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Daphne Sze Ki Cheung,1 Lily Yuen Wah Ho,1 Liliane Chui King Chan,2 Robin Ka Ho Kwok,1 Claudia Kam Yuk Lai1 1School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, People’s Republic of China; 2Ho Cheung Shuk Yuen Charitable Foundation, Hong Kong Special Administrative Region, People’s Republic of ChinaCorrespondence: Daphne Sze Ki Cheung, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, People’s Republic of China, Tel +852 2766 4534, Email daphne.cheung@polyu.edu.hk; Cheungdaphne@gmail.comBackground: Integrating evidence-based music-with-movement into routine practices for people with dementia requires effective implementation strategies. The objectives of this study were to evaluate the clinical efficacy of the intervention and to examine the effectiveness of the implementation strategies in promoting home-based adoption.Methods: This was a cluster randomized controlled trial adopting a clinical effectiveness-implementation hybrid design. The 12-week music-with-movement intervention aims to promote the well-being of people with dementia and their caregivers. Clinical outcomes were assessed to evaluate the efficacy of the intervention. These included the symptoms of anxiety and depression of people with dementia; caregivers’ perception of their stress and the positive aspects of caregiving; and the quality of the dyadic relationship. Caregivers, staff, and volunteers were interviewed and objective figures on reach and adoption were collected to reflect the outcomes of the implementation.Results: Compared to the waitlist control, there was a significant reduction in the anxiety and the symptoms of depression of those in the intervention group. There was also a significant reduction in the perceived stress level of the caregivers. Six focus group interviews were conducted. The intervention and the appropriateness of the implementation strategies were perceived positively by the dyad participants, the staff of the centres, and volunteers. Of the collaborating centres, 57% continued to use the intervention and, after six months, served six times more people than were recruited in this study. Over half of the participating families continued to use the intervention for at least six more months.Conclusion: Music-with-movement interventions showed promise for improving the well-being of people with dementia and their caregivers. Effective strategies facilitated the implementation process, such as integrating communication technology to provide instant support and involving volunteers in engaging the collaborating centres and families. This study sheds light on perceptions of the intervention, and on its scalability for a broader population.Trial Registration: NCT03575026, Registered 2 July 2018.Keywords: music, dementia, implementation, acceptability, well-being

Background: Burning/flaring of oil/gas during the Deepwater Horizon oil spill response and cleanup (OSRC) generated high concentrations of fine particulate matter (PM 2.5 ). Personnel working on the water during these activities may have inhaled combustion products. Neurologic effects of PM 2.5 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 PM 2.5 and measures of sensory and motor nerve function among OSRC workers., Methods: PM 2.5 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 PM 2.5 and sensory or motor nerve function, although there was a suggestion of impairment based on single leg stance among individuals with high exposure to PM 2.5 . 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., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Wildfires are increasing in frequency and intensity, with significant consequences that impact human health. A scoping review was conducted to: (a) understand wildfire-related health effects, (b) identify and describe environmental exposure and health outcome data sources used to research the impacts of wildfire exposures on health, and (c) identify gaps and opportunities to leverage exposure and health data to advance research. A literature search was conducted in PubMed and a sample of 83 articles met inclusion criteria. A majority of studies focused on respiratory and cardiovascular outcomes. Hospital administrative data was the most common health data source, followed by government data sources and health surveys. Wildfire smoke, specifically fine particulate matter (PM 2.5 ), was the most common exposure measure and was predominantly estimated from monitoring networks and satellite data. Health data were not available in real-time, and they lacked spatial and temporal coverage to study health outcomes with longer latency periods. Exposure data were often available in real-time and provided better temporal and spatial coverage but did not capture the complex mixture of hazardous wildfire smoke pollutants nor exposures associated with non-air pathways such as soil, household dust, food, and water. This scoping review of the specific health and exposure data sources used to underpin these studies provides a framework for the research community to understand: (a) the use and value of various environmental and health data sources, and (b) the opportunities for improving data collection, integration, and accessibility to help inform our understanding of wildfires and other environmental exposures., Competing Interests: The authors declare no conflicts of interest relevant to this study., (© 2024 The Authors. GeoHealth published by Wiley Periodicals LLC on behalf of American Geophysical Union. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)

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., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Disaster events adversely affect the health of millions of individuals each year. They create exposure to physical, chemical, biological, and psychosocial hazards while simultaneously exploiting community and individual-level vulnerabilities that allow such exposures to exert harm. Since 2013, the National Institute of Environmental Health Sciences (NIEHS) has led the development of the Disaster Research Response (DR2) program and infrastructure; however, research exploring the nature and effects of disasters on human health is lacking. One reason for this research gap is the challenge of developing and deploying cost-effective sensors for exposure assessment during disaster events., Objectives: The objective of this commentary is to synergize the consensus findings and recommendations from a panel of experts on sensor science in support of DR2., Methods: The NIEHS convened the workshop, "Getting Smart about Sensors for Disaster Response Research" on 28 and 29 July 2021 to discuss current gaps and recommendations for moving the field forward. The workshop invited full discussion from multiple viewpoints, with the goal of identifying recommendations and opportunities for further development of this area of research. The panel of experts included leaders in engineering, epidemiology, social and physical sciences, and community engagement, many of whom had firsthand experience with DR2., Discussion: The primary finding of this workshop is that exposure science in support of DR2 is severely lacking. We highlight unique barriers to DR2, such as the need for time-sensitive exposure data, the chaos and logistical challenges that ensue from a disaster event, and the lack of a robust market for sensor technologies in support of environmental health science. We highlight a need for sensor technologies that are more scalable, reliable, and versatile than those currently available to the research community. We also recommend that the environmental health community renew efforts in support of DR2 facilitation, collaboration, and preparedness. https://doi.org/10.1289/EHP12270.

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.

Background: Atrazine simazine and propazine, widely used triazine herbicides on food crops and in residential areas, disrupt the neuroendocrine system raising human health concerns. USEPA developed a PBPK model based on triazine common Mode of Action (MOA)-suppression of luteinizing hormone surge in female rats-to generate human regulatory points of departure (POD: mg/kg/day). We compared triazine Human Administered Equivalent Dose (AED Human mg/kg/day) predictions from open access computational tools to the PBPK PODs to assess concordance., Methods: Computational tools were the following: ToxCast/Tox21 in vitro assays; Toxicogenomic databases to assess concordance with ToxCast/Tox21 targets; integrated chemical environment (ICE) models with ToxCast/Tox21 inputs to predict AED Human PODs and population-based age-refined high throughput toxicokinetics (HTTK-Pop) to compare to age-related PBPK PODs., Results: ToxCast/Tox21 assays identified critical targets in the triazine common MOA and gene databases; ICE AED Human predictions were mainly concordant with the USEPA PBPK PODs quantitatively. Low fold-differences between PBPK POD and ICE AED Human predictions indicated that the ICE models are health-protective. HTTK-Pop age-refinements were within 10-fold of the USEPA PBPK PODs., Conclusions: CompTox tools were used to identify assay targets in the MOA and identify potential molecular initiating targets in the adverse outcome pathway for potential use in risk assessment., (© 2022 Wiley Periodicals LLC.)

Harmonized language is essential to finding, sharing, and reusing large-scale, complex data. Gaps and barriers prevent the adoption of harmonized language approaches in environmental health sciences (EHS). To address this, the National Institute of Environmental Health Sciences and partners created the Environmental Health Language Collaborative (EHLC). The purpose of EHLC is to facilitate a community-driven effort to advance the development and adoption of harmonized language approaches in EHS. EHLC is a forum to pinpoint language harmonization gaps, to facilitate the development of, raise awareness of, and encourage the use of harmonization approaches and tools, and to develop new standards and recommendations. To ensure that EHLC's focus and structure would be sustainable long-term and meet the needs of the field, EHLC launched an inaugural workshop in September 2021 focused on "Developing Sustainable Language Solutions" and "Building a Sustainable Community". When the attendees were surveyed, 91% said harmonized language solutions would be of high value/benefit, and 60% agreed to continue contributing to EHLC efforts. Based on workshop discussions, future activities will focus on targeted collaborative use-case working groups in addition to offering education and training on ontologies, metadata, and standards, and developing an EHS language resource portal.

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 (PM 2.5 ). Exposure to PM 2.5 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 PM 2.5 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). PM 2.5 exposures were estimated using a job-exposure matrix that linked modelled PM 2.5 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 PM 2.5 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/m 3 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/m 3 -d increase: HR = 1.03, 95% CI: 1.00, 1.05)., Conclusions: Among oil spill workers, exposure to PM 2.5 from flaring/burning of oil/gas was associated with increased risk of CHD., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

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 (p trend  = 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., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Quantifying the exposome is key to understanding how the environment impacts human health and disease. However, accurately, and cost-effectively quantifying exposure in large population health studies remains a major challenge. Geospatial technologies offer one mechanism to integrate high-dimensional environmental data into epidemiology studies, but can present several challenges. In June 2021, the National Institute of Environmental Health Sciences (NIEHS) held a workshop bringing together experts in exposure science, geospatial technologies, data science and population health to address the need for integrating multiscale geospatial environmental data into large population health studies. The primary objectives of the workshop were to highlight recent applications of geospatial technologies to examine the relationships between environmental exposures and health outcomes; identify research gaps and discuss future directions for exposure modeling, data integration and data analysis strategies; and facilitate communications and collaborations across geospatial and population health experts. This commentary provides a high-level overview of the scientific topics covered by the workshop and themes that emerged as areas for future work, including reducing measurement errors and uncertainty in exposure estimates, and improving data accessibility, data interoperability, and computational approaches for more effective multiscale and multi-source data integration, along with potential solutions.

Objective: To examine the frequency of, and risk factors for, disease flare following COVID-19 vaccination in patients with systemic rheumatic disease (SRD)., Methods: An international study was conducted from 2 April to 16 August 2021, using an online survey of 5619 adults with SRD for adverse events following COVID-19 vaccination, including flares of disease requiring a change in treatment. We examined risk factors identified a priori based on published associations with SRD activity and SARS-CoV-2 severity, including demographics, SRD type, comorbidities, vaccine type, cessation of immunosuppressive medications around vaccination and history of reactions to non-COVID-19 vaccines, using multivariable logistic regression., Results: Flares requiring a change in treatment following COVID-19 vaccination were reported by 4.9% of patients. Compared with rheumatoid arthritis, certain SRD, including systemic lupus erythematosus (OR 1.51, 95% CI 1.03, 2.20), psoriatic arthritis (OR 1.95, 95% CI 1.20, 3.18) and polymyalgia rheumatica (OR 1.94, 95% CI 1.08, 2.48) were associated with higher odds of flare, while idiopathic inflammatory myopathies were associated with lower odds for flare (OR 0.54, 95% CI 0.31-0.96). The Oxford-AstraZeneca vaccine was associated with higher odds of flare relative to the Pfizer-BioNTech vaccine (OR 1.44, 95% CI 1.07, 1.95), as were a prior reaction to a non-COVID-19 vaccine (OR 2.50, 95% CI 1.76, 3.54) and female sex (OR 2.71, 95% CI 1.55, 4.72)., Conclusion: SRD flares requiring changes in treatment following COVID-19 vaccination were uncommon in this large international study. Several potential risk factors, as well as differences by disease type, warrant further examination in prospective cohorts., (Published by Oxford University Press on behalf of the British Society for Rheumatology 2022. This work is written by US Government employees and is in the public domain in the US.)

The GuLF Long-term Follow-up Study (GuLF STUDY) is investigating potential adverse health effects of workers involved in the Deepwater Horizon (DWH) oil spill response and cleanup (OSRC). Over 93% of the 160 000 personal air measurements taken on OSRC workers were below the limit of detection (LOD), as reported by the analytic labs. At this high level of censoring, our ability to develop exposure estimates was limited. The primary objective here was to reduce the number of measurements below the labs' reported LODs to reflect the analytic methods' true LODs, thereby facilitating the use of a relatively unbiased and precise Bayesian method to develop exposure estimates for study exposure groups (EGs). The estimates informed a job-exposure matrix to characterize exposure of study participants. A second objective was to develop descriptive statistics for relevant EGs that did not meet the Bayesian criteria of sample size ≥5 and censoring ≤80% to achieve the aforementioned level of bias and precision. One of the analytic labs recalculated the measurements using the analytic method's LOD; the second lab provided raw analytical data, allowing us to recalculate the data values that fell between the originally reported LOD and the analytical method's LOD. We developed rules for developing Bayesian estimates for EGs with >80% censoring. The remaining EGs were 100% censored. An order-based statistical method (OBSM) was developed to estimate exposures that considered the number of measurements, geometric standard deviation, and average LOD of the censored samples for N ≥ 20. For N < 20, substitution of ½ of the LOD was assigned. Recalculation of the measurements lowered overall censoring from 93.2 to 60.5% and of the THC measurements, from 83.1 to 11.2%. A total of 71% of the EGs met the ≤15% relative bias and <65% imprecision goal. Another 15% had censoring >80% but enough non-censored measurements to apply Bayesian methods. We used the OBSM for 3% of the estimates and the simple substitution method for 11%. The methods presented here substantially reduced the degree of censoring in the dataset and increased the number of EGs meeting our Bayesian method's desired performance goal. The OBSM allowed for a systematic and consistent approach impacting only the lowest of the exposure estimates. This approach should be considered when dealing with highly censored datasets., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

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., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

The NIEHS GuLF STUDY is an epidemiologic study of the health of workers who participated in the 2010 Deepwater Horizon oil spill response and clean-up effort. Even with a large database of approximately 28 000 personal samples that were analyzed for total hydrocarbons (THCs) and other oil-related chemicals, resulting in nearly 160 000 full-shift personal measurements, there were still exposure scenarios where the number of measurements was too limited to rigorously assess exposures. Also available were over 26 million volatile organic compounds (VOCs) area air measurements of approximately 1-min duration, collected from direct-reading instruments on 38 large vessels generally located near the leaking well. This paper presents a strategy for converting the VOC database into hourly average air concentrations by vessel as the first step of a larger process designed to use these data to supplement full-shift THC personal exposure measurements. We applied a Bayesian method to account for measurements with values below the analytic instrument's limit of detection while processing the large database into average instrument-hour concentrations and then hourly concentrations across instruments on each day of measurement on each of the vessels. To illustrate this process, we present results on the drilling rig ship, the Discoverer Enterprise. The methods reduced the 26 million measurements to 21 900 hourly averages, which later contributed to the development of additional full-shift THC observations. The approach used here can be applied by occupational health professionals with large datasets of direct-reading instruments to better understand workplace exposures., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

The Deepwater Horizon oil spill response and clean-up (OSRC) involved over 9000 large and small vessels deployed in waters of the Gulf of Mexico across four states (Alabama, Florida, Louisiana, and Mississippi). For the GuLF STUDY, we developed exposure estimates of oil-related components for many work groups to capture a wide range of OSRC operations on these vessels, such as supporting the four rig vessels charged with stopping the spill at the wellhead; skimming oil; in situ burning of oil; absorbing and containing oil by boom; and environmental monitoring. Work groups were developed by: (i) vessel activity; (ii) location (area of the Gulf or state); and (iii) time period. Using Bayesian methods, we computed exposure estimates for these groups for: total hydrocarbons measured as total petroleum hydrocarbons (THC), benzene, toluene, ethylbenzene, xylene, and n-hexane (BTEX-H). Estimates of the arithmetic means for THC ranged from 0.10 ppm [95% credible interval (CI) 0.04, 0.38 ppm] in time periods 2 and 3 (16 July-30 September 2010) to 15.06 ppm (95% CI 10.74, 22.41 ppm) in time period 1a (22 April-15 May 2010). BTEX-H estimates were substantially lower (in the parts per billion range). Exposure levels generally fell over time and differed statistically by activity, location, and time for some groups. These exposure estimates have been used to develop job-exposure matrices for the GuLF STUDY., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

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., (Published by Oxford University Press on behalf of The British Occupational Hygiene Society 2022.)

The GuLF STUDY is investigating health outcomes associated with oil spill-related chemical exposures among workers involved in the spill response and clean-up following the Deepwater Horizon disaster. Due to the lack of dermal exposure measurements, we estimated dermal exposures using a deterministic model, which we customized from a previously published model. Workers provided information on the frequency of contact with oil, tar, chemical dispersants applied to the oil spill and sea water, as well as the use of protective equipment, by job/activity/task. Professional judgment by industrial hygienists served as a source of information for other model variables. The model estimated dermal exposures to total hydrocarbons (THC), benzene, ethylbenzene, toluene, xylene, n-hexane (BTEX-H), polycyclic aromatic hydrocarbons (PAHs), and dispersants in GuLF DREAM units (GDUs). Arithmetic means (AMs) of THC exposure estimates across study participants ranged from <0.02 to 5.50 GDUs for oil and <0.02 to 142.14 GDUs for tar. Statistical differences in the estimates were observed among the AMs of the estimates for some broad groups of worker activities over time and for some time periods across the broad groups of activities. N-Hexane had ranges similar to THC for oil exposures (e.g. AMs up to 2.22 GDUs) but not for tar (up to 5.56 GDUs). Benzene, ethylbenzene, toluene, and xylene, in contrast, were characterized by higher exposure levels than THC for oil (AMs up to 12.77, 12.17, 17.45, and 36.77 GDUs, respectively) but lower levels than THC to tar (AMs up to 3.69, 11.65, 42.37, and 88.18 GDUs, respectively). For PAHs, the AMs were as high as 219.31 and 587.98 for oil and tar, respectively. Correlations of these seven substances to each other were high (>0.9) for most of the substances in oil but were lower for some of the substances in tar. These data were linked to the study participants to allow investigation of adverse health effects that may be related to dermal exposures., (Published by Oxford University Press on behalf of The British Occupational Hygiene Society 2021.)

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., (© The Author(s) 2022. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

The Deepwater Horizon (DWH) drilling unit explosion above the Macondo oil well on 20 April 2010 caused the release of approximately 4.9 million barrels (779 million L) of oil into the Gulf of Mexico. As part of a larger spill response and clean-up effort, approximately 1.84 million gallons (6.81 million L) of chemical dispersants COREXIT™ EC9500A and COREXIT™ EC9527A were applied to the resultant oil slicks through spraying on the water surface by plane and by vessel and through injection at the release source near the seabed. The GuLF STUDY is investigating the health effects of workers involved in the oil spill response and clean-up after the DWH explosion, and estimates of possible exposure to chemical dispersants were needed. Exposures were estimated to the volatile components of COREXIT™ EC9500A [petroleum distillates, hydrotreated light, and propylene glycol (PG)] and of COREXIT™ EC9527A [2-butoxyethanol (2-BE) and PG] using two of AIHA IHMOD2.0© mathematical modeling tools along with the dispersants' chemical and physical properties. Monte Carlo simulations were used to reflect uncertainty in input parameters with both the two-box, constant emission model and the near and mid field plume model for indoor and outdoor activities, respectively. Possible exposure scenarios considered various evaporation rates, sizes of the dispersant pool, wind speeds, and ventilation rates. For the two-box model, mean near field exposure estimates to 2-BE ranged from 0.9 to 5.7 ppm, while mean far field estimated exposures ranged from 0.3 to 3.5 ppm. Estimates of mean near field plume model exposures ranged from 0.01 to 3.7 ppm at 2.5 ft from the source, and <0.01 to 0.3 ppm at 10 ft from the source. Estimated exposures to PG were approximately 10% of the calculated 2-BE exposures and exposures to petroleum distillates about 40% higher than the 2-BE estimates. Results indicate that compared with current occupational exposure guidelines, overexposure to petroleum distillates and PG probably did not occur in our study, but under some conditions, for short periods, exposure to 2-BE may have exceeded the limits for peak exposures. These estimates were developed for use in job-exposure matrices to estimate exposures of workers having contact with dispersant vapors for the GuLF STUDY., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

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., (© The Author(s) 2022. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Objectives: Our objectives were to (i) determine correlations between measurements of THC and of BTEX-H, (ii) apply these linear relationships to predict BTEX-H from measured THC, (iii) use these correlations as informative priors in Bayesian analyses to estimate exposures., Methods: We used a Bayesian left-censored bivariate framework for all 3 objectives. First, we modeled the relationships (i.e. correlations) between THC and each BTEX-H chemical for various overarching groups of measurements using linear regression to determine if correlations derived from linear relationships differed by various exposure determinants. We then used the same linear regression relationships to predict (or impute) BTEX-H measurements from THC when only THC measurements were available. Finally, we used the same linear relationships as priors for the final exposure models that used real and predicted data to develop exposure estimate statistics for each individual exposure group., Results: Correlations between measurements of THC and each of the BTEX-H chemicals (n = 120 for each of BTEX, 36 for n-hexane) differed substantially by area of the Gulf of Mexico and by time period that reflected different oil-spill related exposure opportunities. The correlations generally exceeded 0.5. Use of regression relationships to impute missing data resulted in the addition of >23 000 n-hexane and 541 observations for each of BTEX. The relationships were then used as priors for the calculation of exposure statistics while accounting for censored measurement data., Conclusions: Taking advantage of observed relationships between THC and BTEX-H allowed us to develop robust exposure estimates where a large amount of data were missing, strengthening our exposure estimation process for the epidemiologic study., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Background: The 2010 Deepwater Horizon (DWH) oil spill involved thousands of workers and volunteers to mitigate the oil release and clean-up after the spill. Health concerns for these participants led to the initiation of a prospective epidemiological study (GuLF STUDY) to investigate potential adverse health outcomes associated with the oil spill response and clean-up (OSRC). Characterizing the chemical exposures of the OSRC workers was an essential component of the study. Workers on the four oil rig vessels mitigating the spill and located within a 1852 m (1 nautical mile) radius of the damaged wellhead [the Discoverer Enterprise (Enterprise), the Development Driller II (DDII), the Development Driller III (DDIII), and the HelixQ4000] had some of the greatest potential for chemical exposures., Objectives: The aim of this paper is to characterize potential personal chemical exposures via the inhalation route for workers on those four rig vessels. Specifically, we presented our methodology and descriptive statistics of exposure estimates for total hydrocarbons (THCs), benzene, toluene, ethylbenzene, xylene, and n-hexane (BTEX-H) for various job groups to develop exposure groups for the GuLF STUDY cohort., Methods: Using descriptive information associated with the measurements taken on various jobs on these rig vessels and with job titles from study participant responses to the study questionnaire, job groups [unique job/rig/time period (TP) combinations] were developed to describe groups of workers with the same or closely related job titles. A total of 500 job groups were considered for estimation using the available 8139 personal measurements. We used a univariate Bayesian model to analyze the THC measurements and a bivariate Bayesian regression framework to jointly model the measurements of THC and each of the BTEX-H chemicals separately, both models taking into account the many measurements that were below the analytic limit of detection., Results: Highest THC exposures occurred in TP1a and TP1b, which was before the well was mechanically capped. The posterior medians of the arithmetic mean (AM) ranged from 0.11 ppm ('Inside/Other', TP1b, DDII; and 'Driller', TP3, DDII) to 14.67 ppm ('Methanol Operations', TP1b, Enterprise). There were statistical differences between the THC AMs by broad job groups, rigs, and time periods. The AMs for BTEX-H were generally about two to three orders of magnitude lower than the THC AMs, with benzene and ethylbenzene measurements being highly censored., Conclusions: Our results add new insights to the limited literature on exposures associated with oil spill responses and support the current epidemiologic investigation of potential adverse health effects of the oil spill., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

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., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Even though the Deepwater Horizon oil spill response and clean-up (OSRC) had one of the largest exposure monitoring efforts of any oil spill, a number of exposure groups did not have sufficient personal data available or there were gaps in days measured to adequately characterize exposures for the GuLF STUDY, an epidemiologic study investigating the health of the OSRC workers. Area measurements were available from real-time air monitoring instruments and used to supplement the personal exposure measurements., Objectives: The objective was to present a method that used real-time volatile organic compounds (VOCs) area measurements transformed to daily total hydrocarbons (THC) time-weighted averages (TWAs) to supplement THC personal full-shift measurements collected using passive charcoal badges. A second objective was to develop exposure statistics using these data for workers on vessels piloting remotely operated vehicle (ROV) vessels and other marine vessels (MVs) not at the job title level, but at the vessel level., Methods: From hourly vessel averages derived from ~26 million real-time VOC measurements, we estimated full-shift VOC TWAs. Then, we determined the relationship between these TWAs and corresponding full-shift THC personal measurements taken on the same vessel-day. We used this relationship to convert the full-shift VOC measurements to full-shift 'THC' TWA estimates when no personal THC measurements existed on a vessel-day. We then calculated arithmetic means (AMs) and other statistics of THC exposures for each vessel., Results: The VOC-derived estimates substantially supplemented the THC personal measurements, with the number of vessel-days for which we have exposure estimates increasing by ~60%. The estimates of the AMs are some of the highest observed in the GuLF STUDY. As expected, the AMs decreased over time, consistent with our findings on other vessels., Conclusions: Despite the inherent limitations of using real-time area measurements, we were able to develop additional daily observations of personal THC exposures for workers on the ROV vessels and other MVs over time. The estimates likely resulted in more representative estimates of the AMs in the GuLF STUDY. The method used here can be applied in other occupational settings and industries for personal exposure estimation where large amounts of area measurements and more limited numbers of personal measurements are available., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Following the Deepwater Horizon oil spill disaster, thousands of workers and volunteers cleaned the shoreline across four coastal states of the Gulf of Mexico. For the GuLF STUDY, we developed quantitative estimates of oil-related chemical exposures [total petroleum hydrocarbons (THC), benzene, toluene, ethylbenzene, xylene, and n-hexane (BTEX-H)] from personal measurements on workers performing various spill clean-up operations on land. These operations included decontamination of vessels, equipment, booms, and personnel; handling of oily booms; hazardous waste management; beach, marsh, and jetty clean-up; aerial missions; wildlife rescue and rehabilitation; and administrative support activities. Exposure estimates were developed for unique groups of workers by (i) activity, (ii) state, and (iii) time period. Estimates of the arithmetic means (AMs) for THC ranged from 0.04 to 3.67 ppm. BTEX-H estimates were substantially lower than THC (in the parts per billion range). Both THC and BTEX-H estimates were substantially lower than their respective occupational exposure limits. The work group, 'Fueled engines' consistently was one of the higher exposed groups to THC and BTEX-H. Notable differences in the AM exposures were observed by activity, time and, to a lesser degree, by state. These exposure estimates were used to develop job-exposure matrices for the GuLF STUDY., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Currently, there is a lack of knowledge about the effects of co-exposures of cannabis, contaminated with pesticides like chlorpyrifos (CPF) and the toxic metabolite CPF-oxon (CPFO). CPF/CPFO residues, and Δ9 Tetrahydrocannabinol ( Δ9 THC), the main component in cannabis, are known to disrupt the endocannabinoid system (eCBS) resulting in neurodevelopmental defects. Although there are in vivo data characterizing CPF/CPFO and Δ9 THC, there are mechanistic data gaps and deficiencies. In this study, an investigation of open access CompTox tools and ToxCast/Tox21 data was performed to determine targets relating to the modes of action (MOA) for these compounds and, given the available biological targets, predict points of departure (POD). The main findings were as follows: 1) In vivo PODs for each chemical were from open literature, 2) Concordance between ToxCast/Tox21 assay targets and known targets in the metabolic and eCBS pathways was evaluated, 3) Human Equivalent Administered Dose (EAD Human ) PODs showed the High throughput toxicokinetic (HTTK) 3 compartment model (3COMP) was more predictive of in vivo PODs than the PBTK model for CPF, CPFO and Δ9 THC, 4) Age-adjusted 3COMP HTTK-Pop EAD Human , with CPF and CPFO ToxCast/Tox21 AC 50 values as inputs were predictive for ages 0-4 when but not Δ9 THC compared to in vivo PODs. 5) Age-related refinements for CPF/CPFO were primarily from ToxCast/Tox21 active hit-calls for nuclear receptors, CYP2B6 and AChE inhibition (CPFO only) associated with the metabolic pathway. Only one assay target (arylhydrocarbon hydroxylase receptor) was common between CPF/CPFO and Δ9 THC. While computational refinements may select some sensitive events involved in the metabolic pathways; this is highly dependent on the cytotoxicity limits, availability of metabolic activity in the ToxCast/Tox21 assays and reliability of assay performance. Some uncertainties and data gaps for Δ9 THC might be addressed with assays specific to the eCBS. For CPF, assays with appropriate metabolic activation could better represent the toxic pathway., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Author(s).)

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 ≤ 2.5 μ m ( PM 2.5 )] levels. Exposure to PM 2.5 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 PM 2.5 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 ). PM 2.5 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 PM 2.5 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 [ - 166.8 mL , 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 PM 2.5 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 PM 2.5 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.

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.

In the wake of the Deepwater Horizon (DWH) oil spill, a number of government agencies, academic institutions, consultants, and nonprofit organizations conducted lab- and field-based research to understand the toxic effects of the oil. Lab testing was performed with a variety of fish, birds, turtles, and vertebrate cell lines (as well as invertebrates); field biologists conducted observations on fish, birds, turtles, and marine mammals; and epidemiologists carried out observational studies in humans. Eight years after the spill, scientists and resource managers held a workshop to summarize the similarities and differences in the effects of DWH oil on vertebrate taxa and to identify remaining gaps in our understanding of oil toxicity in wildlife and humans, building upon the cross-taxonomic synthesis initiated during the Natural Resource Damage Assessment. Across the studies, consistency was found in the types of toxic response observed in the different organisms. Impairment of stress responses and adrenal gland function, cardiotoxicity, immune system dysfunction, disruption of blood cells and their function, effects on locomotion, and oxidative damage were observed across taxa. This consistency suggests conservation in the mechanisms of action and disease pathogenesis. From a toxicological perspective, a logical progression of impacts was noted: from molecular and cellular effects that manifest as organ dysfunction, to systemic effects that compromise fitness, growth, reproductive potential, and survival. From a clinical perspective, adverse health effects from DWH oil spill exposure formed a suite of signs/symptomatic responses that at the highest doses/concentrations resulted in multi-organ system failure.

Background: The Gulf Long-Term Follow-up (GuLF) Study is a prospective cohort study of health effects associated with oil spill response and clean-up following the 2010 Deepwater Horizon Disaster (DWH). As part of the study, spirometry testing of lung function was carried out in home visits across multiple states. Few studies have described factors associated with spirometry test failure in field-based settings., Objective: Our objective was to identify what factors, if any, predict test failure among GuLF Study participants who completed spirometry testing in a non-traditional setting., Methods: Trained examiners administered spirometry (May 2011-May 2013) to 10,019 participants living in US Gulf States (LA, MS, TX, AL, FL) using an Easy-on ultrasonic spirometer. We applied American Thoracic Society/European Respiratory Society quality criteria to determine quality test failure and identified factors predictive of failure using both a Stepwise and a LASSO model. We calculated odds ratios and 95% confidence intervals (CIs) for associations of selected factors with test failure., Results: Among GuLF Study participants who conducted spirometry, self-reported African American/Black participants (OR: 1.39, 95% CI: 1.23,1.56); men (OR:1.61, 95% CI: 1.41,1.83); and those making less than $20,000 per year (OR: 1.45, 95% CI: 1.26,1.67) were more likely to fail quality testing, while those who were obese were less likely to fail (OR: 0.61, 95% CI: 0.42,0.89)., Conclusion: Field-based studies involving spirometry should identify and account for participant factors that may influence test failure. Coaching that is tailored to those less likely to have experience with spirometry may help reduce test failure rates., (Published by Elsevier Ltd.)

Background: Both essential and non-essential metals come from natural and anthropogenic sources. Metals can bioaccumulate in humans and may impact human health, including hypertension., Methods: Blood metal (cadmium, lead, mercury, manganese, and selenium) concentrations were measured at baseline for a sample of participants in the Gulf Long-Term Follow-up (GuLF) Study. The GuLF Study is a prospective cohort study focused on potential health effects following the 2010 Deepwater Horizon oil spill. Hypertension was defined as high systolic (≥140 mm Hg) or diastolic (≥90 mm Hg) blood pressure or taking anti-hypertensive medications. A total of 957 participants who had blood measurement for at least one metal, baseline blood pressure measurements, information on any anti-hypertensive medication use, and relevant covariates were included in this cross-sectional analysis. We used Poisson regression to explore the association between individual blood metal levels and hypertension. Quantile-based g-computation was used to investigate the association between the metal mixture and hypertension. We also explored the association between individual blood metal levels and continuous blood pressure measurements using general linear regression., Results: Comparing the highest quartile of blood metals with the lowest (Q4vs1), the hypertension prevalence ratio (PR) was 0.92 (95 % confidence interval (CI) = 0.73,1.15) for cadmium, 0.86 (95%CI = 0.66,1.12) for lead, 0.89 (95%CI = 0.71,1.12) for mercury, 1.00 (95%CI = 0.80,1.26) for selenium, and 1.22 (95%CI = 0.95,1.57) for manganese. We observed some qualitative differences across race and BMI strata although none of these differences were statistically significant. In stratified analyses, the PR (Q4vs1) for mercury was 0.69 (95%CI = 0.53, 0.91) in White participants and 1.29 (95%CI = 0.86,1.92) in Black participants (p for interaction = 0.5). The PR (Q4vs1) for manganese was relatively higher in Black participants (PR = 1.37, 95%CI = 0.92,2.05) than in White participants (PR = 1.15, 95%CI = 0.83,1.60, p for interaction = 0.5), with a suggestive dose-response among Blacks. After stratifying by obesity (BMI ≥30 and < 30), positive associations of of hypertension with cadmium (PR [Q4vs1] = 1.19, 95%CI = 0.91,1.56, p for interaction = 0.5), lead (PR [Q4vs1] = 1.14, 95%CI = 0.84,1.55, p for interaction = 1.0) and manganese (PR = 1.25, 95%CI = 0.93,1.68, p for interaction = 0.8) were observed in participants with BMI≥30, but not in participants with BMI<30. The joint effect of the metal mixture was 0.96 (95%CI = 0.73,1.27). We did not observe clear associations between blood metal levels and continuous blood pressure measurements., Conclusion: We did not find overall cross-sectional associations between blood cadmium, lead, mercury, selenium levels and hypertension or blood pressure. We found some evidence suggesting that manganese might be positively associated with risk of hypertension. Associations varied somewhat by race and BMI., (Published by Elsevier Inc.)

Background: Individuals affected by disasters are at risk for adverse mental health sequelae. Individuals living in the US Gulf Coast have experienced many recent major disasters, but few studies have explored the cumulative burden of experiencing multiple disasters on mental health., Objective: The objective of this study was to evaluate the relationship between disaster burden and mental health., Methods: We used data from 9278 Gulf Long-term Follow-up Study participants who completed questionnaires on perceived stress, anxiety, depression, and post-traumatic stress disorder (PTSD) in 2011-2013. We linked 2005-2010 county-level data from the Spatial Hazard Events and Losses Database for the United States, a database of loss-causing events, to participant's home address. Exposure measures included total count of loss events as well as severity quantified as property/crop losses per capita from all hazards. We used multilevel modeling to estimate odds ratios (OR) and 95% confidence intervals (CI) for each exposure-outcome relationship., Results: Total count of loss events was positively associated with perceived stress (OR Q4 :1.40, 95% CI:1.21-1.61) and was inversely associated with PTSD (OR Q4 :0.66, 95% CI:0.45-0.96). Total duration of exposure was also associated with stress (OR Q4 :1.16, 95% CI:1.01-1.33) but not with other outcomes. Severity based on cumulative fatalities/injuries was associated with anxiety (OR Q4 :1.31, 95% CI:1.05-1.63) and stress (OR Q4 :1.34, 95% CI:1.15-1.57), and severity based on cumulative property/crop losses was associated with anxiety (OR Q4 :1.42, 95% CI:1.12-1.81), depression (OR Q4 :1.22, 95% CI:0.95-1.57) and PTSD (OR Q4 :1.99, 95% CI:1.44-2.76)., (© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)

Harmonized language is critical for helping researchers to find data, collecting scientific data to facilitate comparison, and performing pooled and meta-analyses. Using standard terms to link data to knowledge systems facilitates knowledge-driven analysis, allows for the use of biomedical knowledge bases for scientific interpretation and hypothesis generation, and increasingly supports artificial intelligence (AI) and machine learning. Due to the breadth of environmental health sciences (EHS) research and the continuous evolution in scientific methods, the gaps in standard terminologies, vocabularies, ontologies, and related tools hamper the capabilities to address large-scale, complex EHS research questions that require the integration of disparate data and knowledge sources. The results of prior workshops to advance a harmonized environmental health language demonstrate that future efforts should be sustained and grounded in scientific need. We describe a community initiative whose mission was to advance integrative environmental health sciences research via the development and adoption of a harmonized language. The products, outcomes, and recommendations developed and endorsed by this community are expected to enhance data collection and management efforts for NIEHS and the EHS community, making data more findable and interoperable. This initiative will provide a community of practice space to exchange information and expertise, be a coordination hub for identifying and prioritizing activities, and a collaboration platform for the development and adoption of semantic solutions. We encourage anyone interested in advancing this mission to engage in this community.

Socioeconomic status has been associated with cardiovascular disease risk factors. However, few studies have examined this relationship among populations in the US Gulf Coast region. We assessed neighborhood deprivation in relation to obesity and diabetes in 9,626 residents participating in the Gulf Long-Term Follow-Up Study (2011-present) who completed a home visit (2011-2013) with height, weight, waist, and hip measurements. Obesity was categorized as body mass index of at least 30, and diabetes was defined by doctor's diagnosis or prescription medication. Participant home addresses were linked to an established Area Deprivation Index and categorized into 4 levels (1 = least deprived). In adjusted, modified Poisson regression models, participants with greatest deprivation were more likely to have obesity compared with those with least deprivation (adjusted prevalence ratio (aPR) = 1.21, 95% confidence interval (CI): 1.08, 1.35), central obesity (aPR = 1.11, 95% CI: 1.04, 1.19), and diabetes (aPR = 1.49, 95% CI: 1.03, 2.14). Repeated analyses among a subgroup of participants (n = 3,016) whose hemoglobin A1C values were measured 3 years later indicated the association with diabetes (defined as diagnosis, medications, or hemoglobin A1C ≥ 6.5) was similar (aPR = 1.46, 95% CI: 1.14, 1.86). Results suggest neighborhood deprivation is associated with obesity and diabetes in a US region with high baseline prevalence., (Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2020.)

Oil spill response and clean-up (OSRC) workers were exposed to hazardous airborne chemicals following the 2010 Deepwater Horizon disaster. The aim of this study was to evaluate lung function in workers 4-6 years following the disaster using a prospective cohort. Participants who completed two spirometry test sessions 1-3 years, and 4-6 years after the spill (N = 1,838) were included and forced expiratory volume in 1 s (FEV 1 ; ml), forced vital capacity (FVC; ml), and ratio (FEV 1 /FVC; %) determined. Linear mixed models were utilized to estimate relationships between OSRC exposures and lung function 4-6 years after the spill and changes since the prior measurement. Despite suggestive reduced lung function at 1-3 years, at the  4-6-year exam workers with total hydrocarbon (THC) exposure 1-2.99 ppm and ≥3 ppm compared to those with ≤0.29 ppm exhibited higher FEV 1 (β: 108 ml, 95% CI: 17, 198) and (β: 118 ml, 95% CI: 5, 232), respectively. Compared with support workers, those in higher exposed jobs displayed greater improvement in FEV 1 between visits: cleanup on water (β: 143 ml, 95% CI: 35, 250), operations (β: 132 ml, 95% CI: 30, 234) and response (β: 149 ml, 95% CI: 43, 256). Greater FEV 1 improvement was also associated with higher versus the lowest level THC exposure: 1-2.99 ppm (β: 134 ml, 95% CI: 57, 210) and ≥3 ppm (β: 205 ml, 95% CI: 109, 301). Lung function decrements seen shortly after the spill were no longer apparent 4-6 years later, with the greatest improvement among those with the highest exposures.

Introduction: The 2010 Deepwater Horizon (DWH) disaster exposed tens of thousands of oil spill response and cleanup (OSRC) workers to hydrocarbons and other hazardous chemicals. Some hydrocarbons, such as toluene and hexane, have been found to have acute adverse effects on the central nervous system in occupational settings. However, no studies have examined the association between oil spill exposures and neurobehavioral function., Methods: We used data from the Gulf Long-term Follow-up Study, a cohort of adults who worked on the DWH response and cleanup. Total hydrocarbon (THC) exposure attributed to oil spill cleanup work was estimated from a job-exposure matrix linking air measurement data to detailed cleanup work histories. Participants were also categorized into 6 job categories, or OSRC classes, based on their activity with the highest exposure. Neurobehavioral performance was assessed at a clinical exam 4-6 years after the spill. We used multivariable linear regression to evaluate relationships of ordinal THC levels and OSRC classes with 16 neurobehavioral outcomes., Results: We found limited evidence of associations between THC levels or OSRC classes and decreased neurobehavioral function, including attention, memory, and executive function. Workers exposed to ≥3 ppm THC scored significantly worse (difference 1.0-2.9ppm  = -0.39, 95% confidence interval (CI) = -0.74, -0.04) than workers exposed to <0.30 ppm THC for the digit span forward count test. There was also a possible threshold effect above 1 ppm THC for symbol digit test total errors (difference 1.0-2.9ppm  = -0.56 (95% CI = -1.13, -0.003), difference ≥3.0ppm  = -0.55 (95% CI = -1.20, 0.10)). Associations appeared to be stronger in men than in women. A summary latency measure suggested an association between more highly exposed jobs (especially support of operations workers) and decreased neurobehavioral function., Conclusion: OSRC-related exposures were associated with modest decreases in neurobehavioral function, especially attention, memory, and executive function., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: In a previous study of exposure to oil-related chemicals in Gulf coast residents, we measured blood levels of volatile organic compounds. Levels of styrene were substantially elevated compared to a nationally representative sample. We sought to identify factors contributing to these levels, given the opportunities for styrene exposure in this community., Methods: We measured blood styrene levels in 667 Gulf coast residents and compared participants' levels of blood styrene to a nationally representative sample. We assessed personal and environmental predictors of blood styrene levels using linear regression and predicted the risk of elevated blood styrene (defined as above the National Health and Nutrition Examination Survey 95th percentile) using modified Poisson regression. We assessed exposure to styrene using questionnaire data on recent exposure opportunities and leveraged existing databases to assign ambient styrene exposure based on geocoded residential location., Results: These Gulf coast residents were 4-6 times as likely as the nationally representative sample to have elevated blood styrene levels. The change in styrene (log ng/mL) was 0.42 (95% CI: 0.34, 0.51) for smoking, 0.34 (0.09, 0.59) for time spent in vehicles and 1.10 (0.31, 1.89) for boats, and -0.41 (-0.73, -0.10) for fall/winter blood draws. Residential proximity to industrial styrene emissions did not predict blood styrene levels. Ambient styrene predicted elevated blood styrene in subgroups., Conclusions: Personal predictors of increasing blood styrene levels included smoking, vehicle emissions, and housing characteristics. There was a suggestive association between ambient and blood styrene. Our measures of increased regional exposure opportunity do not fully explain the observed elevated blood styrene levels in this population.

Research conducted in the wake of a disaster can provide information to help mitigate health consequences, support future recovery efforts, and improve resilience. However, a number of barriers have prevented time-sensitive research responses following previous disasters. Furthermore, large-scale disasters present their own special challenges due to the number of people exposed to disaster conditions, the number of groups engaged in disaster response, and the logistical challenges of rapidly planning and implementing a large study. In this case study, we illustrate the challenges in planning and conducting a large-scale post-disaster research study by drawing on our experience in establishing the Gulf Long-term Follow-up (GuLF) Study following the 2010 Deepwater Horizon disaster. We describe considerations in identifying at-risk populations and appropriate comparison groups, garnering support for the study from different stakeholders, obtaining timely scientific and ethics review, measuring and characterizing complex exposures, and addressing evolving community health concerns and unmet medical needs. We also describe the NIH Disaster Research Response (DR2) Program, which provides a suite of resources, including data collection tools, research protocols, institutional review board guidance, and training materials to enable the development and implementation of time-critical studies following disasters and public health emergencies. In describing our experiences related to the GuLF Study and the ongoing efforts through the NIH DR2 Program, we aim to help improve the timeliness, quality, and value of future disaster-related data collection and research studies.

Background: The chemicals benzene, toluene, ethylbenzene, and xylenes (BTEX) are neuroactive. Exposures often co-occur because they share common sources. We examined neurologic effects of environmental BTEX exposure among U.S. Gulf coast residents taking into account concomitant exposures., Methods: We measured blood concentrations of BTEX in 690 Gulf state residents. Neurologic symptoms were ascertained via telephone interview. We used log-binomial regression to estimate associations between blood BTEX levels and self-reported neurologic symptoms independently for the presence of any neurologic, central (CNS), or peripheral nervous system (PNS) symptoms. We estimated associations in single chemical models mutually adjusted for co-occurring BTEX and used weighted quantile sum regression to model associations between the combined BTEX mixture and neurologic symptoms., Results: Half (49%) of participants reported at least one neurologic symptom. Each BTEX chemical was associated with increased CNS and PNS symptoms in single-chemical models comparing the highest to lowest quartile of exposure. After adjusting for coexposures, benzene was associated with CNS symptoms among all participants (PR = 2.13, 95% CI: 1.27, 3.57) and among nonsmokers (PR = 2.30, 95% CI: 1.35, 3.91). After adjusting for coexposures, associations with toluene were apparent only for reporting multiple PNS symptoms (PR = 2.00, 95% CI: 0.96, 4.16). In mixture analyses, a one-quartile increase in BTEX exposure was associated with neurologic symptoms (OR = 1.47, 95% CI: 1.11, 1.98). The weighted quantile sum index weighted benzene most heavily, which was consistent with single chemical analyses., Conclusions: Increasing blood benzene concentration was associated with increased prevalence of CNS symptoms. In this sample, BTEX-associated neurologic effects are likely driven by exposure to benzene and, to a lesser extent, toluene., (Copyright © 2019. Published by Elsevier Inc.)

Increasing in frequency and impact in the United States and worldwide, disasters can lead to serious mental health consequences. Although US census data are essential for disaster preparedness and the identification of community-level risk factors for adverse postdisaster mental health outcomes, the US Census Bureau faces many challenges as we approach 2020 Decennial Census data collection. Despite the utility of the information provided by the Census and American Community Survey (ACS), the 2020 US Census and subsequent ACS data face threats to validity. As a result, public health funding could be misallocated, and disaster preparedness and response efforts misinformed; this can also contribute to the worsening of mental health inequities, particularly in the context of disaster. Undercutting the Census and the ACS, rich data sources that allow representation of all people in the United States, is a step backward in our effort to mitigate the population mental health consequences of disasters.

With the threat of climate change looming, the public health community has an interest in identifying communities at the highest risk of devastation based not only on geographic features but also on social characteristics. Indices of community social vulnerability can be created by applying a spatial factor analysis to a set of relevant social variables measured for each community; however, current spatial factor analysis methodology is ill-equipped to handle spatially misaligned data. We introduce a joint spatial factor analysis model that can accommodate spatial data from two distinct partitions of a geographic space and identify a common set of latent factors underlying them. By defining the latent factors over the intersection of the two partitions, the model minimizes loss of information. Using simulated data constructed to mimic the spatial structure of our real data, we confirm the reliability of the model and demonstrate its superiority over competing ad hoc methods for dealing with misaligned data in spatial factor analysis. Finally, we construct an index of community social vulnerability for each census tract in Louisiana, a state prone to environmental disasters, which could be exacerbated by climate change, by applying the joint spatial factor analysis model to a set of misaligned social indicator data from the state. To demonstrate the utility of this index, we integrate it with Louisiana flood insurance claims data to identify communities that may be at particularly high risk during natural disasters, based on both social and geographic features., (© The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Exposure to total hydrocarbons (THC) and volatile organic compounds from air pollution is associated with risk of coronary heart disease. THC exposure from oil spills might be similarly associated, but no research has examined this. We assessed the relationship between THC exposure during the response and cleanup of the Deepwater Horizon oil spill (Gulf of Mexico) and heart attack risk among 24,375 oil spill workers enrolled in the Gulf Long-Term Follow-up Study. There were 312 first heart attacks (self-reported physician-diagnosed myocardial infarction, or fatal coronary heart disease) ascertained during the study period (2010-2016). THC exposures were estimated using a job-exposure matrix incorporating self-reported activities and personal air measurements. We used Cox proportional hazards regression to estimate hazard ratios, with inverse-probability weights to account for confounding and censoring. Maximum THC levels of ≥0.30 parts per million (ppm) were associated with heart attack risk, with a 1.8-fold risk for exposure of ≥3.00 ppm versus <0.30 ppm (hazard ratio = 1.81, 95% confidence interval: 1.11, 2.95). The risk difference for highest versus lowest THC level was 10 excess cases per 1,000 workers. This is the first study of the persistent health impacts of THC exposure during oil spill work, and results support increased protection against oil exposure during cleanup of future spills., (Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2019.)

Background: Although styrene is an established neurotoxicant at occupational exposure levels, its neurotoxicity has not been characterized in relation to general population exposures. Further, occupational research to date has focused on central nervous system impairment., Objective: We assessed styrene-associated differences in sensory and motor function among Gulf coast residents., Methods: We used 2011 National Air Toxics Assessment estimates of ambient styrene to determine exposure levels for 2,956 nondiabetic Gulf state residents enrolled in the Gulf Long-term Follow-up Study, and additionally measured blood styrene concentration in a subset of participants 1 to 2 y after enrollment ([Formula: see text]). Participants completed an enrollment telephone interview and a comprehensive test battery to assess sensory and motor function during a clinical follow-up exam 2 to 4 y later. Detailed covariate information was ascertained at enrollment via telephone interview. We used multivariate linear regression to estimate continuous differences in sensory and motor function, and log-binomial regression to estimate prevalence ratios for dichotomous outcomes. We estimated associations of both ambient and blood styrene exposures with sensory and motor function, independently for five unique tests., Results: Those participants in the highest 25% vs. lowest 75% of ambient exposure and those in the highest 10% vs. lowest 90% of blood styrene had slightly diminished visual contrast sensitivity. Mean vibrotactile thresholds were lower among those in the highest vs. lowest quartile of ambient styrene and the highest 10% vs. lowest 90% of blood styrene ([Formula: see text] log microns; 95% CI: [Formula: see text], [Formula: see text] and [Formula: see text] log microns; 95% CI: [Formula: see text], [Formula: see text], respectively). The highest vs. lowest quartile of ambient styrene was associated with significantly poorer postural stability, and (unexpectedly) with significantly greater grip strength., Discussion: We observed associations between higher styrene exposure and poorer visual, sensory, and vestibular function, though we did not detect associations with reduced voluntary motor system performance. Associations were more consistent for ambient exposures, but we also found notable associations with measured blood styrene. https://doi.org/10.1289/EHP3954.