Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina.
Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
JAMA Netw Open. 2022 Feb 1;5(2):e220108. doi: 10.1001/jamanetworkopen.2022.0108.
Exposure to hydrocarbons, fine particulate matter (PM2.5), and other chemicals from the April 20, 2010, Deepwater Horizon disaster may be associated with increased blood pressure and newly detected hypertension among oil spill response and cleanup workers.
To determine whether participation in cleanup activities following the disaster was associated with increased risk of developing hypertension.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted via telephone interviews and in-person home exams. Participants were 6846 adults who had worked on the oil spill cleanup (workers) and 1505 others who had completed required safety training but did not do cleanup work (nonworkers). Eligible participants did not have diagnosed hypertension at the time of the oil spill. Statistical analyses were performed from June 2018 to December 2021.
Engagement in cleanup activities following the Deepwater Horizon oil spill disaster, job classes, quintiles of cumulative total hydrocarbons exposure level, potential exposure to burning or flaring oil, and estimated PM2.5 were examined.
Systolic and diastolic blood pressure measurements were collected during home exams from 2011 to 2013 using automated oscillometric monitors. Newly detected hypertension was defined as antihypertensive medication use or elevated blood pressure since the spill. Log binomial regression was used to calculate prevalence ratios (PR) and 95% CIs for associations between cleanup exposures and hypertension. Multivariable linear regression was used to estimate exposure effects on continuous blood pressure levels.
Of 8351 participants included in this study, 6484 (77.6%) were male, 517 (6.2%) were Hispanic, 2859 (34.2%) were non-Hispanic Black, and 4418 (52.9%) were non-Hispanic White; the mean (SD) age was 41.9 (12.5) years at enrollment. Among workers, the prevalence of newly detected hypertension was elevated in all quintiles (Q) of cumulative total hydrocarbons above the first quintile (PR for Q3, 1.29 [95% CI, 1.13-1.46], PR for Q4, 1.25 [95% CI, 1.10-1.43], and PR for Q5, 1.31 [95% CI, 1.15-1.50]). Both exposure to burning and/or flaring oil and gas (PR, 1.16 [95% CI, 1.02-1.33]) and PM2.5 from burning (PR, 1.26 [95% CI, 0.89-1.71]) for the highest exposure category were associated with increased risk of newly detected hypertension, as were several types of oil spill work including cleanup on water (PR, 1.34 [95% CI, 1.08-1.66]) and response work (PR, 1.51 [95% CI, 1.20-1.90]).
Oil spill exposures were associated with newly detected hypertension after the Deepwater Horizon disaster. These findings suggest that blood pressure screening should be considered for workers with occupational hydrocarbon exposures.
接触 2010 年 4 月 20 日深海地平线灾难中的碳氢化合物、细颗粒物(PM2.5)和其他化学物质可能与石油泄漏应对和清理工人的血压升高和新发现的高血压有关。
确定参与灾难后的清理活动是否与高血压风险增加有关。
设计、设置和参与者:这项队列研究是通过电话访谈和上门体检进行的。参与者为 6846 名从事过石油泄漏清理工作的成年人(工人)和 1505 名完成了必要安全培训但未从事清理工作的其他人(非工人)。合格的参与者在石油泄漏发生时没有被诊断为高血压。统计分析于 2018 年 6 月至 2021 年 12 月进行。
研究了在深海地平线石油泄漏灾难后参与清理活动、工作类别、累计总碳氢化合物暴露水平的五分位数、潜在的燃烧或燃烧石油暴露以及估计的 PM2.5。
使用自动振荡监测仪在 2011 年至 2013 年期间的上门体检中收集收缩压和舒张压测量值。新发现的高血压定义为使用抗高血压药物或自泄漏以来血压升高。使用对数二项式回归计算清理暴露与高血压之间关联的患病率比(PR)和 95%置信区间。多变量线性回归用于估计暴露对连续血压水平的影响。
在这项研究中,共有 8351 名参与者,其中 6484 名(77.6%)为男性,517 名(6.2%)为西班牙裔,2859 名(34.2%)为非西班牙裔黑人,4418 名(52.9%)为非西班牙裔白人;登记时的平均(SD)年龄为 41.9(12.5)岁。在工人中,所有累积总碳氢化合物五分位数(Q)均高于第一五分位数(Q3 的 PR,1.29[95%CI,1.13-1.46],Q4 的 PR,1.25[95%CI,1.10-1.43],Q5 的 PR,1.31[95%CI,1.15-1.50])的新发现高血压患病率升高。燃烧和/或燃烧石油和天然气(PR,1.16[95%CI,1.02-1.33])以及燃烧产生的 PM2.5(PR,1.26[95%CI,0.89-1.71])的最高暴露类别与新发现的高血压风险增加相关,包括水上清理(PR,1.34[95%CI,1.08-1.66])和应对工作(PR,1.51[95%CI,1.20-1.90])在内的几种石油泄漏工作也是如此。
石油泄漏暴露与深海地平线灾难后新发现的高血压有关。这些发现表明,应对有职业性碳氢化合物暴露的工人应考虑进行血压筛查。