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BACKGROUND: During the 2010 Deepwater Horizon (DWH) disaster, in-situ burning and flaring were conducted to remove oil from the water. Workers near combustion sites were potentially exposed to burning-related fine particulate matter (PM2.5). Exposure to PM2.5 has been linked to increased risk of coronary heart disease (CHD), but no study has examined the relationship among oil spill workers. OBJECTIVES: To investigate the association between estimated PM2.5 from burning/flaring of oil/gas and CHD risk among the DWH oil spill workers. METHODS: We included workers who participated in response and cleanup activities on the water during the DWH disaster (N = 9091). PM2.5 exposures were estimated using a job-exposure matrix that linked modelled PM2.5 concentrations to detailed DWH spill work histories provided by participants. We ascertained CHD events as the first self-reported physician-diagnosed CHD or a fatal CHD event that occurred after each workers last day of burning exposure. We estimated hazard ratios (HR) and 95% confidence intervals (95%CI) for the associations between categories of average or cumulative daily maximum PM2.5 exposure (versus a referent category of water workers not near controlled burning) and subsequent CHD. We assessed exposure-response trends by examining continuous exposure parameters in models. RESULTS: We observed increased CHD hazard among workers with higher levels of average daily maximum exposure (low vs. referent: HR = 1.26, 95% CI: 0.93, 1.70; high vs. referent: HR = 2.11, 95% CI: 1.08, 4.12; per 10 μg/m3 increase: HR = 1.10, 95% CI: 1.02, 1.19). We also observed suggestively elevated HRs among workers with higher cumulative daily maximum exposure (low vs. referent: HR = 1.19, 95% CI: 0.68, 2.08; medium vs. referent: HR = 1.38, 95% CI: 0.88, 2.16; high vs. referent: HR = 1.44, 95% CI: 0.96, 2.14; per 100 μg/m3-d increase: HR = 1.03, 95% CI: 1.00, 1.05). CONCLUSIONS: Among oil spill workers, exposure to PM2.5 from flaring/burning of oil/gas was associated with increased risk of CHD.

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 [less than or equal to] 2.5 [micro]m (P[M.sub.2.5])] levels. Exposure to P[M.sub.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 P[M.sub.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). P[M.sub.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 P[M.sub.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 P[M.sub.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 P[M.sub.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, Introduction The 2010 Deepwater Horizon (DWH) disaster was the largest marine oil spill in U.S. history (National Commission on the BP Deepwater Horizon Oil Spill and Offshore Drilling 2011). An [...]

BackgroundThe use of rasburicase has been evaluated extensively in children, but not in adults. We review the current literature to evaluate its effect on adults.Study designSystematic review and meta-analysis.Setting & populationAdults receiving rasburicase for tumor lysis syndrome (TLS).Selection criteria for studiesElectronic databases, regulatory documents, and websites were searched up to August 7, 2012. Reference lists of published articles were examined for additional relevant references. Any controlled trial or observational studies (controlled before and after) were included. Studies considering children only or mixing data for children and adults were excluded.InterventionRasburicase for TLS.OutcomesThe primary outcome was TLS development. Secondary outcomes included percentage of patients improving, total adverse events, acute kidney failure, deaths, and serum uric acid and creatinine levels.Results21 studies (24 publications) reported data for 1,261 adult patients, 768 receiving rasburicase for either the treatment or prophylaxis of TLS; these comprised 4 controlled trials and 17 observational studies. No statistically significant differences in clinical TLS development were observed in the controlled trials between the rasburicase and control groups. For the observational studies, 7.4% of patients developed clinical TLS after rasburicase (95% CI, 1.7%-16.7%), 93.4% of patients achieved normalized serum uric acid levels after rasburicase treatment (95% CI, 91.7%-94.6%), 4.4% developed acute kidney injury (95% CI, 3.0%-6.0%), and 2.6% died (95% CI, 0.95%-5.0%). The mean reduction in serum uric acid levels ranged from 5.3-12.8 mg/dL, and for serum creatinine levels, from 0.10-2.1 mg/dL.LimitationsControlled trials differed in outcomes reported; meta-analysis was not performed.ConclusionsRasburicase is effective in reducing serum uric acid levels in adults with TLS but at a significant cost, and evidence currently is lacking in adults to report whether rasburicase use improves clinical outcomes compared with other alternatives. Until new evidence is available, use of rasburicase may be limited to adult patients with a high risk of TLS.

ABSTRACT Regulatory agencies are frequently called upon to assess the potential for significant environmental impacts from air pollution emissions. These assessments often entail air dispersion modeling to estimate air concentrations [...]

ABSTRACT Ethanol fuel production is growing rapidly in the rural Midwest, and this growth presents potential environmental impacts. In 2002, the U.S. Environmental Protection Agency (EPA) and the Minnesota Pollution [...]

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. [ABSTRACT FROM AUTHOR]

BACKGROUND: During the 2010 Deepwater Horizon (DWH) disaster, controlled burning was conducted to remove oil from the water. Workers near combustion sites were potentially exposed to increased fine particulate matter [with aerodynamic diameter =2.5µm (PM[sub 2.5])] levels. Exposure to PM[sub 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[sub 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 (푛=2,316). PM[sub 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[sub 2.5] exposure with lower FEV1 (푝-trend=0.04) and FEV1/FVC (푝-trend=0.01). In comparison with the referent group (workers not involved in or near the burning), those with higher cumulative exposures had lower FEV1 [-166.8mL, 95% confidence interval (CI): -337.3, 3.7] and FEV1/FVC (-1.7, 95% CI: -3.6, 0.2). We also saw nonsignificant reductions in FVC (high vs. referent: -120.9, 95% CI: -319.4, 77.6; 푝-trend=0.36). Similar associations were seen for average daily maximum PM[sub 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[sub 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. [ABSTRACT FROM AUTHOR]

The Queensland Police Service (QPS) and Queensland Ambulance Service may detain and transport persons experiencing major disturbances in their mental capacity to an ED for urgent care. Queensland's new mental health legislation (March 2017) makes this legal intervention difficult to scrutinise. For a large non‐metropolitan region, QPS records for emergency examination orders (EEOs) and emergency examination authorities (EEAs) were compared with annual reports of Queensland's Director of Mental Health and Chief Psychiatrist. From 2009–2010 to March 2017, QPS‐registered EEOs totalled 12 903 while annual reports attributed 9441 to QPS (27% fewer). From March 2017 to 2019–2020, QPS‐registered EEAs totalled 6887. Annual reports declared 1803 EEAs in total for this period, without distinguishing those registered by QPS from the Queensland Ambulance Service. Past year proportions of EEOs, however, indicate perhaps ~1100 originated with QPS (84% fewer). Information crucial for considered emergency mental healthcare responses for thousands of people is no longer readily available. [ABSTRACT FROM AUTHOR]