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Environmental exposures to Florida red tides: Effects on emergency room respiratory diagnoses admissions
Abstract
Human exposure to Florida red tides formed by Karenia brevis, occurs from eating contaminated shellfish and inhaling aerosolized brevetoxins. Recent studies have documented acute symptom changes and pulmonary function responses after inhalation of the toxic aerosols, particularly among asthmatics. These findings suggest that there are increases in medical care facility visits for respiratory complaints and for exacerbations of underlying respiratory diseases associated with the occurrence of Florida red tides. This study examined whether the presence of a Florida red tide affected the rates of admission with a respiratory diagnosis to a hospital emergency room in Sarasota, FL. The rate of respiratory diagnoses admissions were compared for a 3-month time period when there was an onshore red tide in 2001 (red tide period) and during the same 3-month period in 2002 when no red tide bloom occurred (non-red tide period). There was no significant increase in the total number of respiratory admissions between the two time periods. However, there was a 19% increase in the rate of pneumonia cases diagnosed during the red tide period compared with the non-red tide period. We categorized home residence zip codes as coastal (within 1.6 km from the shore) or inland (> 1.6 km from shore). Compared with the non-red tide period, the coastal residents had a significantly higher (54%) rate of respiratory diagnoses admissions than during the red tide period. We then divided the diagnoses into subcategories (i.e. pneumonia, bronchitis, asthma, and upper airway disease). When compared with the non-red tide period, the coastal zip codes had increases in the rates of admission of each of the subcategories during the red tide period (i.e. 31, 56, 44, and 64%, respectively). This increase was not observed seen in the inland zip codes.
... A summarization of the retrieved studies was performed below for the study design, location of study data collection, demographic information, and the methods of data collection. In relation to study design, there was found to be one ecologic study, 36 12 experimental studies, 7,12,17,18,22,26,27,31,32,[37][38][39] 5 observational studies, 2,20,21,25,29, 5 prospective cohort studies, 1,19,24,28,40, one case report, 30 2 cross-sectional studies, 8,23 one retrospective cohort study, 16 one pre-post study, 34 and one crossover study. 35 Of the 30 studies, 21 involved both participants and data collected in Florida, 1,2,7,8,12,[16][17][18][19][20][21][23][24][25]27,28,30,[34][35][36]40 one study involved participants located in Christi Corpus, Texas, 39 one study involved participants both in Florida and Texas, 37 and one study involved participants located in North Carolina. ...
... In relation to study design, there was found to be one ecologic study, 36 12 experimental studies, 7,12,17,18,22,26,27,31,32,[37][38][39] 5 observational studies, 2,20,21,25,29, 5 prospective cohort studies, 1,19,24,28,40, one case report, 30 2 cross-sectional studies, 8,23 one retrospective cohort study, 16 one pre-post study, 34 and one crossover study. 35 Of the 30 studies, 21 involved both participants and data collected in Florida, 1,2,7,8,12,[16][17][18][19][20][21][23][24][25]27,28,30,[34][35][36]40 one study involved participants located in Christi Corpus, Texas, 39 one study involved participants both in Florida and Texas, 37 and one study involved participants located in North Carolina. 33 Three studies were located outside of the United States. ...
... 1,25,35,36 However, both upper and lower respiratory symptoms related to biotoxins from aerosolized K. brevis blooms were seen throughout the studies and included wheezing, shortness of breath, chest tightness, coughing, and nasal and throat irritation. [16][17][18][19]25,29,30,[34][35][36] When analyzing respiratory effects via spirometry, one study found with highly variable average peak flow volumes after exposure on the beach. 35 Increased emergency department admissions for respiratory-related issues were higher in the months with blooms versus months without blooms One article found an association with K. brevis exposure and emphysema. ...
Algal blooms of Karenia brevis produce brevetoxins that lead to the natural phenomenon of red tide. Beyond monitoring the red tide concentration and forecasting future outbreaks, uncertainty exists in the field when examining these toxins in relation to the physiology of people. Contaminated air that results from outbreaks of K. brevis leads to inhalation of aerosolized brevetoxins, which directly impact the human respiratory system. This scoping review focused on the respiratory effects of red tide and was conducted by using a comparative method between 2 researchers. Relevant abstracts were collected, and full-text articles were reviewed by using PubMed, Science Direct, CINAHL Complete, and BioMed Central databases. Thirty articles were included in the final analysis and categorized by study design, location, and number and age of participants, and were also divided into assessment by respiratory effects, exposure, measurements of K. brevis, and asthma. The research indicates that respiratory health issues exist and can be compounded with exposure to red tide, specifically upper respiratory symptoms. Both symptomatic issues and pulmonary function tests were of concern when individuals were subjected to brevetoxin exposure. Even low levels of K. brevis resulted in negative respiratory health effects. Red tide is common in many areas of the world. The toxins released can cause adverse respiratory effects. This article provides a comprehensive summary of the scholarly literature focused on the respiratory system and red tide produced by K. brevis.
... The organism produces a potent class of toxins, known as brevetoxins, which are released into ocean or estuarine waters or, upon aerosolization, into the atmosphere following cell lysis. When exposed to sufficient levels of brevetoxins, humans may suffer from respiratory, gastrointestinal, or neurological illnesses (Kirkpatrick et al., 2004(Kirkpatrick et al., , 2006Fleming et al., 2009Fleming et al., , 2010Diaz et al., 2019). Additionally, ecological impacts may occur, such as fish kills or deaths of protected mammals, turtles, or birds (Landsberg et al., 2009). ...
... Where feasible, the public should be notified about the timing and locations of blooms so that they can take actions to avoid impacts to personal health and the economic costs of medical treatments. Certain human gastrointestinal, respiratory, and neurological illnesses appear to be linked to Kb blooms, and these illnesses can be of such severities that they may require visits to hospital emergency departments or inpatient admissions (Kirkpatrick et al., 2004(Kirkpatrick et al., , 2006Fleming et al., 2009Fleming et al., , 2010Diaz et al., 2019). Persons with underlying respiratory (e.g., asthma) and possibly neurologic diseases, and particularly older individuals (≥55 years of age), appear to be among those most seriously at risk of illness during Kb blooms Hoagland et al., 2014;Diaz et al., 2019). ...
... In particular, individuals with pre-existing respiratory conditions, such as asthma, chronic obstructive pulmonary disease, pneumonia, among others, may be at heightened risk, and they and their healthcare providers would benefit significantly from advance and continuing notifications of nearby Kb blooms. Both teenage and adult asthmatics can experience diminutions in respiratory functions during active Kb blooms, with acute symptoms that can last up to 5 days (Kirkpatrick et al., 2006). Emergency department visits for asthma appear to be unrelated to Kb blooms, however, perhaps because of the familiarity of affected individuals with self-treatment for asthmatic attacks (Hoagland et al., 2009). ...
In the Gulf of Mexico, especially along the southwest Florida coast, blooms of the dinoflagellate Karenia brevis are a coastal natural hazard. The organism produces a potent class of toxins, known as brevetoxins, which are released following cell lysis into ocean or estuarine waters or, upon aerosolization, into the atmosphere. When exposed to sufficient levels of brevetoxins, humans may suffer from respiratory, gastrointestinal, or neurological illnesses. The hazard has been exacerbated by the geometric growth of human populations, including both residents and tourists, along Florida’s southwest coast. Impacts to marine organisms or ecosystems also may occur, such as fish kills or deaths of protected mammals, turtles, or birds. Since the occurrence of a severe Karenia brevis bloom off the southwest Florida coast three-quarters of a century ago, there has been an ongoing debate about the best way for humans to mitigate the impacts of this hazard. Because of the importance of tourism to coastal Florida, there are incentives for businesses and governments alike to obfuscate descriptions of these blooms, leading to the social amplification of risk. We argue that policies to improve the public’s ability to understand the physical attributes of blooms, specifically risk communication policies, are to be preferred over physical, chemical, or biological controls. In particular, we argue that responses to this type of hazard must emphasize maintaining the continuity of programs of scientific research, environmental monitoring, public education, and notification. We propose a common-sense approach to risk communication, comprising a simplification of the public provision of existing sources of information to be made available on a mobile website.
... K. brevis produces a neurotoxin called brevetoxin (Baden, 1989), which is responsible for extensive fish kills Steidinger, 2009) resulting in fish community structure breakdown (DiLeone and Ainsworth, 2019), neurotoxic shellfish poisoning (NSP) ( Van Dolah, 2000;Steidinger, 2009), and human respiratory irritation Steidinger, 2009). Brevetoxin has the capacity to aerosolize, thus causing chronic symptoms in both humans and animals (Baden et al., 2005;Landsberg et al., 2009) as well as a rise in emergency room visits for respiratory and digestive illness (Kirkpatrick et al., 2006;Hoagland et al., 2014). Blooms of K. brevis can have a significant economic impact including but not limited to negative impacts to seafood and tourism businesses (Anderson, 2009), and decline in property prices within five miles of the affected coast (Bechard, 2020). ...
... The detection and monitoring of HAB species is critical to protecting vulnerable marine and human populations from exposure (Kirkpatrick et al., 2006;Anderson, 2009;Hoagland et al., 2014). Existing K. brevis monitoring methods, including microscopic identification and enumeration, flow cytometry, and other methods, have limitations typically associated with one or more of the following aspects: coarse resolution, greater minimal detection limits, inability to sample large volumes, etc. ...
Karenia brevis blooms, also known as red tide, are a recurring problem in the coastal Gulf of Mexico. These blooms have the capacity to inflict substantial damage to human and animal health as well as local economies. Thus, monitoring and detection of K. brevis blooms at all life stages and cell concentrations is essential for ensuring public safety. Current K. brevis monitoring methods have several limitations, including size resolution limits and concentration ranges, limited capacity for spatial and temporal profiling, and/or small sample volume processing. Here, a novel monitoring method wherein an autonomous digital holographic imaging microscope (AUTOHOLO), that overcomes these limitations and can characterize K. brevis concentrations in situ, is presented. Using the AUTOHOLO, in situ field measurements were conducted in the coastal Gulf of Mexico during an active K. brevis bloom over the 2020-21 winter season. Surface and sub-surface water samples collected during these field studies were also analyzed in the lab using benchtop holographic imaging and flow cytometry for validation. A convolutional neural network was trained for automated classification of K. brevis at all concentration ranges. The network was validated with manual counts and flow cytometry, yielding a 90% accuracy across diverse datasets with varying K. brevis concentrations. The usefulness of pairing the AUTOHOLO with a towing system was also demonstrated for characterizing particle abundance over large spatial distances, which could potentially facilitate characterization of spatial distributions of K. brevis during bloom events. Future applications of the AUTOHOLO can include integration into existing HAB monitoring networks to enhance detection capabilities for K. brevis in aquatic environments around the world.
... Summarizing the other diagnostic codes that were used at the same time as an HAB exposure code helped to identify common health complaints related to these exposures. As expected, the most common ICD codes reported at the same time as an HAB exposure code were those for respiratory events and were most likely associated with the presence of Karenia brevis red tides in the Gulf of Mexico (Backer et al., 2005;Fleming et al., 2011;Kirkpatrick et al., 2006). A large peak in HAB exposure code use occurred during a particularly intense red tide event in the Gulf of Mexico in August-November 2018. ...
... Examination of the data by region corroborated this assumption, as the South Atlantic region contained approximately 30% of the total records. These results correspond to a study of emergency department admissions in 2002 in Florida that found a significant increase in the rate of admissions for respiratory disease during a red tide event compared with a time when there was no red tide (Kirkpatrick et al., 2006). ...
Harmful algal blooms (HABs) are the rapid growth of algae that can produce toxic or harmful effects in people and animals. Potential health effects include respiratory illness, gastrointestinal illness, skin and eye irritation, and sometimes more severe toxic effects such as liver damage. Defining HAB exposure and related illness is challenging for many reasons, including characterizing the exposure. Large electronic health record databases present an opportunity to study health encounters specifically related to HAB exposure through querying medical diagnostic codes. We queried the MarketScan Research Databases between January 2009 and April 2019 for use of the International Classification of Diseases (ICD) codes for HAB exposure. We found a total of 558 records that used either the ICD-9 or ICD-10 code for HAB exposure. Respiratory illness was most commonly reported along with the HAB exposure code. Use of HAB exposure codes showed seasonal fluctuations during 2012-2019. We found that although the HAB-related ICD-9 and ICD-10 codes were used infrequently, they were most often recorded during bloom seasons in warmer months. This analysis is the first that utilizes a large-scale national database of de-identified health records to understand the use of medical diagnostic codes related to algae exposure.
... brevis) and occurs along the coasts of the Gulf of Mexico, typically beginning in fall and persisting until winter (Steidinger, 2009). Exposure to these blooms is associated with an increased reporting of respiratory symptoms among those with preexisting respiratory disorders or healthy adults in occupational settings Kirkpatrick et al., 2006). The Florida Department of Health (FDOH), along with other state agencies, have developed an integrated public health response plan that relies on known health impacts from brevetoxin exposures, through both marine aerosols and ingestion of molluscan shellfish, to reduce red tide impacts (Reich et al., 2015). ...
... The outcome variables of interest were illnesses, such as emphysema, pneumonia, and asthma and symptoms including upper respiratory tract (URT) symptoms that were previously associated with K. brevis exposure Kirkpatrick et al., 2006;Kirkpatrick et al., 2008). A composite variable for URT symptoms (Composite URT) consisted of either the absence or the presence of one or more of the following four symptoms: sore throat, coughing, nasal congestion, and sneezing. ...
In southwest Florida, Karenia brevis (K. brevis) blooms occur frequently, can be very intense and persist over several years. Individuals living in coastal communities around the Gulf of Mexico are particularly vulnerable to brevetoxins released by K. brevis in seawater and carried inland within marine aerosol. Exposure to K. brevis occurs during residential, recreational, and occupational activities and has been associated with upper respiratory tract (URT) symptoms in healthy and medically vulnerable individuals. Additionally, ingestion of brevetoxin-contaminated seafood causes neurotoxic shellfish poisoning (NSP), and severe headaches prompting emergency department visits which occur in excess during K. brevis blooms. The current study examined a dose-response relationship between K. brevis in coastal waters and URT and NSP-like symptoms and headaches among southwest Florida residents. Data on past medical history (PMH) and medical symptoms were collected from the participants (n = 258) in five southwest Florida counties between June 2019 to August 2021. A dose-response relationship was observed between K. brevis blooms and reporting of URT and NSP-like symptoms and headaches. Reporting of NSP-like symptoms was higher among participants with a PMH of migraines, chronic fatigue syndrome (CFS) and mild memory loss, while the association of headaches with K. brevis blooms was accentuated among individuals with a PMH of migraines. These results suggest further investigations into the threshold of aerosolized brevetoxin dose required to elicit URT, headaches and/or NSP-like symptoms. These symptoms ultimately cause significant public health safety concerns, primarily among vulnerable populations with preexisting neurological conditions.
... Once lysed, brevetoxins can be transported to the surface as droplets and subsequently aerosolized into the atmosphere when bubbles burst (Pierce et al., 1990(Pierce et al., , 2000(Pierce et al., , 2003. Water column and atmospheric (aerosolized) brevetoxins cause neurotoxic and respiratory effects to human and marine life Fleming et al., 2007;Kirkpatrick et al., 2006). The aerosolized toxins affect human respiration by exacerbating asthma and inducing bronchoconstriction in otherwise healthy individuals (Fleming et al., 2007;Kirkpatrick et al., 2006). ...
... Water column and atmospheric (aerosolized) brevetoxins cause neurotoxic and respiratory effects to human and marine life Fleming et al., 2007;Kirkpatrick et al., 2006). The aerosolized toxins affect human respiration by exacerbating asthma and inducing bronchoconstriction in otherwise healthy individuals (Fleming et al., 2007;Kirkpatrick et al., 2006). Recent studies suggest that airborne brevetoxins may be more harmful than health officials previously thought, with the toxin side effects extending beyond initial acute reactions Fleming et al., 2005Fleming et al., , 2011. ...
Florida red tide is a natural phenomenon caused by the dinoflagellate, Karenia brevis. Karenia brevis blooms produce potent toxins (brevetoxins) that can cause neurotoxic and respiratory illness in humans and marine life. Red tides were recorded by Spanish explorers as early as the 17 th century, however published red tide studies before 1940 are unavailable. Recent studies have suggested that red tide events may be becoming more frequent, intense, and longer lasting, which may be linked to modern land development and changing water quality. While the scientific record of modern red tides is relatively short, the distributions and concentrations of chemical biomarkers (e.g., brevetoxins produced by K. brevis) in coastal-marine sediments can potentially be used to study historic red tides. This study aims to quantify the concentration and vertical distribution of brevetoxins in coastal Southwest Florida (SWFL) sediment cores in order to determine if downcore brevetoxins may potentially be used to reconstruct historic red tide events. Sediment samples were radiometrically dated using 210 Pb and subsamples were analyzed utilizing liquid chromatography/triple quadrupole mass spectrometry (LC-MS/MS) for brevetoxin congeners, namely, PbTx-1, PbTx-2, PbTx-3, and PbTx-5. The 210 Pb-dated sediment cores represent ~60-80 years of brevetoxin accumulation and total brevetoxin (ΣPbTx) concentrations in sediment cores varied from below detection limits to 25.3 ng g − 1 of dry sediments. Highest concentrations were found in surficial sediments (top 0-3 cm) and may indicate brevetoxin preservation from the 2017-2019 red-tide event. The down-core preservation and variability of brevetoxin indicate its potential use as a chemical biomarker to assess long-term red tide intensities and frequencies. This research is a first step towards reconstructing historic red tide events from sedimentary chemical biomarkers and may allow for future assessment of the human impacts on red tide frequency, intensity and duration.
... Harmful algal and cyanobacterial blooms (harmful algal blooms) are large colonies of algae or cyanobacteria that can harm humans, animals, and the environment (1)(2)(3). The number of algal blooms has been increasing in the United States, augmented by increasing water temperatures and nutrients in water from industry and agricultural run-off (4,5). ...
... The peak in ED visits during 2018 occurred primarily within Region 4, corresponding to a large-scale red tide event in the Gulf of Mexico that persisted during June 2018-November 2018 (9). The occurrence of this peak at the time of a red tide event might explain the higher frequency of chief complaints associated with respiratory symptoms because red tide has been linked to respiratory health outcomes (2,3). Presumably, these types of large-scale events might cause providers to ask patients about recent harmful algal bloom exposures or cause patients to mention them. ...
Harmful algal and cyanobacterial blooms (harmful algal blooms) are large colonies of algae or cyanobacteria that can harm humans, animals, and the environment (1-3). The number of algal blooms has been increasing in the United States, augmented by increasing water temperatures and nutrients in water from industry and agricultural run-off (4,5). The extent to which harmful algal bloom exposures cause human illness or long-term health effects is unknown. As the number of blooms increases annually, the likelihood of negative health outcomes (e.g., respiratory or gastrointestinal illness) from exposure also increases (4,5). To explore the utility of syndromic surveillance data for studying health effects from harmful algal bloom exposures, CDC queried emergency department (ED) visit data from the National Syndromic Surveillance Program (NSSP) for harmful algal bloom exposure-associated administrative discharge diagnosis codes and chief complaint text terms related to harmful algal bloom exposure (6). A total of 321 harmful algal bloom-associated ED visits were identified during January 1, 2017-December 31, 2019. An increase in harmful algal bloom-associated ED visits occurred during warmer months (June-October), consistent with seasonal fluctuations of blooms and recent publications (6,7). Although syndromic surveillance data are helpful for understanding harmful algal bloom-associated ED visits in the United States, exposures were documented infrequently with discharge diagnosis codes; 67% of harmful algal bloom-associated ED visits were identified through querying chief complaint text. Improving the documentation of harmful algal bloom exposures in medical records would further benefit future health studies.
... Exposure to PbTx through marine aerosols remains the most common route and is thought to contribute to a variety of upper respiratory symptoms, which include coughing, sneezing, sore throat, and headaches (Abdullah et al., 2022;Diaz et al., 2019;Fleming et al., 2011;Kirkpatrick et al., 2006). Consumption of PbTx-contaminated seafood can lead to neurotoxic shellfish poisoning (NSP), causing gastrointestinal and neurological symptoms, which include severe headaches, nausea and ataxia. ...
... In the early studies on harmful algal blooms, which were based on seawater oxygen levels, researchers predicted the occurrence of HABs by analyzing field-sampled seawater data. Due to the potential toxin release from HABs and uncertainties such as offshore wind and waves [12,13], researchers collected seawater samples using water samplers at the boundaries of HAB occurrence areas and obtained seawater analysis data through relevant equipment assays. These field sampling data provided effective data support for researchers seeking to predict the occurrence of HABs via machine learning models. ...
Over the past few decades, harmful algal blooms (HABs) have occurred frequently worldwide. The application of harmful algal bloom detection when based solely on water quality measurements proves challenging in achieving broad generalization across various regions. Satellite remote sensing, due to its low risk, cost effectiveness, and wide ground-coverage capabilities, has been extensively employed in HAB detection tasks. However, relying solely on remote sensing data poses issues of false positives, false negatives, and the incomplete consideration of contributing factors in HAB detection. This study proposes a model for harmful algal bloom detection by integrating MODIS multifactor data with heterogeneous meteorological data. Initially, a dataset named MODIS_MI_HABs is constructed by gathering information from 192 instances of harmful algal bloom events worldwide. Subsequently, remote sensing data corresponding to specific regions are collected; all were obtained from a moderate resolution imaging spectroradiometer (MODIS) aboard an ocean-color-detecting satellite. This dataset encompasses variables such as chlorophyll-a concentration, the sea surface temperature, photosynthetically active radiation, the relative radiation stability differences, the six seawater-absorption coefficients, and three scattering coefficients. By fusing six meteorological factors, latitude and longitude information, and remote sensing data, a regression dataset for harmful algal bloom detection is established. Finally, employing harmful algal bloom cell concentration as the data label, seven machine learning models are employed to establish correlations between the remote sensing data, heterogeneous meteorological data, and harmful algal bloom cell concentrations. The root mean square error (RMSE), mean absolute error (MAE), explained variance (EV), and coefficient of determination (R2) parameters are used to evaluate the regression performance. The results indicate that the extreme gradient boosting (XGR) model demonstrates the best predictive capability for harmful algal blooms (leave-one-out: RMSE/MAE = 0.0714). The XGR model, trained with the entire dataset, yields the optimal predictive performance (RMSE = 0.0236, MAE = 0.0151, EV = 0.9593, R2 = 0.9493). When compared to the predictions based on the fixed-area water quality analysis and single-source remote sensing data usage, the proposed approach in this paper displays wide applicability, offering valuable support for the sustainable development of marine ecology.
... Increased emergency room admissions for respiratory diseases (pneumonia, bronchitis, and asthma) were observed during active Florida red tides, particularly for coastal residents. 70 The number of respiratoryspecific ED diagnoses between 2001 and 2006 in Sarasota, Florida was associated with K. brevis cell counts in nearby oceans in the previous week, after adjusting for temperatures, influenza outbreaks, high pollen counts, and tourist visits. 71 This study design incorporating a 1-week lag accounted for the hypothesized route and timing of exposure by considering the delay between HAB occurrence, the release of toxins from the water after cell lysis, aerosolization, and finally inhalation. ...
Harmful algal blooms (HABs) are increasing across many locations globally. Toxins from HABs can be incorporated into aerosols and transported inland, where subsequent exposure and inhalation can induce adverse health effects. However, the relationship between HAB aerosols and health outcomes remains unclear despite the potential for population-level exposures. In this review, we synthesized the current state of knowledge and identified evidence gaps in the relationship between HAB aerosols and human health. Aerosols from Karenia brevis, Ostreopsis sp., and cyanobacteria were linked with respiratory outcomes. However, most works did not directly measure aerosol or toxin concentrations and instead relied on proxy metrics of exposure, such as cell concentrations in nearby waterbodies. Furthermore, the number of studies with epidemiological designs was limited. Significant uncertainties remain regarding the health effects of other HAB species; threshold dose and the dose-response relationship; effects of concurrent exposures to mixtures of toxins and other aerosol sources, such as microplastics and metals; the impact of long-term exposures; and disparities in exposures and associated health effects across potentially vulnerable subpopulations. Additional studies employing multifaceted exposure assessment methods and leveraging large health databases could address such gaps and improve our understanding of the public health burden of HABs.
... Red tide blooms, caused by the dinoflagellate Karenia brevis, occur in the late summer and early fall but can last days, weeks or months 11 . K. brevis produce brevetoxins, which are lipophilic, cyclic polyethers 12-16 that cause severe morbidity and mortality among wildlife 12,15,[17][18][19][20][21][22][23][24][25][26] , developmental anomalies in fish embryos 27,28 and respiratory toxicity, gastrointestinal symptoms, and neurotoxicity in humans [29][30][31][32] . Brevetoxins impair immune system function 13 and disturb DNA structure 27,33 . ...
Objective
The study objective was to evaluate the association between maternal Karenia brevis (K. brevis) exposure during pregnancy and the prevalence of biliary atresia (BA) in offspring.
Study Design
This was a hospital-based, case-control study in which cases were infants diagnosed with BA at Johns Hopkins All Childrens Hospital from October 2001 to December 2019. Controls were matched 4:1 by age, randomly selected from healthy infants hospitalized during the study period for common pediatric diagnoses. Infants were excluded if they had congenital anomalies and/or were non-Florida residents. Gestational K. brevis exposure levels (cells/liter) were determined from Florida Fish and Wildlife Conservation Commission exposure data at 10- and 50-mile radii from the maternal zip code of residence. Multivariable conditional logistic regression determined adjusted odds of BA in offspring based on maternal gestational K. brevis exposure.
Results
Of 38 cases and 152 controls, no significant inter-group differences were observed in race/ethnicity, season of birth or coastal residence. Median gestational exposure at the 10-mile radius was 0 cells/liter in both groups. A greater proportion of cases had no K. brevis exposure (63.2%, n = 24) in comparison to controls (37.5%, n = 57; p = .04) at a 10-mile radius. At the 50-mile radius, cases had a peak median exposure at 6 months of gestation compared to controls peak at 9 months. After adjustment for sex, seasonality, race/ethnicity, and coastal residence, there was no significant association between BA and maximum K. brevis exposure per trimester of pregnancy at the 10- or 50-mile radius.
Conclusion
We observed no association between gestational K. brevis (cells/liter) exposure at a 10- and 50-mile radius from maternal zip code of residence and BA in offspring.
... Karenia brevis toxic aerosols have significant human health impacts, particularly in people with asthma (Fleming et al., 2005a(Fleming et al., , 2005b(Fleming et al., , 2007(Fleming et al., , 2009Kirkpatrick et al., 2006Kirkpatrick et al., , 2011. These aerosols also lead to significant economic impacts resulting from the cost of associated medical visits and from reductions in tourism when people avoid beaches (Hoagland et al., 2009). ...
A bloom of an unidentified nano-sized cyanobacterium (~3-4 µm x 5 µm) was observed in the Indian River Lagoon (IRL) system, Florida, U.S.A. from August through December 2020, causing greenish water discoloration. Enumeration by light microscopy revealed concentrations of > 106 cells mL-1 in the northern and central IRL proper, Banana River Lagoon, and Mosquito Lagoon (maximum of 3 x 106 cells mL-1). Bloom concentrations (2 x 105 cells mL-1) were first observed in the northern IRL and Banana River where it persisted longer than in other basins, but cell abundance rapidly declined throughout the system as water temperatures decreased in December. Inspection of archived samples suggested this taxon had been in the system since at least late June. Bloom development and decline was readily observed by satellite imagery (Sentinel-2, Landsat-8). Cells were round to oblong, often with two or more cells aligned in a chain. Live cells had an elongated aerotope that became inconspicuous upon preservation. Flow cytometry indicated that this cyanobacterium had low chlorophyll a and high phycocyanin-like fluorescence. Toxin analysis at five time points between 9/24 and 12/03 returned non-detected concentrations of anatoxin-a and cylindrospermopsin, trace levels of total microcystin-LR in four samples, and saxitoxin in three samples; these positive results are likely unrelated to the cyanobacterium bloom. Direct sequencing followed by PacBio 16S amplicon sequencing revealed a novel cyanobacterial ribotype in bloom samples (i.e., >75% of 16S amplicons). A complete metagenome assembled genome was retrieved and phylogenetic analysis placed this organism adjacent to Prochlorothrix hollandica, although within a clade and tree that encompasses large genetic distances between taxa indicating that specific evolutionary and ecological affinities must be interpreted with caution.
... Karenia brevis toxic aerosols have significant human health impacts, particularly in people with asthma (Fleming et al., 2005a(Fleming et al., , 2005b(Fleming et al., , 2007(Fleming et al., , 2009Kirkpatrick et al., 2006Kirkpatrick et al., , 2011. These aerosols also lead to significant economic impacts resulting from the cost of associated medical visits and from reductions in tourism when people avoid beaches (Hoagland et al., 2009). ...
The Cawthron Institute Culture Collection of Micro-algae (CICCM) in New Zealand includes more than 600 unique marine and freshwater microalgae and cyanobacteria isolates from tropical, temperate, and polar regions. Half of the collection is cryopreserved, and the other half is regularly sub-cultured. Live cultures, DNA extracts and chemical compounds may be purchased for research purposes, and all have a full description and toxin profile accompanying them (see www.cultures.cawthron.on-line). To date, isolates have enabled the description of new species, the preparation of biotoxin standards to underpin chemical tests, and the carrying out of toxicity studies amongst other research endeavours. For example, extracts of mass cultures of Alexandrium pacificum have been supplied to pharmaceutical companies for the preparation of paralytic shellfish toxin standards.Additions to the CICCM since 2019 include 10 dinoflagellate species, 14 diatom species and 11 cyanobacteria species. New descriptions of historic cultures in the collection include Pavlomulina ranunculiformis from the newly erected haptophyte class, Rappephyceae.
... Health care costs during K. brevis blooms are related to digestive, gastrointestinal and respiratory impacts (Hoagland et al., 2014;Patel et al., 2020). Kirkpatrick et al. (2006) utilized hospital records to compare the number of patients admitted with respiratory disease during red tide periods with non-bloom periods and found a significant increase in the ER admissions for respiratory diseases during the 2001 red tide compared to the 2002 non-red tide period, with elevated rates among individuals living within 1.6 miles of the shore. A 40% increase in gastrointestinal diagnoses and admissions were also found . ...
... Adams et al. (2018) appropriately suggested that in addition to continued assessments of acute short-term impacts, future research should explore the lagged impacts of HABs (both in space and time) as well as methods for estimating the indirect economic impacts of HABs. Evolving research on the public health, brand-value, and seafood consumption impacts of HABs as well as risk perception and risk preferences of individuals as they relate to HABs can also be used to further our understanding of the complexities involved in understanding the full set of relationships between marine, freshwater, and coastal resources and the human communities that they support and satisfy, which is crucial to effective policy response (Nierenberg et al., 2010;Kirkpatrick et al., 2006;Whitehead et al., 2003;Kasperson et al., 1988;Kuhar et al., 2009). ...
Algal blooms occur when natural algae in lakes, rivers, and coastal zones are stimulated to grow out of control through natural processes or by elevated levels of nutrients in the
water. Algal blooms that produce dangerous toxins that are detrimental to the plants, animals, people, and ecosystems in the affected areas are known as harmful algal blooms (HABs). Florida was impacted by two significant HAB events between late 2017 and early 2019. A large Red Tide event occurred on the Gulf Coast and was observed on the Atlantic coast of Florida in 2018. Additionally, blue-green algae affected fresh
waters in South Florida including the Caloosahatchee and StLucie Estuaries.
When human communities are exposed to HABs, there can be significant economic losses and damages, which often depend on the size, severity, timing, and duration of
the event. However, data limitations often make it difficult to determine the exact extent and value of these economic impacts to local economies. This report was commissioned by the West Coast Inland Navigation District and the Southwest Florida Marine Industries Association to document the economic impacts of the 2017-2019 HABs in Southwestern
Florida, where data allow.
... For the majority of confirmed cases of water-based toxins and toxinproducers in this study, such as ciguatera fish poisoning, neurotoxic shellfish poisoning, and saxitoxin poisoning (paralytic shellfish poisoning), most had their exposure within Florida. Previous work has found an increased medical care burden associated with Florida's red tide events with coastal blooms causing acute and chronic respiratory conditions [33]. Animal morbidity and mortality events are common due to exposure to HABs in fresh, brackish, and saltwater systems [34]. ...
Florida represents a unique challenge for preventing and responding to infectious disease associated with water. This study cataloged the prevalence of reportable waterborne and water-related disease within Florida residents over the last twenty years and identified relationships between confirmed cases by location and additional risk factors. Data was collected through FLHealthCHARTS for confirmed cases between January 1, 1999 and December 31, 2019. Case records were compiled and analyzed by year, county, pathogen name and disease category, patient age, and where the infection was acquired. During this time, 218,707 cases of water-related disease were recorded with 214,745 due to waterborne disease, 3255 cases of water-related vector-borne disease, and 707 cases caused by a water-based toxin. Children aged 0–4 and the elderly demonstrated a higher proportion of waterborne disease while 45–49 year olds had increased rates of water-based toxins and water-related vector-borne disease. Most cases were reported in the southeast region. Across the state, opportunities for water contact have led to high rates of water-related infectious disease. Public health initiatives and response efforts should target the pathogens of greatest impact for each region, largely zoonotic waterborne diseases, using a One Health approach.
... Health care costs during K. brevis blooms are related to digestive, gastrointestinal and respiratory impacts (Hoagland et al., 2014;Patel et al., 2020). Kirkpatrick et al. (2006) utilized hospital records to compare the number of patients admitted with respiratory disease during red tide periods with non-bloom periods and found a significant increase in the ER admissions for respiratory diseases during the 2001 red tide compared to the 2002 non-red tide period, with elevated rates among individuals living within 1.6 miles of the shore. A 40% increase in gastrointestinal diagnoses and admissions were also found . ...
Harmful Algal Blooms (HABs) pose unique risks to the citizens, stakeholders, visitors, environment and economy of the state of Florida. Florida has been historically subjected to reoccurring blooms of the toxic marine dinoflagellate Karenia brevis (C. C. Davis) G. Hansen & Moestrup since at least first contact with explorers in the 1500’s. However, ongoing immigration of more than 100,000 people year–1 into the state, elevated population densities in coastal areas with attendant rapid, often unregulated development, coastal eutrophication, and climate change impacts (e.g., increasing hurricane severity, increases in water temperature, ocean acidification and sea level rise) has likely increased the occurrence of other HABs, both freshwater and marine, within the state as well as the number of people impacted by these blooms. Currently, over 75 freshwater, estuarine, coastal and marine HAB species are routinely monitored by state agencies. While only blooms of K. brevis, the dinoflagellate Pyrodinium bahamense (Böhm) Steidinger, Tester, and Taylor and the diatom Pseudo-nitzschia spp. have resulted in closure of commercial shellfish beds, other HAB species, including freshwater and marine cyanobacteria, pose either imminent or unknown risks to human, environmental and economic health. HAB related human health risks can be classified into those related to consumption of contaminated shellfish and finfish, consumption of or contact with bloom or toxin contaminated water or exposure to aerosolized HAB toxins. While acute human illnesses resulting from consumption of brevetoxin-, saxitoxin-, and domoic acid-contaminated commercial shellfish have been minimized by effective monitoring and regulation, illnesses due to unregulated toxin exposures, e.g., ciguatoxins and cyanotoxins, are not well documented or understood. Aerosolized HAB toxins potentially impact the largest number of people within Florida. While short-term (days to weeks) impacts of aerosolized brevetoxin exposure are well documented (e.g., decreased respiratory function for at-risk subgroups such as asthmatics), little is known of longer term (>1 month) impacts of exposure or the risks posed by aerosolized cyanotoxin [e.g., microcystin, β-N-methylamino-L-alanine (BMAA)] exposure. Environmental risks of K. brevis blooms are the best studied of Florida HABs and include acute exposure impacts such as significant dies-offs of fish, marine mammals, seabirds and turtles, as well as negative impacts on larval and juvenile stages of many biota. When K. brevis blooms are present, brevetoxins can be found throughout the water column and are widespread in both pelagic and benthic biota. The presence of brevetoxins in living tissue of both fish and marine mammals suggests that food web transfer of these toxins is occurring, resulting in toxin transport beyond the spatial and temporal range of the bloom such that impacts of these toxins may occur in areas not regularly subjected to blooms. Climate change impacts, including temperature effects on cell metabolism, shifting ocean circulation patterns and changes in HAB species range and bloom duration, may exacerbate these dynamics. Secondary HAB related environmental impacts are also possible due to hypoxia and anoxia resulting from elevated bloom biomass and/or the decomposition of HAB related mortalities. Economic risks related to HABs in Florida are diverse and impact multiple stakeholder groups. Direct costs related to human health impacts (e.g., increased hospital visits) as well as recreational and commercial fisheries can be significant, especially with wide-spread sustained HABs. Recreational and tourism-based industries which sustain a significant portion of Florida’s economy are especially vulnerable to both direct (e.g., declines in coastal hotel occupancy rates and restaurant and recreational users) and indirect (e.g., negative publicity impacts, associated job losses) impacts from HABs. While risks related to K. brevis blooms are established, Florida also remains susceptible to future HABs due to large scale freshwater management practices, degrading water quality, potential transport of HABs between freshwater and marine systems and the state’s vulnerability to climate change impacts.
... K. brevis produces brevetoxin, a neurotoxin that can result in massive fish kills and mortalities to marine mammals and sea birds. Indirectly, this can lead to neurotoxic shellfish poisoning in humans from consuming contaminated shellfish [6,7]. ...
An accurate forecast of the red tide respiratory irritation level would improve the lives of many people living in areas affected by algal blooms. Using a decades-long database of daily beach conditions, two conceptually different models to forecast the respiratory irritation risk level one day ahead of time are trained. One model is wind-based, using the current days' respiratory level and the predicted wind direction of the following day. The other model is a probabilistic self-exciting Hawkes process model. Both models are trained on beaches in Florida during 2011-2017 and applied to the red tide bloom during 2018-2019. For beaches where there is enough historical data to develop a model, the model which performs best depends on the beach. The wind-based model is the most accurate at half the beaches, correctly predicting the respiratory risk level on average about 84% of the time. The Hawkes model is the most accurate (81% accuracy) at nearly all of the remaining beaches.
... 4,5,8,9 Studies previously found that red tide blooms are positively correlated with an increased incidence of ED visits for asthma exacerbations and respiratory illnesses in coastal areas. 5,8,10 Our patient came in with severe lip angioedema of unclear etiology. His only significant novel exposure was to the outbreak of red tide algae at the beach on the same morning he developed symptoms. ...
Introduction:
Histamine-mediated angioedema is a potentially life-threatening reaction following exposures that incite mast cell activation. In Florida, red tides are a frequent phenomenon caused by overgrowth of the harmful algae species Karenia brevis, which contain environmentally detrimental brevetoxins. Even in low concentrations, brevetoxins can cause disease in humans through inducing histamine release. We report the first documented case of angioedema associated with red tide exposure.
Case report:
A 52-year-old-male presented with severe angioedema encompassing both lips within a few hours after exposure to red tide algae. Other symptoms included voice changes and difficulty swallowing. Laboratory findings revealed complement factors that were within reference range, which ruled out a bradykinin-mediated pathology and supported the diagnosis of histaminergic angioedema. Symptoms resolved after 24 hours in the intensive care unit under management with epinephrine, diphenhydramine, methylprednisolone, and famotidine.
Conclusion:
In coastal regions, red tide algae should be recognized as a rare cause of acute angioedema. Emergency management of histamine-mediated angioedema should focus on preventing respiratory compromise with frequent airway monitoring and treatment with steroids, antihistamines, and epinephrine.
... Most research concerned the toxic aerosols obtained from the red tides of the marine dinoflagellate Karenia brevis with the effects of its Pbtxs being the most studied phenomenon due to high deposition efficiency of its small-sized particles (6-10 µm) [342][343][344][345][346][347][348]. Marine aerosols can also contain PLTXs, produced by dinoflagellates from the genus Ostreopsis [19,349,350] (Table 1). ...
The review summarizes the available knowledge on toxins and their producers from rather disparate algal assemblages of aeroterrestrial, airborne and other versatile extreme environments (hot springs, deserts, ice, snow, caves, etc.) and on phycotoxins as contaminants of emergent concern in soil and plants. There is a growing body of evidence that algal toxins and their producers occur in all general types of extreme habitats, and cyanobacteria/cyanoprokaryotes dominate in most of them. Altogether, 55 toxigenic algal genera (47 cyanoprokaryotes) were enlisted, and our analysis showed that besides the "standard" toxins, routinely known from different waterbodies (microcystins, nodularins, anatoxins, saxitoxins, cylindrospermopsins, BMAA, etc.), they can produce some specific toxic compounds. Whether the toxic biomolecules are related with the harsh conditions on which algae have to thrive and what is their functional role may be answered by future studies. Therefore, we outline the gaps in knowledge and provide ideas for further research, considering, from one side, the health risk from phycotoxins on the background of the global warming and eutrophication and, from the other side, the current surge of interest which phycotoxins provoke due to their potential as novel compounds in medicine, pharmacy, cosmetics, bioremediation, agriculture and all aspects of biotechnological implications in human life.
... Ingestion of neurotoxic shellfish toxins (NSTs, also known as brevetoxins) can cause Neurotoxic Shellfish Poisoning (NSP), and NSTs can cause other negative human health impacts when inhaled in aerosolized form (Backer et al., 2003;Kirkpatrick et al., 2006;Fleming et al., 2011). In the U.S., the vast majority of NST events are Gulf of Mexico blooms of the dinoflagellate Karenia brevis (historically known as Gymnodinium brevis, Gymnodinium breve, and Ptychodiscus brevis). ...
Harmful algal blooms (HABs) are diverse phenomena involving multiple. species and classes of algae that occupy a broad range of habitats from lakes to oceans and produce a multiplicity of toxins or bioactive compounds that impact many different resources. Here, a review of the status of this complex array of marine HAB problems in the U.S. is presented, providing historical information and trends as well as future perspectives. The study relies on thirty years (1990–2019) of data in HAEDAT - the IOC-ICES-PICES Harmful Algal Event database, but also includes many other reports. At a qualitative level, the U.S. national HAB problem is far more extensive than was the case decades ago, with more toxic species and toxins to monitor, as well as a larger range of impacted resources and areas affected. Quantitatively, no significant trend is seen for paralytic shellfish toxin (PST) events over the study interval, though there is clear evidence of the expansion of the problem into new regions and the emergence of a species that produces PSTs in Florida – Pyrodinium bahamense. Amnesic shellfish toxin (AST) events have significantly increased in the U.S., with an overall pattern of frequent outbreaks on the West Coast, emerging, recurring outbreaks on the East Coast, and sporadic incidents in the Gulf of Mexico. Despite the long historical record of neurotoxic shellfish toxin (NST) events, no significant trend is observed over the past 30 years. The recent emergence of diarrhetic shellfish toxins (DSTs) in the U.S. began along the Gulf Coast in 2008 and expanded to the West and East Coasts, though no significant trend through time is seen since then. Ciguatoxin (CTX) events caused by Gambierdiscus dinoflagellates have long impacted tropical and subtropical locations in the U.S., but due to a lack of monitoring programs as well as under-reporting of illnesses, data on these events are not available for time series analysis. Geographic expansion of Gambierdiscus into temperate and non-endemic areas (e.g., northern Gulf of Mexico) is apparent, and fostered by ocean warming. HAB-related marine wildlife morbidity and mortality events appear to be increasing, with statistically significant increasing trends observed in marine mammal poisonings caused by ASTs along the coast of California and NSTs in Florida. Since their first occurrence in 1985 in New York, brown tides resulting from high-density blooms of Aureococcus have spread south to Delaware, Maryland, and Virginia, while those caused by Aureoumbra have spread from the Gulf Coast to the east coast of Florida. Blooms of Margalefidinium polykrikoides occurred in four locations in the U.S. from 1921–2001 but have appeared in more than 15 U.S. estuaries since then, with ocean warming implicated as a causative factor. Numerous blooms of toxic cyanobacteria have been documented in all 50 U.S. states and the transport of cyanotoxins from freshwater systems into marine coastal waters is a recently identified and potentially significant threat to public and ecosystem health.
Taken together, there is a significant increasing trend in all HAB events in HAEDAT over the 30-year study interval. Part of this observed HAB expansion simply reflects a better realization of the true or historic scale of the problem, long obscured by inadequate monitoring. Other contributing factors include the dispersion of species to new areas, the discovery of new HAB poisoning syndromes or impacts, and the stimulatory effects of human activities like nutrient pollution, aquaculture expansion, and ocean warming, among others. One result of this multifaceted expansion is that many regions of the U.S. now face a daunting diversity of species and toxins, representing a significant and growing challenge to resource managers and public health officials in terms of toxins, regions, and time intervals to monitor, and necessitating new approaches to monitoring and management. Mobilization of funding and resources for research, monitoring and management of HABs requires accurate information on the scale and nature of the national problem. HAEDAT and other databases can be of great value in this regard but efforts are needed to expand and sustain the collection of data regionally and nationally.
... People with asthma appear to be at particular risk [358]. Karenia brevis blooms are associated additionally with increases in emergency room admissions for respiratory, gastrointestinal, and neurologic illnesses [359][360][361]. There is evidence that people experience adverse effects also during Sargassum blooms [362] and from exposures to algal-derived palytoxins [363]. ...
Background: Pollution – unwanted waste released to air, water, and land by human activity – is the largest environmental cause of disease in the world today. It is responsible for an estimated nine million premature deaths per year, enormous economic losses, erosion of human capital, and degradation of ecosystems. Ocean pollution is an important, but insufficiently recognized and inadequately controlled component of global pollution. It poses serious threats to human health and well-being. The nature and magnitude of these impacts are only beginning to be understood. Goals: (1) Broadly examine the known and potential impacts of ocean pollution on human health. (2) Inform policy makers, government leaders, international organizations, civil society, and the global public of these threats. (3) Propose priorities for interventions to control and prevent pollution of the seas and safeguard human health.
Methods: Topic-focused reviews that examine the effects of ocean pollution on human health, identify gaps in knowledge, project future trends, and offer evidence-based guidance for effective intervention.
Environmental Findings: Pollution of the oceans is widespread, worsening, and in most countries poorly controlled. It is a complex mixture of toxic metals, plastics, manufactured chemicals, petroleum, urban and industrial wastes, pesticides, fertilizers, pharmaceutical chemicals, agricultural runoff, and sewage. More than 80% arises from land-based sources. It reaches the oceans through rivers, runoff, atmospheric deposition and direct discharges. It is often heaviest near the coasts and most highly concentrated along the coasts of low- and middle-income countries. Plastic is a rapidly increasing and highly visible component of ocean pollution, and an estimated 10 million metric tons of plastic waste enter the seas each year. Mercury is the metal pollutant of greatest concern in the oceans; it is released from two main sources – coal combustion and small-scale gold mining. Global spread of industrialized agriculture with increasing use of chemical fertilizer leads to extension of Harmful Algal Blooms (HABs) to previously unaffected regions. Chemical pollutants are ubiquitous and contaminate seas and marine organisms from the high Arctic to the abyssal depths.
Ecosystem Findings: Ocean pollution has multiple negative impacts on marine ecosystems, and these impacts are exacerbated by global climate change. Petroleum-based pollutants reduce photosynthesis in marine microorganisms that generate oxygen. Increasing absorption of carbon dioxide into the seas causes ocean acidification, which destroys coral reefs, impairs shellfish development, dissolves calcium-containing microorganisms at the base of the marine food web, and increases the toxicity of some pollutants. Plastic pollution threatens marine mammals, fish, and seabirds and accumulates in large mid-ocean gyres. It breaks down into microplastic and nanoplastic particles containing multiple manufactured chemicals that can enter the tissues of marine organisms, including species consumed by humans. Industrial releases, runoff, and sewage increase frequency and severity of HABs, bacterial pollution, and anti-microbial resistance. Pollution and sea surface warming are triggering poleward migration of dangerous pathogens such as the Vibrio species. Industrial discharges, pharmaceutical wastes, pesticides, and sewage contribute to global declines in fish stocks.
Human Health Findings: Methylmercury and PCBs are the ocean pollutants whose human health effects are best understood. Exposures of infants in utero to these pollutants through maternal consumption of contaminated seafood can damage developing brains, reduce IQ and increase children’s risks for autism, ADHD and learning disorders. Adult exposures to methylmercury increase risks for cardiovascular disease and dementia. Manufactured chemicals – phthalates, bisphenol A, flame retardants, and perfluorinated chemicals, many of them released into the seas from plastic waste – can disrupt endocrine signaling, reduce male fertility, damage the nervous system, and increase risk of cancer. HABs produce potent toxins that accumulate in fish and shellfish. When ingested, these toxins can cause severe neurological impairment and rapid death. HAB toxins can also become airborne and cause respiratory disease. Pathogenic marine bacteria cause gastrointestinal diseases and deep wound infections. With climate change and increasing pollution, risk is high that Vibrio infections, including cholera, will increase in frequency and extend to new areas. All of the health impacts of ocean pollution fall disproportionately on vulnerable populations in the Global South – environmental injustice on a planetary scale.
Conclusions: Ocean pollution is a global problem. It arises from multiple sources and crosses national boundaries. It is the consequence of reckless, shortsighted, and unsustainable exploitation of the earth’s resources. It endangers marine ecosystems. It impedes the production of atmospheric oxygen. Its threats to human health are great and growing, but still incompletely understood. Its economic costs are only beginning to be counted. Ocean pollution can be prevented. Like all forms of pollution, ocean pollution can be controlled by deploying data-driven strategies based on law, policy, technology, and enforcement that target priority pollution sources. Many countries have used these tools to control air and water pollution and are now applying them to ocean pollution. Successes achieved to date demonstrate that broader control is feasible. Heavily polluted harbors have been cleaned, estuaries rejuvenated, and coral reefs restored. Prevention of ocean pollution creates many benefits. It boosts economies, increases tourism, helps restore fisheries, and improves human health and well-being. It advances the Sustainable Development Goals (SDG). These benefits will last for centuries.
Recommendations: World leaders who recognize the gravity of ocean pollution, acknowledge its growing dangers, engage civil society and the global public, and take bold, evidence-based action to stop pollution at source will be critical to preventing ocean pollution and safeguarding human health. Prevention of pollution from land-based sources is key. Eliminating coal combustion and banning all uses of mercury will reduce mercury pollution. Bans on single-use plastic and better management of plastic waste reduce plastic pollution. Bans on persistent organic pollutants (POPs) have reduced pollution by PCBs and DDT. Control of industrial discharges, treatment of sewage, and reduced applications of fertilizers have mitigated coastal pollution and are reducing frequency of HABs. National, regional and international marine pollution control programs that are adequately funded and backed by strong enforcement have been shown to be effective. Robust monitoring is essential to track progress. Further interventions that hold great promise include wide-scale transition to renewable fuels; transition to a circular economy that creates little waste and focuses on equity rather than on endless growth; embracing the principles of green chemistry; and building scientific capacity in all countries. Designation of Marine Protected Areas (MPAs) will safeguard critical ecosystems, protect vulnerable fish stocks, and enhance human health and well-being. Creation of MPAs is an important manifestation of national and international commitment to protecting the health of the seas.
... Currently, the NSP incidence is low due to prevention, information and the monitoring of algal blooming [3]. In contrast, airway irritation following respiratory PbTx-exposure increase periodically including emergency room admissions [4]. Inhalation of PbTx aerosols result in respiratory symptoms especially in persons with underlying airway diseases such as asthma. ...
Red tides involving Karenia brevis expose humans to brevetoxins (PbTxs). Oral exposition triggers neurotoxic shellfish poisoning, whereas inhalation induces a respiratory syndrome and sensory disturbances. No curative treatment is available and the pathophysiology is not fully elucidated. Protease-activated receptor 2 (PAR2), cathepsin S (Cat-S) and substance P (SP) release are crucial mediators of the sensory effects of ciguatoxins (CTXs) which are PbTx analogs. This work explored the role of PAR2 and CatS in PbTx-1-induced sensory effects and deciphered the signaling pathway involved. We performed calcium imaging, PAR2 immunolocalization and SP release experiments in monocultured sensory neurons or co-cultured with keratinocytes treated with PbTx-1 or P-CTX-2. We demonstrated that PbTx-1-induced calcium increase and SP release involved CatS , PAR2 and transient receptor potential vanilloid 4 (TRPV4). The PbTx-1-induced signaling pathway included protein kinase A (PKA) and TRPV4, which are compatible with the PAR2 biased signaling induced by CatS. Internalization of PAR2 and protein kinase C (PKC), inositol triphosphate receptor and TRPV4 activation evoked by PbTx-1 are compatible with the PAR2 canonical signaling. Our results suggest that PbTx-1-induced sensory disturbances involve the PAR2-TRPV4 pathway. We identified PAR2, CatS , PKA, and PKC that are involved in TRPV4 sensitization induced by PbTx-1 in sensory neurons.
... People with asthma appear to be at particular risk [358]. Karenia brevis blooms are associated additionally with increases in emergency room admissions for respiratory, gastrointestinal, and neurologic illnesses [359][360][361]. There is evidence that people experience adverse effects also during Sargassum blooms [362] and from exposures to algal-derived palytoxins [363]. ...
Pollution – unwanted waste released to air, water, and land by human activity – is the largest environmental cause of disease in the world today. It is responsible for an estimated nine million premature deaths per year, enormous economic losses, erosion of human capital, and degradation of ecosystems.Ocean pollution is an important, but insufficiently recognized and inadequately controlled component of global pollution. It poses serious threats to human health and well-being. The nature and magnitude of these impacts are only beginning to be understood.
The review paper (1) Broadly examine the known and potential impacts of ocean pollution on human health. (2) Inform policy makers, government leaders, international organizations, civil society, and the global public of these threats. (3) Propose priorities for interventions to control and prevent pollution of the seas and safeguard human health.
... People with asthma appear to be at particular risk [358]. Karenia brevis blooms are associated additionally with increases in emergency room admissions for respiratory, gastrointestinal, and neurologic illnesses [359][360][361]. There is evidence that people experience adverse effects also during Sargassum blooms [362] and from exposures to algal-derived palytoxins [363]. ...
Background: Pollution – unwanted waste released to air, water, and land by human activity – is the largest environmental cause of disease in the world today. It is responsible for an estimated nine million premature deaths per year, enormous economic losses, erosion of human capital, and degradation of ecosystems. Ocean pollution is an important, but insufficiently recognized and inadequately controlled component of global pollution. It poses serious threats to human health and well-being. The nature and magnitude of these impacts are only beginning to be understood. Goals: (1) Broadly examine the known and potential impacts of ocean pollution on human health. (2) Inform policy makers, government leaders, international organizations, civil society, and the global public of these threats. (3) Propose priorities for interventions to control and prevent pollution of the seas and safeguard human health.
Methods: Topic-focused reviews that examine the effects of ocean pollution on human health, identify gaps in knowledge, project future trends, and offer evidence-based guidance for effective intervention.
Environmental Findings: Pollution of the oceans is widespread, worsening, and in most countries poorly controlled. It is a complex mixture of toxic metals, plastics, manufactured chemicals, petroleum, urban and industrial wastes, pesticides, fertilizers, pharmaceutical chemicals, agricultural runoff, and sewage. More than 80% arises from land-based sources. It reaches the oceans through rivers, runoff, atmospheric deposition and direct discharges. It is often heaviest near the coasts and most highly concentrated along the coasts of low- and middle-income countries. Plastic is a rapidly increasing and highly visible component of ocean pollution, and an estimated 10 million metric tons of plastic waste enter the seas each year. Mercury is the metal pollutant of greatest concern in the oceans; it is released from two main sources – coal combustion and small-scale gold mining. Global spread of industrialized agriculture with increasing use of chemical fertilizer leads to extension of Harmful Algal Blooms (HABs) to previously unaffected regions. Chemical pollutants are ubiquitous and contaminate seas and marine organisms from the high Arctic to the abyssal depths.
Ecosystem Findings: Ocean pollution has multiple negative impacts on marine ecosystems, and these impacts are exacerbated by global climate change. Petroleum-based pollutants reduce photosynthesis in marine microorganisms that generate oxygen. Increasing absorption of carbon dioxide into the seas causes ocean acidification, which destroys coral reefs, impairs shellfish development, dissolves calcium-containing microorganisms at the base of the marine food web, and increases the toxicity of some pollutants. Plastic pollution threatens marine mammals, fish, and seabirds and accumulates in large mid-ocean gyres. It breaks down into microplastic and nanoplastic particles containing multiple manufactured chemicals that can enter the tissues of marine organisms, including species consumed by humans. Industrial releases, runoff, and sewage increase frequency and severity of HABs, bacterial pollution, and anti-microbial resistance. Pollution and sea surface warming are triggering poleward migration of dangerous pathogens such as the Vibrio species. Industrial discharges, pharmaceutical wastes, pesticides, and sewage contribute to global declines in fish stocks.
Human Health Findings: Methylmercury and PCBs are the ocean pollutants whose human health effects are best understood. Exposures of infants in utero to these pollutants through maternal consumption of contaminated seafood can damage developing brains, reduce IQ and increase children’s risks for autism, ADHD and learning disorders. Adult exposures to methylmercury increase risks for cardiovascular disease and dementia. Manufactured chemicals – phthalates, bisphenol A, flame retardants, and perfluorinated chemicals, many of them released into the seas from plastic waste – can disrupt endocrine signaling, reduce male fertility, damage the nervous system, and increase risk of cancer. HABs produce potent toxins that accumulate in fish and shellfish. When ingested, these toxins can cause severe neurological impairment and rapid death. HAB toxins can also become airborne and cause respiratory disease. Pathogenic marine bacteria cause gastrointestinal diseases and deep wound infections. With climate change and increasing pollution, risk is high that Vibrio infections, including cholera, will increase in frequency and extend to new areas. All of the health impacts of ocean pollution fall disproportionately on vulnerable populations in the Global South – environmental injustice on a planetary scale.
Conclusions: Ocean pollution is a global problem. It arises from multiple sources and crosses national boundaries. It is the consequence of reckless, shortsighted, and unsustainable exploitation of the earth’s resources. It endangers marine ecosystems. It impedes the production of atmospheric oxygen. Its threats to human health are great and growing, but still incompletely understood. Its economic costs are only beginning to be counted. Ocean pollution can be prevented. Like all forms of pollution, ocean pollution can be controlled by deploying data-driven strategies based on law, policy, technology, and enforcement that target priority pollution sources. Many countries have used these tools to control air and water pollution and are now applying them to ocean pollution. Successes achieved to date demonstrate that broader control is feasible. Heavily polluted harbors have been cleaned, estuaries rejuvenated, and coral reefs restored. Prevention of ocean pollution creates many benefits. It boosts economies, increases tourism, helps restore fisheries, and improves human health and well-being. It advances the Sustainable Development Goals (SDG). These benefits will last for centuries.
Recommendations: World leaders who recognize the gravity of ocean pollution, acknowledge its growing dangers, engage civil society and the global public, and take bold, evidence-based action to stop pollution at source will be critical to preventing ocean pollution and safeguarding human health. Prevention of pollution from land-based sources is key. Eliminating coal combustion and banning all uses of mercury will reduce mercury pollution. Bans on single-use plastic and better management of plastic waste reduce plastic pollution. Bans on persistent organic pollutants (POPs) have reduced pollution by PCBs and DDT. Control of industrial discharges, treatment of sewage, and reduced applications of fertilizers have mitigated coastal pollution and are reducing frequency of HABs. National, regional and international marine pollution control programs that are adequately funded and backed by strong enforcement have been shown to be effective. Robust monitoring is essential to track progress. Further interventions that hold great promise include wide-scale transition to renewable fuels; transition to a circular economy that creates little waste and focuses on equity rather than on endless growth; embracing the principles of green chemistry; and building scientific capacity in all countries. Designation of Marine Protected Areas (MPAs) will safeguard critical ecosystems, protect vulnerable fish stocks, and enhance human health and well-being. Creation of MPAs is an important manifestation of national and international commitment to protecting the health of the seas.
... The HABs have been known to increase wages in select jobs, as many additional labor hours are needed to clean up the fish kills on that line the shore, with several counties paying anywhere from $5 to $15 per foot of beach cleanup (Morgan et al., 2007). Healthcare labor opportunities grow, as hospitals increase staff during blooms to deal with sometimes 50% more cases of respiratory issues (Kirkpatrick et al., 2006). Although these increases could be helpful to a select few, they are temporary and almost certain to have no affect on property transactions. ...
We use a hedonic valuation method to measure the costs of harmful algal blooms to properties in Southwest Florida. Persistent blooms of “red tide” have lasted for over months at a time and can render the appeal of the Gulf Coast useless, usually a valuable amenity to property prices in the area. We study property prices over a sixteen-year period during which, four major blooms plagued the coast. We find property prices within five miles of the coast decline about 10% during a persistent bloom. Property prices also decrease more, in a non-linear fashion as blooms persist for additional months. Our estimate of local costs, although the first of its kind for this region and this type of algae, is similar to those found elsewhere in the literature for different algae across the country. Our results show the importance of mitigation, as counties face tight budgets and must realize the full external costs of these blooms. Keywords: Harmful algal blooms, Karenia brevis, Red tide, Florida gulf coast, Econometrics, Hedonic valuation
... Our patient was exposed to red tide during a period of high concentration (Figure 1). While the annual number of cases of brevotoxin exposure is unknown, studies show an increase in emergency room visits for respiratory symptoms during peak periods [9]. Kirkpatrick et al. found a 19% increase in rates of pneumonia diagnoses during a red tide period compared to a non-red tide period. ...
Florida red tides occur annually due to proliferation of the marine dinoflagellate Karenia brevis , which produces neurotoxins known as brevotoxins. Inhalational exposure to brevotoxins usually results in upper airway symptoms only. Rarely does exposure lead to lower respiratory tract symptoms as in our case. We report a case of a 50-year-old man who presented with a 4-week history of dyspnea after exposure to the red tide. Computed tomography (CT) of the chest showed diffuse bilateral ground glass opacities and interstitial thickening. Bronchoalveolar lavage cultures and cytology were negative. The patient was started on steroids. Over the next few weeks, the patient’s symptoms resolved. Repeat CT chest showed complete resolution of the ground glass opacities. Steroids were then tapered. Most patients who are exposed to algal blooms have self-limiting symptoms. Patients with asthma are particularly susceptible to worsening respiratory symptoms after exposure to brevotoxin aerosols. This case highlights that, in rare cases, exposure to red tide can results in severe lower respiratory tract symptoms.
... 15 The dinoflagellates release neurotoxins that are responsible for a variety of ailments, including neurotoxic shellfish poisoning and respiratory symptoms from ocean aerosols. 1,12,16,17 In the Gulf of Mexico, Karenia brevis releases a suite of toxins known as brevetoxins (PbTx). 13 K. brevis blooms occur nearly annually, and last anywhere from a few weeks to longer than a year. ...
Harmful algal blooms (HABs) occur when excess nutrients allow dinoflagellates to reproduce in large numbers. Marine animals are affected by blooms when algal toxins are ingested or inhaled. In the Gulf of Mexico, near annual blooms of Karenia brevis release a suite of compounds (brevetoxins) that cause sea turtle morbidity and mortality. The primary treatment at rehabilitation facilities for brevetoxin-exposed sea turtles is supportive care, and it has been difficult to design alternative treatment strategies without an understanding of the effects of brevetoxins in turtles in vivo. Previous studies using the freshwater turtle as a model species showed that brevetoxin-3 impacts the nervous and muscular systems, and is detoxified and eliminated primarily through the liver, bile, and feces. In this study, freshwater turtles (Trachemys scripta) were exposed to brevetoxin (PbTx-3) intratracheally at doses causing clear systemic effects, and treatment strategies aimed at reducing the postexposure neurological and muscular deficits were tested. Brevetoxin-exposed T. scripta displayed the same behaviors as animals admitted to rehabilitation centers for toxin exposure, ranging from muscle twitching and incoordination to paralysis and unresponsiveness. Two treatment regimes were tested: cholestyramine, a bile acid sequestrant; and an intravenous lipid emulsion treatment (Intralipidt) that provides an expanded circulating lipid volume. Cholestyramine was administered orally 1 hr and 6 hr post PbTx-3 exposure, but this regime failed to increase toxin clearance. Animals treated with Intralipid (100 mg/kg) 30 min after PbTx-3 exposure had greatly reduced symptoms of brevetoxicosis within the first 2 hr compared with animals that did not receive the treatment, and appeared fully recovered within 24 hr compared with toxin-exposed control animals that did not receive Intralipid. The results strongly suggest that Intralipid treatment for lipophilic toxins such as PbTx-3 has the potential to reduce morbidity and mortality in HAB-exposed sea turtles.
... During active Florida red tide blooms, Fleming et al. (2005aFleming et al. ( , 2005bFleming et al. ( , 2011Bean et al., 2011) found that brevetoxin aerosols could exacerbate asthma or other respiratory conditions with acute and sub-chronic sequelae. Kirkpatrick et al. (2006Kirkpatrick et al. ( , 2009 identified increased visits to a hospital emergency department in Sarasota, Florida associated with red tide blooms for a range of respiratory and digestive illnesses. Hoagland et al. (2009) used an exposure-response framework to estimate the potential economic effects of K. brevis blooms on Florida emergency department visits to a single hospital for respiratory illnesses during 2001-06. ...
... Although human poisoning events are few in the developed world due to careful monitoring of seafood products, it has been estimated that direct human poisonings in many parts of Asia from toxic algae number in the thousands annually (Yan and Zhou 2004). In Florida, USA, when Karenia brevis blooms occur, increases in hospitalizations have been reported due to gastrointestinal and respiratory irritation that especially affects those that are immune-compromised (Kirkpatrick et al. 2006). CyanoHABs also have a range of human effects, depending on the toxin involved. ...
The complexity of the harmful algal bloom (HAB) problem, its causative factors, and the impacts HABs have on the environment are becoming well characterized. The benefits of collaborative, cooperative, and comparative studies on HABs are important in advancing the understanding of this phenomenon and to provide scientific guidance to managers. This chapter introduces several aspects of this complex phenomenon, by addressing the following questions: what are HABs, how are they harmful, where do they occur, why are they expanding, and why the need for an improved understanding of their ecology and oceanography? In so doing, this chapter lays the foundation for the following chapters in this volume that probe these questions and the related advancements in research in more detail.
... Studies attempting to assess the human health effects of red tide blooms have been reported. One study, in Sarasota, Florida, found a 19% increase in the rate of pneumonia cases diagnosed during a 3month onshore red tide event and, among coastal residents, a 54% higher rate of diagnoses of respiratory illness (pneumonia, bronchitis, asthma, and upper airway disease) (7). Other studies have found significant measureable adverse changes in the lung function of asthma patients after exposure to brevetoxins (6,8). ...
Recreational water activities are widely recognized to have a positive impact on our physical and mental well-being. However, recreational water sources and their management are also a risk factor for human health due to different agents, including the overgrowth of cyanobacteria and algae. The presence of cyanobacteria and algae in recreational waters represents a One Health threat because of their potential release and the overuse of biocides. These organisms have the potential to metabolize organic matter and produce thermophilic and thermotolerant toxins. Moreover, different species of algae are involved in biofilm formation processes, thus impacting water quality and safety and also posing risks to the environment and animal and human health. Different species of algae participate in biofilm formation and have an impact on managing water and equipment maintenance. By searching literature databases, e.g., PubMed, we reviewed the state of the art, providing basic definitions, taxonomy, and epidemiological or medical issues related to the recreational uses of water. Methods of treatments and monitoring were summarized, considering both traditional and innovative strategies. Public health and surveillance approaches focus on the detection of toxins, the formation of biofilms, and the understanding of the benthonic and planktonic components as part of the larger microbial biodiversity. The review process allowed us to acknowledge that this is the first comprehensive overview of algae in recreational waters carried out within a wider One Health outlook.
Recreational water activities are widely recognized to have a positive impact on our physical and mental well-being. However, recreational water sources and their management are also a risk factor for human health, due to different agents, including the overgrowth of cyanobacteria and algae. These organisms have the potential to metabolize organic matter and produce thermophilic and thermotolerant toxins. Different species of algae participate in biofilm formation and impact on maintenance of equipment for water treatment. We reviewed the state of the art by providing basic definitions, taxonomy and the epidemiological and clinical issues related to the recreational uses of waters. Methods for treatments and monitoring are summarized, considering both traditional and innovative strategies. Public health and surveillance perspectives impose to focus on the detection of toxins, the formation of biofilms, the understanding of the benthonic and planktonic components as part of a larger microbial biodiversity.
Human lymphoblast cells were treated with the marine algal toxin, brevetoxin-2 (PbTx-2), and its effects on the proteome were assessed by redox proteomics using cysteine reactive tandem mass tags (TMT). Additionally, cells were simultaneously treated with PbTx-2 and the antioxidant and acrolein scavenger sodium 2-mercaptoethylsulfonate (MESNA) to determine if MESNA could prevent the proteomic effects of brevetoxin-2. A massive shift in the redox state of the proteome of brevetoxin-2 treated cells was observed. The main pathway affected was genetic information processing. Significantly oxidized proteins included Trx-1, peroxyredoxins (Prxs), ribosomal proteins, and the eukaryotic initiation factor 2 β subunit (eIF2β). Proteins that were overexpressed in brevetoxin-treated cells included four folding chaperones. These effects were diminished in the presence of MESNA indicating that MESNA may act through its antioxidant properties or as a brevetoxin scavenger. These studies provide novel insights into new prophylactics for brevetoxicosis in humans and wildlife.
Harmful algal blooms (HABs) can cause massive fish kills all over the world. However, some commercially caught species are safe to eat. The fish safe for consumption are vastly different from the fish that wash up on shore. Prior research finds this difference in edibility is mostly unknown by consumers, and that the misperception of unhealthy and unsafe fish is the dominant paradigm. To date, there has been minimal research on the effect of disseminating this information regarding seafood health to consumers, and how consumption habits would change during a bloom. We implement a survey that presents respondents with information explaining the health and safety of certain commercially caught seafood during a HAB, specifically red grouper. It is a particularly popular, large, deep-sea fish. Our results suggest that respondents receiving this information are 34 percentage points more likely to say that they would be willing to consume red grouper during a bloom, relative to consumers who were not provided this added information. Prior knowledge of this information suggests long-term outreach programs may be more effective than last minute "point of sale" information campaigns. The results demonstrated the importance of correct knowledge and awareness regarding HABs, as it pertains to efforts to stabilize local economies dependent on seafood harvesting and consumption.
The adverse economic impacts of harmful algal blooms can be mitigated via tailored forecasting methods. Adequate provision of these services requires knowledge of the losses avoided, or, in other words, the economic benefits they generate. The latter can be difficult to measure for broader population segments, especially if forecasting services or features do not yet exist. We illustrate how stated preference tools and choice experiments are well suited for this case. Using as example forecasts of respiratory irritation levels associated with airborne toxins caused by Florida red tide, we show that 24-hour predictions of spatially and temporally refined air quality conditions are valued highly by the underlying population. This reflects the numerous channels and magnitude of red tide impacts on locals’ life and activities, which are also highlighted by our study. Our approach is broadly applicable to any type of air quality impediment with risk of human exposure.
An accurate forecast of the red tide respiratory irritation level would improve the lives of many people living in areas affected by algal blooms. Using a decades-long database of daily beach conditions, two conceptually different models to forecast the respiratory irritation risk level one day ahead of time are trained. One model is wind-based, using the current days’ respiratory level and the predicted wind direction of the following day. The other model is a probabilistic self-exciting Hawkes process model. Both models are trained on beaches in Florida during 2011--2017 and applied to the red tide bloom during 2018-2019. For beaches where there is enough historical data to develop a model, the model which performs best depends on the beach. The wind-based model is the most accurate at half the beaches, correctly predicting the respiratory risk level on average about 84% of the time. The Hawkes model is the most accurate (81% accuracy) at nearly all of the remaining beaches.
Brevetoxins (PbTx) are a well-recognized group of neurotoxins associated with harmful algal blooms, and specifically recurrent “Florida Red Tides,” in marine waters that are linked to impacts on both human and ecosystem health including well-documented “fish kills” and marine mammal mortalities in affected coastal waters. Understanding mechanisms and pathways of PbTx toxicity enables identification of relevant biomarkers to better understand these environmental impacts, and improve monitoring efforts, in relation to this toxin. Toward a systems-level understanding of toxicity, and identification of potential biomarkers, high-resolution magic angle spinning nuclear magnetic resonance (HRMAS NMR) was utilized for metabolic profiling of zebrafish (Danio rerio) embryos, as an established toxicological model, exposed to PbTx-2 (the most common congener in marine waters). Metabolomics studies were, furthermore, complemented by an assessment of the toxicity of PbTx-2 in embryonic stages of zebrafish and mahi-mahi (Coryphaena hippurus), the latter representing an ecologically and geographically relevant marine species of fish, which identified acute embryotoxicity at environmentally relevant (i.e., parts-per-billion) concentrations in both species. HRMAS NMR analysis of intact zebrafish embryos exposed to sub-lethal concentrations of PbTx-2 afforded well-resolved spectra, and in turn, identification of 38 metabolites of which 28 were found to be significantly altered, relative to controls. Metabolites altered by PbTx-2 exposure specifically included those associated with (1) neuronal excitotoxicity, as well as associated neural homeostasis, and (2) interrelated pathways of carbohydrate and energy metabolism. Metabolomics studies, thereby, enabled a systems-level model of PbTx toxicity which integrated multiple metabolic, molecular and cellular pathways, in relation to environmentally relevant concentrations of the toxin, providing insight to not only targets and mechanisms, but potential biomarkers pertinent to environmental risk assessment and monitoring strategies.
Le golfe de Tunis, subissant une forte pression anthropique, constitue un terrain propice aux efflorescences des dinoflagellés benthiques nuisibles (BHABs). Un suivi saisonnier de la distribution spatio-temporelle des microalgues épiphytes et planctoniques couplée à des facteurs environnementaux a été étudiée durant une année à partir d'octobre 2013 à octobre 2014 au niveau de 6 stations du golfe de Tunis. Les assemblages de microalgues nuisibles ont été dominés par trois dinoflagellés épiphytes toxiques : Ostreopsis sp., Prorocentrum lima et Coolia monotis qui ayant été observés à la fois sur des macrophytes et dans la colonne d’eau. La prolifération d'Ostreopsis sp. en lieu principalement en été alors que les efflorescences de P. lima et C. monotis ont été signalées au printemps. Une analyse morphométrique des cellules d'Ostreopsis cf. ovata a permis de mettre en évidence une grande variabilité de la taille des cellules en fonction des différentes stations de prélèvement du golfe de Tunis. Le rapport dorso-ventral sur le diamètre antéro-postérieur (DV/AP) varie également selon la station de prélèvement. Un suivi hebdomadaire de la distribution spatio-temporelle des cellules d'Ostreopsis cf. ovata épiphytes et planctoniques, couplée à des facteurs environnementaux a été étudiée durant les saisons estivales 2015 et 2016 au niveau de 5 stations de prélèvement du golfe de Tunis. Les efflorescences ont été principalement détectées entre les mois de juillet et d'août. Les concentrations d'Ostreopsis cf. ovata estimées ont été les plus élevées (9,91 × 105 cell. g-1 MF sur macroalgue et 5,11 × 105 cell. dm-3 dans la colonne d'eau) par rapport aux données déjà recensées sur les côtes Tunisiennes. Les pics d'Ostreopsis cf. ovata ont été observés lorsque la salinité et la température de l'eau ont atteint des valeurs élevées, et des concentrations faibles en nitrites, nitrates, azote total et silicates. Une variation spatiale est observée le long du littoral du golfe de Tunis, suggérant que certaines stations seraient plus propices au développement d'Ostreopsis cf. ovata que d'autres. Les méthodes de comptage alternatives MOL et OPR d'Ostreopsis cf. ovata, mises en place lors du projet M3-HABs et testées dans la présente étude, sont en bon accord avec les résultats du comptage manuel. Un modèle prédictif du type Quantile Random Forests a été utilisé et a pu décrire l'abondance d'Ostreopsis cf. ovata dans la colonne d'eau et sur les macrophytes en réponse à 10 variables météorologiques employées dans ce modèle.
Harmful algae blooms (HABs) in coastal marine environments are increasing in number and duration, pressuring local resource managers to implement mitigation solutions to protect human and ecosystem health. However, insufficient spatial and temporal observations create uninformed management decisions. In order to better detect and map blooms, as well as the environmental conditions responsible for their formation, long-term, unattended observation platforms are desired. In this article, we describe a new cost-efficient, autonomous, mobile platform capable of accepting several sensors that can be used to monitor HABs in near real time. The Navocean autonomous sail-powered surface vehicle is deployable by a single person from shore, capable of waypoint navigation in shallow and deep waters, and powered completely by renewable energy. We present results from three surveys of the Florida Red Tide HAB (Karenia brevis) of 2017–2018. The vessel made significant progress toward waypoints regardless of wind conditions while underway measurements revealed patches of elevated chl. a likely attributable to the K. brevis blooms as based on ancillary measurements. Measurements of colored dissolved organic matter (CDOM) and turbidity provided an environmental context for the blooms. While the autonomous sailboat directly adds to our phytoplankton/HAB monitoring capabilities, the package may also help to ground-truth satellite measurements of HABs if careful validation measurements are performed. Finally, several other pending and future use cases for coastal and inland monitoring are discussed. To our knowledge, this is the first demonstration of a sail-driven vessel used for coastal HAB monitoring.
Harmful algal blooms (HABs) pose threats to the environment, public health, and a variety of commercial interests and industries. A single bloom can lead to devastating outcomes, including large mortalities of marine organisms (e.g., fish kills); toxic contamination of filter-feeding organisms such as bivalve shellfish that subsequently enter the market for distribution to consumers; economic hardships for fisheries, aquaculture, and recreational- and tourism-related industries; and a compromised quality of life for people living or working along affected shorelines.
Reductions of zooplankton biomasses and grazing pressures were observed during overfishing-induced trophic cascades and concurrent oil spills at global scales. Recent phytoplankton increments followed, once Fe-, P-, and N-nutrient limitations of commensal diazotrophs and dinoflagellates were also eliminated by respective human desertification, deforestation, and eutrophication during climate changes. Si-limitation of diatoms instead ensued during these last anthropogenic perturbations of agricultural effluents and sewage loadings. Consequently, ~15% of total world-wide annual asthma trigger responses, i.e. amounting to ~45 million adjacent humans during 2004, resulted from brevetoxin and palytoxin poisons in aerosol forms of western boundary current origins. They were denoted by greater global harmful algal bloom [HAB] abundances and breathing attacks among sea-side children during prior decadal surveys of asthma prevalence, compiled here in ten paired shelf ecosystems of western and eutrophied boundary currents. Since 1965, such inferred onshore fluxes of aerosolized DOC poisons of HABs may have served as additional wind-borne organic carriers of toxic marine MeHg, phthalate, and DDT/DDE vectors, traced by radio-iodine isotopes to potentially elicit carcinomas. During these exchanges, as much as 40% of mercury poisonings may instead have been effected by inhalation of collateral HAB-carried marine neurotoxic aerosols of MeHg, not just from eating marine fish. Health impacts in some areas were additional asthma and pneumonia episodes, as well as endocrine disruptions among the same adjacent humans, with known large local rates of thyroid cancers, physician-diagnosed pulmonary problems, and ubiquitous high indices of mercury in hair, pesticides in breast milk, and phthalates in urine.
In 1996, at least 149 manatees (Trichechus manatus latirostris) died in an unprecedented epizootic along the southwest coast of Florida. At about the same time, a bloom of the brevetoxin-producing dinoflagellates, Gymnodinium breve, was present in the same area. Grossly, severe nasopharyngeal, pulmonary, hepatic, renal, and cerebral congestion was present in all cases. Nasopharyngeal and pulmonary edema and hemorrhage were also seen. Consistent microscopic lesions consisted of catarrhal rhinitis, pulmonary hemorrhage and edema, multiorgan hemosiderosis, and nonsuppurative leptomeningitis. Immunohistochemical staining using a polyclonal primary antibody to brevetoxin (GAB) showed intense positive staining of lymphocytes and macrophages in the lung, liver, and secondary lymphoid tissues. Additionally, lymphocytes and macrophages associated with the inflammatory lesions of the nasal mucosa and meninges were also positive for brevetoxin. These findings implicate brevetoxicosis as a component of and the likely primary etiology for the epizootic. The data suggest that mortality resulting from brevetoxicosis may not necessarily be acute but may occur after chronic inhalation and/or ingestion. Immunohistochemical staining with interleukin-1-beta-converting enzyme showed positive staining with a cellular tropism similar to GAB. This suggests that brevetoxicosis may initiate apoptosis and/or the release of inflammatory mediators that culminate in fatal toxic shock.
Brevetoxins are produced by the unarmored marine dinoflagellate Gymnodinium breve (Prychodiscus brevis), an organism linked to red tide outbreaks in the Gulf of Mexico, New Zealand, and Japan. These toxins are responsible for toxicity to marine animals, neurotoxic shellfish poisoning in humans, and respiratory distress if the toxins are inhaled in sea spray. Dinoflagellates are eukaryotes and most are photosynthetic, with at least one form in the life cycle being motile. Of the total known 2000 species of dinoflagellates, only about 20 species have been shown to produce specific toxins. G. breve is a unicellular alga which is the causative organism of red tide resulting from blooms of this toxic dinoflagellate along the west coast of Florida and elsewhere in the Gulf of Mexico. A similar toxic species occurs in Spain, Japan, and more recently in New Zealand waters.
Florida red tides are a natural phenomenon caused by dense aggregations of single cell or several species of unicellular organisms. Patches of discolored water, dead or dying fish, and respiratory irritants in the air often characterize these algal blooms. In humans, two distinct clinical entities, depending on the route of exposure, are associated with exposure to the Florida red tide toxins (particularly the brevetoxins). With the ingestion of brevetoxin-contaminated shellfish, neurotoxic shellfish poisoning (NSP) presents as a milder gastroenteritis with neurologic symptoms compared with other marine toxin diseases such as paralytic shellfish poisoning (PSP) or ciguatera fish poisoning. With the inhalation of the aerosolized red tide toxins (especially the brevetoxins) from the sea spray, respiratory irritation and possibly other health effects are reported in both humans and other mammals (Baden 1995, Fleming 1998a, Fleming 1998b, Fleming 1999a, Bossart 1998, Asai 1982, Eastaugh 1989, Pierce 1986, Music 1973, Temple 1995, Anderson 1994).This paper reviews the literature on the known and possible human health effects of exposure to the Florida red tides and their toxins. The review includes discussion of the red tide organisms and their toxins, as well as the effects of these toxins on both wild and laboratory animals as they relate to possible human health effects and exposures.
Blooms of toxic or harmful microalgae, commonly called "red tides," represent a significant and expanding threat to human health and fisheries resources throughout the United States and the world. Ecological, aesthetic, and public health impacts include: mass mortalities of wild and farmed fish and shellfish, human intoxication and death from the consumption of contaminated shellfish or fish, alterations of marine food webs through adverse effects on larvae and other life history stages of commercial fish species, the noxious smell and appearance of algae accumulated in nearshore waters or deposited on beaches, and mass mortalities of marine mammals, seabirds, and other animals. In this report, we provide an estimate of the economic impacts of HABs in the United States from events where such impacts were measurable with a fair degree of confidence during the interval 1987-92. The total economic impact averaged $49 million per year, with public health impacts representing the largest component (45 percent). Commercial fisheries impacts were the next largest (37 percent of the total), while recreation/tourism accounted for 13 percent, and monitoring/management impacts 4 percent. These estimates are highly conservative, as many economic costs or impacts from HABs could not be estimated. Funding was provided by the National Oceanic and Atmospheric Administration under Grants No. NA46RG0470 and NA90AA-D-SG480, the National Science Foundation under Grant No. OCE-9321244, and the Johnson Endowment of the Marine Policy Center.
Ptychodiscus brevis toxin (brevetoxin) is associated with 'Florida red tide' and cause neurotoxic shellfish poisoning. Saxitoxin is the agent of paralytic shellfish poisoning. Clinical reports of human intoxication suggest that both toxins affect the respiratory system. The toxins were administered by slow intravenous infusion. The effects of the toxins on respiratory function of awake guinea pigs in a pressure plethysmograph were studied. Both toxins caused lactic acidosis of unknown etiology, which was compensated for by increased minute volume with brevetoxin (PbTx-3)- but not with saxitoxin-intoxicated animals. In general, brevetoxin increased ventilation, before respiratory failure, while saxitoxin had a depressive effect on ventilation. Airways resistance was not increased, nor was dynamic compliance decreased during intoxication, although the data suggest that respiratory system failure was the primary cause of death. The responses seen in these experiments are consistent with the dissimilar molecular actions of these toxins.
Florida red tides annually occur in the Gulf of Mexico, resulting from blooms of the marine dinoflagellate Karenia brevis. K. brevis produces highly potent natural polyether toxins, known as brevetoxins, that activate voltage-sensitive sodium channels. In experimental animals, brevetoxins cause significant bronchoconstriction. A study of persons who visited the beach recreationally found a significant increase in self-reported respiratory symptoms after exposure to aerosolized Florida red tides. Anecdotal reports indicate that persons with underlying respiratory diseases may be particularly susceptible to adverse health effects from these aerosolized toxins. Fifty-nine persons with physician-diagnosed asthma were evaluated for 1 hr before and after going to the beach on days with and without Florida red tide. Study participants were evaluated with a brief symptom questionnaire, nose and throat swabs, and spirometry approved by the National Institute for Occupational Safety and Health. Environmental monitoring, water and air sampling (i.e., K. brevis, brevetoxins, and particulate size distribution), and personal monitoring (for toxins) were performed. Brevetoxin concentrations were measured by liquid chromatography mass spectrometry, high-performance liquid chromatography, and a newly developed brevetoxin enzyme-linked immunosorbent assay. Participants were significantly more likely to report respiratory symptoms after Florida red tide exposure. Participants demonstrated small but statistically significant decreases in forced expiratory volume in 1 sec, forced expiratory flow between 25 and 75%, and peak expiratory flow after exposure, particularly those regularly using asthma medications. Similar evaluation during nonexposure periods did not significantly differ. This is the first study to show objectively measurable adverse health effects from exposure to aerosolized Florida red tide toxins in persons with asthma. Future studies will examine the possible chronic effects of these toxins among persons with asthma and other chronic respiratory impairment.
Karenia brevis (formerly Gymnodinium breve) is a marine dinoflagellate responsible for red tides that form in the Gulf of Mexico. K. brevis produces brevetoxins, the potent toxins that cause neurotoxic shellfish poisoning. There is also limited information describing human health effects from environmental exposures to brevetoxins. Our objective was to examine the impact of inhaling aerosolized brevetoxins during red tide events on self-reported symptoms and pulmonary function. We recruited a group of 28 healthy lifeguards who are occupationally exposed to red tide toxins during their daily work-related activities. They performed spirometry tests and reported symptoms before and after their 8-hr shifts during a time when there was no red tide (unexposed period) and again when there was a red tide (exposed period). We also examined how mild exercise affected the reported symptoms and spirometry tests during unexposed and exposed periods with a subgroup of the same lifeguards. Environmental sampling (K. brevis cell concentrations in seawater and brevetoxin concentrations in seawater and air) was used to confirm unexposed/exposed status. Compared with unexposed periods, the group of lifeguards reported more upper respiratory symptoms during the exposed periods. We did not observe any impact of exposure to aerosolized brevetoxins, with or without mild exercise, on pulmonary function.
Red tides in the Gulf of Mexico are commonly formed by the fish-killing dinoflagellate Karenia brevis, which produces nine potent polyether brevetoxins (PbTxs). Brevetoxins can be transferred from water to air in wind-powered white-capped waves. Inhalation exposure to marine aerosol containing brevetoxins causes respiratory symptoms. We describe detailed characterization of aerosols during an epidemiologic study of occupational exposure to Florida red tide aerosol in terms of its concentration, toxin profile, and particle size distribution. This information is essential in understanding its source, assessing exposure to people, and estimating dose of inhaled aerosols. Environmental sampling confirmed the presence of brevetoxins in water and air during a red tide exposure period (September 2001) and lack of significant toxin levels in the water and air during an unexposed period (May 2002). Water samples collected during a red tide bloom in 2001 showed moderate-to-high concentrations of K. brevis cells and PbTxs. The daily mean PbTx concentration in water samples ranged from 8 to 28 microg/L from 7 to 11 September 2001; the daily mean PbTx concentration in air samples ranged from 1.3 to 27 ng/m(3). The daily aerosol concentration on the beach can be related to PbTx concentration in water, wind speed, and wind direction. Personal samples confirmed human exposure to red tide aerosols. The particle size distribution showed a mean aerodynamic diameter in the size range of 6-12 microm, with deposits mainly in the upper airways. The deposition pattern correlated with the observed increase of upper airway symptoms in healthy lifeguards during the exposure periods.
During a Florida red tide, brevetoxins produced by the dinoflagellate Karenia brevis become aerosolized and cause airway symptoms in humans, especially in those with pre-existing airway disease (e.g., asthma). To understand these toxin-induced airway effects, we used sheep with airway hypersensitivity to Ascaris suum antigen as a surrogate for asthmatic patients and studied changes in pulmonary airflow resistance (RL) after inhalation challenge with lysed cultures of K. brevis (crude brevetoxins). Studies were done without and with clinically available drugs to determine which might prevent/reverse these effects. Crude brevetoxins (20 breaths at 100 pg/mL; n = 5) increased R
L 128 ± 6% (mean ± SE) over baseline. This bronchoconstriction was significantly reduced (% inhibition) after pretreatment with the glucocorticosteroid budesonide (49%), the β 2 adrenergic agent albuterol (71%), the anticholinergic agent atropine (58%), and the histamine H1-antagonist diphenhydramine (47%). The protection afforded by atropine and diphenhydramine suggests that both cholinergic (vagal) and H1-mediated pathways contribute to the bronchoconstriction. The response to cutaneous toxin injection was also histamine mediated. Thus, the airway and skin data support the hypothesis that toxin activates mast cells in vivo. Albuterol given immediately after toxin challenge rapidly reversed the bronchoconstriction. Toxin inhalation increased airway kinins, and the response to inhaled toxin was enhanced after allergen challenge. Both factors could contribute to the increased sensitivity of asthmatic patients to toxin exposure. We conclude that K. brevis aerosols are potent airway constrictors. Clinically available drugs may be used to prevent or provide therapeutic relief for affected individuals.
Brevetoxins are potent neurotoxins produced by the marine dinoflagellate Karenia brevis. Exposure to brevetoxins may occur during a K. brevis red tide when the compounds become aerosolized by wind and surf. This study assessed possible adverse health effects associated with inhalation exposure to brevetoxin 3, one of the major brevetoxins produced by K. brevis and present in aerosols collected along beaches affected by red tide. Male F344 rats were exposed to brevetoxin 3 at 0, 37, and 237 microg/m3 by nose-only inhalation 2 hr/day, 5 days/week for up to 22 exposure days. Estimated deposited brevetoxin 3 doses were 0.9 and 5.8 microg/kg/day for the low- and high-dose groups, respectively. Body weights of the high-dose group were significantly below control values. There were no clinical signs of toxicity. Terminal body weights of both low- and high-dose-group rats were significantly below control values. Minimal alveolar macrophage hyperplasia was observed in three of six and six of six of the low- and high-dose groups, respectively. No histopathologic lesions were observed in the nose, brain, liver, or bone marrow of any group. Reticulocyte numbers in whole blood were significantly increased in the high-dose group, and mean corpuscular volume showed a significant decreasing trend with increasing exposure concentration. Humoral-mediated immunity was suppressed in brevetoxin-exposed rats as indicated by significant reduction in splenic plaque-forming cells in both low- and high-dose-group rats compared with controls. Results indicate that the immune system is the primary target for toxicity in rats after repeated inhalation exposure to relatively high concentrations of brevetoxins.
Seafood constitutes a significant proportion of the world food supply, and more than 70 million tons are harvested each year. Per capita global annual seafood consumption averaged about 13 kg in the mid 1990s (Lipp and Rose, 1997) and estimated seafood consumption in the U.S. in 2000 was 9 kg per person per year (Spalding, 1995). Although it is an important and popular food source, seafood ingestion is not free from associated public-health risks. In fact, seafood ranked third on the list of products most frequently associated with foodborne disease (Lipp and Rose, 1997); one type of seafood-related disease, ciguatera fish poisoning, is the most commonly reported food poisoning caused by a chemical toxin (Centers for Disease Control and Prevention, 1996).
Brevetoxins are neurotoxins produced by the marine dinoflagellate Karenia brevis. Histopathologic examination of marine mammals dying following repeated exposure of brevetoxins during red tide events suggests that the respiratory tract, nervous, hematopoietic, and immune systems are potential targets for toxicity in repeatedly exposed individuals. The purpose of this experiment was to evaluate the effects of repeated inhalation of K. brevis extract on these potential target systems in rats. Male Sprague-Dawley rats were exposed four hours/day, five days/week for up to four weeks to target concentrations of 200 and 1000 μg/L K. brevis extract (approximately 50 and 200 μg/L brevetoxin-like compounds; positive neurotoxicity in a fish bioassay). Control rats were sham exposed to air. Immunohistochemical staining of pulmonary macrophages indicated deposition of brevetoxin-like compound within the lung. However, exposure resulted in no clinical signs of toxicity or behavioral changes. There were no adverse effects on hematology or serum chemistry. No histopathological changes were observed in the nose, lung, liver, kidneys, lymph nodes, spleen, or brain of exposed rats. Immune suppression was suggested by reduced responses of spleen cells in the IgM-specific antibody-forming plaque cell response assay and reduced responses of lymphocytes to mitogen stimulation in vitro. Differences between responses observed in rats in this study and those observed in manatees may be a function of dose or species differences in sensitivity.
During two separate Karenia brevis red tide events, we measured the levels of brevetoxins in air and water samples, conducted personal interviews, and performed pulmonary function tests on people before and after they visited one of two Florida beaches. One hundred and twenty-nine people participated in the study, which we conducted during red tide events in Sarasota and Jacksonville, FL, USA. Exposure was categorized into three levels: low/no exposure, moderate exposure, and high exposure. Lower respiratory symptoms (e.g. wheezing) were reported by 8% of unexposed people, 11% of the moderately exposed people, and 28% of the highly exposed people. We performed nasal-pharyngeal swabs on people who experienced moderate or high exposure, and we found an inflammatory response in over 33% of these participants. We did not find any clinically significant changes in pulmonary function test results; however, the study population was small. In future epidemiologic studies, we plan to further investigate the human health impact of inhaled brevetoxins.
We have developed an approach to search for molecules that can be used as lead compounds in designing an inhibitor for a given proteolytic enzyme when the 3D structure of a homologous protein is known. This approach is based on taking the cast of the binding pocket of the protease and comparing its dimensions with that of the dimensions of small molecules. Herein the 3D structure of papain is used to model cathepsin L using the comparative modeling technique. The cast of the binding pocket is computed using the crystal structure of papain because the structures of papain and the model of cathepsin L are found to be similar at the binding site. The dimensions of the cast of the binding site of papain are used to screen for molecules from the Cambridge Structural Database (CSD) of small molecules. Twenty molecules out of the 80,000 small molecules in the CSD are found to have dimensions that are accommodated by the papain binding pocket. Visual comparison of the shapes of the cast and the 20 screened molecules resulted in identifying brevotoxin b, a toxin isolated from the 'red tide' dinoflagellate Ptycho brevis (previously classified as Gymonodium breve), as the structure that best fits the binding pocket of papain. We tested the proteolytic activity of papain and cathepsin L in the presence of brevotoxin b and found inhibition of papain and cathepsin L with Kis of 25 microM and 0.6 microM, respectively. We also compare our method with a more elaborate method in the literature, by presenting our results on the computer search for inhibitors of the HIV-1 protease.
This chapter describes the marine food-borne dinoflagellate toxins. Toxins are substances potentially noxious to living organisms. These include poisonous substances produced by marine algae, either as byproducts of metabolism or as the necessary intermediates of metabolism for cellular growth, maintenance, or reproduction. The unifying factor in toxins is their ability to be transmitted to humans through bioaccumulation in an intermediate marine host. The intermediate accumulator of toxin, known as a “transvector,” can be divided into primary and secondary types. Dinoflagellates are foremost both in the number of known toxic species and in the potency of the toxins produced. Dinoflagellates that are responsible for the biosynthesis of many toxic compounds transmitted through the food chain are eukaryotes. The dinoflagellates are divided into two groups: those associated with red tides (the classic bloom organisms) and those associated with Ciguatera. The chapter discusses the toxinology of marine food-borne dinoflagellate toxins and describes some of the ecological factors governing the initiation and maintenance of toxic populations.
Brevetoxins are cyclic polyether neurotoxins produced by the marine dinoflagellate Ptychodiscus brevis. Blooms of P. brevis (red tides) are toxic to fish, marine mammals, and humans. Humans exposed to seaspray aerosols containing brevetoxins may experience respiratory tract irritation. Because a major route of human exposure to brevetoxins is via the respiratory tract, the objective of this study was to examine the toxicokinetics of brevetoxin 3 (PbTx-3) administered to the lung by intratracheal instillation. Twenty-one male F344/Crl BR rats, 12 wk of age, were administered 3H-PbTx-3 (1 microCi, 6.6 microg PbTx-3/kg) by intratracheal instillation. Groups of 3 rats were sacrificed at 0.5, 3, 6, 24, 48, and 96 h after exposure, and tissues were collected. Three additional rats were placed in glass metabolism cages for collection of urine and feces over a 7-d period. PbTx-3-associated activity was cleared rapidly from the lung and distributed throughout the body, chiefly to the carcass, intestines, and liver. Blood, brain, and fat contained the lowest percentages of the administered dose. Although a majority of the PbTx-3 was cleared rapidly from lung, liver, and kidneys, approximately 20% of the initial concentration present in each organ was retained for 7 d. Concentrations of PbTx-3 in brain and fat were low, but remained relatively constant over time. Approximately twice as much PbTx-3-associated activity was excreted in feces than in urine, with the majority of excretion occurring within 48 h after instillation. The results of this study indicate that over 80% of the PbTx-3 is rapidly absorbed from the lung to the blood and distributed to all tissues. The tissues containing the greatest amount of PbTx-3-associated activity reflect the compound's site of deposition, storage compartment, and major route of metabolism and excretion. These results illustrate that brevetoxin exposure by the respiratory route results in systemic distribution of brevetoxin and suggest that the initial respiratory irritation and bronchoconstriction may only be a part of the overall toxicological consequences associated with brevetoxin inhalation.
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