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Objectives

G ulf C oast H ealth A lliance: Health R isks related to the M acondo S pill (GC-HARMS ) P urpose: Understand long-term health effects of exposure to petrogenic PAH, especially from consuming Gulf seafood. Objectives. Overview of Community-Based Participatory Research approach

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Objectives

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  1. Gulf Coast Health Alliance: Health Risks related to the MacondoSpill (GC-HARMS)Purpose:Understand long-term health effects of exposure to petrogenic PAH, especially from consuming Gulf seafood

  2. Objectives • Overview of Community-Based Participatory Research approach • Overview of benefits and barriers to carrying out CBPR • Context of the DWH Disaster as it relates to research • Overview of strategies we have developed to manage challenges • Introduction to Gulf Coast Health Alliance: health Risks related to the Macondo Spill (GC-HARMS)

  3. “ Collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings. CBPR begins with a research topic of importance to the community with the aim of combining knowledge and action for social change to improve community health and eliminate health disparities.” W.K. Kellogg Community Scholar’s Program (2001) Definition of CBPR

  4. Benefits and Barriers + Enhances relevance of research to communities, reliability and validity of measurement instruments + Improves response, recruitment, and retention rates - Engaged “communities” often have disparate or conflicting goals and agendas - Distrust, fear, misunderstandings (fallout from “helicopter” research) Collaborations vulnerable to loss of funding Community and research objectives often misaligned - Little infrastructure for communication among science, outreach/education, and advocacy

  5. How do we address these barriers? First step: Meaningful engagement

  6. How does academia/government typically address a crisis?

  7. The Deepwater Horizon Disaster. . .the short term

  8. Community Context • Fishing is a way of life: • Subsistence • Economic support • Culture • Family history • Many fishing families also dependent on offshore drilling

  9. Fear and Anger

  10. Distrust

  11. Grief and Loss

  12. Coastal Erosion • LA contains ~ 40% of the nation's wetlands • Represents 90% of coastal wetland loss in lower 48 states • 60% of land loss in Barataria & Terrebonne basins • Losing 25 to 35 square miles of wetlands per year • If not interrupted, nearly 640,000 more acreslost by 2050

  13. Sensory Assessment C&E News, July 18, 2011, Volume 89, Number 29, pp. 12 - 16

  14. After the oil spill, analytical protocols to assess contaminants in seafood found few problems, but the public and some scientists are not reassured Ann M. Thayer C&E News, July 18, 2011, Volume 89, Number 29, pp. 12 - 16

  15. CBPR Approach may be the only way to work with these communities • They are: • Angry • Distrustful of industry, the government, and science • Frightened • In economic turmoil • Concerned over long-term health effects for their families • Past victims of “helicopter research”

  16. Long-term Relationships with Involved Communities • Katrina, Rita, Gustav, Ike • Community forums • Response to disaster workshops • Bryan Parras full-time on site in aftermath of the spill • Multiple communications (meetings, conferences, etc. during and after spill)

  17. Community Engagement Related to the Gulf Oil Spill Initial town hall meetings to assess community needs/concerns • Primary concerns related to long-term health effects of consuming potentially contaminated seafood. Many families not only subsist on Gulf seafood, but make their living from harvesting and marketing it Interviews with partners in Louisiana to assess oil-spill related research, education, & outreach interests • Suggestions from participants to increase participation to ensure representation of geographically/ethnically disparate communities Face-to-face meetings with 24 community groups in four states to collectively frame research questions • Research questions framed • Specific aims drafted Series of meetings involving scientists, clinicians, and community groups held in Louisiana, Mississippi, and Alabama • Logistics, logistics, logistics • Research proposal initiated

  18. GC-HARMS • Co-identified purpose: • Understand long-term health effects of exposure to petrogenic PAHs, especially from consuming Gulf seafood • Gulf Coast Consortium • Coalition of community organizations from LA, MS, AL, TX • Academic institutions: UTMB, UPenn, TAMUG, LSU • Research projects: • Clinical cohort study of coastal residents • Exposure assessment & bio-monitoring research in seafood & human population • Community vulnerability & resilience research • Community outreach, education, & dissemination

  19. GC-HARMS Projects • Project 1: • Clinical cohort study of coastal residents • Community vulnerability & resilience research • Project 2: • Exposure assessment & bio-monitoring research in seafood & human population • Predict future exposure risks using Inverse Modeling • Project 3: • Evaluate the toxicity of selected alkylated and oxygenated PAH, and PAH extracts from seafood using validated cell-based assay systems, as well as elucidate the metabolism of the petrogenic PAH • Project 4: • Personalized biomarker approach to identify increases in disease risk and psychosocial stress • Community outreach, education, & dissemination

  20. Community and Academic Partners • UTMB, University of Pennsylvania, Louisiana State University, Texas A&M at Galveston • Houston Advanced Research Council (HARC)? • Louisiana Environmental Action Network (Regional LA) • Center for Environmental and Economic Justice (Biloxi) • Mississippi Coalition for Vietnamese-American Fisherfolk and Families (Gulfport/Biloxi, MS) • United Houma Nation (Houma, LA) • South Bay Communities Alliance (Coden/Bayou La Batre, AL) • Zion Travelers Cooperative Center (Phoenix, LA) • Bayou Interfaith Shared Community Organizing (Thibodaux)

  21. Cohort Study Sites • Biloxi • Gulfport • Southeast LA • Galveston (comparison Site)

  22. Protocol • Enrollment of 400 subjects, 100 each from: • Gulfport, MS • Biloxi, MS • Southeast Louisiana • Galveston (comparison community) • Each participant will be followed for three years: • Baseline then follow-up surveys • Physical Assessments • Biological samples (blood, urine, cord blood, breast milk)

  23. Questionnaire • Health symptoms and degree of belief that they are associated with the spill • Indicators of general health • Respiratory symptoms (based upon the ATS survey) • Chronic health problems • Access to medical and mental health resources

  24. Questionnaire • Mental health • Habits and lifestyle • Brief family history • Occupational and residential histories (no demographic data are solicited) • Fishing • Seafood consumption • Trust in social institutions

  25. Seafood Sampling • Sites: Louisiana, Gulfport/Biloxi, Alabama • Shrimp (coastal and off-shore waters) • Blue crabs • Finfish • Speckled trout • Redfish • Drum • Sheepshead • Oysters

  26. Sampling Sites

  27. Seafood sampling coordinated by W. Subra, B. Parras, and J. Sullivan

  28. Seafood Economics • Landing reports • Potential partnership with Houston Advanced Research Center (HARC) • Environmental anthropologist to assess seafood economics at family and community level • Independently funded collaborator • Indicators of well being in fishing communities • The Role of Shrimp Imports in the Decline of Shrimp Reliant Communities in the Gulf of Mexico

  29. Community Outreach and Dissemination Core • Development of communications plan • Research dissemination • Community outreach and education • Environmental health policy advocacy

  30. Roles for Community • Community Outreach and Dissemination • Development of communications plan • Research dissemination • Community outreach and education • Environmental health policy advocacy

  31. Progress since funded by NIEHS in July • Study instruments collectively built, finalized, and translated • Established scopes of work, SOPs, reporting mechanisms, and invoicing processes • Protection of privacy • Federal requirements for preservation of documents • Identification of local health resources for patient follow-up for a medical or mental health issue • Advertisement underway and recruitment in August • Steering Committee established

  32. Progress since funded by NIEHS in July • Organized and carrying out a series of community forums for fisherfolk from LA, MS, and AL • Compiled a directory of our community contacts and had a two-day training session in August • Three sampling sessions have been carried out to harvest shrimp, crabs, oysters, and finfish. Currently being analyzed in the laboratory of Dr. Shakeel Ansari, using GC-MS technology. • IRB approval received February, 2012 • Community groups completed human subjects training • Meetings between scientific team and community groups to prepare for CODC efforts

  33. Results

  34. Assessment of Petrogenic PAH Toxicity Treat cells with PAH extracts or single PAHs Perform assay and measure response light Standardize results Analyze the data Effect Dose

  35. Results • Dioxin is the prototypical carcinogenic toxin for all PAHs • Standard curve of dioxin in our system as a control • Evaluation of extracted PAHs in seafood

  36. Results

  37. PAH Metabolites

  38. Questions?

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