HUMAN HEALTH AND SOCIOECONOMIC EFFECTS OF THE DEEPWATER HORIZON OIL SPILL IN THE GULF OF MEXICO
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SPECIAL ISSUE ON THE GULF OF MEXICO RESEARCH INITIATIVE: TEN YEARS OF OIL SPILL AND ECOSYSTEM SCIENCE
HUMAN HEALTH AND
SOCIOECONOMIC EFFECTS OF THE
DEEPWATER HORIZON OIL SPILL
IN THE GULF OF MEXICO
By Paul A. Sandifer, Alesia Ferguson, Melissa L. Finucane, Melissa Partyka,
Helena M. Solo-Gabriele, Ann Hayward Walker, Kateryna Wowk, Rex Caffey, and David Yoskowitz
In the wake of the Deepwater Horizon oil spill, hundreds of miles of floating barriers, known as
boom, were anchored in place to prevent oil from stranding on the shore and to reduce impacts to
sensitive areas such as marshes and bird nesting grounds, as well as areas valued for human use
like this fishing spot north of Dauphin Island, Alabama. Photo credit: US Navy Photo by Chief Mass
Communication Specialist Joe Kane, Fleet Combat Camera Group Pacific (Released)
174 Oceanography | Vol.34, No.1
ABSTRACT. The Deepwater Horizon (DWH) oil spill is the only declared Spill of were extensive, and they compounded
National Significance in US history, and it significantly impacted the health of people negative effects of previous disasters
and communities in the Gulf of Mexico region. These impacts amplified adverse effects such as Hurricane Katrina in the Gulf.
of prior disasters and may compound those of future traumas. Studies, both to date and In turn, these effects are likely to exac-
ongoing, show some negative mental and physical health outcomes associated with erbate traumas of subsequent disasters
DWH in some spill workers, as well as some coastal residents in all Gulf States. The as well as ongoing threats from chem-
spill was also associated with negative effects in the living resources, tourism, and rec- ical pollution, oil seeps, and harmful
reation sectors, at least in the short term. Compared with others, people dependent on algal blooms. In this article, we describe
these sectors reported more health and financial concerns. Consumer concerns about potential, perceived, and actual impacts,
the safety and marketability of seafood persisted well after data demonstrated very low beginning with the people expected to
risk. Parents were concerned about possible exposures of children as they played on be most exposed to toxic substances—
beaches, but this risk was found to be minor. Spill-related stress was an overarching fac- the response and cleanup workers—
tor associated with adverse health outcomes, and some residents reported greater stress followed by effects on those who resided
from navigating the legal and claims processes following the spill than from the spill in spill-affected areas, possible hazards
itself. Research revealed a serious lack of baseline health, environmental, and socio- to children at play on beaches, seafood
economic data against which to compare spill effects. This finding highlighted the need contamination risks, and socioeconomic
for ongoing observing systems to monitor health and socioeconomic parameters and effects on the Gulf ’s iconic fisheries and
establish continuous baselines of such information. tourism industries and communities. We
conclude with a discussion of the need for
INTRODUCTION demographic, economic, social, physi- a human health observing system in the
The Deepwater Horizon (DWH) oil spill cal, and other variables (McEwen, 2005; Gulf and a list of major findings and criti-
was the largest ever in United States Norris et al., 2008). Inhabitants of the cal research needs for the future.
(National Commission, 2011) and the Gulf region are particularly susceptible
only Spill of National Significance. How- to oil spill health impacts due to wide- HEALTH EFFECTS ON
ever, large oil spills, defined by NOAA spread, preexisting health disparities, RESPONDERS AND
(2017) as exceeding 100,000 barrels continuing exposure to contaminants, CLEAN-UP WORKERS
(420,000 gal) of oil are relatively rare, and and location in a disaster-prone region Oil spill response and cleanup workers
very large ones even more so. Between (Lichtveld et al., 2016; Slack et al., 2020). (hereafter referred to as workers) can be
1969 and 2017, only 44 large oil spills Not surprisingly, the DWH oil spill, like exposed to a variety of hazards, includ-
(45 including the long-leaking Taylor Hurricane Katrina and other disasters, ing the oil and its components, burning
Energy wells in the Gulf of Mexico; “had its greatest impact among those oil, dispersants, and cleaning agents, plus
Mason et al., 2019) have occurred in US with the least” (Abramson et al., 2010). mixtures of oil, dispersants, and other
waters (NOAA, 2017), with about one- From its beginning, the Gulf of Mexico chemicals. Other work stressors include
third of these in the Gulf. Research Initiative (GoMRI) recog- high heat and humidity, musculoskeletal
Although they are rare, large oil nized the need for human-focused as strain, long working hours, and finan-
spills can adversely impact the health of well as environmental impact research. cial (e.g., job loss) and psychological
responders, cleanup workers, and resi- It sponsored a public health workshop (e.g., depression, anxiety) effects.
dents, and the public welfare of affected and broadly advertised a request for Between 1970 and 2009, there were
communities (Walker et al., in press; research proposals focused on human 458 tanker spills greater than 700 metric
Figure 1). The DWH spill also resulted health effects. Although articles explic- tonnes (approximately 222,500 gals) of oil
in deaths of 11 oil industry workers. itly focused on human health comprised (IOTPF, 2009); 38 of those spills affected
Physical and mental health effects have only a small portion of research publica- human populations. Of those 38 spills,
been reported and are closely related tions supported by GoMRI funding, they only eight that occurred between 1989
in disaster contexts (Aguilera et al., present important findings (Eklund et al., and 2007 were studied in some detail
2010; Palinkas, 2015; Ohrnberger et al., 2019). Additional health-related research for human health effects (Kwok et al.,
2017; H.J. Osofsky et al., 2018), in part was supported via the US National 2017a): Exxon Valdez (US), Braer (UK),
because environmental contamination Institute of Environmental Health Sea Empress (UK), Prestige (Spain),
results in significant stress (Hallman and Sciences (NIEHS), in part with BP fund- Tasman Spirit (Pakistan), Erika (France),
Wandersman, 1992). How people adapt ing, some of which is summarized here. Nadhodka (Japan), and the Hebei Spirit
to repeated exposure to stress depends DWH impacts on individuals, fami- (South Korea) (B.-M. Kim et al., 2009;
on an array of psychological, socio- lies, groups, businesses, and communities Aguilera et al., 2010; Jung et al., 2013).
Oceanography | March 2021 175
Response to the Exxon Valdez oil spill led primarily investigated acute health symp- Human health studies following the to many changes in oil spill preparedness, toms. Acute health impacts were studied DWH spill, the largest of their kind in training, response, and worker safety and for up to one year after oil spill exposure history, are ongoing. Two epidemiologi- health, including use of personal protec- in workers and affected community mem- cal studies examine effects on the health tive equipment (PPE) in the United States bers to assess anxiety and post-traumatic of workers: the NIEHS Gulf Long Term (OSHA, 2020) and globally. Most stud- stress, eye and skin irritation, and respi- Follow-Up Study (GuLF STUDY; Kwok ies of human health effects occurred in ratory tract consequences (Palinkas et al., 2017a) and the US Coast Guard non-US countries where many workers et al., 1993; Zock et al., 2007; Na et al., (USCG) Deepwater Horizon Oil Spill from the community as well as volun- 2012). Several studies reported longer- Cohort study (Rusiecki et al., 2018). teers engaged in oil spill cleanup with lit- term respiratory symptoms in workers These study teams have collaborated, and tle protective gear. Studies that included responding to the Hebei Spirit (Gwack both are assessing potential long-term pre-disaster health data were generally et al., 2012) and Prestige (Zock et al., effects, including cancer. small, had shorter follow-up periods, and 2012) oil spills. The GuLF STUDY is assessing a FIGURE 1. A summary of human effects research findings from studies on nine large oil spills: Exxon Valdez (USA), Braer (UK), Sea Empress (UK), Prestige (Spain), Tasman Spirit (Pakistan), Erika (France), Nadhodka (Japan), Hebei Spirit (South Korea), and Deepwater Horizon (USA). Relatively few spills have been shown to directly and adversely affect human mental and/or physical health, although many may have socioeconomic, ecological, or other effects of concern (Murphy et al., 2016). Whether any direct human effects occur from future spills will depend upon incident-specific condi- tions such as spilled oil type and volume, location, time of year, response actions, and safety and health protocols. Human susceptibilities to oil spill effects may be increased by pre-existing conditions, incident-specific and general life stressors, traumas, and previous disaster experience. Original concept developed by NASEM (2017) and adapted from Figure 3 in Beyer et al. (2016). Redrawn with permission from Sandifer and Walker (2018), with modifications. 176 Oceanography | Vol.34, No.1
range of human health effects, includ- Worker Exposures documented in workers exposed to oily
ing worker access to mental health ser- To determine effects, physical health plants and wildlife compared to unex-
vices (Lowe et al., 2015). It uses extensive assessments evaluate elements of expo- posed workers (Gam et al., 2018a). While
data on actual and estimated exposures sure pathways (ATSDR, 2005). THC Kwok et al. (2017b) linked reduced lung
and health outcomes derived from sur- and BTEX are generally considered to be function with adverse mental health out-
veys, home visits, and clinical records. the more toxic components of oil. THC comes, Gam et al. (2018 a,b,c) found
Such limitations as self-reporting errors, is a composite of the volatile chemi- no association of depression and post-
confounding factors, and potential biases cals from the oil and was used as a sur- traumatic stress with lung function.
are documented in all papers and are fre- rogate for the workers’ “oil experience.” Lawrence et al. (2020) reported improve-
quently investigated with sensitivity anal- The exposure assessment used BP mon- ments in lung function decrements four
yses. The full cohort includes 32,608 peo- itoring samples and agency short-term to six years after the spill, with those
ple. Approximately 25,000 of these were studies and accounted for oil changes due with the highest exposure exhibiting the
actual workers, and the remainder were to weathering. greatest improvement.
non-workers for comparison (i.e., peo- Kwok et al. (2017a), Rusiecki et al. When Strelitz et al. (2018) compared
ple who were trained but not hired). The (2018), and Ng et al. (2019) provided individual workers involved in DWH
period of oil spill work activities was details of potential worker exposures cleanup work with non-workers, they
from April 20, 2010, through June 2011. and their measurements and estima- found a positive association between sev-
Workers performed a variety of tasks tions. Primary exposure pathways to the eral oil spill related exposures and an
with different exposure profiles under the oil, burning oil (particulates), and oil spill increased risk of nonfatal heart attacks
primary categories of response, support chemicals are inhalation and direct con- one to three years post spill. Factors asso-
operations, cleanup on water, decontam- tact (skin and eye). Due to the way off- ciated with oil spill work, such as heat,
ination, cleanup on land, and adminis- shore and onshore air quality measure- strenuous conditions, physical exertion,
tration (Kwok et al., 2017a). The ultimate ments and exposure estimates were and the health limitations of the indi-
goal of the GuLF STUDY was to quantify made, reported or observed symptoms vidual worker, make it difficult to ascer-
exposures to total hydrocarbons (THC) cannot be linked to a specific crude oil tain whether the risk of heart disease
and BTEX-H (benzene, toluene, ethyl- chemical. From available data, it appears can be related directly to exposure to
benzene, xylene, hexane) via air measure- that total hydrocarbon exposure levels oil spill pollutants (Strelitz et al., 2019a).
ments as a means of estimating poten- for workers likely were low compared to However, risk of heart disease has been
tial toxic effects of THC and BTEX-H on occupational standards (Middlebrook associated with oil pollutants, cleanup
workers (Kwok et al., 2017a). et al., 2012). However, an onshore study activities, burned oil particulates, and
The USCG cohort study consisted of conducted from May 1 to September 30, volatile organic compounds (Strelitz
53,519 USCG personnel, 8,696 of whom 2010, assessed coastal ambient air qual- et al., 2019b). The emotional stress related
responded to the spill and 44,823 who ity for benzene and particulate con- to the spill was also a possible cause of
were not responders. The USCG study centrations (PM2.5; Nance et al., 2016) increased physical health risks such as
used health data from military medical using air monitoring data from the US heart attacks (Strelitz et al., 2018). Other
encounters and cross-sectional survey Environmental Protection Agency (EPA) analyses suggest that physical health
data. Importantly, the USCG study can and BP. The EPA’s Air Quality Index was symptoms contribute to cleanup workers’
access a substantial amount of baseline compared prior to and during the spill. risk for mental health issues (Lowe,
health data for its participants, because Onshore concentrations were generally 2016). However, fishers who had longer
medical data are available for all active- higher following the spill, with benzene periods of cleanup work and thus poten-
duty Coast Guard members from 2007 2 to 19 times higher and PM2.5 10 to tially higher work-related oil exposure
forward (Rusiecki et al., 2018). For the 45 times higher. Both concentrations were also had higher income, which in turn is
study, exposure levels and symptoms high enough to exceed public health cri- associated with lower anxiety and depres-
were based on self-reported and clinical teria, with coastal areas near the spill and sion (Lowe et al., 2016).
data from the total cohort. While many cleanup activities indicating measurable The USCG study reported posi-
health studies use self-reported informa- exposure disparities. tive associations between exposure to
tion, including for toxic exposures, such crude oil, and in some cases oil and
data can be subject to recall and other Worker Health Findings dispersant mixtures, and acute respi-
biases (IOM, 1994; Williamson, 2007). GuLF STUDY findings to date have ratory symptoms (Alexander et al.,
Both the GuLF and USCG studies are included nonfatal and fatal heart dis- 2018); neurological symptoms includ-
continuing, with additional health effect ease and reduced lung function in some ing headache, lightheadedness, difficulty
papers expected. workers. Reduced lung function has been concentrating, numbness/tingling sensa-
Oceanography | March 2021 177tion, blurred vision, and memory loss/ ent at the time of study enrollment one to Physical health problems or indica-
confusion (Krishnamurthy et al., 2019); three years after the spill). Although only tors identified with oil exposure include
heat stress (Erickson et al., 2018); and 5% of the Coast Guard personnel who assorted respiratory issues; irritation
skin issues, as well as some gastrointes- responded to the Deepwater Horizon Oil of skin, eyes, nose, throat; chest pain;
tinal and genitourinary symptoms that Spill Cohort study health questionnaire cardiovascular disease; gastrointesti-
have not previously been well evaluated reported contact with both oil and dis- nal complaints; headaches, dizziness,
(Rusiecki et al., 2018). persants, for example, through assign- fatigue, memory issues; and abnormal
ments to conduct Special Monitoring of blood cell counts and liver and kidney
Dispersants Applied Oil Spill Technologies (Levine function tests (e.g., Nance et al., 2016;
Dispersants warrant separate mention et al., 2011), self-reported adverse neuro- Singleton et al., 2016; Afshar-Mohajer
given the widespread public concern logical health effects were worse for those et al., 2018, 2019; Strelitz et al., 2019a).
about their unprecedented use during workers than for those exposed only to Laboratory experiments suggest that dis-
DWH (Starbird et al., 2015; Kwok et al., oil, and heat exposure also exacerbated persant and dispersant-oil mixtures pro-
2017a). Although studied for decades by symptoms (Krishnamurthy et al., 2019). duce effects indicative of lung diseases
oil spill scientists, dispersants remain a However, these authors cautioned that such as asthma and chronic obstructive
controversial response option (Bostrom self-reported information can be subject pulmonary disease (Liu et al., 2016) and
et al., 2015; Walker et al., 2018). Robust to bias, and they did not have informa- mixtures may affect the gut microbiome
protocols for their application on the tion about who was where and when in (J.N. Kim et al., 2012).
water surface were implemented during reference to possible exposures. Evidence for mental health dis-
DWH (Houma ICP, 2010; ASTM, 2018), tress associated with the DWH oil spill
including monitoring for environmen- HEALTH EFFECTS ON is mixed (Finucane et al., 2020a). Two
tal effects and some air monitoring for NON-WORKERS large, population-based surveys in the
2-butoxyethanol, one of the compo- Human impacts of oil spills are much Gulf Coast region suggest only modest
nents in Corexit EC9527A. Although less studied than environmental impacts or minimal changes in mental or behav-
2-butoxyethanol had been removed from (Murphy et al., 2016), physical health ioral health—at the aggregate level—
Corexit EC9500A as a result of health effects are better researched among before versus after the DWH spill (Gould
concerns related to the Exxon Valdez spill workers than in other populations et al., 2015). However, results across a
spill (NRC, 2005), it remained in Corexit (Laffon et al., 2016; Eklund et al., 2019), range of other, more targeted studies indi-
EC9527A, which was used only in surface and mental health distress is better cate increased reports from individu-
applications for about a month during researched among community residents als of symptoms consistent with depres-
the DWH spill (McGowan et al., 2017). (Finucane et al., 2020a). Many, if not all, sion, anxiety, and post-traumatic stress
Dispersants were also applied at the well- of the health effects noted for workers (Grattan et al., 2011; H.J. Osofsky et al.,
head to mitigate impacts from surface probably also apply to the general popu- 2011, 2015; Buttke et al., 2012a,b; Gill et al.
oil slicks and to reduce levels of vola- lation that may be exposed, although the 2012, 2014; Morris et al., 2013; Drescher
tile organic compounds near the source. magnitude of the exposures may be con- et al., 2014; Cherry et al., 2015; Fan et al.,
Because the measurements and sup- siderably greater for workers. 2015; Aiena et al., 2016; Rung et al., 2016,
port documentation related to the dis- Oil and associated chemical com- Gaston et al., 2017; Kwok et al., 2017b).
persants were insufficient to allow reli- ponents have a wide range of known Substantial portions of coastal house-
able estimation of exposure levels across or putative toxic outcomes, includ- holds (e.g., nearly 38% of an Alabama
the Gulf (Stewart et al., 2018), the GuLF ing endocrine disrupting, carcino- sample; Ritchie et al., 2018) were involved
STUDY used responses to survey ques- genic, cytotoxic, immunotoxic, muta- directly or indirectly in DWH-related
tions to assess dispersant exposure and genic, and genotoxic effects (Solomon claims, settlements, or litigation activ-
estimated that about 10% of its cohort and Janssen, 2010; Bhattacharya et al., ity. Research on the compensation pro-
could have been exposed to disper- 2016; Du et al., 2016; Laffon et al., 2016; cess suggests it was perceived by residents
sants (Kwok et al., 2017a). Findings by Doctors for Environment Australia, 2019; as random and lacking transparency, and
McGowan et al. (2017) suggest associa- Holme et al., 2019). Exposures can occur resulted in additional psychological stress
tions between exposure to dispersants, through physical contact with contami- for individuals and corrosive effects on
specifically Corexit EC9527A or Corexit nants in air, water, or on materials; dis- communities (Mayer et al, 2015; Ritchie
EC9500A, and acute adverse health effects ruptions of routine behaviors; socio- et al., 2018; Halmo et al., 2019).
(e.g., respiratory and eye irritation and economic impacts; or other pathways Even years after the spill, Gulf Coast
chest tightness at the time of the oil spill (Hobfoll, 1991; Eisenberg and McKone, residents report DWH-associated dis-
work as well as symptoms that were pres- 1998; Slack et al., 2020). tress, but this may vary for different
178 Oceanography | Vol.34, No.1social groups, in part because of differing Cope et al. (2013) evaluated suites of Hodler, 2019). Among patients (predom-
prior trauma, life disruption (especially self-reported mental and physical health inantly African American women) seek-
income loss), or available support (Arata issues via the Louisiana Community Oil ing care at a Federally Qualified Health
et al., 2000; Grattan et al., 2011; Morris Spill Survey, conducted in spill-affected Center in an underserved area affected
et al., 2013, Cherry et al., 2015; Rung parishes in June 2010 while the DWH oil by DWH, post-traumatic stress dis-
et al., 2016; Ayer et al., 2019; Ramchand spill was ongoing, and again in October order was associated with headaches,
et al., 2019; Bell et al., 2020; Parks et al., 2010 and April 2011. A physical health chest pains, dizziness, or trouble sleep-
2020). Higher levels of social support, index was calculated based on responses ing (Langhinrichsen-Rohling et al.,
sense of community, and perceived resil- to questions about how worries about 2017). However, where patients received
iency seem to be protective against spill- the spill manifested as physical symp- post-disaster, integrated health services,
related stress. However, social support toms. The index was significantly higher perceptions of personal resilience
was not ameliorative for all groups, such (indicating more health concerns) among increased and negative physical symp-
as those with high attachment to dam- fishing households, and while the index toms decreased (H.J. Osofsky et al., 2018).
aged resources (e.g., fishing households; declined in subsequent survey waves for Children are especially vulnerable to
Parks et al., 2020) or nonreligious people those not involved in the fishing industry, oil spills due to their physiology (high
living in highly religious areas (Drakeford it grew stronger over time for people in respiratory and metabolic rates, devel-
et al., 2019). Ayer et al. (2019) reported the industry. Parks et al. (2018) used the oping immune and hormonal systems,
that, after controlling for other traumatic same data source to examine disruption small stature), behavior (e.g., inquisitive
experiences, individuals with higher lev- of routine behaviors, including sleep, fol- play; Tipre et al., 2017; Slack et al., 2020),
els of DWH exposure were not at greater lowing the spill. On average, respondents and poorly developed ability to estimate
risk for behavioral health problems, reported difficulty with about one-third risk (Fischhoff et al., 2010) (see section
except for illness anxiety. of the activities. Again, respondents with on Beach Exposures). Children exposed
ties to the fishing industry were more to the DWH oil spill were twice as likely
Fishers and Seafood Workers likely than non-fishers to report disrup- to have mental and physical health prob-
Fishers and seafood workers are often tion to routine behaviors. lems compared to those who were not
members of tight-knit cultural communi- exposed, and African American children
ties (Picou and Gill, 1996; Marshall et al., Women, Pregnant Women, and those from low-income households
2007), and the cultural identity of the Gulf and Children had higher prevalence of health effects
Coast region is intertwined with fishing Results of previous studies revealing (Abramson et al., 2010). Based on health
(Henry and Bankston, 2002). Short-term adverse reproductive health effects for status reports for children four, six, and
fishing moratoria were enacted immedi- people exposed to petroleum hydro- eight years after the spill, general health
ately following DWH (see Seafood Safety carbons led to concerns about poten- and numbers of recent physical health
section), and even when the moratoria tial impacts on pregnant women in the problems (respiratory symptoms, eye
were lifted, uncertainty about the con- Gulf following the DWH spill (Merhi, and/or vision issues, skin problems, head-
tamination of fishing grounds continued 2010). In the case of the DWH event, aches, or unusual bleeding) were worse
for fishers and seafood workers (Simon- women physically exposed to the spill in households that experienced physi-
Friedt et al., 2016). In addition to pre- or who experienced negative economic cal exposure to the spill or job/economic
existing economic pressures (Harrison, impacts reported physical symptoms losses (Slack et al., 2020).
2020), the ongoing disruption and stress such as wheezing or irritated eyes and
from the DWH spill contributed to the nose (Peres et al., 2016). Similarly, preg- PHYSICAL HEALTH EFFECTS
unique vulnerability of these workers nant women who lived near the Hebei TO POPULATIONS FOLLOWING
(Gill et al., 2012; Lee and Blanchard, Spirit spill site in South Korea reported BEACH CONTAMINATION:
2012; Cope et al., 2013, 2016; Parks et al., more eye irritation, headaches, and pain CHILDREN’S EXPOSURES
2018). While greater social support is typ- than those further away (B.-M. Kim AS AN EXAMPLE
ically helpful in bolstering mental health, et al., 2009). With regard to reproductive Health-related exposures associated with
it may operate differently among renew- health, Harville et al. (2018) found little oil spills can be estimated through quan-
able resource communities (Freudenburg, evidence of DWH spill exposure being titative risk assessment of health impacts.
1992; Gill et al., 2014). Indeed, Parks et al. associated with increased miscarriages or The risk assessment process addresses
(2020) found that fishing households with infertility in women from southeastern hazard identification (chemicals of con-
greater social support were more suscep- Louisiana, although spills in Nigeria have cern and their environmental concen-
tible to depressive symptoms six years been linked with increased mortality rates trations), exposure assessment (human
after the DWH oil spill. among newborn children (Bruederle and activities that lead to exposure through
Oceanography | March 2021 179ingestion, skin contact, or inhalation), cals were available within environmen- mouth and nose are generally closer to
and dose-response evaluation (amounts tal matrices, including nearshore water the ground than an adult’s, resulting in
of the chemicals likely to enter and be and beach sediments, where beachgoers greater inhalation of pollutants that accu-
absorbed in the body (Figure 2; NRC, could be affected. Although these data mulate in sediments. Also, children’s play
2009; Ferguson et al., 2020a). The effect provide snapshots of chemical concen- habits involve intimate contact with and
is an estimate of risk typically provided in trations, a more complete picture in time potential ingestion of beach sand (Shoaf
units of probability. and space possibly could be obtained by et al., 2005), and they tend to dig, bury
using the data in oil spill models to predict themselves, and sit in the very shal-
Hazard Assessment oil spill chemical concentrations in near- low water, which typically has the high-
The first step in quantifying risks is to esti- shore environments. The General NOAA est levels of contaminants (Shah et al.,
mate the concentrations of oil spill chem- Operational Modeling Environment 2011; Wright et al., 2011). Although these
icals within human exposure zones such (GNOME) was used to help inform the behaviors are specific to the beach envi-
as beaches. Thousands of chemicals can be Coast Guard-led response efforts about ronment, they had not been quantified
found in crude oils. They can be broadly the areal extent of oil contamination. prior to research supported by GoMRI
categorized into hydrocarbon, non- Initial efforts have been made to evalu- following the DWH. GoMRI-supported
hydrocarbon, organometallic, and metal- ate how well predictions from GNOME studies have quantified children’s behav-
lic compounds (Huba and Gardinali, coincide with chemical concentration iors on beaches in Miami, Florida,
2016). Chemicals of concern in crude oil, measurements (Montas et al., 2020; J. Xia and Galveston, Texas, through surveys
those potentially toxic to humans, are the et al., 2020, 2021), opening the possibil- (Ferguson et al., 2019), sand adherence
volatile aromatic hydrocarbons, BTEX-H, ity for future use of operational models to studies (Ferguson et al., 2020b,c; Perone
and the polycyclic aromatic hydrocarbons forecast oil spill chemical concentration et al., 2020; Tomenchok et al., 2020), and
(PAHs) (ATSDR, 2005). Mitigation of oil distributions and provide an important videotaping of children and translat-
spills can also include the use of disper- first step for risk assessment. ing the videos to quantitative values that
sants, for which potential toxicities to describe child beach play behavior (Alicia
humans are under debate (Ferguson et al., Exposure Assessment Ferguson, North Carolina Agricultural
2020a; NASEM, 2020; Quigg et al., 2021, Different groups of humans can be and Technical State University, pers.
in this issue); their use would need to be exposed to oil spill chemicals at beaches, comm., 2021). Collectively, these stud-
considered in risk assessments for future including response workers who actively ies have documented child beach play
oil spills. Of the chemicals listed above, engage in cleanup of contaminated shore- behaviors that can now be utilized in risk
the PAHs and their degradation prod- lines and recreational users of these areas. assessment analyses.
ucts have the most significant impacts Here, we focus on the recreational user
at beaches because they weather slowly category, and specifically on children who Dose-Response Assessment
and are generally the most toxic (ATSDR, may be exposed to incidental residual oil Effects from the uptake of chemicals
2005). Also, toxicological profiles are not that remains after beach cleaning and also are typically separated into two types:
currently available for many oil chemicals to low level oiling that may occur from non-cancerous (acute and chronic) and
and degradation products and for vulner- continuous leaks (e.g., Taylor Energy cancerous. Non-cancerous effects are
able populations for which information is wells, seeps) and the redistribution of evaluated by comparing the estimated
very limited (e.g., pregnant women and sunken oil. As noted elsewhere, children dose to minimum risk levels for chemi-
children; Aeppli et al., 2012; White et al., are a vulnerable constituency for expo- cal compounds. If the dose is greater than
2016; Farrington, 2019). sures to contaminants in soil and sands, the corresponding minimum risk level,
Immediately after the DWH explosion, including potentially at beaches (Freeman then non-cancerous illnesses are likely
large-scale sampling efforts were initiated et al., 2005; Xue et al., 2007; Beamer et al., to occur. To estimate the probability of
by the EPA, BP, and other organizations. 2012; Ferguson et al., 2019). In addi- cancer, a slope factor is needed and can
Their measurements of oil spill chemi- tion to factors noted previously, a child’s be obtained for some oil chemicals from
transport, fate activity intake interaction
source concentration exposure dose effect
FIGURE 2. Framework for a risk assessment modeling platform.
180 Oceanography | Vol.34, No.1toxicological profiles available through ination, surveillance testing of seafood followed a similar approach to that used
the US Center for Disease Control’s around the periphery of the spill began on in the response to the Exxon Valdez spill
(CDC’s) Agency for Toxic Substances & April 28, 2010. Just four days later, May 2, in 1990, with minor modifications based
Disease Registry and EPA’s Integrated 2010, the first emergency fishery closure on the difference in the nature of the Gulf
Risk Information System. was announced. This was only the second oil and the environmental conditions in
time in US history that a fishery in federal which the spill occurred (Ylitalo et al.,
Risk Assessment Framework waters was closed because of an oil spill 2012; Dickey and Huettel, 2016). Finfish
Available information about hazard (Fitzgerald and Gohlke, 2014). Shortly and shellfish samples were collected from
characterization, exposure assessment, thereafter, on May 24, the federal govern- multiple seafood sources and at multi-
and dose- response assessment has ment declared a fisheries disaster for the ple locations and depths in areas free or
been incorporated in a risk assessment states of Alabama, Mississippi, Louisiana, cleared of oil (Ylitalo et al., 2012). Seafood
framework. Although work is currently and Florida (K. Xia et al., 2012). By early samples were not collected from areas
ongoing to quantify children’s activities, June, at the height of the spill, nearly where oil was visibly present on the sur-
results to date indicate that children who 37% of federal waters in the Gulf of face or chemically detected in the water
play at beaches that were cleaned after oil Mexico Exclusive Economic Zone were column since these locations were closed
contamination are unlikely to experience closed to fishing along with state waters to fishing (USFDA, 2010). Samples were
non-cancerous acute or chronic health extending from Louisiana to the panhan- screened for the presence and concentra-
effects. Additionally, increased cancer dle of Florida and some public beaches tions of 13 PAHs determined to have the
risks are very low, within the 10–6 order (Ylitalo et al., 2012). Though federal most potential to harm consumers as well
of magnitude (i.e., about one in a mil- fishing waters began to reopen as early as dioctyl sodium sulfosuccinate (DOSS),
lion; Black et al., 2016, Altomare et al., as the end of June 2010, it was not until an indicator compound for the disper-
2021), given toxicological information April 2011 that all federal waters, includ- sant Corexit 9500A. Levels of concern for
available at the time. Also, simultaneous ing those immediately surrounding the each targeted compound were calculated
exposure to multiple chemical contami- wellhead, were fully opened. Sampling based on a variety of factors that included
nants was not compounded in the anal- of previously closed waters continued estimated dose, mean adult body weight,
ysis. Moreover, mental health outcomes through June 2011 (Ylitalo et al. 2012). and averaged seafood consumption rates
can manifest in physical outcomes from Although most fishery closures in state for the 90th percentile of seafood con-
chemical exposures and were not inte- waters were lifted by August/September sumers (USFDA, 2010). These levels were
grated into the analysis. 2010, it was several more years before the considered to be safe or associated with
most heavily impacted coastal waters in negligible cancer and non-cancer risk for
SEAFOOD SAFETY Louisiana were considered safe for fishing the US population (Ylitalo et al., 2012).
Oil Spills and Fisheries Closures (Deepwater Horizon Natural Resource However, the risk level, estimated dura-
Following all oil spills in marine waters, Damage Assessment Trustees, 2016). tion of exposure, and the use of national
the potential contamination of seafood demographic values for body weight, con-
supplies and the subsequent risks posed Federal Response to Human sumption rate, and longevity were exten-
to human health from seafood consump- Health Concerns sively scrutinized (Gohlke et al., 2011;
tion are of major concern to government Higher molecular weight PAHs, like those Ylitalo et al., 2012; Wilson et al., 2015;
authorities and community members that made up ~3.9% of the oil from the Dickey and Huettel, 2016). There was
where the spill occurred (Gohlke et al., DWH well, are of particular concern for particularly strong criticism around the
2011; Dickey and Huettel, 2016; Wickliffe seafood safety because of their persistence adequacy of information about exposure
et al., 2018). The magnitude and duration in the environment, potential for uptake risks and how those risks were communi-
of the DWH spill posed a significant threat in aquatic species, and toxic or carcino- cated to vulnerable populations (Rotkin-
to the well-being of Gulf Coast communi- genic effects (Goldstein et al., 2011; Allan Ellman et al., 2012; K. Xia et al., 2012;
ties, many of which depend upon safe and et al., 2012). Though the use of disper- Sathiakumar et al., 2017), such as preg-
productive fisheries (Dickey and Huettel, sants (Corexit 9500A and 9527) had been nant women and Vietnamese-American
2016). At the time of the spill, Gulf fish- approved by the EPA, and they were deter- fishers and their families.
eries accounted for around 16% of all mined to have minimal toxicity in labo- After nearly 10,000 samples and
US domestic landings (Shepard et al., ratory experiments (Judson et al., 2010), months of testing, federal and state
2013), fueling concerns of Gulf residents their unprecedented use led to public con- authorities determined that Gulf seafood
and non-residents about the safety of the cern about potential accumulation in sea- from reopened areas was safe for con-
nation’s seafood supply. food supplies (Ylitalo et al., 2012). sumption (Ylitalo et al., 2012; Dickey and
In anticipation of potential contam- The federal response to seafood safety Huettel, 2016). While individual PAHs
Oceanography | March 2021 181of the 13 considered to be most harm- ers found shortcomings in the federal total economic losses to commercial and ful and/or carcinogenic were detected in approach, including the narrow scope of recreational fishing, US $4.9 billion and many seafood samples, the concentra- the PAHs included in chemical screening $3.5 billion, respectively. The largest com- tions were at least two orders of magni- (Andersson and Achten, 2015; Dickey mercial fisher losses were predicted for tude below levels of public health con- and Huettel, 2016; Farrington, 2019), shrimpers, which accounted for almost cern (Ylitalo et al., 2012). Further, DOSS based on toxicity information available 85% of the study’s projected impact to was detected in less than 1% of samples at the time, no studies concluded that that sector. In a separate analysis, Asche and at very low concentrations. Though there was an excess exposure risk from et al. (2012) suggested that, due to mar- heavy metals were also a concern for consuming Gulf seafood in the months ket integration, any increase in prices many, particularly for vulnerable popula- and years after the oil spill (Gohlke et al., (driven by spill-related reductions in tions (Zilversmit et al., 2017), they were 2011; Dickey and Huettel, 2016; Wickliffe supply) would not offset expected reve- not included in the federal or state testing et al., 2018). However, it is also largely nue losses to domestic shrimpers. Rather, protocols (Fitzgerald and Gohlke, 2014). agreed that the communication of expo- imports of farmed shrimp would rapidly However, trace metal levels in both fin- sure risks in general, and to vulnerable increase to satisfy demand, meaning that fish and shellfish samples did not exceed populations specifically, left much to be while consumers would be mostly unaf- background levels as determined by inde- desired (Greiner et al., 2013; Dickey and fected, producers could face significant pendent testing (Fitzgerald and Gohlke, Huettel, 2016). and additive supply shocks. Overall, such 2014; Zilversmit et al., 2017). impacts were expected to result in signif- Sathiakumar et al. (2017) specifically SOCIOECONOMIC IMPACTS icant loss of income to shrimpers, as well examined additional exposure risks to ON FISHERIES, TOURISM, AND as in boat building or repair, restaurants, children from the coastal area of Mobile, COMMUNITIES and other businesses. Alabama, compared to children living The DWH spill resulted in numerous Notably, analysis is still needed to inland. They concluded that there was no socioeconomic impacts, including effects confirm economic impacts to fisher- increased risk of exposure despite higher on the fishing, tourism, and transporta- ies 10 years after the spill. For exam- seafood consumption rates among coastal tion sectors, and others that may affect ple, while studies alluded to signifi- children compared to the general pop- community vulnerability and resil- cant impacts to US shrimpers, in 2011, ulation. Further, Wickliffe et al. (2018) ience. Similar to investigations related the year following the DWH spill, the found that, even with consumption rates to human health impacts, GoMRI sup- Gulf produced >216 million pounds of both shrimp and finfish set at highly ported research on DWH socioeconomic (98 million kilograms) of heads-on conservative values for human health effects but at comparatively modest levels, shrimp at a commercial landings value (0.7 lbs [0.3 kg] per week and upward of with resulting publications constituting of >US $421 million (NOAA, 2020), 8.3 lbs [3.8 kg] per week, respectively), only approximately 6% of total GoMRI- accounting for about 68% of US shrimp nearly three times the rates used to cal- funded publications and about 4.2% of landings that year (NRC, 2013). For com- culate the federal threshold levels of con- total competitive grant funds awarded parison, average Gulf shrimp landings for cern, concentrations in seafood samples (Petrolia, 2014; Finucane et al., 2020a). the period 1990–2009 were 236 million did not constitute an unacceptable life- While much progress has been made in pounds (107 million kilograms), with time cancer risk. longitudinal monitoring of biophysical a range of 181–290 million pounds/yr Widespread fisheries closures follow- parameters, there is a lack of similarly (82–132 million kilograms/yr). While evi- ing the DWH event reduced the proba- robust efforts to monitor a suite of socio- dence does show reduced demand and a bility of contaminated seafood entering economic variables that could be used to decrease in seafood sales directly after the into commerce. However, comparisons assess the value of non-market resources, spill (McGill, 2011), it is not clear whether of pre- and post-spill consumption of or identify cultural attributes, attitudes, these effects persisted. For example, the seafood in multiple populations found social connectivity, or resilience in an total commercial landings value for all a significant decrease in consumption oil spill or other disaster context (NRC, species in the Gulf (Texas, Louisiana, in the immediate aftermath of the spill 2013; Yoskowitz et al., 2015). Mississippi, Alabama, and Florida West (Sathiakumar et al., 2017; Zilversmit Coast) for the seven years following the et al., 2017; Wickliffe et al., 2018). Though Economic Impacts spill (2011–2017) was US $6.8 billion the federal response to the spill, including In an initial study, Sumaila et al. (2012) (Consumer Price Index [CPI] adjusted), the seafood testing program, drew much utilized input-output analysis to esti- whereas landings for the seven years pre- public scrutiny and concern, results from mate economic impacts for commercial ceding the spill (2003–2009) had a total independent studies largely corroborated fishing, recreational fishing, and marine CPI adjusted value of US $5.9 billion the federal effort. While some research- aquaculture. They projected the highest (NOAA Fisheries data, CPI adjusted). 182 Oceanography | Vol.34, No.1
Using biophysical projections from the were most impacted. Effects differed from non-market value losses at a mean
Atlantis ecosystem model (Ainsworth among the states, with Texas receiv- of US $585 million with a 95% confi-
et al., 2018) with input-output analysis, ing a relatively small amount of paid dence interval. Petrolia (2014) offers that
Court et al. (2020) modeled total eco- claims, while individuals in Florida and perhaps the most prominent change for
nomic impacts for the 10 years following Louisiana received US $340 million and research resulting from the disaster was
the spill for commercial fishing revenues $227 million, respectively, and businesses an expansion to an ecosystem services
and recreational fishing expenditures. US $164 million and $88 million, respec- approach to damage assessment. The
Results indicate that, across both sec- tively (Eastern Research Group, 2014). National Research Council (NRC, 2013)
tors, impacts could include losses totaling Though individuals and businesses clearly assessed oil spill impacts on the provi-
US $2.3 billion composed of $1.2 billion suffered economic losses, counties with sioning ecosystem service of seafood and
in gross regional product, $700 million in over 1,000 employees in tourism experi- fish-based products, as well as the cul-
labor income, and $160 million each in enced only temporary or no declines in tural services provided through recre-
federal and state tax revenues. However, tourism-related employment, followed ational fishing (among other case stud-
more research is needed to reconcile by growth, though there were excep- ies). Results suggested that, while fishery
modeled outputs and actual landings tions. For example, Hancock County, closures may have decreased landings
data, particularly for sectors anticipated Mississippi, experienced a 7.7% decline in in the immediate aftermath of the spill
to incur significant impacts such as the tourism employment compared to 2009 (McCrea-Strub et al., 2011; NRC, 2013),
shrimping industry. (Eastern Research Group, 2014). increased catch rates were later observed
With nearly 223,000 km2 of fishable An important finding is that consumer for a large group of regularly harvested
waters and public beaches closed or show- perception matters and is an important species (Fodrie and Heck, 2011; NRC,
ing oil spill advisories during the months- driver of economic impacts. A review 2013). However, impacts from the spill
long spill event (Ylitalo et al., 2012), the of news articles and interviews found to fishery harvest may take years or
tourism industry was also impacted. numerous inaccurate portrayals of condi- even decades to materialize, particu-
Misperception also contributed to tour- tions, with media sensationalism contrib- larly regarding cascading effects through
ism impacts, with one report demonstrat- uting to a perception that the entire Gulf marine food chains (NRC, 2013).
ing that the public was unaware of loca- coast was contaminated with oil (Eastern
tions and extent of damage and believing Research Group, 2014). To counter such Community Resilience Impacts
Louisiana waterways to be closed when misinformation in the future, Nelson et al. Resilience is “the capacity of a system
they remained open (MDRG, 2010). Of (2018) offer a spatially explicit approach to absorb shocks and disturbance and
those surveyed, 44% believed the oil spill for evaluating and visualizing risks to still maintain function” (Berkes and
caused damages on par with Hurricane tourism or other economic sectors. Folke, 1998), or “the capacity of a social-
Katrina, and 29% of tourists canceled or Other studies also lend insights for ecological system to adapt to change
postponed planned trips to Louisiana future research. In a case study of New through self-organization and learn-
due to the spill (MDRG, 2010). Another Orleans, Porter (2011) argues that fishing ing” (Berkes et al., 2003). Finucane et al.
study found that about US $147 million and tourism should be viewed as a cluster (2020a) examined a set of adaptive capac-
in tourism and recreation claims were of overlapping geographic space, knowl- ities that may diminish impacts of an
paid between August 2010 and March edge, and impact, for example, with tour- ecological disaster like the DWH, find-
2012. While this amount only represented ism concentrated on recreational fishing ing that although the spill resulted in dif-
2% of total claims, it spanned 23 differ- and the seafood culture. Such interdepen- fering economic impacts across fisher-
ent business types within the industry, dence may limit opportunities for growth ies, tourism, and oil and gas sectors with
including airlines, aquaria, entertain- where risks of economic and environ- location, the aggregate impacts were pri-
ment, water sports, wildlife watching, and mental crisis persist, yet innovation could marily short term. However, at the house-
more. Claims for impacts to retail, sales, address some risks to external shocks. For hold level, and particularly in poorer
and services were about US $1.9 billion example, a tourism subsector could focus households, financial impacts were still
representing 31% of total claims, while on ecotourism and demonstrate how the being felt years later. Further, commu-
those for food, beverage, and lodging city and ecosystem remained resilient nity well-being showed signals of distress
amounted to US $1.6 billion and 26% of to the DWH disaster, which could pro- related to the spill across multiple studies.
the total (Eastern Research Group, 2014). vide a new kind of growth (Porter, 2011). Distress was expressed differently across
Analysis of claims across the Gulf fur- Researchers also investigated non-market different groups, with those tied to natu-
ther found significant impacts on resorts, impacts of the oil spill. Alvarez et al. ral resources for their livelihoods exhib-
charter fishing, and marinas/ docks/
ice (2014) used choice modeling to estimate iting higher rates, including through an
houses, though hotels and restaurants compensation due to marine anglers erosion of trust (Finucane et al., 2020a).
Oceanography | March 2021 183Similarly, Cope et al. (2016) found levels pounded by subsequent disasters such known to be particularly vulnerable to
of distrust across communities regard- as Hurricane Harvey in 2017, and others disasters, and include mental and phys-
ing information provided by both BP (J.D. Osofsky et al., 2014; Shultz et al., ical health assessments and measures of
and the federal government, with trust 2015; SAMHSA, 2018). Recurrent disas- stress. In addition to collecting and pro-
in state government being somewhat ters take a heavy toll on human health in viding information on direct and indi-
stable. Mayer et al. (2015) reported that, the region, where many people already rect health impacts to individuals, the
although the compensation process suffer significant health and economic system should also incorporate commu-
helped to mitigate economic impacts, disparities (Lichtveld and Arosemena, nity data. As far as we are aware, this is
apparent confusion, lack of transpar- 2014; Lichtveld et al., 2016). Climate the only observing system designed for a
ency, and perceived inequality in the pro- change, land subsidence, and popula- disaster-prone area and focused explicitly
cess eroded trust and strained commu- tion and development pressures are all on disaster-related health effects.
nity relations. In addition to those reliant likely to increase the incidence and sever- Components of the proposed Gulf
on natural resources, other groups iden- ity of environmental disasters in the of Mexico Community Health Observ-
tified as having higher vulnerability to Gulf region, along with their accompa- ing System would include: three cross-
the spill included populations that exhibit nying adverse effects on human health sectional surveys, the National Health and
disadvantages related to rural environ- (Sandifer et al., 2020). Nutrition Examination Survey (NHANES;
ment, dependence, older age, and socio- Previous studies of health effects of https://www.cdc.gov/n chs/n hanes/),
economic and/or educational disparities, Gulf disasters, as well as other sections of the Behavioral Risk Factor Surveillance
as well as living in mobile homes (Cope this article, demonstrate the lack of, and Survey (BRFSS; https://www.cdc.gov/
and Slack, 2017), being of minority eth- critical need for, baseline health infor- brfss/), and the National Health Inter-
nicity (e.g., Vietnamese; Patel et al. 2018), mation with which to compare effects view Survey (NHIS; https://www.cdc.gov/
or being female (Lightfoot et al., 2020). of future disasters (Sandifer et al., 2020). nchs/nhis/); a proposed new Augmented
In a case study of Apalachicola, place, Ongoing health monitoring is essential to BRFSS survey for the Gulf states; the
heritage, and moral identity were found develop and maintain such a baseline and new National Institutes of Health (NIH)
not to be fixed community attributes but capture acute, chronic, and long-term All of Us national longitudinal study
rather to provide individuals with vary- health impacts, as well as secondary com- (https://allofus.nih.gov/); and proposed
ing resources, which in turn impact plicating events that occur in the intervals new Large, Small, and Disaster-Specific
disaster recovery (Clarke and Mayer, between major disasters. Recognizing the Gulf of Mexico longitudinal cohort stud-
2017). This has important implications urgent need for a health observing sys- ies (Figure 3). The cohort studies are
for institutional recovery frameworks— tem in the Gulf of Mexico region anal- designed to build upon one another and
often crafted by external actors—in a ogous to the kinds of atmospheric and are the unique and most important parts
precarious Gulf region where resilience oceanic observing systems well estab- of the observing system. Another signif-
may vary locally. For future spills and lished for monitoring and predicting icant strength of the system is its abil-
other disasters, more attention should be hurricanes and other extreme weather ity to adapt rapidly as needs arise and
given to the researcher-community rela- events, GoMRI commissioned a design new biomedical and other technologies
tionship, where cultural norms and trust study. The intent was to devise a frame- are developed.
are critical for successful engagement work that would provide for continuous The geographic focus of the proposed
with local residents (Lesen et al., 2019; collection of health information to ensure observing system is the 68 coastal coun-
Finucane, 2020b). existence of adequate pre-, during, and ties of the five Gulf states. These are
post-disaster information for compara- counties that either have a Gulf shore-
NEED FOR A COMMUNITY tive purposes and to improve emergency line or are near the coast and contain
HEALTH OBSERVING SYSTEM planning and public health response. Federal Emergency Management Agency
Environmental disasters of various kinds The resulting framework (Sandifer et al., (FEMA)-identified areas with high risk
and magnitudes occur frequently in 2020) builds upon and leverages exist- for tidal and/or storm surge flooding
the Gulf region (NOAA, 2020; Sandifer ing ongoing national health surveys and (Ache et al., 2013). A statistically repre-
et al., 2020; Smith, 2020), with one often includes new longitudinal cohort studies sentative sample of volunteers from the
following another and compounding designed to elucidate long-term health populations in these counties is proposed,
the impacts of the previous incident. trends and disaster-associated health with stratification to ensure proportion-
Examples include the 2010 DWH oil effects in the five Gulf states. The system’s ate inclusion of both urban and rural
spill that followed the catastrophic effects new cohort studies must continue indef- populations and with additional, targeted
of Hurricane Katrina in 2005, and the initely, be large enough to represent the recruitment as necessary to enroll ade-
health effects of which were then com- risk-prone coastal areas and populations quate numbers of people deemed par-
184 Oceanography | Vol.34, No.1ticularly vulnerable or typically under-
represented (e.g., ethnic minorities,
the underserved, and those who suffer
health, health care, and economic dis-
parities). Initially, volunteer participants
are expected to be recruited using a mail-
address sampling frame, followed by use
of electronic communication means to
the greatest extent possible.
If implemented, assessments of men-
tal and physical health in the new cohort
studies will include information obtained
via detailed health questionnaires, clin-
ical examinations, biological speci-
mens, electronic health records, and use
of wearable health devices. These will
be augmented with data from second-
ary sources such as information from
State Health Departments and the CDC,
national community surveys, environ-
mental exposure databases, social media,
remote sensing, and others. Biomarker
data derived from biological samples
are expected to be used as indicators of
health status, including for calculation of
measures of chronic stress and its impacts
on physical and mental health. FIGURE 3. A conceptual framework for a Gulf of Mexico Community
Health Observing System. From Sandifer et al. (2020)
Primary users of information from
the health observing system will be
public health and medical profession-
als, emergency managers and respond- effects and their interactions are inad- spill, heavy reliance on self-reported and
ers, and clinical and academic research- equately studied for oil spill workers, cross-sectional survey data, limited collec-
ers. Secondary users are likely to include their families, and others who may be tion of clinical health information, and a
political, community, and business lead- exposed to or affected by them. Besides paucity of long-term, longitudinal cohort
ers, and many others. Data and infor- spill workers, special attention is needed studies. Health studies need to be initiated
mation products are expected to be used to vulnerable people, including individ- before, during, or immediately following a
to assess disaster-related health effects; uals with chronic illness or who suffer large spill and must continue long enough
enhance disaster planning and response; health and health-care disparities and/or to identify long-term effects and second-
improve protection for disaster respond- socioeconomic deprivations, lack strong ary surges of chronic illnesses. Critically
ers and workers; build individual and social support, the elderly, and natural- needed are cohort studies that start before
community resilience; and promote new resource-dependent communities. a major spill and continue through it and
clinical, biomedical, and public health A common theme across studies is onward for a long period after.
research and practice. the overarching role of stress (e.g., from Considerable information about com-
physical exposure, job or income loss, ponents of oil (e.g., benzene) and their
CONCLUSIONS, GAPS, compensation/ litigation processes, or potential toxicity to humans was avail-
AND OPPORTUNITIES behavioral disruption) as an important able before the DWH spill, but many gaps
A broad range of mental and physical factor associated with poor mental and in knowledge were identified, including
health impacts has been attributed to physical health outcomes. effects of field-relevant exposures to oil
oil spills in general and the DWH disas- Human health findings were severely components, engine exhaust, and other
ter in particular, but in most cases defin- limited by a lack of baseline health data, chemicals (e.g., dispersants and decon-
itive cause-and-effect linkages are lack- long delays in implementing major tamination cleaners) as well as these in
ing. Overall, mental and physical health health research activities following the combination with additional stressors
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