239843 Sub Acute and Chronic Health Effects of Aerosolized Red Tide Toxins (Brevetoxins) and Asthma

Wednesday, November 2, 2011

Lora E. Fleming, MD, PhD , European Centre for Environment and Human Health (PCMD) and Univesity of Miami OHH Center and NIOSH Research Group, Miami, FL
Judy Bean, PhD , Childrens Hospital Medical Center of Cincinnati, Cincinnati, OH
Barbara Kirkpatrick, EdD, RRT , Mote Marine Laboratory, Environmental Health Program, Sarasota, FL
Kate Nierenberg, MS , Mote Marine Laboratory, Environmental Health Program, Sarasota, FL
Lorraine C. Backer, PhD, MPH , National Center for Environmental Health, US Centers for Disease Control and Prevention, Chamblee, GA
Andrew Reich, MS, MSPH , Florida Department of Health, Aquatic Toxins Program, Tallahassee, FL
Julie Hollenbeck, MA , OHHC / NIOSH Occupational Research Group, University of Miami, Key Biscayne, FL
Yung Sung Cheng, PhD , Lovelace Respiratory Institute, Albuquerque, NM
Richard Pierce, PhD , Mote Marine Laboratory, Environmental Health Program, Sarasota, FL
Jerome Naar, PhD , Center for Marine Research, Wilmington, NC
Adam Wanner, MD , Pulmonary Medicine, University of Miami Miller School of Medicine, Miami, FL
William M. Abraham, PhD , Mt Sinai Hospital, Miami, FL
Janet Benson, PhD , Lovelace Respiratory Institute, Albuquerque, NM
Daniel Baden, PhD , Center for Marine Science, University of North Carolina at Wilmington, Wilmington, NC
Introduction: In previous studies, we demonstrated statistically significant changes in pulmonary function testing (PFTs) and reported symptoms for asthmatics before and after 1 hour at the beach with exposure to brevetoxins in Florida red tide (Karenia brevis bloom) aerosols. In this study, we explored the possible longer term health effects over several days and over 7 years from intermittent environmental exposure to brevetoxins in an open cohort of asthmatics age 12 and older.

Methods: In addition to the quantification of their environmental exposure, 147 asthmatic subjects were assessed for their PFTs and reported symptoms before and after 1 hour of exposure to Florida red tide aerosols over both several days and several years of exposed and unexposed studies.

Results: Over the 7 years of studies, as a group, the asthmatics came to the studies with normal percent predicted PFT values standardized for age, gender, race, and BMI. Asthmatics followed for several days after the 1 hour of exposure to the Florida red tide toxin aerosols continued to have significantly increased symptoms and delayed decreased PFTs. The 38 asthmatics participating in only one exposure study reacted statistically significantly more in terms of their pre- vs post-exposure PFTs compared to the 36 asthmatics who came to 4 or more exposure studies. These 36 asthmatics participating in 4 or more exposure studies demonstrated no significant change in their standardized percent predicted pre-exposure PFT values over the 7 years of the study.

Conclusions: These results appear to indicate that asthmatics living in areas with intermittent Florida red tides experience acute and subacute, but not chronic, respiratory effects from intermittent environmental exposure to aerosolized brevetoxins over a 7 year period.

Learning Areas:
Basic medical science applied in public health
Clinical medicine applied in public health
Environmental health sciences
Occupational health and safety
Public health or related research

Learning Objectives:
- Identify known exposures and health effects of Florida red tide aerosols - Assess the possible chronic health effects to asthmatics with intermittent chronic exposure to these aerosols - Demonstrate the importance of natural toxins as environmental air pollutants

Keywords: Asthma, Toxicants

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator of this research
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.