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Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop (2015)

Chapter: 6 Capacity to Address Environmental Health Risks

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Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
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6

Capacity to Address Environmental Health Risks

BOX 6-1 Points Highlighted by Individual Speakers

  • Understanding the health and connectivity of ecosystems requires knowledge about sustainable practices on land and at sea, which encompass everything from inland agricultural practices to resource extraction to transportation (Dickey).
  • The absence of baseline health and environmental information limits researchers’ abilities to assess the impacts of environmental stressors and the thresholds for harm (Dickey).
  • High levels of uncertainty and concern remain among Gulf coast citizens about the impacts of the oil spill on the health of Gulf ecosystems (Kane).
  • Communities can be engaged with the scientific process and are one of a researcher’s most valuable assets (Kane).
  • State health agencies need better access to good, local data and expertise during disasters; reliable and realistic regional exposure data are often lacking (Brackin).
  • Risk communication and applied risk assessment training for Gulf States health departments could enhance capacity to respond to environmental health threats (Brackin).
  • Inexpensive sampling technologies could provide a more comprehensive (across space and time) and holistic (air, water, individuals) view of exposure to toxic substances (Anderson).
  • New environmental sampling technologies could help communities to respond to environmental disasters (Anderson).
  • Studies that have been done by several National Institutes of Health (NIH) institutes could serve as platforms for future human health and toxicology research (Miller).
  • Public health is often relegated to the sidelines during responses to disasters. The inclusion of a public health coordinator into the incident command structure could help mitigate health concerns during disaster responses (Walker).

Several speakers at the workshop examined specific ideas for improving capacity to detect, assess, and manage environmental health risks along the Gulf Coast. The presentations summarized in this chapter reflect the experiences of researchers, health agencies, and communities. Presenters suggested potential opportunities to address persistent and acute environmental health threats and to develop capacity to better respond to environmental health threats associated with disasters. Presenters also offered suggestions for improving communication about environmental health risks among residents, policy makers, and researchers.

SENTINEL SYSTEM FOR ECOSYSTEM AND HUMAN HEALTH

By supporting the development of an integrated understanding of the health and connectivity of human and natural ecosystems—from watershed to coastal oceans—the Gulf Research Program could significantly contribute to coastal health and sustainability over the long term, said Robert Dickey, director of the University of Texas Marine Science Institute. Defining and communicating interdependencies and their influence on human health, ecosystem dynamics, services, and societal well-being is a “very tall order.” It requires understanding what sustainable practices are on land, at sea, and along the coast, which encompasses everything from inland agricultural practices to resource extraction to transportation on coastal oceans and inland waterways.

In his previous position as director of the U.S. Food and Drug Administration Gulf Coast Seafood Laboratory in Dauphin Island, Alabama, one recognized challenge was identifying and assessing stressors and the thresholds for harm in aquatic ecosystems, whether acute, chronic, or episodic. Chronic stressors (e.g., ex-

Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×

cessive nutrients, sediments, toxins, and pathogens) are often introduced far inland and transit through the watershed to the coastal oceans, making them particularly challenging to trace and characterize, said Dickey. A potential role for the Gulf Research Program is to couple assessments of the “health” of coastal oceans and communities with research to identify upstream inputs and impacts on coastal resources and communities.

A system for assessing baseline health of a community and surrounding ecosystems is essential, he said, “Otherwise, you’re not going to be able to detect any differences.” As an example of such a monitoring activity, Dickey described the Mussel Watch program, which has been monitoring more than 100 different contaminants in shellfish since its establishment in 1986.1 This has been an extremely valuable program, said Dickey, because it has produced a searchable archive of data that can be “mined” to determine the burden and potential impact of environmental stressors on ecosystems and human health. This program could be expanded to include different sentinel species up and down the food chain, which would provide a much better understanding of the contaminant burden in our coastal oceans and what that might mean for basal human health in coastal communities (e.g., as determined through state and federal programs such as the National Health and Nutrition Examination Survey). The Mussel Watch program is a good model to think about, Dickey said, because it supports research that links the environment with human health concerns. A similarly integrated system that considers the complete life cycle of environmental health threats in the Gulf region could provide information that can guide wise decision making, Dickey concluded.

UNIVERSITY–COMMUNITY PARTNERSHIPS AND SEAFOOD SAFETY

As part of the NIEHS-supported Deepwater Horizon Research Consortia, Andrew Kane, associate professor of Environmental and Global Health in the College of Public Health and Health Professions at the University of Florida, has been working on a multidisciplinary program to address seafood safety concerns that have been identified by communities along the northern Gulf coast. Meeting community needs requires coupling community expertise and assets with science, he said. In his work he has found that communities can be engaged with the scientific process and are one of a researcher’s most valuable assets in this type of applied research.

Kane noted that high levels of uncertainty and concern remained among many people in the Gulf region about impacts of the oil spill on the health of Gulf ecosystems (Figure 6-1). With respect to seafood safety,

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FIGURE 6-1 Environmental health perception data from the Healthy Gulf Healthy Communities project through the University of Florida. Many citizens living along the Gulf coast still perceive notable levels of risk to ecosystem health 3 years after the Deepwater Horizon oil spill. Data from more than 300 Gulf coast study participants surveyed about their perception of Gulf ecosystem health and well-being 3 years after the oil spill (differentiated from human health outcomes associated with the spill). SOURCE: Presented by Andy Kane on September 24, 2014.

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1 The NOAA Mussel Watch project analyzes “chemical and biological contaminant trends in sediments and bivalve tissues.” It is the longest running continuous contaminant monitoring program in U.S. coastal and Great Lakes waters, quantifying contaminants such as PAHs, PCBs, DDTs and its metabolites, chlorinated pesticides, and heavy metals. See http://ccma.nos.noaa.gov/about/coast/nsandt/musselwatch.aspx.

Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×

communities identified concerns centered on what seafood was (and was not) tested by FDA and NOAA during and after the spill, and on the use of national levels of seafood consumption to assess risk. This was especially true for fishing communities, who can eat “a lot more [seafood] than the national average.” A goal of Kane’s work is to develop seafood consumption risk assessments—in partnership with communities—that are tailored to the people and practices of Gulf communities. The project includes analytical toxicology of self-caught, inshore seafood and the collection of data to assess seafood consumption patterns for multiple Gulf communities. “To date, all seafood samples tested have had levels of polycyclic aromatic hydrocarbons (PAHs) near or below levels of detection for the majority of samples,” Kane said, “and all of the samples have been well below the FDA’s levels of concern.” “This information needs to be effectively disseminated,” Kane said. “Effective risk communication underscores the difference between people knowing certain outcomes and believing them, and is key to potentially changing the way people think and behave.”

Community members tend to trust academics more than they do people from other sectors, such as the government and media, Kane said. “Researchers thus have an opportunity and a responsibility to work with communities to make a difference.” “To make it work, the bottom line is that we need to be part of the community,” he said. “We can’t respond to what we want to do … It’s a question of listening carefully and responding to what communities need. Can we really meet some of those needs? And then how do we go about doing it?” To move quickly in a disaster, personal and professional connections need to be in place, said Kane. “What we’ve learned is that the organization and structure of different communities are different, and those differences matter when communicating and disseminating information. Developing dialogue and trusted partnerships in advance is essential. There’s ownership and responsibility and a sense of organization that can be counted on with existing relationships.”

PUBLIC HEALTH DEPARTMENT NEEDS AND OPPORTUNITES

The organizational structures of public health departments can vary by state or even by county or city, but they all have certain basic goals when it comes to environmental health threats associated with disasters, said Bruce Brackin, a consulting environmental epidemiologist at the Mississippi State Department of Health.

Before disasters, the most important thing health departments can do is to make sure that critical infrastructure is “hardened” to withstand disasters, he said. Developing systems that ensure the availability of safe water and safe sewage disposal, for example, have significantly reduced health risks related to water contamination following hurricanes, he said.

Another basic goal is to develop a workforce that is able to work effectively during disasters, Brackin noted. Many public health workers are getting older, and there has not been an influx of younger people taking their places. “That’s disconcerting,” said Brackin. Informal training will be needed to transfer what has been learned from real-life experiences, he said. Just knowing how to manage and talk to people during disasters is important, he said. Common risk communication and applied risk assessment training for health department staff across the Gulf States would be ideal, perhaps working through the Association of State and Territorial Health Organizations or other umbrella groups.

Getting good, clear information out quickly during disasters is another important goal of health departments, said Brackin. One lesson from the Deepwater Horizon (DWH) oil spill is that if relevant information is not available quickly for health departments and others to communicate to the public, information from other sources will rush in to fill the vacuum. This was the case for dispersants and for seafood safety, he said. While state epidemiologists and others are developing risk assessments “on-the fly, in a hurry, and in high-stress environments,” they need better access to good, local data and expertise, he said. They also need the formulated risk and public health messages released. Getting this type of pertinent information out can be difficult in large, multiagency incident command systems.

Public health departments are reliant upon research findings to make decisions and to communicate with the public during disasters. In general, health departments do not get involved in the conduct of basic research, but, because they are consumers of research, they can provide an important perspective on key research needs. One example is reliable and realistic exposure data are often lacking, particularly on a regional basis. This was the case during the DWH oil spill and the public health community’s need for seafood consumption data to respond to duration of exposure questions. Public health departments are willing partners in this work, he said.

DETECTING AND UNDERSTANDING EXPOSURES

Understanding the human and ecosystem effects of disasters requires understanding exposure, observed Kim Anderson, professor in the Department of Environmental and Molecular Toxicology and director of the Food Safety and Environmental Stewardship program at Oregon State University. However, as evidenced by the

Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×

DWH oil spill2—which resulted in potential exposures to components of crude oil, such as PAHs, and to chemicals in the dispersants used to clean up the spill—understanding exposures during an environmental disaster is a complex problem (Allan et al., 2012; Kujawinski et al., 2011; Reddy et al., 2011; Tidwell et al., 2015).

In general, all of the chemicals to which people may be exposed following an environmental disaster are often not known at the time of the disaster. Thus, developing detection technologies that do not require advance knowledge of specific chemicals of concern will be critical, Anderson said. There are technologies that currently exist, including sensors and media that can be used to sample a wide variety of chemicals from the water, the air, and individuals, she said, and research is needed to further develop these technologies. Passive sampling devices are one such technological platform that could address some of these issues. Passive sampling devices sequester compounds through passive diffusion, in a time-integrated manner. Water and air passive samplers sequester the water dissolved fraction and air vapor respectively each strongly associated with the bioavailable fraction. Passive samplers are applicable to a wide range of chemicals. The passive sampling technology also may be applied to individuals through the use of simple, lightweight silicone wristbands (O’Connell et al., 2014). Opportunities for sensor technology include other low-cost options that can be deployed on wide temporal and spatial scales, and where the sensors can be stably archived for future use as the spill evolves.

In developing these technologies, it is important to keep in mind what types of information is most helpful in assessing the effects of exposure, she said. For example, bioavailability3 of chemicals is a critical factor, because in order for a chemical to have an effect, it must get into an organism. The bioavailability of chemicals in oil changes as those chemicals “weather” due to exposure to heat, light, and other environmental processes, she said. Technology that can sufficiently sample the bioavailable fraction is especially valuable because this fraction provides a better way to assess the potential health effects of exposure. The bioavailable fraction, as collected by passive samplers, has been shown to be a good predictor of toxicity (and the lack of toxicity) (Ghosh et al., 2013).

Technologies that take bioavailability into account would also lessen the need to collect biotic samples, such as mussels or other organisms. During environmental disasters, “We already have a situation that puts pressures on organisms—and then we are going to go in and collect more organisms,” Anderson said. Baseline data from curated archived samples can be essential to know what has changed after an event. It is noteworthy that many communities have identified a lack of local and neighborhood specific sampling and chemical information surrounding disasters, specifically predisaster baseline chemical hazards information. An available sampling platform that allows for informed communities to build their vision of response and recovery will contribute to their health, well-being, and resilience.

Finally, new and inexpensive technologies could support adequate spatial and temporal coverage during an event. Anderson described the “tendrils of oil” that she witnessed during the Gulf oil spill, that would impact some coastal areas but leave adjacent areas untouched. Technologies that can provide a more comprehensive view—over space and time—and technologies that provide a more holistic view across air, water, and individuals are needed, she said.

Another important opportunity for the Gulf Research Program is to encourage the integration of new and developing detection technologies into communities so they are ready to use them when a disaster occurs. “We have fire stations around the country that are equipped with various equipment to respond to emergencies, but we don’t equip communities to deal with environmental disasters when it comes to environmental sampling,” Anderson pointed out. The Gulf Research Program could support activities to help integrate these tools into communities. She asked, “What are the tools that communities could use when a disaster occurs? And, what is the training they need to use those tools effectively?”

NIH GULF OIL SPILL AND DISASTER RESEARCH RESPONSE

NIH has developed several important programs to address some of the key needs and research questions emerging from the Deepwater Horizon oil spill—from training programs for oil spill cleanup workers, to intramural and extramural research on toxicology, health effects, and resilience. Aubrey Miller, senior medical advisor to the director at the NIEHS, provided an overview of these activities and identified some potential opportunities for the Gulf Research Program.

The intramural Gulf Long-term Follow-up Study4 (GuLF STUDY)5 is a prospective study of almost 33,000 adults that were involved in cleanup or support activi-

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2 Crude oil is composed of many chemicals including alkanes, cycloalkanes, PAHs, as well as other substituted PAHs. Weathering of the oil mixture generates additional chemicals of concern like oxygenated PAHs. Products used for cleanup are generally composed of a mixture of chemicals, for example dispersants.

3 Bioavailable chemicals are able to penetrate permeable tissues of an organism. See http://superfund.oregonstate.edu/oilspillglossary.

4 For more information See https://gulfstudy.nih.gov/en/index.html.

5 See https://gulfstudy.nih.gov/en/index.html.

Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×

ties during the DWH oil spill. The project has involved baseline telephone interviews to capture information about job duties, symptoms, and health status, followed by an in-home clinical assessment and biospecimen collection (i.e., blood, urine, toenails, hair) for more than 11,000 people. In addition, the project is now starting a more comprehensive clinical examination of up to 4,000 workers that previously participated in the in-home clinical assessment, and are currently living in Alabama and Louisiana. The GuLF STUDY intends to follow study participants for 10 or more years through follow-up telephone interviews, clinical assessments of identified subgroups, and links to vital records and cancer registries.

The Deepwater Horizon Research Consortia6 is a 5-year, $25.2 million program funded by eight NIH institutes. The Consortia, which ends in 2015, supports the work of four university–community partnerships in the Gulf region to address issues and concerns identified in concert with impacted communities. Projects are focused on women and children, pregnant women, cultural and ethnic minorities, and seafood safety. Approximately 45 community-based partners throughout the Gulf have been involved with the consortia, which offers multiple opportunities for leveraging activities and creating networks for research (Box 6-2).

Additionally, the Substance Abuse and Mental Health Services Administration (SAMHSA) has collaborated with NIEHS and provided funding to expand longitudinal research involving the mental health impacts and risk factors of resiliency among participants involved in the GuLF STUDY and Consortia, as well as the development and assessment of new resiliency training materials (NIEHS Worker Education and Training Program). The goal of this training program is to prepare

BOX 6-2 Deepwater Horizon Research Consortia

5-year $25.2 M Program

Four university/community partnerships

• Tulane University

• Louisiana State University

• University of Florida

• University of Texas Medical Branch

Steering Group Leadership

• Includes GuLF STUDY

• Input from (NTP) National Toxicology Program

Distinct populations & foci

• Women and children

• Pregnant women

• Cultural/ethnic minorities

• Seafood safety

Shared approaches

• Seafood

• Resiliency

• Population studies

• Community outreach & dissemination

> 45 Community Partners (Louisiana, Alabama, Mississippi, Florida)

Mary Queen of Vietnam Community Development Corporation

Louisiana Public Health Institute

Bayou Interfaith Shared Community Org

Assoc. of Occupational & Environmental Clinics

WIC clinics

South East Louisiana Community Coalition

United Houma Nation

Advocacy Center of Louisiana

Catholic Charities – Spirit of Hope

Episcopal Community Services

Louisiana Language Access Coalition

Latino Forum

McFarland Institute

Crescent Regional Collaborative Problem Solving Coalition

Stuart H. Smith Law Clinic & Center for Social Justice

Alabama Seafood Association

Alabama Department of Public Health

South Bay Communities Alliance of Alabama

Center for Environmental and Economic Justice

Mississippi Coalition for Vietnamese-American Fisherfolk & Families

MS Interfaith Disaster Task Force

Cedar Key Aquaculture Association

Citizens Against Toxic Exposure

Be Ready Alliance Coordinating for Emergencies

Families Count

United Way of Escambia

Catholic Charities, NE Florida

Community Resource Associates

Emerald Coast Counseling

Florida Asset Building Coalition

Florida Division of Children and Families

Island Fresh Seafood

RAISE Florida Network – War on Poverty

SAFER: Support Alliance for Emergency Readiness

Franklin’s Promise Coalition

Steinhatchee River Chamber of Commerce

Florida Center for Prevention Research

Wakulla County Coalition for Youth

Funding: NIEHS, NCI, NHLBI, NIMH, NIMHD, NINR, NCATS, OBSSR

SOURCE: Presented by Aubrey Miller on September 24, 2014. Credit: Symma Finn, PhD, Division of Extramural Research and Training, NIEHS 2014

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6 See http://www.niehs.nih.gov/esearch/supported/dert/programs/gulfconsortium/index.cfm.

Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×

disaster workers to recognize the signs and symptoms of disaster work-related stress and trauma, avoid posttraumatic stress disorder, make use of organizational and community support resources, and build resilience.

The NIEHS National Toxicology Program (NTP) identified improved characterization of exposure and toxicity of PAHs as a high-priority research topic and is developing a PAH research program to address multiple knowledge gaps and inform the cumulative risk assessment process. The primary aim of the PAH research program is to characterize the toxicity of a broad range of individual PAHs, defined PAH mixtures, and complex environmental mixtures containing PAHs.

Miller identified several needs and opportunities for improving the detection, assessment, and management of environmental risks from disasters. One opportunity is to use NIH studies as resources and platforms for future human health and toxicology research. “[Research conducted] in the 4 years since the spill should not be lost,” he said. Newly created cohorts and bio-marker repositories are important resources for long-term studies of health, vulnerability, and resilience. Additionally, what do we know about background ambient exposures in Gulf communities? he asked. There are many industries in the Gulf region, including the petrochemical industry that could help in evaluating baseline environmental levels of various substances of concern. Ongoing and new research studies could also help to establish health baselines for different communities. Additionally, it would be especially helpful in understanding baselines if there were biobanking of novel tissues such as placentas, breast milk, and cord blood, with the understanding that sound privacy protocols need to be in place for donors.

Another opportunity is to improve understanding of resilience and vulnerability both at a community and individual level, Miller said. What do we mean by resilience? What metrics can we use to measure resilience, and how can we combine them with socioeconomic and environmental risk factors to reveal the impact of multiple stressors? What biomarkers can we use to study resilience? And how can we integrate this information to develop interventions to promote resilience?

Miller also outlined the need for exposure and toxicology research. He said that an improved understanding of petroleum exposures is needed. “What are the different chemical profiles for different crude oils, and how do these profiles change as oil weathers and degrades?” Research regarding relevant ambient exposures to chemicals mixtures, including PAHs, across Gulf Coast communities is currently lacking. “We also need to better understand the toxicology of oils, the mixtures, and the dispersants, as well as other relevant environmental exposures that come into play,” he said.

Uncertainty and the lack of information often undermine the credibility of government programs, Miller observed. In response, NIH has created the Disaster Research Response (DR2) Project7 to accelerate the development of needed infrastructure as part of a larger effort in the Department of Health and Human Services. The goal, said Miller, is to create opportunities for the more rapid collection of timely health and environmental data across the Gulf, and other areas across the country in response to disasters or other emerging threats. Currently, the DR2 project is focusing on the development of a publically accessible database of environmental health data collection tools, clinical protocols, forms, and guidance, and a national resource of trained EHS disaster “research responders.” This effort seeks to involve federal, state, and local officials, academia, responders, and community stakeholders in helping to perform critical health research during disasters and other emergencies. “We need good exposure characterization and a better understanding of the health effects,” he said, “and we must be able to capture these quickly and simultaneously.”

Looking forward, Miller said that the Gulf Research Program has many opportunities to improve understanding and communication about environmental health risks related to disasters. Activities to enhance the environmental health literacy8 of NGOs, community residents, healthcare workers, and policy makers are needed, he said, as are programs that enhance community understanding and capacity for evaluating the impacts of future disasters. The Gulf Research Program could also evaluate the effectiveness of existing training materials and programs and conduct research to inform the development of capacity to collect robust and representative health and exposure data in a timely fashion. For all of these activities, the Gulf Research Program can leverage ongoing and established community engagement and outreach activities, such as those supported by NIEHS and GRHOP, Miller said.

CONNECTING OIL SPILL RESPONDERS TO COMMUNITIES AND RESEARCHERS

The Oil Pollution Act of 1990 (OPA 90) established research as a prohibited response expense under the Oil Spill Liability Trust Fund9 (OSLTF), noted Ann Hay-

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7 See For more information see: http://sis.nlm.nih.gov/dimrc/dr2/disasterresearch.html.

8 See http://www.niehs.nih.gov/research/supported/dert/programs/peph/webinars/health_literacy/.

9 The OSLTF has two major components: the Emergency Fund is available for Federal On-Scene Coordinators (FOSCs) to respond to discharges and for federal trustees to initiate natural resource damage assessments. The Emergency Fund is a recurring $50 million available to the President annually. The remaining Principal Fund balance is used to pay claims and

Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×

ward Walker, president of SEA Consulting Group. As a result, the U.S. Coast Guard, which administers the fund, cannot authorize funding for research during a spill response or address research related to community resilience and health opportunities through existing oil spill funding mechanisms. The Gulf Research Program, thus represents a “rare and unique opportunity,” to advance scientific research and coordination activities that could fill public and community health research gaps and improve decision making for oil spill preparedness and response, said Walker,.

Walker provided several suggestions for activities that the Gulf Research Program could undertake. First and most important, she said, “Connections with the U.S. framework for oil spill preparedness and response are essential to achieve the goal of promoting oil spill-related community health and resilience.” As noted by Cheong (2012), a key component of building community resilience is to raise the capacity of communities to adapt following a significant oil spill, and this requires the transfer of resources and knowledge from the response organization to the community. The transfer of knowledge and resources shifts emphasis from self-reliance and encourages collaboration with oil spill experts, which is a necessary component of adaptive resilience.

Walker encouraged public health researchers to be aware of some oil spill research relevant to public health, community resilience, and risk communications. OPA 90 established the Interagency Coordinating Committee for Oil Pollution Research (ICCOPR),10 which produces the federal government’s Oil Pollution Research and Technology Plan. ICCOPR was established to

coordinate a comprehensive program of oil pollution research, technology development, and demonstration among the federal agencies, in cooperation and coordination with industry, universities, research institutions, state governments, and other nations, as appropriate, and shall foster cost-effective research mechanisms, including the joint funding of the research.

In addition, a European Union project has produced community engagement guidance for oil and hazardous substance spills,11 and NOAA has supported a project12 on dispersant risk communications (Bostrom et al., 2015; Walker et al., 2015). Experience with other spills can provide insights into community relations and the use of social media.

To connect with the oil spill community, actions need to be identified that could be taken during a spill to protect human health and mitigate impacts on human health, including the psychosocial impacts on individuals and communities, Walker said. “During a response to an oil spill, rapid and complex decisions are being made inside the command post to reduce risk. There are advantages and disadvantages to almost every choice that has to be made.”

Research to inform such decisions is extremely valuable, she said. Walker agreed that interdisciplinary research and research syntheses are essential to address and manage risk perception about oil spills. “I also see a need for synthesizing and applying research from multiple natural, social, and decision sciences,” she added. “Take, for example, the highly complex issue of managing seafood safety during an oil spill.” Finned fish can swim away from a spill, but shellfish cannot. “To be conservative, fisheries are usually closed, which begins a terrible cycle of scientific dilemmas, marketing challenges, and socioeconomic and psychosocial impacts on fisher folk, which, as you know, can take years to resolve.”

She also pointed to several needs and opportunities to improve the detection, assessment, and management of environmental health risks associated with disasters. Specific actions are rapid seafood safety monitoring studies, studies to inform decision making about trade-offs, and health studies and prespill component analyses of chemical countermeasures such as dispersants.

Walker emphasized the need to integrate public health officials and community considerations into the incident command system (ICS) during responses to technological disasters like the DWH incident. Analyses of previous responses have shown that public health issues receive less attention than the environment because the regulatory driver in oil spill response is mitigating environmental pollution and associated impacts, and because there is little opportunity for the public to be directly exposed to oil spill hazards. She proposed a model for the integration of public health into disaster responses that includes a public health coordinator as part of the command staff, which would enable broad influence throughout the response (Figure 6-2). The inclusion of a public health coordinator under a unified command would also help integrate public health into a community’s disaster responses. Figure 6-2 highlights in blue the areas of functional coordination within the ICS to support improved communications with an affected community about potential public health and environmental risks.

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to fund appropriations by Congress to federal agencies to administer the provisions of OPA and support research and development by federal agencies, such as the Bureau of Environmental Safety and Enforcement. See http://www.uscg.mil/npfc/About_NPFC/osltf.asp and http://www.bsee.gov/Technology-and-Research/Oil-Spill-Response-Research/index.

10 See http://www.uscg.mil/iccopr.

11 See http://www.arcopol.eu/?/=/section/resources/sub/r_hns/pag/1/resource/147.

12 See http://www.crrc.unh.edu/center-funded-projects#Dispersant_Initiative_Projects.

Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×

image

FIGURE 6-2 Example model for integrating public health concerns and communities in the incident command system during response. SOURCE: Walker et al., 2014. Presented by Anne Hayward Walker on September 24, 2014.

RISK COMMUNICATIONS

The remarks of the presenters on risk communications inspired an extended discussion among workshop participants.

Robert Dickey, director of the University of Texas Marine Science Institute, pointed to the need to have a trained cadre of risk communicators and community spokespeople available to translate information into understandable language. “You don’t send a practicing analytical chemist to communicate with the general public,” he said. Risk communicators tailor their messages to their audiences, relay appropriate information, and build trust. In addition, a cadre of very dedicated and passionate educators can get the word out to the public, some of whom also are specialized in bringing civic leaders up to speed on environmental risk assessments and community planning needs. This applies not only to chemical hazards but other hazards as well.

Andrew Kane from the University of Florida emphasized the need for coordinated outreach efforts. Communities are different, which means that messages need to be crafted with care. “That is often times done with community partners to understand the best ways to get the messages across.” He also noted that scientists bring a great deal of credibility to communications and outreach. “Science in a vacuum is meaningless,” Kane said. “Experts with insights and experience in the community can provide immeasurable cohesiveness as part of an effective communications team.”

Risk communications training for scientists can help them fill this role, said Michael Blum of the Tulane/Xavier Center for Bioenvironmental Research. This training could be linked with a regional center to provide opportunities for researchers, policy makers, and community members to interact and learn, together, about environmental health issues. Academics often speak a different language than do people in communities or policy makers,

Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×

observed Kristina Peterson of the Lowland Center. As a result, community members often need to learn a new language, which communications training for academics could help overcome.

Aubrey Miller, NIEHS, pointed out that trusted sources need to be identified early, such as clergy or community leaders. If they can be brought up to speed on environmental health issues, they in turn could greatly help to improve communications with affected communities. Ann Hayward Walker of SEA Consulting Group pointed to the need for oil spill literacy, which is a measure of a person’s ability to understand oil spill risks and information and make informed choices about what to believe or do with that information, at all levels—including the federal government and academic communities. Another need is for communicating uncertainty in the face of incomplete information, which is the case for every spill situation especially at the outset of an incident, she said. However, several speakers reminded the workshop about the complications involved in risk communications. As Bernard Goldstein, University of Pittsburgh, pointed out, messages are not necessarily reviewed by experts in risk communication but are controlled by people who may want to withhold information, “and you have to fight very hard to get information out, that’s my personal experience.” Engaging outside experts as early as possible can be a way to increase transparency and avoid this problem, he said. Similarly, Steven Picou, University of South Alabama, pointed out that litigation can be a complicating factor for risk communication. Messages tend to be reviewed by attorneys before they are communicated, and both litigation and the courts can become involved after massive catastrophes.

USING SOCIAL MEDIA DURING DISASTERS

One prominent topic of discussion was the evolving role of social media in communicating and working with communities during disasters. Aubrey Miller of NIEHS noted that the Red Cross has been using more social media to help provide situational awareness during disasters to help with their response. He also noted that after a recent chemical spill into the Elk River in West Virginia, which contaminated drinking water for 300,000 people, the information getting out on social media did not necessarily correspond with government information. It is important to understand that information is now widely available to the public, and we need to be very cognizant of this in order to have credible risk communications and to effectively address an increasingly well-informed audience, he said.

“That’s an ongoing difficulty for pretty much any agency that uses social media,” replied Angela Grajeda of the American Red Cross. Organizations would like to have control over information to ensure it is accurate, yet they have to figure out how to do that “without it looking censored.” Part of the answer is open communication behind the scenes, she said. Even though the Red Cross has open sites and shares a lot of information across social media, it has specific, designated communicators to whom all information is directed behind the scenes. Those communicators are the ones who develop precise and accurate messages for posting.

Jennifer Horney, Texas A&M University, added that researchers who study the use of social media in disasters find that it can be very effective for informing the public about, say, which roads are blocked off. But she also has heard about local and state government agencies not being allowed to have any social media presence. So, in effect, they have “ceded the territory” of social media communications to whomever else wants to release information, she said.

Linda McCauley of Emory University commented that figuring out how new systems might use the wonderful connectivity resource of social media may be an area of opportunity for the National Academies.

BUILDING TRUST

Several participants observed that the lack of trust among agencies, communities, and scientists often limits effective communication during an environmental disaster. During discussion, several participants suggested opportunities to improve trust, communication, and collaboration among scientists, agencies, and citizens about environmental health issues.

Kristina Petersen of the Lowlander Center noted that distrust was particularly evident during the oil spill, when several concerned communities in Louisiana were willing to help collect environmental monitoring data, but were told that this was already being done by the state health department. Kim Anderson agreed, noting that in her experience agencies would not accept samples collected by citizens, and this can lead to distrust among communities with people saying, “Well, they didn’t sample in my neighborhood.” Peterson suggested that building trusted relationships between citizens and government around this issue, before the next disaster, would be an important area of work.

Kim Anderson noted that agencies need to be willing to accept samples from citizen scientists, which means that they need to have a level of trust that the samples will be gathered and handled correctly. Anderson has developed training modules, based on her experiences with citizens and representatives of NGOs during the DWH oil spill. They received information about passive sampling, explaining the technology in training modules offered in English, Spanish, and Vietnamese. Since then additional training has been created for citizens to participate in the sampling process and sample collection, such as in Ohio near oil/gas pro-

Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×

duction, and in rural areas for agricultural workers. This training could be further expanded to other regions to prepare for disasters.

Anderson noted that there have been a number of training modules developed to train citizens as sample collectors. An opportunity for the Gulf Research Program is to look at how to credential such programs to ensure the safe handling of samples and the correct chain of custody. There needs to be metrics developed for quality assurance, she said. Another participant noted the need to include safety training to ensure proper use of protective equipment and awareness of substances that sample collectors might be exposed to in the field.

John Hosey of the The Corps Network Gulf Coast Restoration Corps, raised some opportunities related to the funding that will come to the Gulf States for environmental restoration. His organization is in the process of creating conservation restoration corps, he said, which will create opportunities for communities to be directly engaged in recovery and restoration efforts related to the oil spill. There is a significant need for workforce training, he said, which could bridge many of the topics discussed at the workshop—health, environmental stewardship and sustainability, and resilience. This could include curricula or a credentialed program that would allow the restoration workforce to also support standardized collection of environmental monitoring data as part of disaster response, he said.

Steve Wolfe of the Florida Institute of Oceanography noted that it was important to appreciate that existing networks in the Gulf region contributed to the response effort going as well as it did, especially considering that the economic and physical effects of the spill crossed five state borders and thousands of square miles of ocean and coastal land. The Gulf of Mexico Alliance, for example, is an extensive network of individuals from academia, state and federal agencies, and NGOs. While the Alliance does not focus on oil-related issues, relationships forged through its work played an important role during the response period. Thus, the most effective way to build the desired “network of trust” is to build upon existing networks of relationships, rather than creating new ones for that purpose.

BREAKOUT DISCUSSION SUMMARY

Summarized below are responses generated by two breakout discussion groups charged with developing suggestions for (1) research (basic and translational) or monitoring investments that could improve capacity to detect, assess, and manage environmental health risks associated with disasters; and (2) encouraging needed collaboration across disciplines, sectors, and regions to improve understanding and communication about environmental health risks.

Breakout question: What research (basic and translational) or monitoring system investments could significantly improve current capacity to detect, assess, and manage environmental health risks associated with disasters?

As a summary of the breakout discussion Lynn Goldman, George Washington University, presented the list, below, to all workshop participants. This list summarizes items suggested by individual and multiple participants during the breakout discussion and should not be seen as the consensus recommendations of the workshop participants; nor are they necessarily actions that the Gulf Research Program should undertake:

Investing in improved monitoring systems (including research to support).

  • Link to existing efforts, where monitoring for oil could be added in (e.g., Mussel Watch, SWAMPS [System Wide Analytical Monitoring Platforms], etc.) and where there is routine collection and rapid analysis of samples.
  • Develop new methods and technologies (e.g., enhanced remote sensing, use of solid phase collection devices for chemicals, development of biosensors).
  • Employ human capital (e.g., lifeguards and fisher-folk) who are on the water every day and mobile technologies for instant information that could be mined for early alerts.

Potential opportunities related to threat assessment (risk assessment, hazard identification, exposure analysis, health impacts).

  • Improve models to better understand the scale and path of a spill, the populations affected, and exposure. Better parameters could improve these models.
  • Improve understanding of how components of oil change due to weathering.
  • Characterize components that come from different sources (spills, seeps).
  • Improve understanding of biologic responses (especially those relevant to human health risks) to chemicals involved in oil spills.
  • Develop high throughput bioassays to more quickly detect the presence of chemicals involved in oil spills.
  • Assess physical and mental health via emergency room surveillance and electronic health records.
  • Also assess psycho-social determinants of health.
  • Characterize the range of potential threats to health from oil spills to better inform response (each spill unique).
Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×

Potential opportunities related to risk management:

  • System operates within legal, long-standing relationships, which can facilitate or get in the way of an effective response. Whole process evokes different areas of science—people engaged with management science, system engineers, and beyond. Could study how our incident management systems work for managing disasters. Can we develop scenarios and use them to understand how to improve management of public health risks?
  • Research to improve the capability of teams to manage disasters, including consideration of human health issues and how to integrate multiple parties that are all used to being in charge.
  • In the process of managing environmental health threats, much data and samples are collected; can these data/samples be better curated and coordinated so they have lasting value?
  • How can information about health risks and uncertainties, who is vulnerable, and how to minimize exposure be better gathered and communicated to the public?
  • Breakout question: How can the Gulf Research Program encourage needed collaboration across disciplines, sectors, and regions, to improve understanding and communication about environmental health threats? What are some potential opportunities?

As a summary of the breakout discussion, LaDon Swann, Mississippi-Alabama Sea Grant Consortium, presented the list, below, to all workshop participants. This list summarizes items suggested by individual and multiple participants during the breakout discussion and should not be seen as the consensus recommendations of the workshop participants; nor are they necessarily actions that the Gulf Research Program should undertake.

Potential opportunities to facilitate collaborations that involve local communities:

  • Support tailored communication on what different agencies, the academies, the Gulf Research Program, and NGOs are doing (e.g., research, mission, goals) and the relevance of their work to local communities.
  • Identify points of access to different communities (e.g., social nodes such as faith-based groups).
  • Develop a map of the local resources and social nodes for various communities (social network analysis).
  • Facilitate cross-disciplinary collaborations, by tapping into existing networks, such as Sea Grant Consortia, Gulf of Mexico Coastal Ocean Observing System (GCOOS), Gulf of Mexico Alliance’s (GOMA) Environmental Education Network.

Potential opportunities to foster collaborations not centered on a specific request for application (RFA):

  • Encourage coalition building across sectors and regions.
  • Identify common vision among disciplines/sectors/regions to move toward improved resilience, may be more powerful than individual RFAs.
  • Identify factors that have allowed existing partnerships to endure and be self-sustaining over time.
  • Develop partnership awards to recognize successful partnerships.
  • Develop an inventory of groups (across sectors, regions) that could be potential partners.

Potential opportunities to foster collaboration via the RFA process:

  • (At front-end) Make collaboration a requirement in RFA. For example,
    • Inter-disciplinarity as review criterion (and review by reviewers that understand inter-disciplinarity).
    • Identify problem that requires cross disciplinary/ sector collaborations through community input.
    • Have a job description that requires work across disciplines—“here are the kinds of expertise that we’d like to see reflected in a proposal.”
  • (At back-end) Focus on peer-review process. Having well-versed reviewers who understand the context and the complexity of what the sponsor is trying to accomplish.
Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×
Page 34
Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×
Page 35
Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×
Page 36
Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×
Page 37
Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×
Page 38
Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×
Page 39
Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×
Page 40
Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×
Page 41
Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×
Page 42
Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×
Page 43
Suggested Citation:"6 Capacity to Address Environmental Health Risks." National Research Council. 2015. Opportunities for the Gulf Research Program: Community Resilience and Health: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21691.
×
Page 44
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There are many connections between human communities and their surrounding environments that influence community resilience and health in the Gulf of Mexico. The impacts of the Deepwater Horizon oil spill on Gulf communities and ecosystems - coupled with the region's preexisting health challenges and environmental stressors - illustrate the need to better understand these connections. In the future, natural and man-made disasters, climate change impacts, and other environmental stressors will present complex challenges to the physical, mental, and social well-being of communities in the Gulf. Understanding the interrelationships among health, ecological, and economic impacts of disasters and other environmental stressors will be crucial to addressing these challenges.

Opportunities for the Gulf Research Program: Community Resilience and Health summarizes a Gulf Research Program workshop held on September 22-23, 2014, in New Orleans, Louisiana. The workshop examined opportunities to improve the health, well-being, and resilience of communities in the Gulf region through discussions with about 50 participants with diverse expertise and experience. These discussions identified perceived needs, challenges, and opportunities that align with the Gulf Research Program's mission and goals - particularly its goal to improve understanding of the connections between human health and the environment to support the development of health and resilient Gulf communities. This workshop is expected to lead to the development of additional Program activities and opportunities for the research community.

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