Health Effects of Hurricane Ian

飓风伊恩对健康的影响

基本信息

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
项目类别：
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

项目摘要

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.

飓风大大改变了社会物理和环境的生化特征（以后的环境压力源）。这揭示了影响了新的环境压力源，后者在飓风发生后数周至数月持续存在。例如，失去家庭，商业/就业，基础设施会导致社会心理压力；霉菌进水损坏的建筑物提升了暴露于生物美感；一氧化碳和颗粒物（PM）汽油驱动的发电机提高了暴露于化学应力源。该项目旨在取消飓风伊恩（2022）及其持久性的不利影响。我们将评估严重性 IAN飓风的物理影响，检查环境压力及其的变化对发病率，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功率和光线的数据。和FEMA评估身体强度飓风伊恩的影响。我们将对使用我们的环境压力进行现场监控飓风后6、9和12个月移动实验室。我们将招募按强度分层的240名受试者飓风撞击，并监视室内和室外环境压力源，例如空气污染物，生物美感（霉菌和花粉孢子以及内毒素），基础设施和家庭公用事业的损害，损失的持续时间电力和其他设施，并将其筛选为健康（症状）和人口统计。我们有一个批准的IRB（20190217）从佛罗里达州获得特定地点的特定死亡率和分娩数据健康（FLDH）以及Oneflorida临床研究联盟的医院和急诊室记录（Onefl）（从2020-2024起）。由Co-Pi的Shenkman执导的OneFL是最大的全州存储库医院记录，占佛罗里达人的75％。从2015年开始，我们已经获得了死亡率和出生数据到2022年9月。我们还将收集这些数据，直到2024年。我们将进行两组分析。首先，我们将评估特定原因的死亡率，发病率和不良的出生结果，包括预期和较低出生体重，就时间和远距离延迟暴露于飓风撞击使用横截面设计（即基于飓风的物理影响的强度），然后使用自然实验设计（即在飓风后两年前和最多两年的时间间隔3个月）进行调整社会人口统计学和邻里特征。其次，我们将研究不同的持久性疾病症状（过敏，糖尿病，哮喘和COPD等）使用调查数据，这将允许评估疾病的发病负担不足，否则无法使用临床记录来量化。该项目将提高我们对飓风疾病负担的理解，并指导政策制定有效干预措施的策略，及时收集不良暴露数据和资源在飓风之后，需要分配健康影响。