title: The human health effects of Florida red tide (FRT) blooms: an expanded analysis.
abstract: Human respiratory and digestive illnesses can be caused by exposures to brevetoxins from blooms of the marine alga Karenia brevis, also known as Florida red tide (FRT). K. brevis requires macro-nutrients to grow; although the sources of these nutrients have not been resolved completely, they are thought to originate both naturally and anthropogenically. The latter sources comprise atmospheric depositions, industrial effluents, land runoffs, or submerged groundwater discharges. To date, there has been only limited research on the extent of human health risks and economic impacts due to FRT. We hypothesized that FRT blooms were associated with increases in the numbers of emergency room visits and hospital inpatient admissions for both respiratory and digestive illnesses. We sought to estimate these relationships and to calculate the costs of associated adverse health impacts. We developed environmental exposure-response models to test the effects of FRT blooms on human health, using data from diverse sources. We estimated the FRT bloom-associated illness costs, using extant data and parameters from the literature. When controlling for resident population, a proxy for tourism, and seasonal and annual effects, we found that increases in respiratory and digestive illnesses can be explained by FRT blooms. Specifically, FRT blooms were associated with human health and economic effects in older cohorts (≥55 years of age) in six southwest Florida counties. Annual costs of illness ranged from $60,000 to $700,000 annually, but these costs could exceed $1.0 million per year for severe, long-lasting FRT blooms, such as the one that occurred during 2005. Assuming that the average annual illness costs of FRT blooms persist into the future, using a discount rate of 3%, the capitalized costs of future illnesses would range between $2 and 24 million.
authors.affiliation: Marine Policy Center, Woods Hole Oceanographic Institution, Woods Hole, MA, USA. Electronic address: phoagland@whoi.edu.
authors.forename: Porter
authors.initials: P
authors.lastname: Hoagland
authors.affiliation: Marine Policy Center, Woods Hole Oceanographic Institution, Woods Hole, MA, USA.
authors.forename: Di
authors.initials: D
authors.lastname: Jin
authors.affiliation: Marine Policy Center, Woods Hole Oceanographic Institution, Woods Hole, MA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Beet
authors.affiliation: Mote Marine Laboratory, Sarasota, FL, USA; Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Kirkpatrick
authors.affiliation: Aquatic Toxins Program, Bureau of Epidemiology, Florida Department of Health, Tallahassee, FL, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Reich
authors.affiliation: Programs and Center in Health Sector Management and Policy, University of Miami, Miami, FL, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Ullmann
authors.affiliation: Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL, USA; European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK.
authors.forename: Lora E
authors.initials: LE
authors.lastname: Fleming
authors.affiliation: Mote Marine Laboratory, Sarasota, FL, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Kirkpatrick
mesh_terms: D000368:Aged; D017281:Cost of Illness; D004141:Dinoflagellida / Q000737:chemistry*; D004781:Environmental Exposure; D005260:Female; D005431:Florida; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000191:economics / Q000473:pathology; D006801:Humans; D019570:Inhalation Exposure; D008171:Lung Diseases / Q000139:chemically induced / Q000191:economics / Q000473:pathology; D008297:Male; D008387:Marine Toxins / Q000633:toxicity*; D008875:Middle Aged; D035964:Oxocins / Q000633:toxicity*; D000095702:Polyether Toxins
chemical_list: D008387:Marine Toxins; D035964:Oxocins; C053342:brevetoxin; D000095702:Polyether Toxins
keywords: Brevetoxin; Florida red tide; Harmful algal bloom; Illness cost; Karenia brevis; Nutrients