Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina.
Am J Epidemiol. 2019 May 1;188(5):917-927. doi: 10.1093/aje/kwz017.
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.
暴露于总碳氢化合物(THC)和空气污染中的挥发性有机化合物与冠心病风险相关。油溢出物中的 THC 暴露可能也与之相关,但尚无研究对此进行检验。我们评估了墨西哥湾深水地平线石油泄漏(Deepwater Horizon oil spill)应对和清理期间 THC 暴露与海湾长期随访研究(Gulf Long-Term Follow-up Study)中 24375 名石油泄漏工人心脏病发作风险之间的关系。在研究期间(2010-2016 年)确定了 312 例首次心脏病发作(经医生诊断的心肌梗死或致命性冠心病)。使用包含自我报告活动和个人空气测量的职业暴露矩阵估算 THC 暴露量。我们使用 Cox 比例风险回归来估计风险比,使用逆概率权重来考虑混杂因素和删失。最大 THC 水平≥0.30ppm 与心脏病发作风险相关,暴露于≥3.00ppm 与<0.30ppm 相比风险增加了 1.8 倍(危险比=1.81,95%置信区间:1.11,2.95)。最高 THC 水平与最低 THC 水平之间的风险差异为每 1000 名工人中增加 10 例心脏病发作。这是首次研究 THC 暴露在石油泄漏工作期间对持久健康影响的研究,结果支持在未来溢油清理工作中加强对石油暴露的保护。