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. 2001 Oct;109(Suppl 5):781–786. doi: 10.1289/ehp.01109s5781

Cohort studies of health effects among people exposed to estuarine waters: North Carolina, Virginia, and Maryland.

C L Moe 1, E Turf 1, D Oldach 1, P Bell 1, S Hutton 1, D Savitz 1, D Koltai 1, M Turf 1, L Ingsrisawang 1, R Hart 1, J D Ball 1, M Stutts 1, R McCarter 1, L Wilson 1, D Haselow 1, L Grattan 1, J G Morris 1, D J Weber 1
PMCID: PMC1240611  PMID: 11677189

Abstract

A variety of human symptoms have been associated with exposure to the dinoflagellate Pfiesteria and have been grouped together into a syndrome termed "possible estuary-associated syndrome." Prospective cohort studies of health effects associated with exposure to estuarine waters that may contain Pfiesteria spp. and related organisms are in progress in North Carolina, Virginia, and Maryland. The three studies recruited cohorts of 118-238 subjects who work or engaged in recreation in estuary waters. Baseline health and neuropsychological evaluations are conducted, and study subjects are followed prospectively for 2-5 years with periodic assessments of health and performance on a battery of neuropsychological tests. Health symptoms and estuary water exposure are recorded by telephone interviews or diaries every 1-2 weeks. Water quality information, including measurements of Pfiesteria spp., is collected in the areas where the subjects are working. Because it is not possible to measure individual exposure to Pfiesteria or a toxin produced by this organism, these studies examine surrogate exposure measures (e.g., time spent in estuary waters, in a fish kill area, or in waters where Pfiesteria DNA was detected by molecular amplification). Preliminary analyses of the first 2 years (1998-2000) of data indicate that none of the three ongoing cohorts have detected adverse health effects. However, there have not been any reported fish kills associated with Pfiesteria since the studies began, so it is possible that none of the study subjects have been exposed to toxin-producing Pfiesteria spp.

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Selected References

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  1. Anger W. K., Letz R., Chrislip D. W., Frumkin H., Hudnell K., Russo J. M., Chappell W., Hutchinson L. Neurobehavioral test methods for environmental health studies of adults. Neurotoxicol Teratol. 1994 Sep-Oct;16(5):489–497. doi: 10.1016/0892-0362(94)90128-7. [DOI] [PubMed] [Google Scholar]
  2. Bever C. T., Jr, Grattan L., Morris J. G. Neurologic symptoms following Pfiesteria exposure: case report and literature review. Md Med J. 1998 May;47(3):120–123. [PubMed] [Google Scholar]
  3. Burkholder J. M., Glasgow H. B., Jr Trophic controls on stage transformations of a toxic ambush-predator dinoflagellate. J Eukaryot Microbiol. 1997 May-Jun;44(3):200–205. doi: 10.1111/j.1550-7408.1997.tb05700.x. [DOI] [PubMed] [Google Scholar]
  4. Burkholder J. M., Noga E. J., Hobbs C. H., Glasgow H. B., Jr, Smith S. A. New 'phantom' dinoflagellate is the causative agent of major estuarine fish kills. Nature. 1992 Jul 30;358(6385):407–410. doi: 10.1038/358407a0. [DOI] [PubMed] [Google Scholar]
  5. Burkholder J. M. The lurking perils of Pfiesteria. Sci Am. 1999 Aug;281(2):42–49. doi: 10.1038/scientificamerican0899-42. [DOI] [PubMed] [Google Scholar]
  6. Frenette B., Mergler D., Ferraris J. Measurement precision of a portable instrument to assess vibrotactile perception threshold. Eur J Appl Physiol Occup Physiol. 1990;61(5-6):386–391. doi: 10.1007/BF00236057. [DOI] [PubMed] [Google Scholar]
  7. Gerr F., Letz R., Hershman D., Farraye J., Simpson D. Comparison of vibrotactile thresholds with physical examination and electrophysiological assessment. Muscle Nerve. 1991 Nov;14(11):1059–1066. doi: 10.1002/mus.880141104. [DOI] [PubMed] [Google Scholar]
  8. Glasgow H. B., Jr, Burkholder J. M., Schmechel D. E., Tester P. A., Rublee P. A. Insidious effects of a toxic estuarine dinoflagellate on fish survival and human health. J Toxicol Environ Health. 1995 Dec;46(4):501–522. doi: 10.1080/15287399509532051. [DOI] [PubMed] [Google Scholar]
  9. Grattan L. M., Oldach D., Perl T. M., Lowitt M. H., Matuszak D. L., Dickson C., Parrott C., Shoemaker R. C., Kauffman C. L., Wasserman M. P. Learning and memory difficulties after environmental exposure to waterways containing toxin-producing Pfiesteria or Pfiesteria-like dinoflagellates. Lancet. 1998 Aug 15;352(9127):532–539. doi: 10.1016/S0140-6736(98)02132-1. [DOI] [PubMed] [Google Scholar]
  10. Lanthony P. The desaturated panel D-15. Doc Ophthalmol. 1978 Oct 16;46(1):185–189. doi: 10.1007/BF00174107. [DOI] [PubMed] [Google Scholar]
  11. Lowitt M. H., Kauffman C. L. Pfiesteria and the skin: a practical update for the clinician. Md Med J. 1998 May;47(3):124–126. [PubMed] [Google Scholar]
  12. Morris J. G., Jr Pfiesteria, "the cell from hell," and other toxic algal nightmares. Clin Infect Dis. 1999 Jun;28(6):1191–1198. doi: 10.1086/514799. [DOI] [PubMed] [Google Scholar]
  13. Oldach D. W., Delwiche C. F., Jakobsen K. S., Tengs T., Brown E. G., Kempton J. W., Schaefer E. F., Bowers H. A., Glasgow H. B., Jr, Burkholder J. M. Heteroduplex mobility assay-guided sequence discovery: elucidation of the small subunit (18S) rDNA sequences of Pfiesteria piscicida and related dinoflagellates from complex algal culture and environmental sample DNA pools. Proc Natl Acad Sci U S A. 2000 Apr 11;97(8):4303–4308. doi: 10.1073/pnas.97.8.4303. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. 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. doi: 10.1289/ehp.0110921. [DOI] [PMC free article] [PubMed] [Google Scholar]

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