Surveillance of acute health effects among the general population during the Deepwater Horizon oil spill

Transcription

1 Surveillance of acute health effects among the general population during the Deepwater Horizon oil spill LCDR Jeneita Bell, MD, MPH US Public Health Service Epidemic Intelligence Service Officer 2011 CSTE Annual Conference June 13, 2011 National Center for Environmental Health Division of Environmental Hazards and Health Effects

2 Outline Background Description of activities Results Strength and Limitations Lessons learned

3 BACKGROUND

4 Timeline of Events April 20, 2010: Explosion and fire of Deepwater Horizon oil rig, 11 died April 26, 2010: Oil stretches 80 mi SE of Louisiana May 1, 2010: Skimming, burning, and dispersing efforts unsuccessful May 6, 2010: CDC Emergency Operations Center (EOC) activated April 20, 2010 May 1, 2010 April 24, 2010: Oil leak discovered, ~5,000 barrels/day leaking April 29, 2010: Gov. Jindal of LA declares state of emergency May 4, 2010: NCEH discussed surveillance approach with 5 Gulf State Epidemiologists

5 SURVEILLANCE

6 Previous Oil Spill Events April August 2010 Deepwater Horizon Gulf of Mexico 4,900,000

7 Gulf Oil Spill Surveillance Objectives: Monitor health threats from oil spill-related exposures Provide health authorities with early indications of health impacts on exposed populations

8 Oil 4.9 million barrels discharged Particulate Matter 400 in-situ burns conducted Human Exposure Volatile Organic Compounds Gaseous emissions from oil Dispersants 1.07 million gallons of dispersants applied Contaminated Seafood

9 Acute Health Effects Organ System Respiratory Circulatory Nervous Digestive Integumentary Signs/Symptoms Worsening of asthma, COPD Cough Shortness of breath Chest pain Headache Nausea Vomiting Rash Skin irritation

10 Target Population General population impacted Alabama Florida Louisiana Mississippi Texas Mainly residing in costal areas Clean-up workers not explicitly excluded

11 State based Surveillance Alabama State Surveillance Description Active surveillance Coastal area emergency departments, urgent care facilities and community health centers Only patients indicating oil exposure Florida State-based Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE) 6 coastal counties Symptoms from emergency departments, calls to poison centers, and the Florida Poison Information Center Network Symptoms included headache, nausea, vomiting, skin problems, respiratory and cardiovascular problems

12 State based Surveillance State Louisiana Surveillance Description Active surveillance for oil spill -related complaints from emergency departments, Occupational, primary care, and urgent care clinics, Louisiana Poison Center, Health department hotline Early Aberration Reporting System (EARS) for oil in 7 metro New Orleans hospitals Mississippi Active surveillance 5 coastal emergency departments Syndromes such as upper respiratory illness, lower respiratory illness, and rash EARS to analyze chief complaints for 4 coastal hospitals

13 National Surveillance Surveillance System National Poison Data System (NPDS) BioSense Description All information and human poison exposure phone calls into all US poison centers Tracked calls related to oil spill exposure, including dispersants and contaminated seafood Provided state-specific call reports to each state National program includes 86 coastal healthcare facilities in the five Gulf states Monitored chief complaints, syndromes, and final diagnosis from 21 emergency departments CDC provided daily reports of the BioSense findings to the five Gulf States

14 RESULTS

15 Louisiana Department of Public Health: Surveillance Report

16 Louisiana Department of Public Health: Surveillance Report

17 Louisiana Department of Public Health: Surveillance Report

18 Exposure Visits Total exposure-related visits to participating health care facilities in Alabama, May 6 August 28, % % 0.5% % % 0.3% Total Exposure Visits % 0.2% 0.2% Percent Total Visits* % 0.1% 0.1%0.1% 0.1% 0.1% 0.0% 0.0% 0.1% 0.1% 0.0% 0.1% 0 0.0% Date (Weekly) *Percentage of visits related to the oil spill compared to total visits

19 Number of Calls Total oil spill-related calls to Poison Centers (PC) in the Gulf States April 30 August 28, Calls to BP Medical Support Hotline Calls to PC Help Hotline Date (Weekly) *Gulf Oil Spill call surveillance started on April 30, so the first bar represents data only for April 30 to May 1

20 BioSense Few cluster of syndromes identified Rash and Respiratory illness Not associated with oil exposure

21 Strengths Strengths and Limitations Rapid detection of possible exposures among groups of people with symptoms National and state-level systems provides a more comprehensive picture of population Limitations No case definition Exposures self-reported Over- or under-estimate depending on surveillance method

22 Addressing Mental Health Concerns BRFSS partnered with state and local public health officials Gulf States Population Survey Conducted December 15, 2010 to December 15, 2011 Questions from BRFSS and standardized surveys Measures anxiety, depression, and potential stressassociated physical health effects Provide data to state health departments and SAMHSA

23 Lessons Learned Deepwater Horizon Emergency Response Expandable and flexible Non-traditional means of data collection Need for timely response Importance of innovation Prepare for future disasters

24 Acknowledgments Fuyuen Yip Amy Wolkin Sara Vagi For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA Telephone, CDC-INFO ( )/TTY: Web: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. National Center for Environmental Health Division of Environmental Hazards and Health Effects

25 Photo Title Myriad Pro, Bold, Shadow, 20pt Caption for photo, references, citations, or credits Myriad Pro, 14pt