深水地平线石油泄漏暴露与 GuLF STUDY 中的非致命性心肌梗死
Deepwater Horizon oil spill exposures and nonfatal myocardial infarction in the GuLF STUDY.
机构信息
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA.
出版信息
Environ Health. 2018 Aug 25;17(1):69. doi: 10.1186/s12940-018-0408-8.
BACKGROUND
Workers involved in the response and clean-up of the 2010 Deepwater Horizon oil spill faced possible exposures to crude oil, burning oil, dispersants and other pollutants in addition to physical and emotional stress. These exposures may have increased risk of myocardial infarction (MI) among oil spill workers.
METHODS
Gulf Long-term Follow-up (GuLF) STUDY participants comprise individuals who either participated in the Deepwater Horizon response efforts or registered for safety training but were not hired. Oil spill-related exposures were assessed during enrollment interviews conducted in 2011-2013. We estimated risk ratios (RR) and 95% confidence intervals for the associations of clean-up work characteristics with self-reported nonfatal MI up to three years post-spill.
RESULTS
Among 31,109 participants without history of MI prior to the spill, 77% worked on the oil spill. There were 192 self-reported MI during the study period; 151 among workers. Among the full cohort, working on the oil spill clean-up (vs not working on the clean-up) and living in proximity to the oil spill (vs further away) were suggestively associated with a possible increased risk of nonfatal MI [RR: 1.22 (0.86, 1.73) and 1.15 (0.82, 1.60), respectively]. Among oil spill workers, working for > 180 days was associated with MI [RR for > 180 days (vs 1-30 days): 2.05 (1.05, 4.01)], as was stopping working due to heat [RR: 1.99 (1.43, 2.78)]. There were suggestive associations of maximum total hydrocarbon exposure ≥3.00 ppm (vs < 0.30 ppm) [RR: 1.69 (0.90, 3.19)] and working on decontaminating oiled equipment (vs administrative support) [1.72 (0.96, 3.09)] with nonfatal MI.
CONCLUSION
This is the first study to assess the associations between oil spill exposures and MI. Results suggest that working on the spill for > 180 days and stopping work due to heat increased risk of nonfatal MI. Future research should evaluate whether the observed associations are related to specific chemical exposures or other stressors associated with the spill.
背景
参与 2010 年深海地平线石油泄漏应对和清理工作的工人除了面临身体和情绪压力外，还可能接触到原油、燃烧的油、分散剂和其他污染物。这些接触可能会增加石油泄漏工人患心肌梗死（MI）的风险。
方法
墨西哥湾长期随访（GuLF）研究参与者包括参与深海地平线应对工作或登记参加安全培训但未被雇用的人员。在 2011-2013 年进行的登记访谈中，评估了与石油泄漏相关的接触情况。我们估计了清洁工作特征与报告的非致命性 MI 之间的关联风险比（RR）和 95%置信区间，直到泄漏后三年。
结果
在泄漏前没有 MI 病史的 31109 名参与者中，77%参与了石油泄漏清理工作。在研究期间，有 192 例自我报告的 MI，其中 151 例发生在工人中。在整个队列中，从事石油泄漏清理工作（与不从事清理工作相比）和居住在离石油泄漏地点较近（与较远相比）与非致命性 MI 风险增加有关[RR：1.22（0.86，1.73）和 1.15（0.82，1.60）]。在石油泄漏工人中，工作时间超过 180 天与 MI 相关[RR 超过 180 天（与 1-30 天相比）：2.05（1.05，4.01）]，因热而停止工作也是如此[RR：1.99（1.43，2.78）]。最高总碳氢化合物暴露量≥3.00 ppm（与 <0.30 ppm 相比）[RR：1.69（0.90，3.19）]和从事受污染设备去污工作（与行政支持相比）[1.72（0.96，3.09）]与非致命性 MI 有提示性关联。
结论
这是第一项评估石油泄漏暴露与 MI 之间关联的研究。结果表明，从事石油泄漏工作超过 180 天和因热而停止工作会增加非致命性 MI 的风险。未来的研究应评估观察到的关联是否与特定的化学暴露或与泄漏相关的其他压力源有关。
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