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In a racially and ethnically diverse urban area (Harris County, Texas) with historic nonattainment O3 levels, we obtained birth and fetal death records from 2008–2013 and estimated maternal residential O3 concentrations from conception until delivery using inverse-distance interpolation from the local air monitoring network. We examined multipollutant models (with fine particulate matter and nitrogen dioxide) and effect measure modification by race/ethnicity and length of gestation. We found a 9% (95% confidence interval (CI): 1, 18) increased stillbirth risk associated with a 3.6-parts-per-billion increase in O3 exposure. The risk was higher among women with pregnancies of <37 gestational weeks (hazard ratio (HR) = 1.13, 95% CI: 1.04, 1.23) compared with women with pregnancies of longer gestation (HR = 1.05, 95% CI: 0.87, 1.27) and among Hispanic women (HR = 1.14, 95% CI: 1.02, 1.27). We also conducted a case-crossover analysis and detected no associations with short-term exposure. To our knowledge, this study is the first to use time-to-event analyses to examine stillbirth risk associated with time-varying prenatal ozone (O3) exposure over pregnancy. Our findings indicate that maternal O3 exposure over pregnancy is associated with stillbirth risk and that Hispanic women and women with shorter pregnancies might be at particular risk.

Objectives: The aim of this study was to provide insights learned from disaster research response (DR2) efforts following Hurricane Harvey in 2017 to launch DR2 activities following the Intercontinental Terminals Company (ITC) fire in Deer Park, Texas, in 2019. Methods: A multidisciplinary group of academic, community, and government partners launched a myriad of DR2 activities. Results: The DR2 response to Hurricane Harvey focused on enhancing environmental health literacy around clean-up efforts, measuring environmental contaminants in soil and water in impacted neighborhoods, and launching studies to evaluate the health impact of the disaster. The lessons learned after Harvey enabled rapid DR2 activities following the ITC fire, including air monitoring and administering surveys and in-depth interviews with affected residents. Conclusions: Embedding DR2 activities at academic institutions can enable rapid deployment of lessons learned from one disaster to enhance the response to subsequent disasters, even when those disasters are different. Our experience demonstrates the importance of academic institutions working with governmental and community partners to support timely disaster response efforts. Efforts enabled by such experience include providing health and safety training and consistent and reliable messaging, collecting time-sensitive and critical data in the wake of the event, and launching research to understand health impacts and improve resiliency.

Objectives: This study evaluated the effectiveness of an outreach program which included safety training and the distribution of personal protection kits in the Houston area in the aftermath of Hurricane Harvey. Methods: Outreach : 71 volunteers conducted training sessions at 19 different sites and distributed a total of 1187 kits. Follow-up study : We conducted telephonic interviews to collect data on respiratory symptoms and obtain perceptions of the quality of the safety training provided among 83 participants. Results: Participants reported an increase in airway symptoms four weeks after Hurricane Harvey. Outreach efforts were felt to be effective by a majority of participants. Conclusion: Future studies may adopt some of the best practices from our training efforts in terms of utilizing a combination of verbal demonstrations and written training guidelines on proper respirator usage.

On Sunday, 17 March 2019, a fire erupted at the Intercontinental Terminals Company (ITC, Deer Park, La Porte, TX, USA), resulting in a large fire that blazed for several days. In response, we rapidly launched disaster response activities to monitor air pollutants (total volatile organic compounds (TVOCs), fine particulate matter (PM2.5), black carbon (BC), and ultra-fine particles (UFPs) during the fire in two affected communities. To assess immediate health effects and residential air quality, we also rapidly launched a pilot study, the Deer Park Chemical Fire (DeeP Fire) Study, in which we administered health surveys and installed samplers to monitor air quality outdoors of resident homes for up to six weeks. In both communities, mean ambient concentrations of PM2.5, BC and TVOCs were higher during the first week of the fire than a week after it was extinguished. Thirteen residents participated in the DeeP Fire Study. Most residents reported experiencing respiratory symptoms and some reported being bothered by at least one post-traumatic stress disorder symptom during the fire and two weeks afterwards. In the months following the fire, the 7-day mean ambient concentration of benzene from 12 homes was 0.13 ± 0.10 parts per billion (ppb) and the 6-week mean ambient concentrations of PM2.5 and TVOCs were 13 ± 6 µg/m3 and 108 ± 98 ppb, respectively. All residents requested and received individualized air monitoring reports. Surveillance systems that enable real-time monitoring of the environmental health impact during a major industrial incident are needed to provide timely information to adequately respond to a disaster in the future.

Our findings add to the evidence of a positive association between individual and family stressors on hypertension among Hispanics and other racial/ethnic groups. Contrary to previous studies reporting positive associations, our results suggest that long-term exposure to O may be inversely related to prevalent hypertension.

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