied,” says Gina Solomon, codirector of the occupational and environmental medicine residency and fellowship program at the University of California, San Francisco, and a senior scientist with the Natural Resources Defense Council. “They tend to be ignored.” Professional emergency responders such as firefighters may not put much emphasis on health effects studies. “They are going to do what they need to do regardless of their own safety,” says Don Donahue, executive director of the Center for Health Policy & Preparedness at the Potomac Institute for Policy Studies, who has firefighters in his extended family. “They have to be a little crazy by definition.” That heroic approach is manna for the people they save, but firefighters may pay a price with disorders such as cancer. Studies of cancers in firefighters have had mixed results, but there is evidence linking this occupation with brain, thyroid, esophageal, bladder, testicular, prostate, and cervical cancers, as well as melanoma and Hodgkin disease (Bates1 and Ma et al.2 are two such studies). Health risks tend to be even greater for the many nonprofessional emergency responders who rush to the scene of crises such as oil spills, terrorist attacks, hurricanes, train derailments, and chemical releases. Those workers often don’t have the training and advanced equipment that protect professional emergency responders to some degree. These and many other factors make it a daunting challenge to protect the health of emergency responders during disasters.

Environmental Health Insights into the 2010 Deepwater Horizon (BP) Oil Blowout

Part I of this three-part set of articles focused on the various types and amounts of oil inputs to the marine environment. The complexity of the mixture of chemicals making up crude oils, fuel oil...

Disclaimer: The contents, views or opinions expressed in this presentation are those of the author(s) and do not necessarily reflect official policy or position of Uniformed Services University of the Health Sciences, the Department of Defense (DoD), or the United States Coast Guard. 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 post-deployment surveys on a number of topics, including oil spill-related exposures and experiences. Methods: This secondary data analysis of survey responses used latent class analysis (LCA) methods to determine the most common exposure patterns in this population of responders. Our LCA model was based on six indicator variables assumed to be independent of each other within latent classes. The indicator variables reflected different aspects of the responders’ experiences: exposure to oil, exposure to engine exhaust fumes, hand sanitizer use, sunblock use, mosquito bites, and level of anxiety. To assess the convergent construct validity of these models, we considered the relationship of the latent classes to indicators not used in the latent class models. We also considered the relationship to the types of missions reported by cohort participants. Results: The data were consistent with four exposure profiles, which we interpreted as “low exposure”, “higher environmental hazard exposure and moderate time outdoors, “moderate environmental hazard exposure and more time outdoors”, and “high exposure to both environmental hazards and time outdoors”. The tests for convergent construct validity supported this interpretation of the latent classes. For example, participants in administrative roles were most likely to be in the low-exposure latent class. Conclusions: The exposure pattern variables resulting from this analysis can help inform future studies of the health impacts of exposure mixtures among oil spill responders.

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.

Response to “The unknown: respiratory effects of cleaning up an oil spill”

#2017-373 Federal agencies involved in oil spill response in the U.S. are required to comply with several environmental compliance laws. Where a Federal agency is operating in a way that may affect endangered species in the area, Section 7 of the Endangered Species Act (ESA) requires the agency to “consult” with the two Federal agencies responsible for protecting those species and habitats – the National Marine Fisheries Service (NMFS) and the United States Fish and Wildlife Service (USFWS). Following the Deepwater Horizon oil spill, nonprofit organizations filed several lawsuits against the U.S. Coast Guard (USCG) and the Environmental Protection Agency (EPA) (the “Action Agencies”) for failure to comply with the ESA during oil spill contingency planning. In one case, a settlement required the Action Agencies to consult with the NMFS and USFWS (together, called the “Services”) on the plan to use oil spill dispersants in California waters. Perhaps responding to these developments, several Regional Response Teams across the country initiated or made plans to review the status of their ESA Section 7 consultations. These efforts have varied in cost, scope, composition of agency representatives involved, and success in completing a consultation for a variety of reasons. There have been numerous challenges for USCG and EPA in meeting the ESA Section 7 consultation requirements for oil spill planning. First, the most recent framework for cooperation between the Action Agencies and the Services regarding consulting on oil spill planning and response activities is contained in an Interagency Memorandum of Agreement (MOA) signed in 2001. Although the agreement is still valid, some parts have been identified as outdated or in need of clarification. Secondly, there are no direct funding mechanisms or dedicated personnel assigned to the Action Agencies to work on pre-spill ESA Section 7 consultations. Third, recommendations and consultation outcomes can vary between Service agencies as well as internally within each Service agency due to a high level of regional autonomy. In 2015, the National Response Team (NRT) formed a new, interagency subcommittee to improve the Federal Action Agencies’ ability to comply with environmental laws such as the ESA with respect to oil spill response and pre-spill planning. A workgroup of the NRT Subcommittee was formed to specifically address pre-spill ESA Section 7 consultation processes. The workgroup includes regional and national representatives from the Action Agencies and the Services. In addition to strengthening relationships and understanding among the participating agencies, the workgroup has identified gaps in the 2001 MOA and is in the process of developing tools and templates on how to conduct pre-spill ESA Section 7 consultations to help fill some of the existing gaps. The workgroup ultimately hopes to facilitate the development of updated, complete, efficient, and consistent ESA Section 7 consultations across the nation.

ObjectivesLong-term studies of oil spill responders are urgently needed as oil spills continue to occur. To this end, we established the prospective Deepwater Horizon (DWH) Oil Spill Coast Guard Cohort...

Background/Aim: The 2010 Deepwater Horizon (DWH) Oil Spill was the largest marine oil spill in U.S. history. Over 8,500 U.S. Coast Guard (USCG) members were deployed to carry out a wide range of response and clean-up activities. Measures of oil spill response work, such as deployment length, timing, and oil exposure, may have an acute mental health impact. This population of USCG responders, many of whom are young, healthy, and have equal access to healthcare, has the unique potential to address challenges in understanding mental health impacts of disaster response work.Methods: In this cross-sectional study of 4,855 USCG responders, deployment-related exposures, health symptoms, and lifestyle factors were ascertained via post-deployment surveys. An oil exposure index (OEI), which incorporated duration/timing of response and self-reported crude oil exposure, was developed to semi-quantitatively estimate crude oil exposure(none; medium/low; high). To investigate associations with self-reported anxiety and depression, we used adjusted log-binomial regressions to calculate prevalence ratios (PRs) and95% confidence intervals (CI).Results: Deployment duration of >30 days (versus <30 days) was significantly associated with increased prevalence of anxiety (PR=1.55, 95% CI: 1.19-2.05). Higher levels of OEI (versus none) were associated with anxiety (PRmedium/low=1.52, 95%CI= 1.26-1.83; PRhigh=1.70, 95% CI:1.44-2.03) and depression (PRmedium/low=1.72, 95%CI= 1.32-2.26; PRhigh=1.89, 95% CI: 1.47-2.42); p-trend<0.0001 for both.Conclusions: Our study found cross-sectional associations between oil spill response work and self-reported mental health symptoms among USCG responders. These findings may help inform disaster planners in implementing interventions to mitigate adverse health effects among response workers in future disasters.Disclaimer: The contents, views or opinions expressed in this presentation are those of the authors and do not necessarily reflect official policy or position of USU, the Department of Defense, or the USCG.

ABSTRACTThe Deepwater Horizon (DWH) oil spill was a pivotal moment in the expression of and reporting on stakeholder risk perceptions about oil spills, response options, and safety. Public engagement through both traditional and social media was arguably much higher than in prior spills. The DWH response organization undertook a wide variety of activities to manage risks and communicate with both the general public and those directly affected, such as commercial fishers. However, these did not fully address widespread concerns about ecological and human health risks associated with dispersant use. Consequentially the DWH spill heightened awareness of persistent risk communication problems around oil spill response, and especially dispersant use. Oil spill risk research and experience suggests that institutional and operational factors inhibit engaging communities and stakeholders during oil spill preparedness and response, and that such engagement is essential for effective risk management. In this article we review and assess current oil spill preparedness and response practices for community and stakeholder engagement, including related institutional and operational constraints. This assessment suggests five example risk management practices to improve and advance risk communications during oil spill preparedness and response activities.

The deepwater horizon oil spill coast guard cohort study: A cross-sectional study of acute respiratory health symptoms

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.

Adverse mental health effects have been reported following oil spills but few studies have identified specific responsible attributes of the clean-up experience. We aimed to analyse the effects of the 2010 Deepwater Horizon (Gulf of Mexico) disaster on the mental health of individuals involved in oil spill response and clean-up. We used data from the Gulf Long-term Follow-up Study, a cohort of workers and volunteers involved in oil spill clean-up after the Deepwater Horizon disaster. We included 8968 workers (hired after completing training for oil spill response and clean-up) and 2225 non-workers (completed training but were not hired) who completed a Patient Health Questionnaire-8 and four-item Primary Care PTSD Screen to assess for probable depression and post-traumatic stress disorder (PTSD) indicators. Participants were recruited between March 28, 2011, and March 29, 2013. The mental health indicators were assessed at home visits done between May 12, 2011, and May 15, 2013. We used regression models to analyse the effect of potentially stressful job experiences, job type, and total hydrocarbon exposure on mental health indicators. Oil spill response and clean-up work was associated with increased prevalence of depression (prevalence ratio [PR] 1·22, 95% CI 1·08-1·37) and PTSD (PR 1·35, 95% CI 1·07-1·71). Among workers, individuals who reported smelling oil, dispersants, or cleaning chemicals had an elevated prevalence of depression (1·56, 1·37-1·78) and PTSD (2·25, 1·71-2·96). Stopping work because of the heat was also associated with depression (1·37, 1·23-1·53) and PTSD (1·41, 1·15-1·74), as was working as a commercial fisherman before the spill (1·38, 1·21-1·57; and 2·01, 1·58-2·55, respectively). An increase in exposure to total hydrocarbons appeared to be associated with depression and PTSD, but after taking into account oil spill job experiences, only the association between the highest amount of total hydrocarbons and PTSD remained (1·75, 1·11-2·76). Oil spill clean-up workers with high amounts of total hydrocarbon exposure or potentially stressful job experiences had an increased prevalence of depression and PTSD. These findings provide evidence that response and clean-up work is associated with adverse psychological effects and suggest the need for mental health services both before and after the event. National Institutes of Health (NIH) Common Fund and the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences.

The use of chemical dispersants during oil spill responses has long been controversial. During the Deepwater Horizon (DWH) oil spill, 1.8 million gallons of dispersant, mainly Corexit 9500, were applied in offshore waters to mitigate the human health and coastal environmental impact of surface oil contamination. To evaluate the potential impact of the dispersant on marine life, 18 species, representing important ecological and commercial taxa, were tested using low-energy, dispersant-only water accommodated fractions (WAFs) of Corexit 9500 and standard acute toxicity test methods. All prepared WAFs were analytically characterized. Analyses included the two dispersant markers found in the dispersant and evaluated in samples collected during the DWH Response, dioctylsulfosuccinate sodium salt, and dipropylene glycol n-butyl ether (DPnB). The median lethal and effective concentrations (LC/EC50s) were calculated using a nominal exposure concentration (mg/L, based on the experimental loading rate of 50mg/L) and measured DPnB (µg/L). Results ranged from 5.50 to > 50mg/L dispersant and 492 to > 304,000µg/L DPnB. Species sensitivity distributions of the data demonstrated that taxa were evenly distributed; however, algae and oysters were among the more sensitive organisms. The calculated 5% hazard concentration (HC5) for DPnB (1172µg/L) was slightly higher than the USEPA chronic criteria of 1000µg/L and substantially higher than all measured concentrations of DPnB measured in the Gulf of Mexico during the DWH oil spill response.

Neurological symptoms associated with oil spill response exposures: Results from the Deepwater Horizon Oil Spill Coast Guard Cohort Study