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Purpose of ReviewBurning of petroleum products has been consistently associated with adverse respiratory health effects. Combustion of crude oil, specifically, produces toxic byproducts, but there have been relatively few studies of health effects. Burning of crude oil is increasingly employed as a means of mitigating environmental disasters despite the potential health risks to workers involved in clean-up efforts. Here, we review epidemiological studies of respiratory effects following unique crude oil burning events to (1) characterize respiratory health effects from this nontraditional occupational exposure and (2) identify approaches used to characterize exposures that could be applied to future disaster-related studies.Recent FindingsWe searched PubMed and EMBASE for references from inception to January 30, 2023. We also manually screened references cited in eligible articles. We identified 14 eligible publications. Our review suggests that exposure to crude oil combustion has adverse respiratory effects, including reduced lung function and increased occurrence of respiratory symptoms and disease. However, the evidence is inconsistent, and quality of data varied across studies. While some studies used quantitative, modeled exposure estimates, most used self-reported proxies of exposure.SummaryAlthough disasters involving crude oil combustion are relatively rare, limited evidence suggests that some worker populations may be at risk for respiratory effects from burning exposures in disaster settings. Future studies that use improved exposure assessment methods (e.g., personal monitors, remote sensing data) may help further quantify the respiratory risk from crude oil burning exposures.

BackgroundSocioeconomic status (SES) at the individual level is associated with hypertension risk. Less is known about neighbourhood level SES or how neighbourhood and individual level SES may jointly affect hypertension risk.MethodsThe Area Deprivation Index (ADI) includes 17 census-based measures reflecting neighbourhood SES. The ADI was linked to enrolment addresses of 47 329 women in the Sister Study cohort and categorised as ≤10% (low deprivation), 11%–20%, 21%–35%, 36%–55% and >55% (high deprivation). Hypertension was defined as either high systolic (≥140 mm Hg) or diastolic (≥90 mm Hg) blood pressure or taking antihypertensive medication. We used log binomial regression to investigate the cross-sectional association between ADI and hypertension and evaluated interactions between ADI and race/ethnicity and between ADI and individual SES.ResultsThe highest ADI level of >55% was associated with increased prevalence of hypertension, compared with the lowest level of ADI≤10%, in a model adjusted for age, race/ethnicity, educational attainment and annual household income (prevalence ratio=1.26, 95% CI 1.21 to 1.32). We observed interaction between race/ethnicity and ADI (interaction contrast ratio (ICR)=1.9; 95% CI 0.94 to 2.8 comparing non-Hispanic Black women with ADI >55% to non-Hispanic White women with ADI≤10%) and between household income and ADI (ICR 0.38; 95% CI 0.12 to 0.65 comparing participants with household income ≤US$49 999 and ADI>55% to those with household income >US$100 000 and ADI≤10%).ConclusionsThese findings suggest that neighbourhood deprivation measured by ADI may be a risk factor for hypertension and that ADI may act synergistically with race/ethnicity and individual household income to contribute to hypertension.

During the 2010 ( ) disaster, response and cleanup workers were potentially exposed to toxic volatile components of crude oil. However, to our knowledge, no study has examined exposure to individual oil spill-related chemicals in relation to cardiovascular outcomes among oil spill workers. Our aim was to investigate the association of several spill-related chemicals [benzene, toluene, ethylbenzene, xylene, -hexane (BTEX-H)] and total hydrocarbons (THC) with incident coronary heart disease (CHD) events among workers enrolled in a prospective cohort. Cumulative exposures to THC and BTEX-H across the cleanup period were estimated via a job-exposure matrix that linked air measurement data with self-reported spill work histories. We ascertained CHD events following each worker's last day of cleanup work as the first self-reported physician-diagnosed myocardial infarction (MI) or a fatal CHD event. We estimated hazard ratios (HR) and 95% confidence intervals for the associations of exposure quintiles (Q) with risk of CHD. We applied inverse probability weights to account for bias due to confounding and loss to follow-up. We used quantile g-computation to assess the joint effect of the BTEX-H mixture. Among 22,655 workers with no previous MI diagnoses, 509 experienced an incident CHD event through December 2019. Workers in higher quintiles of each exposure agent had increased CHD risks in comparison with the referent group (Q1) of that agent, with the strongest associations observed in Q5 (range of ). However, most associations were nonsignificant, and there was no evidence of exposure-response trends. We observed stronger associations among ever smokers, workers with education, and workers with body mass index . No apparent positive association was observed for the BTEX-H mixture. Higher exposures to volatile components of crude oil were associated with modest increases in risk of CHD among oil spill workers, although we did not observe exposure-response trends. https://doi.org/10.1289/EHP11859.

Cannabis is widely used worldwide, yet its links to health outcomes are not fully understood. DNA methylation can serve as a mediator to link environmental exposures to health outcomes. We conducted an epigenome-wide association study (EWAS) of peripheral blood-based DNA methylation and lifetime cannabis use (ever vs. never) in a meta-analysis including 9436 participants (7795 European and 1641 African ancestry) from seven cohorts. Accounting for effects of cigarette smoking, our trans-ancestry EWAS meta-analysis revealed four CpG sites significantly associated with lifetime cannabis use at a false discovery rate of 0.05 ( p < 5.85 × 10 − 7 ) : cg22572071 near gene ADGRF1 , cg15280358 in ADAM12 , cg00813162 in ACTN1 , and cg01101459 near LINC01132 . Additionally, our EWAS analysis in participants who never smoked cigarettes identified another epigenome-wide significant CpG site, cg14237301 annotated to APOBR . We used a leave-one-out approach to evaluate methylation scores constructed as a weighted sum of the significant CpGs. The best model can explain 3.79% of the variance in lifetime cannabis use. These findings unravel the DNA methylation changes associated with lifetime cannabis use that are independent of cigarette smoking and may serve as a starting point for further research on the mechanisms through which cannabis exposure impacts health outcomes.

While several studies have found positive associations between exposure to oil spill cleanup-related chemicals and hypertension, no study has examined these associations longitudinally. This study examined associations of oil spill-related benzene, toluene, ethylbenzene, xylene, and n-hexane (BTEX-H) exposures, individually and as both the aggregate sum (total) of BTEX-H and the BTEX-H mixture with incident hypertension among Gulf Long-term Follow-up (GuLF) Study participants. Participants were 18,619 Deepwater Horizon (DWH) oil spill cleanup and response workers who enrolled in the GuLF Study (2011-2013). Cumulative exposures to each BTEX-H chemical were estimated with a job-exposure matrix linking detailed self-reported DWH participant work histories to exposure group estimates developed from air monitoring data. We defined incident hypertension as the first self-reported physician diagnosis of hypertension or high blood pressure after each worker's last date of cleanup work, as reported at enrollment or a follow-up interview (2013-2016 or 2017-2021). We used Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI). We used quantile g-computation to estimate the joint effect of the BTEX-H mixture. Approximately 20% (n = 3,779) of workers reported an incident hypertension diagnosis. Exposures to the individual BTEX-H chemicals were highly correlated (r = 0.87-0.95). The HRs comparing the highest to lowest quartiles of individual BTEX-H and total BTEX-H exposures ranged from 1.27 to 1.35. We found evidence of exposure-response trends across increasing quartiles of exposure. Each one quartile increase in the BTEX-H mixture was positively associated with incident hypertension (HR: 1.10, 95% CI: 1.07, 1.14). Oil spill cleanup work-related BTEX-H exposures were associated with the risk of incident hypertension, extending prior findings of cross-sectional associations. Since BTEX-H exposures are common in occupational and population settings, these findings may have broader public health implications.

Neighborhood deprivation is associated with age-related disease, mortality, and reduced life expectancy. However, biological pathways underlying these associations are not well understood. To evaluate the association between neighborhood deprivation and epigenetic measures of age acceleration and genome-wide methylation. This cross-sectional study used data from the Sister Study, a prospective cohort study comprising 50 884 women living in the US and Puerto Rico aged 35 to 74 years at enrollment who had a sister with breast cancer but had not had breast cancer themselves. Cohort enrollment occurred between July 2003 and March 2009. Participants completed a computer-assisted telephone interview on demographic, socioeconomic, lifestyle, and residential factors and provided anthropometric measures and peripheral blood samples at a home examination. DNA methylation data obtained for 2630 non-Hispanic White women selected for a case-cohort study in 2014 were used in this cross-sectional analysis. DNA methylation was measured using the HumanMethylation450 BeadChips in whole blood samples collected at baseline. Data analysis for this study was performed from October 17, 2019, to August 27, 2020. Each participants' primary address was linked to an established index of neighborhood deprivation. Epigenetic age was estimated using 4 epigenetic clocks (Horvath, Hannum, PhenoAge, and GrimAge). Age acceleration was determined using residuals from regressing chronologic age on each of the 4 epigenetic age metrics. Linear regression was used to estimate associations between neighborhood deprivation and epigenetic age acceleration as well as DNA methylation at individual cytosine-guanine sites across the genome. Mean (SD) age of the 2630 participants was 56.9 (8.7) years. Those with the greatest (>75th percentile) vs least (≤25th percentile) neighborhood deprivation had higher epigenetic age acceleration estimated by Hannum (β = 0.23; 95% CI, 0.01-0.45), PhenoAge (β = 0.28; 95% CI, 0.06-.50), and GrimAge (β = 0.37; 95% CI, 0.12-0.62). Increasing US quartiles of neighborhood deprivation exhibited a trend with Hannum, PhenoAge, and GrimAge. For example, GrimAge showed a significant dose-response (P test for trend <.001) as follows: level 2 vs level 1 (β = 0.30; 95% CI, 0.17-0.42), level 3 vs level 1 (β = 0.35; 95% CI, 0.19-0.50), and level 4 vs level 1 (β = 0.37; 95% CI, 0.12-0.62). Neighborhood deprivation was found to be associated with 3 cytosine-phosphate-guanine sites, with 1 of these annotated to a known gene MAOB (P = 9.71 × 10-08). The findings of this study suggest that residing in a neighborhood with a higher deprivation index appears to be reflected by methylation-based markers of aging.

BackgroundIndividuals affected by disasters are at risk for adverse mental health sequelae. Individuals living in the US Gulf Coast have experienced many recent major disasters, but few studies have explored the cumulative burden of experiencing multiple disasters on mental health.ObjectiveThe objective of this study was to evaluate the relationship between disaster burden and mental health.MethodsWe used data from 9278 Gulf Long-term Follow-up Study participants who completed questionnaires on perceived stress, anxiety, depression, and post-traumatic stress disorder (PTSD) in 2011–2013. We linked 2005–2010 county-level data from the Spatial Hazard Events and Losses Database for the United States, a database of loss-causing events, to participant’s home address. Exposure measures included total count of loss events as well as severity quantified as property/crop losses per capita from all hazards. We used multilevel modeling to estimate odds ratios (OR) and 95% confidence intervals (CI) for each exposure–outcome relationship.ResultsTotal count of loss events was positively associated with perceived stress (ORQ4:1.40, 95% CI:1.21–1.61) and was inversely associated with PTSD (ORQ4:0.66, 95% CI:0.45–0.96). Total duration of exposure was also associated with stress (ORQ4:1.16, 95% CI:1.01–1.33) but not with other outcomes. Severity based on cumulative fatalities/injuries was associated with anxiety (ORQ4:1.31, 95% CI:1.05–1.63) and stress (ORQ4:1.34, 95% CI:1.15–1.57), and severity based on cumulative property/crop losses was associated with anxiety (ORQ4:1.42, 95% CI:1.12–1.81), depression (ORQ4:1.22, 95% CI:0.95–1.57) and PTSD (ORQ4:1.99, 95% CI:1.44–2.76).

During the 2010 ( ) disaster, controlled burning was conducted to remove oil from the water. Workers near combustion sites were potentially exposed to increased fine particulate matter [with aerodynamic diameter ( )] levels. Exposure to has been linked to decreased lung function, but to our knowledge, no study has examined exposure encountered in an oil spill cleanup. We investigated the association between estimated only from burning/flaring of oil/gas and lung function measured 1-3 y after the disaster. We included workers who participated in response and cleanup activities on the water during the disaster and had lung function measured at a subsequent home visit ( ). concentrations were estimated using a Gaussian plume dispersion model and linked to work histories via a job-exposure matrix. We evaluated forced expiratory volume in 1 s (FEV1; milliliters), forced vital capacity (FVC; milliliters), and their ratio (FEV1/FVC; %) in relation to average and cumulative daily maximum exposures using multivariable linear regressions. We observed significant exposure-response trends associating higher cumulative daily maximum exposure with lower FEV1 ( ) and FEV1/FVC ( ). In comparison with the referent group (workers not involved in or near the burning), those with higher cumulative exposures had lower FEV1 [ , 95% confidence interval (CI): , 3.7] and FEV1/FVC ( , 95% CI: , 0.2). We also saw nonsignificant reductions in FVC (high vs. referent: , 95% CI: , 77.6; ). Similar associations were seen for average daily maximum exposure. Inverse associations were also observed in analyses stratified by smoking and time from exposure to spirometry and when we restricted to workers without prespill lung disease. Among oil spill workers, exposure to specifically from controlled burning of oil/gas was associated with significantly lower FEV1 and FEV1/FVC when compared with workers not involved in burning. https://doi.org/10.1289/EHP8930.

BackgroundBurning/flaring of oil/gas during the Deepwater Horizon oil spill response and cleanup (OSRC) generated high concentrations of fine particulate matter (PM2.5). Personnel working on the water during these activities may have inhaled combustion products. Neurologic effects of PM2.5 have been reported previously but few studies have examined lasting effects following disaster exposures. The association of brief, high exposures and adverse effects on sensory and motor nerve function in the years following exposure have not been examined for OSRC workers.ObjectivesWe assessed the relationship between exposure to burning/flaring-related PM2.5 and measures of sensory and motor nerve function among OSRC workers.MethodsPM2.5 concentrations were estimated from Gaussian plume dispersion models and linked to self-reported work histories. Quantitative measures of sensory and motor nerve function were obtained 4–6 years after the disaster during a clinical exam restricted to those living close to two clinics in Mobile, AL or New Orleans, LA (n = 3401). We obtained covariate data from a baseline enrollment survey and a home visit, both in 2011–2013. The analytic sample included 1186 participants.ResultsWe did not find strong evidence of associations between exposure to PM2.5 and sensory or motor nerve function, although there was a suggestion of impairment based on single leg stance among individuals with high exposure to PM2.5. Results were generally consistent whether we examined average or cumulative maximum exposures or removed individuals with the highest crude oil exposures to account for co-pollutant confounding. There was no evidence of exposure-response trends.Impact statementRemediating environmental disasters is essential for long-term human and environmental health. During the Deepwater Horizon oil spill disaster, burning and flaring of oil and gas were used to remove these pollutants from the environment, but led to potentially high fine particulate matter exposures for spill response workers working on the water. We investigate the potential adverse effects of these exposures on peripheral nerve function; understanding the potential health harm of remediation tactics is necessary to inform future clean up approaches and protect human health.

BackgroundToenails are a promising matrix for chronic metal exposure assessment, but there are currently no standard methods for collection and analysis. Questions remain about sample mass requirements and the extent to which metals measured in this matrix are representative of chronic body burden.ObjectiveThis study proposes a method to maximize sample conservation for toenail metals analysis using inductively coupled plasma mass spectrometry (ICP-MS). We demonstrate the reliability of an ~25 mg toenail sample (typically 1–2 clippings) for metals analysis and evaluate the intra-individual variability of multiple metals in this matrix over time in men from the Gulf Long-term Follow-up (GuLF) Study.MethodsToenail samples from 123 GuLF Study participants were collected at two visits 3 years apart and analyzed for 18 elements using ICP-MS. Participants with samples exceeding 200 mg at the first visit (n = 29) were selected for triplicate sub-sample analysis. Kendall’s coefficient of concordance (W) was used to assess sub-sample reliability and Spearman’s correlation coefficients (ρ) were used to evaluate fluctuations in elemental concentrations over time.ResultsResults were not reported for Cd, Co, Mo, Sb, and V (detected in <60% of the samples). There was strong agreement among triplicate samples (Kendall’s W: 0.72 (Cu)–0.90 (Cu)) across all elements evaluated, moderate correlations of elemental concentrations (Spearman’s ρ: 0.21–0.42) over 3 years for As, Ca, Cr, Fe, Pb, Mn, and Zn, and strong correlations (>0.50) for Se, Cu, and Hg.Impact StatementThis toenail reliability study found that a low-mass (~25 mg) toenail sample (1-2 clippings) is suitable for the determination of most elements using ICP-MS and helps to increase the analytical capacity of limited toenail biospecimens collected in cohort studies. The results highlight differences in the suitability of toenails for chronic metal exposure assessment by element and underscore the need to consider intra-person variability, especially when comparing results across studies. We also provide recommendations for analytical standardization and the partitioning of the total collected toenail sample into multiple analytic sub-samples for future studies using toenail biospecimen for multiple assays.