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Investigating the impact of Hurricane Maria on an ongoing birth cohort in Puerto Rico

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Abstract

Prior to Hurricane Maria, Puerto Rico already had 200+ hazardous waste sites, significant contamination of water resources, and among the highest rates of preterm birth in the USA. To address these issues, the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) Center was formed in 2010 to investigate prenatal environmental exposures, particularly phthalates, and adverse birth outcomes. Recent work from the PROTECT study confirms that in utero exposure to certain phthalates is associated with shorter gestation and increased risk of preterm birth. However, previous research also suggests that pregnant women who experience a natural disaster such as Hurricane Maria are at higher risk of adverse birth outcomes, but it is unknown whether this is due to stress, hazardous exposures, or a combination of factors. Thus, the aim of this analysis was to characterize hurricane-related changes in phthalate exposures and experiences within the PROTECT cohort. Among 176 participants who were pregnant during or within 5 months after Maria, 122 completed a questionnaire on hurricane-related experiences. Questionnaire results and biomarkers of exposure suggest that participants did not have regular access to fresh foods and water during hurricane recovery, and almost half reported structural damage to their home. In addition, biomarker concentrations of phthalates commonly used in food packaging were higher among participants post-hurricane, while phthalates commonly used in personal care products were lower compared to pre-hurricane levels. Hurricane-related increases in phthalate exposure, as well as widespread structural damage, food and water shortages, and long-term absence of electricity and cell phone service, likely increased the risk of adverse birth outcomes among this already vulnerable population.

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Acknowledgments

We would like to thank Drs. Antonia Calafat and Xiaoyun Ye at the Centers for Disease Control and Prevention for the measurement of phthalate metabolites in PROTECT urine samples. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the NIEHS, EPA, or CDC.

Funding

This work is supported by the National Institute of Environmental Health Sciences (NIEHS) grants R21ES029751, P42ES017198, P50ES026049, and UH3OD023251, EPA grant R836155, and the National Institute on Minority Health and Health Disparities grants U54MD007600 and R21MD013709.

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Authors and Affiliations

  1. Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA

    Deborah J. Watkins & John D. Meeker

  2. School of Public Health, University of Puerto Rico—Medical Sciences Campus, San Juan, PR, USA

    Héctor Ramón Torres Zayas, Carmen M. Vélez Vega, Zaira Rosario, Luis D. Agosto Arroyo, Nancy Cardona, Zulmarie J. Díaz Reguero, Amailie Santos Rivera & Gredia Huerta-Montañez

  3. Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA

    Michael Welton & José F. Cordero

  4. Social Science Environmental Health Research Institute, Northeastern University, Boston, MA, USA

    Phil Brown

  5. Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA

    Akram Alshawabkeh

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  1. Deborah J. Watkins
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  2. Héctor Ramón Torres Zayas
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  3. Carmen M. Vélez Vega
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Watkins, D.J., Torres Zayas, H.R., Vélez Vega, C.M. et al. Investigating the impact of Hurricane Maria on an ongoing birth cohort in Puerto Rico. Popul Environ 42, 95–111 (2020). https://doi.org/10.1007/s11111-020-00345-7

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