Fine particulate matter from burning oil and gas and associated neurological symptoms among Deepwater Horizon oil spill cleanup workers

Burning and flaring of oil and gas following the 2010 Deepwater Horizon (DWH) oil spill generated high airborne concentrations of fine particulate matter (PM2.5). Neurological effects of PM2.5 have been previously reported, but this relationship has received limited attention in the context of oil spills. We evaluated associations between burning-related PM2.5 and prevalence of self-reported neurological symptoms during, and 1-3 years after, the DWH disaster cleanup. For 9914 DWH disaster responders in the Gulf Long-term Follow-up Study who worked on the water, we examined aggregate outcomes (central nervous system [CNS; dizziness, sweating, palpitations, nausea, or migraine/severe headache] and peripheral nervous system [PNS; tingling/numbness in extremities, blurred vision, or stumbling] symptoms) and individual symptoms (CNS and PNS symptoms, plus insomnia, vomiting, seizures, and fatigue). We estimated PM2.5 concentrations via Gaussian plume dispersion models and linked these to detailed DWH cleanup work histories. We used log-binomial regression to estimate adjusted prevalence ratios (PR) and 95% confidence intervals, accounting for age, race, ethnicity, and sex, and DWH disaster-related co-exposures to benzene, toluene, ethylbenzene, xylene, and n-hexane (BTEX-H). We examined effect measure modification by age, race, smoking, and BTEX-H exposure. During the disaster, 34% of participants experienced at least one symptom (23% CNS, 12% PNS); 1-3 years later, 30% did (19% CNS, 17% PNS). Evidence of associations with PM2.5 was most consistent for CNS symptoms (PR range: 1.17 to 1.51), although we did not observe exposure-response trends. For PNS, PR ranged from 0.96 to 1.84. Associations with PM were more apparent among those with lower BTEX-H exposure and among older workers. We found some evidence of an association between burning-related PM2.5 and prevalence of neurologic symptoms during the DWH disaster response and 1-3 years later. Understanding these relationships can inform responses to future disasters to better protect human health.