Hypertension risk elevated among Deepwater Horizon oil spill responders, cleanup workers
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Exposure to burning oil and gas was associated with newly detected hypertension among individuals who worked on response and cleanup for the Deepwater Horizon oil spill, researchers reported.
“The Deepwater Horizon (DWH) explosion on April 20, 2010, caused the largest marine oil spill in U.S. history,” Richard K. Kwok, PhD, acting chief of staff in the office of the director and staff scientist in the epidemiology branch at the National Institute of Environmental Health Sciences, and colleagues wrote in JAMA Network Open. “Tens of thousands of individuals participated in oil spill response and cleanup (OSRC) work, which resulted in respiratory exposures to volatile hydrocarbons, such as benzene, toluene, ethylbenzene, xylenes and n-hexane (BTEX-H), and other hydrocarbons measured as total petroleum hydrocarbons. Some cleanup workers were also exposed to in situ burning of crude oil and flaring of oil and/or natural gas, which generated inhalable fine particulate matter (PM2.5).”
The GuLF study
Kwok and colleagues recognized that while prior studies have shown that exposure to total petroleum hydrocarbons and PM2.5 have adverse effects on CV health, few have analyzed the association between oil spill response and cleanup exposures and adverse CV outcomes, and none have examined its effects on BP.
The researchers conducted an analysis of participants in the Gulf Long-Term Follow-Up (GuLF) study, a prospective study of 32,608 workers who participated in at least 1 day of oil spill response and cleanup following the Deepwater Horizon oil spill. Participants completed an initial telephone enrollment interview, which collected baseline information on oil spill jobs and activities, demographics, lifestyle and health. Follow-up home exams were conducted between May 2011 and May 2013.
After excluding participants with hypertension at baseline and those who were missing BP data at follow-up, the analysis included 6,846 adults who worked on the oil spill cleanup and 1,505 others who completed the required safety training but did not do cleanup work (mean age, 42 years; 78% men; 34% Black). Researchers defined newly detected hypertension as antihypertensive medication use or elevated BP since the Deepwater Horizon oil spill. Participants were stratified into quintiles based on cumulative daily maximum total hydrocarbon exposure levels.
Hypertension following oil spill
Among oil spill response and cleanup workers, the prevalence of newly detected hypertension was elevated for participants in the second through fifth quintiles compared with those in the first quintile:
- quintile 2 (prevalence ratio = 1.05; 95% CI, 0.93-1.18);
- quintile 3 (PR = 1.29; 95% CI, 1.13-1.46);
- quintile 4 (PR = 1.25; 95% CI, 1.1-1.43); and
- quintile 5 (PR = 1.31; 95% CI, 1.15-1.5).
Moreover, any exposure to burning oil and/or flaring natural gas (PR vs. none = 1.16; 95% CI, 1.02-1.33) and/or working in the “hot zone” (1 hour maximum of 545 g/m3; PR vs. no = 1.26; 95% CI, 0.89-1.71) were both associated with increased risk for newly detected hypertension.
Oil spill cleanup on water (PR vs. not = 1.34; 95% CI, 1.08-1.66) and response work (PR vs. none = 1.51; 95% CI, 1.2-1.9) were also associated with newly detected hypertension.
The researchers acknowledged that participants in the GuLF study population were at greater baseline risk compared with other groups, such as the NHANES 2011-2014 cohort. More of the GuLF study participants were more likely to be classified as obese (37.8% vs. 36.3%) and fewer had a high school diploma (44.9% vs. 60%) or any form of health insurance (47.6% vs. 82%) compared with the NHANES population.
“The frequency of health insurance coverage among workers and the full cohort did not differ, and insurance coverage was not associated with how hypertension was detected (antihypertensive medication use, measured elevated BP or both),” the researchers wrote. “Furthermore, the proportion of participants categorized as hypertensive by medication only, by elevated BP only or by both approaches was identical for the full sample and among workers only, suggesting that workers were not differentially diagnosed.”
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