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共同造成了重大灾难之后的破坏 飓风等灾难。 尽管许多研究已经考察了影响的广泛模式 灾害后的妊娠结果，不良结果的原因并不总是明确的，因为 环境污染物暴露、心理压力和缺乏健康是相互关联的 关心。如果不了解灾害暴露的哪些方面对 不良后果，将不可能建立有效针对的灾害应对措施 最重要的因素。此应用程序的目的是检查以下效果 环境（有害藻华、一氧化碳）暴露和普遍遭遇的灾难 暴露（停电、风暴破坏）对怀孕相关结果的影响。 我们的中心假设是 严重暴露于任何这些压力源（由强度和持续时间定义）将 与更糟糕的结果相关。 我们的具体目标是 1）检查之间的关系 环境暴露（HAB 和 CO）和出生结果； 2）评估一般之间的关系 与灾害相关的风险（受损程度、医疗保健关闭）和出生结果； 3） 确定哪些与灾害相关的暴露最能预测出生结果，以及综合结果 环境和一般灾害暴露的影响； 4) 让初级保健从业者参与 通过开发关于 HAB 和 CO 的 CME 内容来培养 EOH 知识和技能。我们将完成这些 通过比较暴露于这些环境预测因素的地区的出生结果来实现具体目标 未暴露的区域和时间。我们将根据生态采样绘制暴露模式 基于卫星的估计 (HAB)、一氧化碳监测数据和毒物控制中心数据，以及 飓风损害报告（最先进的卫星测量、灾难声明、电力 断电数据、医疗机构关闭）和物理影响测量（风暴潮淹没、 风速、土地覆盖变化）。 将在接触过的区域之间和内部进行比较 不同程度的环境污染物，以及飓风前后。 推广 翻译和传播，我们将开发针对潜在不利风险的 CME 内容 与接触 HAB 和 CO 相关的妊娠和分娩结果。在项目结束时， 我们的预期结果是确定与迈克尔飓风最相关的方面 不良的分娩结果。 拟议的研究代表了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害；在方法上，通过使用合成孔径 用于检查人类怀孕期间 HAB 暴露情况的雷达数据； 3）翻译，通过 将时间敏感的灾害相关环境健康调查结果用于前线 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.