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Burden of Disease Attributable to the Hebei Spirit Oil Spill in Taean, Korea

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Burden of Disease Attributable to the Hebei Spirit Oil Spill in Taean, Korea Downloaded from http://bmjopen.bmj.com/ on November 13, 2015 - Published by group.bmj.com Open Access Research Burden of disease attributable to the Hebei Spirit oil spill in Taean, Korea Young-Min Kim,1 Jae-Hyun Park,2 Kyusik Choi,2 Su Ryeon Noh,3 Young-Hyun Choi,3 Hae-Kwan Cheong2 To cite: Kim Y-M, Park J-H, ABSTRACT et al ARTICLE SUMMARY Choi K, . Burden of Objectives: We aimed to assess the burden of disease attributable to the disease (BOD) of the residents living in contaminated Hebei Spirit oil spill in Taean, Strength and limitations of this study coastal area with oil spill and also analysed the BOD Korea. BMJ Open 2013;3: ▪ This is the first study to quantify the burden of e003334. doi:10.1136/ attributable to the oil spill by disease, age, sex and disease (BOD) of a single environmental bmjopen-2013-003334 subregion. disaster. Design: Health impact assessment by measuring ▪ This study demonstrates that BOD is an objective years lived with disability (YLD) due to an oil spill. ▸ Prepublication history and and comprehensive metric for estimating and additional material for this Setting: A whole population of a community affected comparing the health effects of environmental paper is available online. To by an anthropogenic environmental disaster and hazards and disasters across different regions view these files please visit secondary health outcome data. and time periods. the journal online Participants: Based on the health outcome survey ▪ To estimate excess incidence, we used preva- (http://dx.doi.org/10.1136/ including 10 171 individuals (male 4354; female lence data classified by distance from the con- bmjopen-2013-003334). 5817), BOD of 66 473 populations (male 33 441; taminated coast, under the assumption that the female 33 032) was measured. farthest region, area 4, has not been affected by Received 6 June 2013 the oil spill and that the prevalence of diseases Revised 8 August 2013 Interventions: None. Observational study on the Accepted 9 August 2013 effect of a specific environmental health hazard. had been same across the whole study area Primary and secondary outcome measures: before the accident because prevalence data Using disability adjusted life year (DALY) method, BOD recorded prior to the oil spill were not including physical and mental diseases was measured. available. For the BOD measurement, excess incidences of ▪ We did not consider long-term health outcomes illnesses related to oil spill were estimated from the such as cancers and chronic degenerative dis- comparison of prevalence of the health outcomes eases mainly because of lack of data. between contaminated areas and reference area without contamination. Results: YLD attributable to the oil spill were from the coast of Taean, Korea. This was the estimated to be 14 724 DALYs (male 7425 DALYs; largest oil spill in the history of Korea. Spilled oil female 7299 DALYs) for the year 2008. The YLD of contaminated over 1000 km of the western coast mental diseases including post-traumatic stress of Korea including the Taean Coast National disorder (PTSD) and depression for men were higher 1 than that for women. The YLD for women was higher Park. Crude oil contains various volatile in asthma and allergies (rhinitis, dermatitis, organic compounds (VOCs), such as benzene, conjunctivitis) than that for men. The effects of asthma toluene, ethylbenzene, xylenes and polycyclic 2 and allergies were the greatest for people in their 40s, aromatic hydrocarbons (PAHs), all of which with the burden of mental illness being the greatest for are potential air-borne toxins. Certain VOCs, 1 Department of those in their 20s. Proximity to the spill site was benzene in particular, are carcinogenic to Environmental Health, Rollins associated with increased BOD. School of Public Health, humans and are associated with haematological 3 4–11 Emory University, Atlanta, Conclusions: An oil spill near a coastline can cause cancer. Previous studies have reported that Georgia, USA substantial adverse health effects. As the health effects oil spills have caused adverse health effects for 2Department of Social and of hazardous pollutants from oil spills are long-lasting, residents of contaminated areas and clean-up Preventive Medicine, close follow-up studies are required to identify chronic workers. Risk analyses revealed that more fre- Sungkyunkwan University health effects. School of Medicine, Suwon, quent clean-ups and greater exposure to oil are Gyeonggi, Republic of Korea strongly associated with higher frequencies of 8–11 6 3Taean Environmental Health psychological symptoms. Rodríguez-Trigo Center, Taean, Chungnam, reported that participation in a major oil spill Republic of Korea INTRODUCTION clean-up is associated with chromosomal Correspondence to On 7 December 2007, the Hebei Spirit oil damage, although they were unable to deter- Professor Hae-Kwan Cheong; tanker spilled 12 547 kL (10 900 tons) of crude mine whether oil exposure itself caused the [email protected] oil into the Yellow Sea, approximately 8 km away abnormalities. Kim Y-M, Park J-H, Choi K, et al. BMJ Open 2013;3:e003334. doi:10.1136/bmjopen-2013-003334 1 Downloaded from http://bmjopen.bmj.com/ on November 13, 2015 - Published by group.bmj.com Open Access After the Hebei Spirit oil spill, more than 2 000 000 and physical and laboratory examinations of respiratory, people (person-days), including over 1 200 000 person- cardiovascular, neurological and psychological systems. days by volunteers, participated in clean-up activities The TEHC published its first report in 2010 after ana- during the first 7 months.1 Among them were residents lysing the prolonged health effects for 1.5 years and of Taean, a highly exposed group that experienced demonstrated significant relationships between exposure adverse health effects, including physical and psycho- concentrations and adverse health outcomes.15 To esti- logical symptoms.412Although many studies have mate the BOD caused by the Hebei Spirit oil spill, we reported positive relationships between oil spills and obtained the survey data from the TEHC, which acute and chronic health impacts, there have been no included disease, residence and demographic informa- studies quantifying the burden of disease (BOD) due to tion. Residents in Taean County and some islands in oil spills, which are necessary to assess the scale of neighbouring Boryeong County were included in the health damage at the population level as well as the asso- survey. The Boryeong islands were expected to be ciated compensation costs. affected by the oil spill because the islands are located Therefore, we sought to quantify the adverse health in the affected area based on the wind direction and impacts of exposure to oil spills by applying the tidal current at the time of the spill.16 Kim et al16 disability-adjusted life year (DALY) measure developed by reported that the VOCs moved in a southeasterly direc- the WHO. The DALY measures health gaps as opposed to tion, following the coastline from the accident point. health expectancies. It measures the difference between a We classified the residents of Taean County and the current situation and an ideal situation where everyone Boryeong islands into five based on distance from the lives up to the age of the standard life expectancy and in contaminated coastline and contamination level. Area 1 perfect health. The DALY is based on the premise that the is less than 1.1 km away from the coastline adjacent to best approach for measuring the BOD is to use units of the accident location where the coastline was contami- time.13 The DALY method has been used to measure the nated at a high level. Area 2 is 1.1–4.2 km away with no BOD attributable to specific risk factors including environ- coastline, but was directly affected by atmospheric VOCs mental burdens of disease (EBD).14 This approach can be and PAHs due to the wind direction. Area 3 is 4.2– practical in that the estimated adverse health burden 23 km away from the coastline with a moderately con- attributable to a risk factor can be compared with other taminated coastline and area 4 is more than 23 km from BODs and the analyses of disease burdens by disease and the contaminated coastline. We classified the Boryeong region can inform policy prioritisation to mitigate adverse islands as a separate area. Figure 1 shows the locations health effects for specific exposed populations. of the five study areas and five classified regions. The purposes of this study are to assess the BOD of We assessed health outcome data regarding asthma, the residents of the contaminated Taean coastal area allergy (rhinitis, dermatitis, conjunctivitis) and mental due to the Hebei Spirit oil spill and to analyse the BOD disorders (post-traumatic stress disorder (PTSD) and by disease, age, sex and subregion. depression) that were well documented by the TEHC.15 We focused on subchronic (duration of a few months) METHODS and chronic (over 1 year duration) adverse health Study area and design effects of the Hebei Spirit oil spill, assessing prolonged In September 2008, the Taean Environmental Health health effects during a period of 1.5 years to estimate Center (TEHC) was established with the support of the the BOD of the Hebei Spirit oil spill for the year 2008. Korean Ministry of Environment to monitor the effects of the Hebei Spirit oil spill on the health of the resi- Estimation of BOD attributable to oil spill dents of the Taean coastal area. The TEHC first con- To estimate the BOD attributable to the oil spill, we ducted health surveys on the residents, including the applied the DALY method. DALY is the sum of the life referent population, 1.5 years after the spill, establishing years lost due to disability and premature death.13 As a cohort.
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