Courtesy: The Annals of Internal Medicine
Editorial
Each environmental disaster is unique, with health consequences that depend on the intersection of the event, the geographic setting, and the characteristics of the local population. Yet, all environmental disasters require the identification of health consequences and strategies to mitigate them and provide lessons for how to do better in future disasters (1–6). The Prestige oil spill and the rigorous health effects research that has followed (7–9) have direct relevance for the affected population but are also part of the broader body of disaster epidemiology that includes study of chemical explosions in Bhopal, India, and Seveso, Italy; the Chernobyl nuclear disaster; and the World Trade Center attack. In this issue, the report by Rodríguez-Trigo and colleagues of health effects in fishermen who helped clean up the Prestige oil spill (7) provides an opportunity to consider practices that will facilitate study of health effects among the 50 000 workers and others exposed during the 2010 Deepwater Horizon spill and future incidents.
Photo Credit: Win McNamee/Getty Images
THE FOLLOWING IS A SUMMARY OF THE FULL REPORT WHICH CAN BE FOUND HERE.
Recommendation 1:
Collect exposure and medical histories from workers as early as possible.
Ideally, investigators studying health effects of environmental disasters would collect biological samples and histories from workers before the start of clean-up work, but such data are seldom available. Consequently, these data should be obtained as early as possible after the work begins and preferably before any work-related symptoms appear. Rapid field data collection requires partnerships among various stakeholders, including workers, industry, local universities, and government agencies…
Recommendation 2:
Conduct detailed exposure assessment.
The urgency of immediate needs (such as saving lives and containing oil) can hamper efforts to methodically assess exposure, and opportunities for exposure assessment in the Deepwater Horizon spill are now largely retrospective. Developing job- or task-exposure matrices that encompass the broad spectrum of clean-up activities will help epidemiologists more accurately estimate exposure….
Recommendation 3:
Consider a broad range of health issues.
Studies in the Gulf of Mexico should investigate acute symptoms reported previously as well as delayed conditions such as cancer. Leukemia, multiple myeloma, and melanoma are of particular interest, on the basis of evidence from occupational studies of petrochemical workers (15, 16). Evidence of genotoxicity and chromosomal damage from the Prestige spill (7) demonstrates the importance of examining biomarkers, such as genetic, epigenetic, immune, and inflammatory alterations because some diseases…
Recommendation 4:
Plan research to guide immediate public health interventions and advance science.
Researchers should strive to generate information of immediate value to the affected community. Opportunities to identify health service needs, suggest interventions to ameliorate the ongoing effects of the disaster, and to disseminate clear information need to be pursued…
Recommendation 5:
Recognize and work within the political context.
Controversy, litigation, and economic consequences follow most environmental disasters, and data from research on the health effects of the disaster will be used as ammunition in the battles that ensue. In the Deepwater Horizon spill, tension has already developed between the desire to fully investigate the health consequences of the spill and the desire to provide reassurance that will reinvigorate the region’s tourism and seafood enterprises. In the face of such conflicts, results will inevitably be seen as supportive of one view and counter to another…
- David A. Savitz, PhD; and Lawrence S. Engel, PhD
