April 20, 2010, will be a day those who live and work along the Gulf Coast will never forget. A Deepwater Horizon oil tanker exploded in the Gulf of Mexico, and an estimated 4.9 million barrels of oil escaped from a gushing wellhead before it was stopped three months later.

The Institute of Medicine’s Expert Committee reviewing the federal response to the potential health effects associated with the Gulf oil spill has recommended five areas for research to address crucial gaps in knowledge surrounding this and similar disasters.

Nalini Sathiakumar, M.D., Dr. P.H., an associate professor in UAB’s Department of Epidemiology and a pediatric nephro-logist, is one of 12 members of the Institute of Medicine’s Expert Committee reviewing the federal response to the potential health effects associated with the Gulf oil spill. The committee evaluated areas for research to address crucial gaps in knowledge surrounding this and similar disasters and narrowed the list to five priorities:

• Behavioral health
• Exposure assessment
• Seafood safety
• Communication
• Rapid research-response framework

Sathiakumar says behavioral health research should be designed to generate evidence on the psychological and behavior-al effects of the spill that would guide efforts to improve the health status of individuals and contribute to the prevention and treatment of similar health outcomes in future disasters.

“The research should identify factors associated with either vulnerability or resilience to situations like oil spills and other disasters,” she says.

The exposure assessment should obtain information that is as comprehensive as possible on exposure to the oil, dispersants and by-products.

Seafood-safety research should assess near and long term effects and clearly communicate results to affected communities.

Communication research should evaluate and compare communication and engagement methods to determine those most effective for disaster and disaster-preparedness research.

The rapid research-response framework should explore the development of protocols and procedures needed to deploy a rapid research response for future oil spills and other potential disasters.

The National Institute of Environmental Health Sciences Gulf Workers Study, now under way, will enroll 55,000 oil-spill workers and volunteers. “The study, now in the preliminary phase, will investigate potential short and long-term health effects associated with oil-spill-cleanup activities,” Sathiakumar says. “In addition to physical effects, psychological effects also will be evaluated. Bio-monitoring will be conducted for a subgroup of study subjects.

“Several other studies are ongoing or in development,” Sathiakumar says. “Hopefully we will be able to glean some useful information from all of them to help us now and in the future.”

Knowledge from prior spills
Much of the knowledge on human health effects of exposure to spilled oil comes from epidemiologic studies of supertanker oil spills. Only seven of the 38 supertanker spills since the 1980s have been studied, one of them by Sathiakumar and investigators from Aga Khan University in Pakistan; it pertained to a Greek supertanker that ran aground in Karachi in 2003. The available studies provide consistent evidence of short-term toxic symptoms involving ocular, respiratory and neurological systems and of psychological symptoms among exposed community members and among cleanup/volunteer workers.

“The short-term health effects of oil spills are primarily acute toxic symptoms and impairment of psychological health,” Sathiakumar says. “Psychological symp-toms have been found to persist for longer time periods. There is no question that considerable uncertainty remains with regard to the potential for long-term, systemic health effects.”