Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), NIH, Research Triangle Park, North Carolina, USA.
Office of the Director, NIEHS, NIH, Bethesda, Maryland, USA.
Curr Environ Health Rep. 2019 Sep;6(3):174-187. doi: 10.1007/s40572-019-00241-9.
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.
灾难发生后的研究可以提供信息,帮助减轻健康后果,支持未来的恢复工作,并提高韧性。然而,由于之前的灾难,许多障碍阻止了对时间敏感的研究反应。此外,由于暴露于灾害条件的人数众多、参与灾害应对的团体众多以及快速规划和实施大型研究的后勤挑战,大规模灾害本身带来了特殊的挑战。在这个案例研究中,我们通过借鉴在 2010 年深水地平线灾难后建立海湾长期随访 (GuLF) 研究的经验,说明了在规划和进行大规模灾后研究时面临的挑战。我们描述了在确定高危人群和适当对照组时需要考虑的因素,从不同利益相关者那里获得对研究的支持,及时获得科学和伦理审查,测量和描述复杂的暴露情况,并解决不断变化的社区健康问题和未满足的医疗需求。我们还介绍了 NIH 灾难研究响应 (DR2) 计划,该计划提供了一系列资源,包括数据收集工具、研究方案、机构审查委员会指南和培训材料,以支持在灾难和公共卫生紧急情况发生后及时开展关键研究。在描述与 GuLF 研究相关的经验以及通过 NIH DR2 计划正在进行的努力时,我们旨在帮助提高未来与灾害相关的数据收集和研究的及时性、质量和价值。