Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Oak Ridge Institute for Science and Education, MD, USA.
Department of Laboratory Animal Resources, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Environ Int. 2022 Jan;158:106937. doi: 10.1016/j.envint.2021.106937. Epub 2021 Oct 20.
In 2010, the U.S. Coast Guard (USCG) led a clean-up response to the Deepwater Horizon (DWH) oil spill. Human studies evaluating acute and longer-term cardiovascular conditions associated with oil spill-related exposures are sparse. Thus, we aimed to investigate prevalent and incident cardiovascular symptoms/conditions in the DHW Oil Spill Coast Guard Cohort.
Self-reported oil spill exposures and cardiovascular symptoms were ascertained from post-deployment surveys (n = 4,885). For all active-duty cohort members (n = 45,193), prospective cardiovascular outcomes were classified via International Classification of Diseases, 9th Edition from military health encounter records up to 5.5 years post-DWH. We used log-binomial regression to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) in the cross-sectional analyses and Cox Proportional Hazards regression to calculate adjusted hazard ratios (aHR) and 95% CIs for incident cardiovascular diagnoses during 2010-2015 and stratifying by earlier (2010-2012) and later (2013-2015) time periods.
Prevalence of chest pain was associated with increasing levels of crude oil exposure via inhalation (aPR = 2.00, 95% CI = 1.16-3.42, p-trend = 0.03) and direct skin contact (aPR = 2.72, 95% CI = 1.30-5.16, p-trend = 0.03). Similar associations were observed for sudden heartbeat changes and for being in the vicinity of burning oil exposure. In prospective analyses, responders (vs. non-responders) had an elevated risk for mitral valve disorders during 2013-2015 (aHR = 2.12, 95% CI = 1.15-3.90). Responders reporting ever (vs. never) crude oil inhalation exposure were at increased risk for essential hypertension, particularly benign essential hypertension during 2010-2012 (aHR = 2.00, 95% CI = 1.08-3.69). Responders with crude oil inhalation exposure also had an elevated risk for palpitations during 2013-2015 (aHR = 2.54, 95% CI = 1.36-4.74). Cardiovascular symptoms/conditions aPR and aHR estimates were generally stronger among responders reporting exposure to both crude oil and oil dispersants than among those reporting neither.
In this large study of the DWH oil spill USCG responders, self-reported spill clean-up exposures were associated with acute and longer-term cardiovascular symptoms/conditions.
2010 年，美国海岸警卫队（USCG）领导了对深海地平线（DWH）溢油事故的清理工作。评估与溢油事故相关暴露相关的急性和长期心血管状况的人体研究很少。因此，我们旨在调查 DWH 溢油事故海岸警卫队队列中普遍存在和新发的心血管症状/状况。
从部署后调查（n=4885）中确定了自我报告的溢油暴露和心血管症状。对于所有现役队列成员（n=45193），根据国际疾病分类第 9 版，从军事健康接触记录中前瞻性地分类心血管结局，直至 DWH 后 5.5 年。我们使用对数二项式回归在横断面分析中计算调整后的患病率比（aPR）和 95%置信区间（CI），并使用 Cox 比例风险回归计算 2010-2015 年期间新发心血管诊断的调整后风险比（aHR）和分层分析，分为早期（2010-2012）和晚期（2013-2015）。
胸痛的患病率与通过吸入（aPR=2.00，95%CI=1.16-3.42，p-trend=0.03）和直接皮肤接触（aPR=2.72，95%CI=1.30-5.16，p-trend=0.03）接触粗油的水平升高有关。对于心跳变化突然和接触燃烧的油的情况也观察到类似的关联。在前瞻性分析中，响应者（与非响应者相比）在 2013-2015 年期间发生二尖瓣疾病的风险增加（aHR=2.12，95%CI=1.15-3.90）。报告曾经（与从未）接触过粗油吸入的响应者在 2010-2012 年期间患原发性高血压（尤其是良性原发性高血压）的风险增加（aHR=2.00，95%CI=1.08-3.69）。接触粗油吸入的响应者在 2013-2015 年期间也有心悸的风险增加（aHR=2.54，95%CI=1.36-4.74）。心血管症状/状况的 aPR 和 aHR 估计值在报告同时接触粗油和油分散剂的响应者中通常比报告两者均未接触的响应者更强。
在这项针对 DWH 溢油事故的美国海岸警卫队响应者的大型研究中，自我报告的溢油清理暴露与急性和长期心血管症状/状况有关。
