Richard K Kwok1, John A McGrath2, Sarah R Lowe3, Lawrence S Engel4, W Braxton Jackson2, Matthew D Curry2, Julianne Payne5, Sandro Galea6, Dale P Sandler7. 1. Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA. Electronic address: richard.kwok@nih.gov. 2. Social & Scientific Systems Inc, Durham, NC, USA. 3. Department of Psychology, Montclair State University, Montclair, NJ, USA. 4. Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 5. RTI International, Durham, NC, USA. 6. School of Public Health, Boston University, Boston, MA, USA. 7. Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA.
Abstract
BACKGROUND: Adverse mental health effects have been reported following oil spills but few studies have identified specific responsible attributes of the clean-up experience. We aimed to analyse the effects of the 2010 Deepwater Horizon (Gulf of Mexico) disaster on the mental health of individuals involved in oil spill response and clean-up. METHODS: We used data from the Gulf Long-term Follow-up Study, a cohort of workers and volunteers involved in oil spill clean-up after the Deepwater Horizon disaster. We included 8968 workers (hired after completing training for oil spill response and clean-up) and 2225 non-workers (completed training but were not hired) who completed a Patient Health Questionnaire-8 and four-item Primary Care PTSD Screen to assess for probable depression and post-traumatic stress disorder (PTSD) indicators. Participants were recruited between March 28, 2011, and March 29, 2013. The mental health indicators were assessed at home visits done between May 12, 2011, and May 15, 2013. We used regression models to analyse the effect of potentially stressful job experiences, job type, and total hydrocarbon exposure on mental health indicators. FINDINGS: Oil spill response and clean-up work was associated with increased prevalence of depression (prevalence ratio [PR] 1·22, 95% CI 1·08-1·37) and PTSD (PR 1·35, 95% CI 1·07-1·71). Among workers, individuals who reported smelling oil, dispersants, or cleaning chemicals had an elevated prevalence of depression (1·56, 1·37-1·78) and PTSD (2·25, 1·71-2·96). Stopping work because of the heat was also associated with depression (1·37, 1·23-1·53) and PTSD (1·41, 1·15-1·74), as was working as a commercial fisherman before the spill (1·38, 1·21-1·57; and 2·01, 1·58-2·55, respectively). An increase in exposure to total hydrocarbons appeared to be associated with depression and PTSD, but after taking into account oil spill job experiences, only the association between the highest amount of total hydrocarbons and PTSD remained (1·75, 1·11-2·76). INTERPRETATION: Oil spill clean-up workers with high amounts of total hydrocarbon exposure or potentially stressful job experiences had an increased prevalence of depression and PTSD. These findings provide evidence that response and clean-up work is associated with adverse psychological effects and suggest the need for mental health services both before and after the event. FUNDING: National Institutes of Health (NIH) Common Fund and the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences.
BACKGROUND: Adverse mental health effects have been reported following oil spills but few studies have identified specific responsible attributes of the clean-up experience. We aimed to analyse the effects of the 2010 Deepwater Horizon (Gulf of Mexico) disaster on the mental health of individuals involved in oil spill response and clean-up. METHODS: We used data from the Gulf Long-term Follow-up Study, a cohort of workers and volunteers involved in oil spill clean-up after the Deepwater Horizon disaster. We included 8968 workers (hired after completing training for oil spill response and clean-up) and 2225 non-workers (completed training but were not hired) who completed a Patient Health Questionnaire-8 and four-item Primary Care PTSD Screen to assess for probable depression and post-traumatic stress disorder (PTSD) indicators. Participants were recruited between March 28, 2011, and March 29, 2013. The mental health indicators were assessed at home visits done between May 12, 2011, and May 15, 2013. We used regression models to analyse the effect of potentially stressful job experiences, job type, and total hydrocarbon exposure on mental health indicators. FINDINGS:Oil spill response and clean-up work was associated with increased prevalence of depression (prevalence ratio [PR] 1·22, 95% CI 1·08-1·37) and PTSD (PR 1·35, 95% CI 1·07-1·71). Among workers, individuals who reported smelling oil, dispersants, or cleaning chemicals had an elevated prevalence of depression (1·56, 1·37-1·78) and PTSD (2·25, 1·71-2·96). Stopping work because of the heat was also associated with depression (1·37, 1·23-1·53) and PTSD (1·41, 1·15-1·74), as was working as a commercial fisherman before the spill (1·38, 1·21-1·57; and 2·01, 1·58-2·55, respectively). An increase in exposure to total hydrocarbons appeared to be associated with depression and PTSD, but after taking into account oil spill job experiences, only the association between the highest amount of total hydrocarbons and PTSD remained (1·75, 1·11-2·76). INTERPRETATION:Oil spill clean-up workers with high amounts of total hydrocarbon exposure or potentially stressful job experiences had an increased prevalence of depression and PTSD. These findings provide evidence that response and clean-up work is associated with adverse psychological effects and suggest the need for mental health services both before and after the event. FUNDING: National Institutes of Health (NIH) Common Fund and the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences.
Authors: Richard K Kwok; Lawrence S Engel; Aubrey K Miller; Aaron Blair; Matthew D Curry; W Braxton Jackson; Patricia A Stewart; Mark R Stenzel; Linda S Birnbaum; Dale P Sandler Journal: Environ Health Perspect Date: 2017-03-31 Impact factor: 9.031
Authors: Kaitlyn B Gam; Lawrence S Engel; Richard K Kwok; Matthew D Curry; Patricia A Stewart; Mark R Stenzel; John A McGrath; W Braxton Jackson; Maureen Y Lichtveld; Dale P Sandler Journal: Environ Int Date: 2018-10-11 Impact factor: 9.621
Authors: Jean Strelitz; Dale P Sandler; Alexander P Keil; David B Richardson; Gerardo Heiss; Marilie D Gammon; Richard K Kwok; Patricia A Stewart; Mark R Stenzel; Lawrence S Engel Journal: Am J Epidemiol Date: 2019-05-01 Impact factor: 4.897
Authors: Sarah R Lowe; John A McGrath; Megan N Young; Richard K Kwok; Lawrence S Engel; Sandro Galea; Dale P Sandler Journal: J Trauma Stress Date: 2019-03-26
Authors: Jeanny H Wang; Hristina Denic-Roberts; Jeffrey L Goodie; Dana L Thomas; Lawrence S Engel; Jennifer A Rusiecki Journal: J Trauma Stress Date: 2022-03-15
Authors: Jean Strelitz; Alexander P Keil; David B Richardson; Gerardo Heiss; Marilie D Gammon; Richard K Kwok; Dale P Sandler; Lawrence S Engel Journal: Environ Res Date: 2018-09-22 Impact factor: 6.498
Authors: Richard K Kwok; Aubrey K Miller; Kaitlyn B Gam; Matthew D Curry; Steven K Ramsey; Aaron Blair; Lawrence S Engel; Dale P Sandler Journal: Curr Environ Health Rep Date: 2019-09
Authors: Joan P Packenham; Richard Rosselli; Alice Fothergill; Julia Slutsman; Steve Ramsey; Janet E Hall; Aubrey Miller Journal: Curr Environ Health Rep Date: 2021-05-11
Authors: Kyung-Hwa Choi; Myung-Sook Park; Mina Ha; Jong-Il Hur; Hae-Kwan Cheong Journal: Int J Environ Res Public Health Date: 2018-05-17 Impact factor: 3.390