Introduction

In 2010, the U.S. Coast Guard (USCG) led a clean-up response to the Deepwater Horizon (DWH) oil spill. Human studies evaluating acute and longer-term cardiovascular conditions associated with oil spill-related exposures are sparse. Thus, we aimed to investigate prevalent and incident cardiovascular symptoms/conditions in the DHW Oil Spill Coast Guard Cohort.

Methods

Self-reported oil spill exposures and cardiovascular symptoms were ascertained from post-deployment surveys (n = 4,885). For all active-duty cohort members (n = 45,193), prospective cardiovascular outcomes were classified via International Classification of Diseases, 9th Edition from military health encounter records up to 5.5 years post-DWH. We used log-binomial regression to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) in the cross-sectional analyses and Cox Proportional Hazards regression to calculate adjusted hazard ratios (aHR) and 95% CIs for incident cardiovascular diagnoses during 2010–2015 and stratifying by earlier (2010–2012) and later (2013–2015) time periods.

Results

Prevalence of chest pain was associated with increasing levels of crude oil exposure via inhalation (aPR_{high vs. none} = 2.00, 95% CI = 1.16–3.42, p-trend = 0.03) and direct skin contact (aPR_{high vs. none} = 2.72, 95% CI = 1.30–5.16, p-trend = 0.03). Similar associations were observed for sudden heartbeat changes and for being in the vicinity of burning oil exposure. In prospective analyses, responders (vs. non-responders) had an elevated risk for mitral valve disorders during 2013–2015 (aHR = 2.12, 95% CI = 1.15–3.90). Responders reporting ever (vs. never) crude oil inhalation exposure were at increased risk for essential hypertension, particularly benign essential hypertension during 2010–2012 (aHR = 2.00, 95% CI = 1.08–3.69). Responders with crude oil inhalation exposure also had an elevated risk for palpitations during 2013–2015 (aHR = 2.54, 95% CI = 1.36–4.74). Cardiovascular symptoms/conditions aPR and aHR estimates were generally stronger among responders reporting exposure to both crude oil and oil dispersants than among those reporting neither.

Conclusions

In this large study of the DWH oil spill USCG responders, self-reported spill clean-up exposures were associated with acute and longer-term cardiovascular symptoms/conditions.

中文翻译：

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深水地平线溢油海岸警卫队的急性和长期心血管疾病

介绍

2010 年，美国海岸警卫队 (USCG) 领导了对深水地平线 (DWH) 漏油事件的清理工作。评估与漏油相关暴露相关的急性和长期心血管疾病的人体研究很少。因此，我们的目的是调查 DHW 溢油海岸警卫队队列中普遍存在的和偶发的心血管症状/状况。

方法

部署后调查 (n = 4,885) 确定了自我报告的溢油暴露和心血管症状。对于所有现役队列成员 (n = 45,193)，前瞻性心血管结果根据国际疾病分类第 9 版根据 DWH 后 5.5 年的军事健康遭遇记录进行分类。我们使用对数二项式回归来计算横断面分析中的调整后患病率 (aPR) 和 95% 置信区间 (CI)，并使用 Cox 比例风险回归来计算期间心血管事件诊断的调整后风险比 (aHR) 和 95% CI 2010-2015 年，并按较早 (2010-2012) 和较晚 (2013-2015) 时间段进行分层。

结果

胸痛的患病率与通过吸入（aPR_高与无 = 2.00，95% CI = 1.16–3.42，p 趋势 = 0.03）和直接皮肤接触（aPR_高与无 = 2.72 ）接触原油的水平增加有关, 95% CI = 1.30–5.16, p 趋势 = 0.03)。对于突然的心跳变化和处于燃烧的油暴露附近，观察到类似的关联。在前瞻性分析中，反应者（相对于无反应者）在 2013-2015 年期间二尖瓣疾病的风险升高（aHR = 2.12，95% CI = 1.15-3.90）。报告曾（相对于从未）吸入原油的响应者患原发性高血压的风险增加，尤其是2010-2012 年良性原发性高血压（aHR = 2.00，95% CI = 1.08-3.69）。2013 年至 2015 年期间，吸入原油的响应者发生心悸的风险也较高（aHR = 2.54，95% CI = 1.36-4.74）。报告暴露于原油和油分散剂的响应者的心血管症状/状况 aPR 和 aHR 估计值普遍强于未报告两者的响应者。

结论

在这项针对 DWH 溢油事故 USCG 响应者的大型研究中，自我报告的溢油清理暴露与急性和长期心血管症状/病症有关。