Acute and longer-term cardiovascular conditions in the Deepwater Horizon Oil Spill Coast Guard Cohort

Introduction: In 2010, the U.S. Coast Guard (USCG) led a clean-up response to the Deepwater Horizon (DWH) oil spill. Human studies evaluating acute and longer-term cardiovascular conditions associated with oil spill-related exposures are sparse. Thus, we aimed to investigate prevalent and incident cardiovascular symptoms/conditions in the DHW Oil Spill Coast Guard Cohort. Methods: Self-reported oil spill exposures and cardiovascular symptoms were ascertained from post-deployment surveys (n = 4,885). For all active-duty cohort members (n = 45,193), prospective cardiovascular outcomes were classified via International Classification of Diseases, 9th Edition from military health encounter records up to 5.5 years post-DWH. We used log-binomial regression to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) in the cross-sectional analyses and Cox Proportional Hazards regression to calculate adjusted hazard ratios (aHR) and 95% CIs for incident cardiovascular diagnoses during 2010–2015 and stratifying by earlier (2010–2012) and later (2013–2015) time periods. Results: Prevalence of chest pain was associated with increasing levels of crude oil exposure via inhalation (aPR_{high vs. none} = 2.00, 95% CI = 1.16–3.42, p-trend = 0.03) and direct skin contact (aPR_{high vs. none} = 2.72, 95% CI = 1.30–5.16, p-trend = 0.03). Similar associations were observed for sudden heartbeat changes and for being in the vicinity of burning oil exposure. In prospective analyses, responders (vs. non-responders) had an elevated risk for mitral valve disorders during 2013–2015 (aHR = 2.12, 95% CI = 1.15–3.90). Responders reporting ever (vs. never) crude oil inhalation exposure were at increased risk for essential hypertension, particularly benign essential hypertension during 2010–2012 (aHR = 2.00, 95% CI = 1.08–3.69). Responders with crude oil inhalation exposure also had an elevated risk for palpitations during 2013–2015 (aHR = 2.54, 95% CI = 1.36–4.74). Cardiovascular symptoms/conditions aPR and aHR estimates were generally stronger among responders reporting exposure to both crude oil and oil dispersants than among those reporting neither. Conclusions: In this large study of the DWH oil spill USCG responders, self-reported spill clean-up exposures were associated with acute and longer-term cardiovascular symptoms/conditions.