Health Effects of Hurricane Ian

飓风伊恩对健康的影响

• 批准号: 10743484
• 负责人: Naresh Kumar
• 金额: $ 43.47万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-13 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10743484
• 关键词: Accident and Emergency department; Accidental Injury; Affect; Air Pollutants; Asthma; Attention; Biochemical; Birth; Businesses; Carbon Monoxide; Characteristics; Chemicals; Chronic Obstructive Pulmonary Disease; Clinical; Clinical Research; Collection; Communities; Data; Data Set; Diabetes Mellitus; Disease; Electricity; Emergency department visit; Employment; Endotoxins; Environment; Environmental Monitoring; Environmental Pollutants; Environmental Wind; Experimental Designs; Exposure to; Floods; Florida; Gasoline; Health; Health care facility; Heat Stress Disorders; High Performance Computing; Home; Hospital Records; Hospitals; Household; Housing; Hurricane; Hypersensitivity; Immune System Diseases; Individual; Infrastructure; Institutional Review Boards; Knowledge; Laboratories; Light; Location; Low Birth Weight Infant; Molds; Monitor; Morbidity - disease rate; Motivation; Natural Disasters; Natural experiment; Neighborhoods; Normalcy; Paralysed; Particulate Matter; Policies; Pollen; Pregnancy Outcome; Premature Birth; Property; Psychological Stress; Public Health; Records; Recovery; Reproduction spores; Research; Research Personnel; Resource Allocation; Resources; Services; Severities; Surveys; Symptoms; Time; Universities; Water; adverse birth outcomes; burden of illness; contaminated water; demographics; design; effective intervention; environmental stressor; health care availability; health management; improved; large datasets; mortality; nutrition; pollutant; recruit; repository; restoration; social; sociodemographics; stressor; water mold

Hurricanes dramatically modify the physical landscape and trigger changes in the socio-physical and biochemical characteristics of the environment (environmental stressors hereafter). This exposes the affected communities to new environmental stressors, which persist for weeks to months after the hurricane. For example, loss of home, business/employment, infrastructure results in socio-psychological stress; mold in water damaged building elevates exposure to bioaerosols; carbon monoxide and particulate matter (PM) from gasoline-powered generators elevate exposure to chemical stressors. This project aims to tease out the adverse health impacts of Hurricane Ian (2022) and their persistence over time. We will assess the severity of the physical impacts of Hurricane Ian, examine changes in environmental stressors and their associated impacts on morbidity, mortality and pregnancy outcomes. We will use Landsat 8/9 and MODIS satellite data, and the data from Florida Power and Light. And FEMA to assess the intensity of physical impact of Hurricane Ian. We will conduct field monitoring to screen for environmental stressors using our mobile laboratory 6, 9 and 12 months after the hurricane. We will recruit 240 subjects stratified by the intensity of hurricane impact, and monitor indoor and outdoor environmental stressors, e.g. air pollutants, bioaerosols (mold and pollen spores, and endotoxins), damage to infrastructure and household utilities, duration of the loss of electricity and other facilities, and screen them for health (symptoms) and demographics. We have an approved IRB (20190217) to acquire location-time specific mortality and birth data from Florida Department of Health (FLDH), and hospital and emergency room record from OneFlorida Clinical Research Consortium (OneFL) (from 2020-2024). OneFL, directed by co-PI, Shenkman, is the largest statewide repository of hospital records, representing 75% of Floridians. We have already acquired mortality and birth data from 2015 to September 2022. We will also acquire these data until 2024. We will conduct two sets of analyses. First, we will assess cause-specific mortality, morbidity and adverse birth outcomes, including pre-term birth and low birth weight, with respect to time- and distance-lagged exposure to hurricane impacts using a cross-sectional design (i.e. based on the intensity of the physical impacts of hurricanes) and then using a natural experiment design (i.e. two years before and up to two years after the hurricane at an interval of 3 months) adjusting for socio-demographic and neighborhood characteristics. Second, we will examine the persistence of different disease symptoms (allergies, diabetes, asthma and COPD etc.) using the survey data, which will allow to assess underreported morbidity burden of disease, which otherwise cannot be quantified using clinical records. The project will improve our understanding of the disease burden of hurricanes and guide policies for developing strategies for effective interventions, timely collection of adverse exposure data and resource allocation needed to manage the health effects in the aftermath of hurricanes.

飓风极大地改变了自然景观并引发了社会物理和环境的变化 环境的生化特征（以下简称环境压力源）。这暴露了 影响社区的新环境压力源在飓风过后持续数周至数月。 例如，失去家园、生意/就业、基础设施会导致社会心理压力；模入 被水损坏的建筑物增加了生物气溶胶的暴露程度；一氧化碳和颗粒物 (PM) 汽油发电机会增加化学应激源的暴露程度。该项目旨在梳理出 飓风伊恩（2022 年）对健康的不利影响及其随着时间的推移持续存在。我们将评估严重程度 飓风伊恩的物理影响，检查环境压力源的变化及其 对发病率、死亡率和妊娠结局的相关影响。我们将使用 Landsat 8/9 和 MODIS 卫星数据以及来自佛罗里达电力和照明公司的数据。和 FEMA 评估身体强度 飓风伊恩的影响。我们将利用我们的技术进行现场监测以筛查环境压力源 飓风过后 6、9 和 12 个月的移动实验室。我们将招募 240 名受试者，按强度分层 飓风影响，并监测室内和室外环境压力源，例如空气污染物、生物气溶胶 （霉菌和花粉孢子以及内毒素）、对基础设施和家庭设施的损害、损失持续时间 电力和其他设施，并对其健康（症状）和人口统计进行筛查。我们有一个 批准 IRB (20190217) 从佛罗里达州卫生部门获取特定时间地点的死亡率和出生数据 OneFlorida 临床研究联盟的健康 (FLDH) 以及医院和急诊室记录 (OneFL)（2020 年至 2024 年）。 OneFL 由联合 PI Shenkman 领导，是全州最大的 医院记录，占佛罗里达人的 75%。我们已经获得了 2015 年的死亡率和出生数据 到 2022 年 9 月。我们还将在 2024 年之前获取这些数据。我们将进行两组分析。首先，我们 将评估特定原因的死亡率、发病率和不良出生结果，包括早产和低产 出生体重，相对于飓风影响的时间和距离滞后，使用横截面 设计（即基于飓风物理影响的强度），然后使用自然实验 设计（即飓风发生前两年和飓风发生后两年内，间隔 3 个月）调整 社会人口和邻里特征。其次，我们将检查不同的持续性 使用调查数据了解疾病症状（过敏、糖尿病、哮喘和慢性阻塞性肺病等），这将有助于 评估漏报的疾病发病率负担，否则无法使用临床记录对其进行量化。 该项目将增进我们对飓风造成的疾病负担的了解，并指导相关政策 制定有效干预策略，及时收集不良暴露数据和资源 管理飓风后健康影响所需的拨款。