Environmental influences on pregnancy outcomes after Hurricane Michael

迈克尔飓风后环境对妊娠结局的影响

• 批准号: 9918368
• 负责人: Emily Wheeler Harville
• 金额: $ 22.93万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-18 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9918368
• 关键词: Address; Affect; Area; Awareness; Birth; Birth Certificates; Carbon Monoxide; Caring; Continuing Education; County; Data; Disaster Planning; Disasters; Environmental Exposure; Environmental Health; Environmental Pollutants; Environmental Pollution; Environmental Wind; Exposure to; Florida; Future; General Population; Goals; Health; Health Personnel; Health care facility; Healthcare; Human; Hurricane; Individual; Infant; Knowledge; Low Birth Weight Infant; Maps; Measurement; Methodology; Mothers; Neighborhood Health Center; Outcome; Pattern; Physicians; Poison Control Centers; Population; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Primary Health Care; Radar; Reporting; Research; Risk; Sampling; Speed; Time; Toxic Environmental Substances; Translations; Work; adverse birth outcomes; adverse outcome; base; design; harmful algal blooms; innovation; land cover; prenatal; prevent; primary outcome; programs; psychological stressor; response; skills; stressor; surveillance data

The natural world and human influences work together to create the devastation that follows a major disaster such as a hurricane. Although many studies have examined broad patterns of effects on pregnancy outcomes after disasters, the causes of adverse outcomes are not always clear, as there are interrelated environmental pollutant exposures, psychological stressors, and lack of health care. Without understanding which aspects of disaster exposure are the strongest contributors to adverse outcomes, it will not be possible to establish disaster responses that efficiently target the most important factors. The objective of this application is to examine effects of environmental (harmful algal bloom, carbon monoxide) exposures and generally encountered disaster exposures (power outages, storm damage) on pregnancy-related outcomes. Our central hypothesis is that severe exposure (defined by both magnitude and duration) to any of these stressors will be associated with worse outcomes. Our specific aims are to 1) Examine the relationship between environmental exposures (HAB and CO) and birth outcomes; 2) Assess the relationship between general disaster-related exposures (extent of damage, health care closings) and birth outcomes; 3) Determine which disaster- related exposures most strongly predict birth outcomes, and the combined effect of environmental and general disaster exposure; 4) Engage primary care practitioners to build EOH knowledge and skills by developing CME content on HAB and CO. We will accomplish these specific aims by comparing birth outcomes in areas exposed to these environmental predictors to areas and times that are unexposed. We will map exposure patterns based on ecological sampling and satellite-based estimates (HAB), CO surveillance data and poison control centers data, and hurricane damage reports (state of the art satellite measurements, disaster declarations, power outage data, health facility closing) and physical impacts measurements (storm surge inundation, wind speed, land cover change). Comparisons will be made across and within areas exposed to different levels of environmental contaminants, as well as pre-post hurricane. To promote translation and dissemination, we will develop CME content targeting the potential risks adverse pregnancy and birth outcomes associated with exposures to HAB and CO. At the end of the project, our expected outcome is to have identified the aspects of Hurricane Michael most associated with adverse birth outcomes. The proposed research represents a three-pronged innovative design- conceptually, by determining the potential cumulative risk of two integrated exposure domains - environmental contaminants and traditional disaster; methodologically, by using Synthetic Aperture Radar data to examine exposures to HAB during pregnancy in humans; and 3) translational, by utilizing time sensitive disaster-related environmental health findings for frontline CME.

自然世界和人类影响力共同构成造成重大损害的破坏 诸如飓风之类的灾难。 尽管许多研究已经检查了对影响的广泛影响 灾难后的怀孕结局，不良后果的原因并不总是很清楚，因为 是相互关联的环境污染物暴露，心理压力源和缺乏健康 关心。不了解灾难暴露的哪些方面是最强大的贡献者 不利的结果，不可能建立有效针对的灾难反应 最重要的因素。此应用的目的是检查 环境（有害的藻华，一氧化碳）暴露，通常遇到灾难 与妊娠有关的结果暴露（停电，暴风雨破坏）。 我们的中心假设是 这些压力源中的任何一个都将是 与较差的结果相关。 我们的具体目的是1）检查 环境暴露（HAB和CO）以及出生结果； 2）评估一般关系 与灾难有关的暴露（损害范围，卫生保健封闭）和出生结果； 3） 确定哪些与灾难相关的暴露最强烈预测出生结果，并结合在一起 环境和一般灾难暴露的影响； 4）让初级保健从业者参与 通过在HAB和CO上开发CME内容来建立EOH知识和技能。我们将完成这些知识和技能 通过将暴露于这些环境预测的领域的分娩结果与 未暴露的区域和时间。我们将根据生态采样和 基于卫星的估计（HAB），CO监视数据和毒物控制中心数据，以及 飓风伤害报告（最先进的卫星测量，灾难声明，权力 中断数据，医疗机构关闭）和物理影响测量（风暴浪潮淹没， 风速，土地覆盖率变化）。 比较将在暴露于 不同水平的环境污染物以及前飓风。 促进 翻译和传播，我们将开发针对潜在风险不利的CME内容 与HAB和CO的暴露相关的怀孕和出生结果，在项目结束时， 我们的预期结果是确定了迈克尔飓风最相关的方面 不利的出生结果。 拟议的研究代表了一个三管齐下的创新设计 - 从概念上讲，通过确定两个综合暴露域的潜在累积风险 - 环境污染物和传统灾难；从方法上讲，使用合成孔径 雷达数据以检查人类怀孕期间对HAB的暴露； 3）翻译，由 利用时间敏感的灾难相关的环境健康发现，用于前线CME。

项目成果

Remotely sensed measures of Hurricane Michael damage and adverse perinatal outcomes and access to prenatal care services in the Florida panhandle.

• DOI: 10.1186/s12940-022-00924-1
• 发表时间: 2022-11-29
• 期刊: ENVIRONMENTAL HEALTH
• 影响因子: 6
• 作者: Pan, Ke;Gonsoroski, Elaina;Uejio, Christopher K.;Beitsch, Leslie;Sherchan, Samendra P.;Lichtveld, Maureen Y.;Harville, Emily W.
• 通讯作者: Harville, Emily W.

Effects of Hurricane Michael on Access to Care for Pregnant Women and Associated Pregnancy Outcomes.

• DOI: 10.3390/ijerph18020390
• 发表时间: 2021-01-06
• 期刊: International journal of environmental research and public health
• 作者: Pan K;Beitsch L;Gonsoroski E;Sherchan SP;Uejio CK;Lichtveld MY;Harville EW
• 通讯作者: Harville EW

Hurricane Michael and Adverse Birth Outcomes in the Florida Panhandle: Analysis of Vital Statistics Data.

• DOI: 10.1017/dmp.2021.367
• 发表时间: 2022-03-03
• 期刊: DISASTER MEDICINE AND PUBLIC HEALTH PREPAREDNESS
• 影响因子: 2.7
• 作者: Harville, Emily W.;Pan, Ke;Beitsch, Leslie;Sherchan, Samendra P.;Gonsoroski, Elaina;Uejio, Christopher;Lichtveld, Maureen Y.
• 通讯作者: Lichtveld, Maureen Y.