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  • 1.                             A Literature Review on Health Effects of Exposure to Oil Spill Mina Ha, Won Jin Lee1), Seungmin Lee2), Hae-Kwan Cheong3) Department of Preventive Medicine, Dankook University College of Medicine, Department of Preventive Medicine, College of Medicine, Korea University1), Citizen Institute of Environmental Studies, Korean Federation for Environmental Movement2), s Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine3) Objectives : Our objective is to review and summarize focused on the subjective physical symptoms related to the previous studies on the health effects of exposure to oil clean-up work or residential exposure. Late or mid-term spills in order to make suggestions for mid- and long-term follow-up studies were performed to investigate a range of study plans regarding the health effects of the Hebei Spirit health effects such as pulmonary function and endocrine, oil spill occured in Korea. immunologic and genetic toxicity. The economic and social Methods : We searched PubMed to systemically retrieve impact of the accidents resulted in the socio-psychological reports on the human health effects related to oil spill exposure and the psychosocial health effects. accidents. The papersreference lists and reviews on the Conclusions : Studies of the health effects of exposure topic were searched as well. to oil spills should consider a range of health outcomes, Results : We found 24 articles that examined seven oil including the physical and psychological effects, and the spill accidents worldwide over the period from 1989 to studies should be extended for a considerable period of August 2008, including the Exxon Valdes, Braer, Sea time to study the long-term chronic health effects. Empress, Erika, Nakhodka, Prestige and Tasman Spirit oil spills. Most of the studies applied cross-sectional and J Prev Med Public Health 2008;41(5):345-354 short-term follow-up study designs. The exposure level was measured by assessing the place of residence, using a Key words : A c c i d e n t s , T r a n s p o r t a t i o n , P e t r o l e u m , questionnaire and environmental and personal monitoring. Health, Review Studies on the acute or immediate health effects mainly        2008 7 4      (1995)      2,122,296, 2007 12 7  7      ( 5,000 )   556,343,  1,226,730,  10 km       ,     152,695,  32,356,  (1, 10,800)      .   17,394,  6,663,           53,431,  76,684             1,052 km  [1].               ,  ,  (12 8),    (Hebei Spirit, 146,858)    3,000 ha      (12 9)   .         (Figure 1).     ,      3  12,547  ( 10,900 t)  2  6  2006             [1].  64,082   [2].   .     2~3                                         
  • 2. 346     [3].   ,                           .        PubMed       .   oil spill spillage ,oil ,tanker, accident,petroleum ,health effect, exposure,       . ,    ,        .   1989 2008   Figure 1. Map of daily spilled oil distribution from December 7th, 2007 to January 6th, 2008 from the ,  1,  24,  1 Hebei Spirit oil spill accident in the Korean West Sea. Adapted by data from Taean Coast Guard, Korea. ,  7     .                ,     84% 7 t        .       , 1970  2007 700 t       452, 7 t  700 t    1,292  1,744  ,       5,648,000 t      [4].  Figure 2 ,        Figure 2. Number of oil spills and quantity of oil released. A. Oil spills with 7 or more tones from 1970 to 2007, worldwide. Statistics from the International Tanker Owners Pollution Federation Limited      (http://www.itopf.com/information-services/data-and-statistics/statistics/#no), B. Oil spills from 1993 to  (Figure 2-A),   93 2006 in Korea. Statistics from Korea Coast Guard, 2007 and the Ministry of Maritaime Affairs and Fishery 1997 (B).      [5,6],        .            (Figure 2-B).           ,                        ,                      ,   
  • 3.     347     ,  Table 1. Summary of oil spill accidents upon which health effect studies were performed      Accidents Date Country Spilled oil and type Contaminated area (km of shoreline)       Exxon Valdez Mar 24, 1989 US (Alaska) 37,000 ton/crude oil 4,800 km of coastline of land, headlands       and bays Braer Jan 5, 1993 UK (Shetland) 85,000 ton/crude oil       Sea Empress Feb 15, 1996 UK (Wales) 72,000 ton crude oil + 360 ton 200 km of coastline heavy fuel oil   6 t    Nakhodka Jan 2, 1997 Japan 6,000 ton/Buncker C oil    7   (number 6 heavy fuel oil) Erika Dec 12, 1999 France 10,000 ton/ Buncker C oil 400-500 km of coastline of mainland  (Table 1). (number 6 heavy fuel oil) small islands Prestige Nov 11, 2002 Spain 67,000 ton/Buncker C oil 900 km of coast line, from northern       Portugal to southern France      Tasman Spirit July 27, 2003 Pakistan 35,000 tone/ crude oil (Iranian 10 km of residential coastline (Karachi) light crud oil)    ,                  (Shetland)   ,          .            ,   5    .  (2002)         .  Campbell  [12] 1      . 1993      13-21 ( 8 )                             2        .  ,       [10].     4.5 km     (Table 2).  , ,        681          412 .   1989 4 24     , ,     95 km (Hillswick)      (Exxon            Valez)        .  200    92          (2004)      .      .  4,000 t (crude oil)       , , , ,      ,      4,800 km         .    ,   11,000  .                 [7].   (social disruption)         (NIOSH)     1              1,811  ,    . 1   Campbell      ,   ,       [13]   5 (44%),  (15%),    ,          (2%)     [8].     [11].  80%(344),  84%(77)     3         .      . 1990 3 30             5 15 ( 1 )  ,       (weakness)                 .      (community based random    .       sample) 599 ,   84%                188            371   [9].        1     . Foster  [14]   6                  ,     .       . ,            ,        1993 1 5   ,   .    6     85,000 t 
  • 4. 348   Table 2. Summary of health effect studies in relation to oil spill accidents Studies Beginning of Accidents (Authors, Design survey (after the Date of survey Number of subjects Exposure measurement Outcomes Results year) accident) Exxon Palinkas et al, Cross sectional +1 year Mar 30~May 15, 1990 Exposed (Native 188, 6 questions (low/high) Family support/social + valdez 1992 [9] Euro-American 371) relations, depression Palinkas et al, Cross sectional +1 year Mar 30~May 15, 1990 Exposed 312, Area (exp/unexp) Anxiety, PTSD, depression + 1993 [10]) Unexposed 281 6 questions (low/high) PTSD Palinkas et al, Cross sectional +1 year Mar 30~May 15, 1990 Exposed (Native 188, 6 questions (low/high) + 2004 [11] Euro-American 371) Braer Campbell et Cross sectional +8 days Jan 13~Jan 21, 1993 Exposed 412, Area (exp/unexp) Symptoms, P/exam, PFT, + (symptom) al, 1993 [12] Unexposed 92 lab test Campbell et Follow up after +5 months June 1993 Exposed 344, Area (exp/unexp) Symptoms + (weakness) al, 1994 [13] 6 months Unexposed 77 Foster et al. Descriptive +8 day Jan 13, 1993 59 non-responders for - Reasons for non- Attitudinal reasons 1995 [14] study +5 months June 1993 1st survey and 16 for respondants 2nd survey Crum 1993 Follow up after +9 days Jan 14, 1993 44 for 1st exam and Area (all exposed) PFT - [15] 1-2 weeks 56 for 2nd exam. Cole et al, Cross sectional +10 days, <exposed> Exposed 73, Area DNA adduct 32P- - 1997 [16] +about 3months, Jan 15~Jan 18, 1993 Unexposed 21 (exp/unexp) postlabelling, HPRT +about 11months Mar 23~Mar 31, 1993 Biological monitering mutant Nov 30~Dec 16, 1993 <nonexposed> Jan 1993, Mar 1993, Jan 1994 Sea Lyons et al, Cross sectional +7 weeks <exposed> Exposed 1000, Area (exp/unexp) Acute symptoms, anxiety, + empress 1999 [17] Apr 4~May 4, 1996 Unexposed 1000 depression scale, SF36 <nonexposed> May 21~June 18, 1996 Anxiety, depression Gallacher et Cross sectional +7 weeks <exposed> Exposed 794, Psychological exposure, (Hospital Anxiety and Physical exposure al, 2007 [18] Apr 4~May 4, 1996 Unexposed 791 Area (4 exposed town Depression Scal, HAD), (toxic symptoms), <nonexposed> and 2 unexposed town) SF36 psychological May 21~June 18, 1996 exposure(anxiety, nontoxic symptoms) Nakhodka Morita et al, Cross sectional +18 days Jan 10~1997 (air) Exposed 282 Area (exp/unexp) Symptoms, lab test. + 1999 [19] Jan 20~Jan 31, 1997 Environmental, personal, (interview) biological monitoring Erika Baars, 2002 Review (Risk +2 weeks Dec 1999, last week, - - Risk assessment + (people cleaning [21] assessment) +2 months Feb 2000, Mid-term birds) +6 months June 2000 Dor et al, Review (Risk +4 months Apr 14~Apr 30, 2000 - - Risk assessment for bathers -(no scientific 2003 [22] assessment) in beachs decontaminated health risk) Prestige Suarez et al, Cross sectional +7 months June 2003 Exposed 799 Job (clean up activity) Injury, toxic symptoms + 2005 [23] Carrasco et al, Cross sectional +7 months June 2003 Exposed 799 Job Injury, toxic symptoms + (non-informed 2006 [24] person) Carrasco et al, Cross sectional +1 year Mar 22~Mar 23, 2004 Exposed 1350 Area (7 exposed and 7 HRQoL (mental health, - 2007 [25] and 4 months Unexposed 1350 unexposed) anxiety, depression) Zock et al, Cross sectional +6 weeks, Jan 31, 2002 Exposed 9050 Area (exp/unexp) Respiratory symptoms + 2007 [26] +7 weeks, Jan 1~Feb 28, 2003 About 3 months Mar 1, 2003 Laffon et al, Cross sectional +about 7 June 2004, Male exposed, 34, Job Comet and MN assay + 2006 [27] months, about Oct 2004 Male unexposed 35 11 months Perez-Cadahia Cross sectional +about 4 months, Mar 2003 Exposed, 68, Job SCE, hormones (prolactin + et al, 2007[28] +about 6 months May 2003 Unexposed 42 and cortisol) Perez-Cadahia Cross sectional +4 month Mar 24~May 12, 2003 Exposed 179 Job, Biological SCE, Comet, hormones + et al, 2008[29] monitoring (prolactin cortisol) Perez-Cadahia Cross sectional +about 4 Mar 2003 Exposed, 159, Job MN, genotype (DNA repair + et al, 2008[30] months, +about May 2003 Unexposed, 60 gene) 6 months Tasman Janjua et al, Cross sectional +3 weeks Sep 2003 Exposed 216, Area (exp/unexp) Symptoms + spirit 2006 [31] Unexposed (83, 101) Meo et al, Cross sectional +3days Aug 2003 Exposed 20, Job PFT + 2008 [32] and one year Aug 2004 Unexposed 31 follow up Khurshid et al, Cross sectional +1 month Aug 2003 Near-by residents and Organic compounds CBC and diff count, LFT, + (slightly elevated 2008 [33] beach workers 100 assay in air, water, sand BUN/creatinine number of in the spilled beach lymphocyte and eosinophil)
  • 5.     349     ,   .    4  ,                  ,   ,   (situational or organizational)    2   .        (attitudinal)     ,     .     .  Crum [15]              3  5 km      , , , ,        5-12   44(     ,     .   79%)     ,          3   , 9-12  56    [17].        , 4    .    (physical exposure)      .        (psychological exposure)                 794,  791                 [18].       .    .               , (perceived risk),   1999 12 12                (Brittanny) , (Penmarch)         (belief of individuals that they have             been exposed to an incident or its conse-   10,000 t (6       . quences) .    )       Cole  [16]  73  , ,    (toxic .      21   .  symptom)    ,   3,669     DNA-adduct HPRT ,  (nontoxic symptoms)        ,  1993     ,  . 1,465(43%)    1, 3, 11-12 3            53% , 7.5% .       .     .                , ,      .           .          .                       ,                            .     [20].   ,         2000 12          1997 1      .       2                6,000 t  6  ()               .   .          [7].   Morita  [19]     6  (       .   ,  ,   ,    1996 2 15             ,  (Wales)    72,000 t ( 8 )   (     ,    360t   200 km  28 ) .     )     .      (Anto)  1,041     [21].    7    ,  282            , ,  ,   97         ,      ( 18-28 )            1,000     .     .    
  • 6. 350            .                           .             [29].       ,      .   159  60                 ,                (CYP1A1 3 -UTR, EPHX1 codons 113 and , 16          139, GSTP1, GSTM1 and GSTT1)  DNA       .   1   2004  (RCC3 codon 241 and XPD   ,    3-4 7  7  codon 751)  ,    16  PAH      1,350 ,      ,  5      [25].    ,      [22]. 2  , ,          4            [30]. (fuel ball)  ,   .             ,                  .      ,     Zock  [26]                   9,050  ,    .    .  14-27         .     2002 11 16   ,         2003 (Galicia)  30           7 27   (light crude          . oil)       11 19  77,000 t        (Karachi)   2003 8   .     . Laffon [27]  29 4     ,           35,000t   .  (Austrias), (Cantabria),              (Basque)      . 34      10 km   .           35 .                      .     8 .  (comet assay),  (Micronuclei assay),           , DNA  (DNA repair gene)      216   ,       .      2 km  20  .      km     83 101  7  2003 6  DNA  , DNA        Suarez  [23] ,    XRCC1 399Glu  APE   [31].     4 (  ,  1 48Glu      , ,    ,  , )  799           .          . Perez-Cadahia  [28]   115  .     2003 3-5(  4-6) 68          20    42   ,     20    ,   , ,       [32].      . Carrasco  (sister chromatid   80   , ,  [24]  Suarez    exchange) (cortisol)   ,            .     179  31     (informed person)          . 2003 8   
  • 7.     351                     1       .                  ,   .       .                         .  .               [33].  lymphocyte, eosi-         nophil,   glutamic pyruvic             transaminase                        .     (, ,  )      .                   1-2 6 ,                1       ,   3        .        .   , ,                .            .                    .                  .             .               ,                          .              .   , , ,      .          .                 .                ,          .  , ,     .                    ,    ,     ,      ,                         .         ,   .                             ,                     .              .             .              ,      , ,         ,                      ,         .    .    .                         ,                            .                    .                        .   
  • 8. 352   Figure 3. Theoretical pathway of exposure and health effects of oil spill along the coastline.              .                  .   (, )               (  ,   IARC  Group 1, 2A, 2B    ,     ,  )                .        ,    (VOCs)       .   DNA ,           . adduct, HPRT (mutant)   ,       (polycyclic aromatic        ,  , hydrocarbons, PAHs)     ,    ,      .  ,  ,                        .                    .                   ,        .       ,                          ,      (Figure 3).     .              .         ,                  ,         .      ,                 ,       .            ,  ,    ,      . ,                              . (delayed health effect)    ( I)   
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