Risk of longer-term endocrine and metabolic conditions in the Deepwater Horizon Oil Spill Coast Guard cohort study – five years of follow-up

Abstract

Introduction

Long-term endocrine and metabolic health risks associated with oil spill cleanup exposures are largely unknown, despite the endocrine-disrupting potential of crude oil and oil dispersant constituents. We aimed to investigate risks of longer-term endocrine and metabolic conditions among U.S. Coast Guard (USCG) responders to the Deepwater Horizon (DWH) oil spill.

Methods

Our study population included all active duty DWH Oil Spill Coast Guard Cohort members (N = 45,224). Self-reported spill exposures were ascertained from post-deployment surveys. Incident endocrine and metabolic outcomes were defined using International Classification of Diseases (9th Revision) diagnostic codes from military health encounter records up to 5.5 years post-DWH. Using Cox proportional hazards regression, we estimated adjusted hazard ratios (aHR) and 95% confidence intervals (CIs) for various incident endocrine and metabolic diagnoses (2010–2015, and separately during 2010–2012 and 2013–2015).

Results

The mean baseline age was 30 years (~ 77% white, ~ 86% male). Compared to non-responders (n = 39,260), spill responders (n = 5,964) had elevated risks for simple and unspecified goiter (aHR = 2.09, 95% CI: 1.29–3.38) and disorders of lipid metabolism (aHR = 1.09, 95% CI: 1.00–1.18), including its subcategory other and unspecified hyperlipidemia (aHR = 1.10, 95% CI: 1.01–1.21). The dysmetabolic syndrome X risk was elevated only during 2010–2012 (aHR = 2.07, 95% CI: 1.22–3.51). Responders reporting ever (n = 1,068) vs. never (n = 2,424) crude oil inhalation exposure had elevated risks for disorders of lipid metabolism (aHR = 1.24, 95% CI: 1.00–1.53), including its subcategory pure hypercholesterolemia (aHR = 1.71, 95% CI: 1.08–2.72), the overweight, obesity and other hyperalimentation subcategory of unspecified obesity (aHR = 1.52, 95% CI: 1.09–2.13), and abnormal weight gain (aHR = 2.60, 95% CI: 1.04–6.55). Risk estimates for endocrine/metabolic conditions were generally stronger among responders reporting exposure to both crude oil and dispersants (vs. neither) than among responders reporting only oil exposure (vs. neither).

Conclusion

In this large cohort of active duty USCG responders to the DWH disaster, oil spill cleanup exposures were associated with elevated risks for longer-term endocrine and metabolic conditions.