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Cohort Studies of Health Effects among People Exposed to Estuarine Waters: North Carolina, Virginia, and Maryland


Moe, Christine L.; Turf, Elizabeth; Oldach, David; Bell, Paula; Hutton, Steve; Savitz, David A.; Koltai, Deborah; Turf, Megan; Ingsrisawang, Lily; & Hart, Robert, et al. (2001). Cohort Studies of Health Effects among People Exposed to Estuarine Waters: North Carolina, Virginia, and Maryland. Environmental Health Perspectives, 109(Suppl. 5), 781-786. PMCID: PMC1240611


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


Reference Type

Journal Article

Year Published


Journal Title

Environmental Health Perspectives


Moe, Christine L.
Turf, Elizabeth
Oldach, David
Bell, Paula
Hutton, Steve
Savitz, David A.
Koltai, Deborah
Turf, Megan
Ingsrisawang, Lily
Hart, Robert
Ball, J. D.
Stutts, Michael
McCarter, Robert
Wilson, Leslie
Haselow, Dirk
Grattan, Lynn
Morris, J. Glenn
Weber, David J.