Environmental disasters are anthropogenic catastrophic events that affect health. Famous disasters include the Seveso disaster and the Fukushima-Daiichi nuclear meltdown, which had disastrous health consequences. Traditional methods for studying environmental disasters are costly and time-intensive. We propose the use of electronic health records (EHR) and informatics methods to study the health effects of emergent environmental disasters in a cost-effective manner. An emergent environmental disaster is exposure to perfluoroalkyl substances (PFAS) in the Philadelphia area. Penn Medicine (PennMed) comprises multiple hospitals and facilities within the Philadelphia Metropolitan area, including over three thousand PFAS-exposed women living in one of the highest PFAS exposure areas nationwide. We developed a high-throughput method that utilizes only EHR data to evaluate the disease risk in this heavily exposed population. We replicated all five disease/conditions implicated by PFAS exposure, including hypercholesterolemia, thyroid disease, proteinuria, kidney disease and colitis, either directly or via closely related diagnoses. Using EHRs coupled with informatics enables the health impacts of environmental disasters to be more easily studied in large cohorts versus traditional methods that rely on interviews and expensive serum-based testing. By reducing cost and increasing the diversity of individuals included in studies, we can overcome many of the hurdles faced by previous studies, including a lack of racial and ethnic diversity. This proof-of-concept study confirms that EHRs can be used to study human health and disease impacts of environmental disasters and produces equivalent disease-exposure knowledge to prospective epidemiology studies while remaining cost-effective.

环境灾害是影响健康的人为灾难性事件。著名的灾难包括塞韦索灾难和福岛第一核泄漏事故，它们对健康造成了灾难性的后果。研究环境灾害的传统方法成本高昂且耗时。我们建议使用电子健康记录 (EHR) 和信息学方法以具有成本效益的方式研究突发环境灾害对健康的影响。费城地区的一项紧急环境灾难是接触全氟烷基物质 (PFAS)。Penn Medicine (PennMed) 由费城都会区内的多家医院和设施组成，其中包括生活在全国 PFAS 接触率最高的地区之一的三千多名接触 PFAS 的妇女。我们开发了一种高通量方法，该方法仅利用 EHR 数据来评估这一严重暴露人群的疾病风险。我们直接或通过密切相关的诊断复制了与 PFAS 暴露有关的所有五种疾病/病症，包括高胆固醇血症、甲状腺疾病、蛋白尿、肾脏疾病和结肠炎。与依赖访谈和昂贵的血清检测的传统方法相比，使用 EHR 与信息学相结合，可以更容易地在大型队列中研究环境灾难对健康的影响。通过降低成本和增加研究中个体的多样性，我们可以克服先前研究面临的许多障碍，包括缺乏种族和民族多样性。