Epidemiologic research in the context of an environmental disaster: Lessons from the GuLF STUDY

The oil spill following the April 2010 Deepwater Horizon Disaster in the Gulf of Mexico is larger than any previous spill and disrupted the lives of thousands of workers and communities along the Gulf Coast. Surprisingly little is known about short and long-term health effects of oil spill exposures. Shortly after the spill NIEHS began a prospective study of the health of individuals involved in oil spill clean-up. Workers were largely residents of Gulf Coast communities previously affected by other man-made and natural disasters such as Hurricane Katrina. The GuLF STUDY plans to enroll and follow a cohort of 40,000 oil-spill clean-up workers and conduct home visits for clinical assessment and biological specimen collection in a subcohort of 15,000. Nearly 25,000 workers enrolled as of July 2012. Opportunities for exposure to oil during the disaster, unemployment and economic disadvantage, mental distress, and self-reported health symptoms are highly correlated making it especially challenging to distinguish health changes due to oil spill exposures from those due to other factors. The study is attempting to balance the need for scientific rigor with the need to be responsive to the concerns of community members and workers, many of whom have unaddressed health care needs that may be unrelated to exposures during the oil spill clean-up but are potentially exacerbated by the emotional and economic toll of the protracted spill.