1. National Institutes of Health U.S. Department of Health and Human Services Linking Earth Sciences and Health: Responding to and Preparing for Environmental Disasters Capt. Aubrey K. Miller, MD, MPH National Institute of Environmental Health Sciences USGS Congressional Briefing Series October 9, 2015

2. National Institutes of Health U.S. Department of Health and Human Services The National Institute of Environmental Health Sciences One of the 27 National Institutes of Health –Located in Research Triangle Park, North Carolina Wide variety of programs supporting our mission of environmental health: ‒ Intramural laboratories ‒ Clinical research program ‒ Extramural funding programs ‒ National Toxicology Program ‒ Disease Prevention ‒ Public Health Focus

3. National Institutes of Health U.S. Department of Health and Human Services NIEHS Strategic Plan

4. National Institutes of Health U.S. Department of Health and Human Services Each disaster presents new issues & uncertainties Research is vital for response, recovery, and future preparedness

5. National Institutes of Health U.S. Department of Health and Human Services Need for Public Health and Earth Sciences Research Is it safe?  For whom, what, when, and where?  Longer-term physical & mental health impacts?  Safety of homes, residences, work places Focal areas of research 1.Environmental Exposures 2.Health Risks and Effects 3.Value of Interventions 4.Ecosystem Effects

6. National Institutes of Health U.S. Department of Health and Human Services Health Impacts of World Trade Center (WTC) Attack Widespread contamination USGS identified complex, mixed exposures WTC Medical Monitoring program findings –Study of 27,500 Responders  Asthma 28 %  Sinusitis 42 %  Lung Tests 42 %  PTSD 9 %  Panic 8 %  Depression 28 % * Wisnivesky et al, 2011. Lancet. 378:9794:888-897

7. National Institutes of Health U.S. Department of Health and Human Services Gulf Oil Spill April 2010 11 workers killed, 17 injured, many others impacted Exposures of Concern:  Oil Components Poly-aromatic hydrocarbons (PAHs) Volatile organic chemicals (VOCs) Heavy metals  Dispersants  Burning Particulate Health Concerns:  Skin  Lungs  Eating contaminated seafood  Mental health

8. National Institutes of Health U.S. Department of Health and Human Services Gulf Oil Spill Research Questions Little known about long-term health effects of exposure to oil, dispersants or mixtures Limited health studies from past events NIEHS GuLF STUDY  33,000 clean-up workers  Largest study ever conducted on the health effects of oil spills  University & Community Research Consortia  USGS research & data to help understand exposures

9. National Institutes of Health U.S. Department of Health and Human Services West Virginia: Chemical Spill into Elk River January, 2014 Water use suspended for 300,000 people in nine counties >500 hospital visits: reported nausea, vomiting, rashes, lung & eye irritation Unknown health effects of released chemical Residents told to not drink, bathe, cook or wash with tap water due to uncertainty

10. National Institutes of Health U.S. Department of Health and Human Services USGS Powell Center: Researching Mineral Fibers and Health Fort Collins, Colorado Goal: To understand health risks of erionite and asbestos by combining geospatial and health information. Naturally occurring deposits of asbestos are a potential hazard to workers and communities. Powell Center Workgroup is addressing these issues USGS and NIEHS are co-chairs http://powellcenter.usgs.gov/ Group Members:  U.S. Geological Survey (USGS  Universities: Cincinnati, Hawaii, and Nevada- Las Vegas  Centers for Disease Control (CDC): Agency for Toxic Substances and Disease Registry (ATSDR), and National Institute for Occupational Safety and Health (NIOSH)  Department of Agriculture (USDA): National Soil Conservation Service  NIEHS and National Cancer Institute (NIH)

11. National Institutes of Health U.S. Department of Health and Human Services NIH Disaster Research Response (DR2) Program 1.Timely and integrated collection of health and geospatial data 2.Creating national network of transdisciplinary researchers 3.Broad inclusion of public health, academia, and community stakeholders  Partners include CDC, HHS/ASPR, USGS and others 4.Training researchers to use data collection questionnaires, protocols, and safety issues Improving Disaster Responses, Reducing Health Impacts, and Preventing future harm through:

12. National Institutes of Health U.S. Department of Health and Human Services Tools & Resources Training & Exercises Protocols & Surveys Networks Collaborations & Projects News & Events NIH Disaster Research Response Program http://dr2.nlm.nih.gov New

13. National Institutes of Health U.S. Department of Health and Human Services NIEHS & USGS Working To Improve Response, Training, & Education 2014 partnership to explore disaster research  Los Angeles area 140 stakeholders attended Discussed data sharing, collaboration and process Based on USGS Tsunami Scenario

14. National Institutes of Health U.S. Department of Health and Human Services THANK YOU! For more information, please visit: http://dr2.nlm.nih.gov CAPT Aubrey Miller, MD, MPH miller.aubrey@nih.gov