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Estuary-associated syndrome in North Carolina: an occupational prevalence study.

Publication ,  Journal Article
Swinker, M; Koltai, D; Wilkins, J; Hudnell, K; Hall, C; Darcey, D; Robertson, K; Schmechel, D; Stopford, W; Music, S
Published in: Environ Health Perspect
January 2001

Atlantic coast estuaries recently have experienced fish kills and fish with lesions attributed to Pfiesteria piscicida and related dinoflagellates. Human health effects have been reported from laboratory exposure and from a 1997 Maryland fish kill. North Carolina has recorded Pfiesteria-related fish kill events over the past decade, but human health effects from environmental exposure have not been systematically investigated or documented here. At the request of the state health agency, comprehensive examinations were conducted in a cross-sectional prevalence study of watermen working where Pfiesteria exposure may occur: waters where diseased or stressed fish were reported from June to September 1997, and where Pfiesteria had been identified in the past. Controls worked on unaffected waterways. The study was conducted 3 months after the last documented Pfiesteria-related fish kill. The goal was to document any persistent health effects from recent or remote contact with fish kills, fish with lesions, or affected waterways, using the 1997 U.S. Centers for Disease Control and Prevention case description for estuary-associated syndrome (EAS). Examinations included comprehensive medical, occupational, and environmental history, general medical, dermatologic, and neurologic examinations, vision testing, and neuropsychologic evaluations. Seventeen of 22 watermen working in affected waters and 11 of 21 in unaffected waters reported exposure to a fish kill or to fish with lesions. We found no pattern of abnormalities on medical, neurologic, neuropsychologic, or NES-2 evaluation. By history, one subject in each group met the EAS criteria, neither of whom had significant neuropsychological impairment when examined. Watermen from affected waterways had a significant reduction in visual contrast sensitivity (VCS) at the midspatial frequencies, but we did not identify a specific factor or exposure associated with this reduction. The cohorts did not differ in reported occupational exposure to solvents (qualitative) or to other neurotoxicants; however, exposure history was not sufficiently detailed to measure or control for solvent exposure. This small prevalence study in watermen, conducted 3 months after the last documented fish kill related to Pfiesteria, did not identify an increased risk of estuary-associated syndrome in those working on affected waterways. A significant difference between the estuary and ocean watermen was found on VCS, which could not be attributed to any specific factor or exposure. VCS may be affected by chemicals, drugs, alcohol, and several developmental and degenerative conditions; it has not been validated as being affected by known exposure to dinoflagellate secretions. VCS should be considered for inclusion in further studies, together with documentation or quantification of its potential confounders, to assess whether it has utility in relationship to dinoflagellate exposure.

Duke Scholars

Published In

Environ Health Perspect

DOI

ISSN

0091-6765

Publication Date

January 2001

Volume

109

Issue

1

Start / End Page

21 / 26

Location

United States

Related Subject Headings

  • Vision Disorders
  • Toxicology
  • Syndrome
  • Risk Factors
  • Prevalence
  • Pfiesteria piscicida
  • Occupational Exposure
  • Occupational Diseases
  • North Carolina
  • Mortality
 

Citation

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Swinker, M., Koltai, D., Wilkins, J., Hudnell, K., Hall, C., Darcey, D., … Music, S. (2001). Estuary-associated syndrome in North Carolina: an occupational prevalence study. Environ Health Perspect, 109(1), 21–26. https://doi.org/10.1289/ehp.0110921
Swinker, M., D. Koltai, J. Wilkins, K. Hudnell, C. Hall, D. Darcey, K. Robertson, D. Schmechel, W. Stopford, and S. Music. “Estuary-associated syndrome in North Carolina: an occupational prevalence study.Environ Health Perspect 109, no. 1 (January 2001): 21–26. https://doi.org/10.1289/ehp.0110921.
Swinker M, Koltai D, Wilkins J, Hudnell K, Hall C, Darcey D, et al. Estuary-associated syndrome in North Carolina: an occupational prevalence study. Environ Health Perspect. 2001 Jan;109(1):21–6.
Swinker, M., et al. “Estuary-associated syndrome in North Carolina: an occupational prevalence study.Environ Health Perspect, vol. 109, no. 1, Jan. 2001, pp. 21–26. Pubmed, doi:10.1289/ehp.0110921.
Swinker M, Koltai D, Wilkins J, Hudnell K, Hall C, Darcey D, Robertson K, Schmechel D, Stopford W, Music S. Estuary-associated syndrome in North Carolina: an occupational prevalence study. Environ Health Perspect. 2001 Jan;109(1):21–26.

Published In

Environ Health Perspect

DOI

ISSN

0091-6765

Publication Date

January 2001

Volume

109

Issue

1

Start / End Page

21 / 26

Location

United States

Related Subject Headings

  • Vision Disorders
  • Toxicology
  • Syndrome
  • Risk Factors
  • Prevalence
  • Pfiesteria piscicida
  • Occupational Exposure
  • Occupational Diseases
  • North Carolina
  • Mortality