Fleming Lora E.

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Fleming

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Lora E.

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CHANS : Florida red tides and coastal populations as a coupled nature-human system

( 2013-10-28) Hoagland, Porter ; Kirkpatrick, Barbara ; Kirkpatrick, Gary ; Hitchcock, Gary ; Kohler, Kate ; Lovko, Vince ; Ullmann, Steven G. ; Reich, Andrew ; Fleming, Lora E.

Coupled nature-human (CNH) systems are now the focus of a growing number of inter-disciplinary research programs worldwide. As implied by the term “coupled,” these systems in-volve interactions between humans and nature, often affecting the dynamic characteristics of each component. Both natural and social scientists are engaged in developing a deeper un-derstanding of these dynamics, focusing on the linkages and feedbacks affecting the trajectories of coupled system behavior. Several researchers have begun to identify the generic aspects of nature-human couplings. Many of these aspects have been adapted from the field of ecology, where the dynamic characteristics of ecological systems have been studied for decades. These aspects include system heterogeneity, time lags, reciprocal feedbacks, thresholds, surprises, legacies, and resilience. The presence of such aspects has implications for the stability and persistence of particular ecosystem states, leading potentially to further implications for human heath and welfare. This talk reviews a specific type of natural hazard-human coupling that relates to coastal blooms of toxic marine algae, drawing examples primarily from human interactions with blooms of the toxic dinoflagellate Karenia brevis from the eastern Gulf of Mexico. This talk introduces a set of HAB Symposium “speed” presentations relating to different aspects of an ongoing multi-institutional and inter-disciplinary research project that examines Florida red tides as a type of CNH system. We present examples of the generic aspects of CNH systems in the context of Florida red tides, and we discuss also some of the challenges involved in compiling relevant data to support our analytical efforts.
Changes in work habits of lifeguards in relation to Florida red tide

( 2010-06-15) Nierenberg, Kate ; Kirner, Karen ; Hoagland, Porter ; Ullmann, Steven G. ; LeBlanc, William G. ; Kirkpatrick, Gary ; Fleming, Lora E. ; Kirkpatrick, Barbara

The marine dinoflagellate, Karenia brevis, is responsible for Florida red tides. Brevetoxins, the neurotoxins produced by K. brevis blooms, can cause fish kills, contaminate shellfish, and lead to respiratory illness in humans. Although several studies have assessed different economic impacts from Florida red tide blooms, no studies to date have considered the impact on beach lifeguard work performance. Sarasota County experiences frequent Florida red tides and staffs lifeguards at its beaches 365 days a year. This study examined lifeguard attendance records during the time periods of March 1 to September 30 in 2004 (no bloom) and March 1 to September 30 in 2005 (bloom). The lifeguard attendance data demonstrated statistically significant absenteeism during a Florida red tide bloom. The potential economic costs resulting from red tide blooms were comprised of both lifeguard absenteeism and presenteeism. Our estimate of the costs of absenteeism due to the 2005 red tide in Sarasota County is about $3,000. On average, the capitalized costs of lifeguard absenteeism in Sarasota County may be on the order of $100,000 at Sarasota County beaches alone. When surveyed, lifeguards reported not only that they experienced adverse health effects of exposure to Florida red tide but also that their attentiveness and abilities to take preventative actions decrease when they worked during a bloom, implying presenteeism effects. The costs of presenteeism, which imply increased risks to beachgoers, arguably could exceed those of absenteeism by an order of magnitude. Due to the lack of data, however, we are unable to provide credible estimates of the costs of presenteeism or the potential increased risks to bathers.
Centers for Oceans and Human Health : contributions to an emerging discipline

(BioMed Central, 2008-11-07) Laws, Edward A. ; Fleming, Lora E. ; Stegeman, John J.

The oceans are the dominant feature of the planet and are fundamentally linked to human history and to human health. Concerns about the impact of the oceans on human health can be traced to ancient times. Jewish law prohibited the consumption of shellfish, probably reflecting the fact that filter-feeding bivalves can accumulate pathogens and toxins. The Portuguese explorer Pedro Fernandes de Queirós described symptoms associated with ciguatera fish poisoning after eating Caribbean sea bream in 1606, and several of British explorer James Cook's crew experienced similar symptoms after eating fish off the coast of Vanuatu in 1774 [1]. Roughly 1,200 people died from the consumption of fish and shellfish contaminated with methyl mercury in Minamata (Japan) during the 20th century; an even larger number were affected by chronic long-term neurotoxicological impacts [2]. A tsunami caused by an undersea earthquake on December 26, 2004 killed more than 225,000 people in eleven countries bordering the Indian Ocean; and more than 1,400 people died within a single day when the storm surge generated by Hurricane Katrina overwhelmed the New Orleans levee system on August 29, 2005 [3]. Looking ahead, the International Panel on Climate Change has projected a sea level rise of as much as 88 cm during the 21st century as a result of global warming [4], with major implications for the welfare and sustainability of coastal communities.
Lessening the hazards of Florida red tides: a common sense approach

(Frontiers Media, 2020-07-09) Hoagland, Porter ; Kirkpatrick, Barbara ; Jin, Di ; Kirkpatrick, Gary ; Fleming, Lora E. ; Ullmann, Steven G. ; Beet, Andrew R. ; Hitchcock, Gary ; Harrison, Kate K. ; Li, Zongchao C. ; Garrison, Bruce ; Diaz, Roberto E. ; Lovko, Vince

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.
Linking the oceans to public health : current efforts and future directions

(BioMed Central, 2008-11-07) Kite-Powell, Hauke L. ; Fleming, Lora E. ; Backer, Lorraine C. ; Faustman, Elaine M. ; Hoagland, Porter ; Tsuchiya, Ami ; Younglove, Lisa R. ; Wilcox, Bruce A. ; Gast, Rebecca J.

We review the major linkages between the oceans and public health, focusing on exposures and potential health effects due to anthropogenic and natural factors including: harmful algal blooms, microbes, and chemical pollutants in the oceans; consumption of seafood; and flooding events. We summarize briefly the current state of knowledge about public health effects and their economic consequences; and we discuss priorities for future research. We find that: • There are numerous connections between the oceans, human activities, and human health that result in both positive and negative exposures and health effects (risks and benefits); and the study of these connections comprises a new interdisciplinary area, "oceans and human health." • The state of present knowledge about the linkages between oceans and public health varies. Some risks, such as the acute health effects caused by toxins associated with shellfish poisoning and red tide, are relatively well understood. Other risks, such as those posed by chronic exposure to many anthropogenic chemicals, pathogens, and naturally occurring toxins in coastal waters, are less well quantified. Even where there is a good understanding of the mechanism for health effects, good epidemiological data are often lacking. Solid data on economic and social consequences of these linkages are also lacking in most cases. • The design of management measures to address these risks must take into account the complexities of human response to warnings and other guidance, and the economic tradeoffs among different risks and benefits. Future research in oceans and human health to address public health risks associated with marine pathogens and toxins, and with marine dimensions of global change, should include epidemiological, behavioral, and economic components to ensure that resulting management measures incorporate effective economic and risk/benefit tradeoffs.
CHANS : the characteristics of cost-effective policy responses for harmful algal blooms [poster]

( 2015-11-11) Hoagland, Porter ; Kirkpatrick, Barbara ; Kirkpatrick, Gary ; Hitchcock, Gary ; Ullmann, Steven G. ; Reich, Andrew ; Fleming, Lora E. ; Jin, Di ; Beet, Andrew R. ; Li, Cathy ; Garrison, Bruce ; Lovko, Vince ; Kohler, Kate ; Rudge, Katrin

A growing concern for coastal management is the choice of appropriate public or private responses to HABs as a natural hazard. Considerable efforts have been devoted to understanding the scientific aspects of HABs, including their distributions in space and time, their ecological roles, and the nature of their toxic effects, among others. Much energy also has been directed at exploring socio-economic impacts and identifying potential management actions, including actions to prevent, control, or mitigate blooms. Using blooms of Florida red tide (Karenia brevis) as a case study, we develop an approach to the choice of policy responses to K. brevis blooms. Importantly, several new types of public health, environmental, and socio-economic impacts now are beginning to be revealed, including human gastrointestinal and potential neurological illnesses; morbidities and mortalities of protected species, including manatees, cetaceans, and sea turtles; increased numbers of hospital emergency room visits for the elderly; increased respiratory morbidities in workers, such as beach lifeguards; and potential reduced K- 12 school attendance. Optimal policy responses to this hazard are likely to depend critically upon why and where a bloom occurs, its spatial and temporal scales and toxicity, and the nature of its impacts. In the face of significant ongoing scientific uncertainties, and given estimates of impacts, we find that policies to expand and stabilize scientific research programs and environmental monitoring efforts, to develop and implement education programs for both residents and tourists, and to communicate the physical aspects of blooms to the public in a timely fashion are likely optimal.
Human responses to Florida red tides : policy awareness and adherence to local fertilizer ordinances

( 2014-06) Kirkpatrick, Barbara ; Kohler, Kate ; Byrne, Margaret ; Fleming, Lora E. ; Scheller, Karen ; Reich, Andrew ; Hitchcock, Gary ; Kirkpatrick, Gary ; Ullmann, Steven G. ; Hoagland, Porter

To mitigate the damages of natural hazards, policy responses can be beneficial only if they are effective. Using a self-administered survey approach, this paper focuses on the adherence to local fertilizer ordinances (i.e., county or municipal rules regulating the application of fertilizer to private lawns or facilities such as golf courses) implemented in jurisdictions along the southwest Florida coast in response to hazardous blooms of Florida red tides (Karenia brevis). These ordinances play a role in the context of evolving programs of water pollution control at federal, state, water basin, and local levels. With respect to policy effectiveness, while the strength of physical linkages is of critical importance, the extent to which humans affected are aware of and adhere to the relevant rules, is equally critical. We sought to understand the public’s depth of understanding about the rationales for local fertilizer ordinances. Respondents in Sarasota, Florida, were asked about their fertilizer practices in an area that has experienced several major blooms of Florida red tides over the past two decades. A highly educated, older population of 305 residents and “snowbirds” reported relatively little knowledge about a local fertilizer ordinance, its purpose, or whether it would change the frequency, size, or duration of red tides. This finding held true even among subpopulations that were expected to have more interest in or to be more knowledgeable about harmful algal blooms. In the face of uncertain science and environmental outcomes, and with individual motivations at odds with evolving public policies, the effectiveness of local community efforts to decrease the impacts of red tides may be compromised. Targeted social-science research on human perceptions about the risks of Florida red tides and education about the rationales for potential policy responses is warranted.
Marine harmful algal blooms, human health and wellbeing : challenges and opportunities in the 21st century

( 2015-10-01) Berdalet, Elisa ; Fleming, Lora E. ; Gowen, Richard J. ; Davidson, Keith ; Hess, Philipp ; Backer, Lorraine C. ; Moore, Stephanie K. ; Hoagland, Porter ; Enevoldsen, Henrik O.

Microalgal blooms are a natural part of the seasonal cycle of photosynthetic organisms in marine ecosystems. They are key components of the structure and dynamics of the oceans and thus sustain the benefits that humans obtain from these aquatic environments. However, some microalgal blooms can cause harm to humans and other organisms. These harmful algal blooms (HABs) have direct impacts on human health and negative influences on human wellbeing, mainly through their consequences to coastal ecosystem services (valued fisheries, tourism and recreation) and other marine organisms and environments. HABs are natural phenomena, but these events can be favoured by anthropogenic pressures in coastal areas. Global warming and associated changes in the oceans could affect HAB occurrences and toxicity as well, although forecasting the possible trends is still speculative and requires intensive multidisciplinary research. At the beginning of the 21st century, with expanding human populations, particularly in coastal and developing countries, there is an urgent need to prevent and mitigate HABs’ impacts on human health and wellbeing. The available tools to address this global challenge include maintaining intensive, multidisciplinary and collaborative scientific research, and strengthening the coordination with stakeholders, policymakers and the general public. Here we provide an overview of different aspects to understand the relevance of the HABs phenomena, an important element of the intrinsic links between oceans and human health and wellbeing.
The costs of respiratory illnesses arising from Florida Gulf Coast Karenia brevis blooms

(National Institute of Environmental Health Sciences, 2009-05-01) Hoagland, Porter ; Jin, Di ; Polansky, Lara Y. ; Kirkpatrick, Barbara ; Kirkpatrick, Gary ; Fleming, Lora E. ; Reich, Andrew ; Watkins, Sharon M. ; Ullmann, Steven G. ; Backer, Lorraine C.

Algal blooms of Karenia brevis, a harmful marine algae, occur almost annually off the west coast of Florida. At high concentrations, K. brevis blooms can cause harm through the release of potent toxins, known as brevetoxins, to the atmosphere. Epidemiologic studies suggest that aerosolized brevetoxins are linked to respiratory illnesses in humans. We hypothesized a relationship between K. brevis blooms and respiratory illness visits to hospital emergency departments (EDs) while controlling for environmental factors, disease, and tourism. We sought to use this relationship to estimate the costs of illness associated with aerosolized brevetoxins. We developed a statistical exposure–response model to express hypotheses about the relationship between respiratory illnesses and bloom events. We estimated the model with data on ED visits, K. brevis cell densities, and measures of pollen, pollutants, respiratory disease, and intra-annual population changes. We found that lagged K. brevis cell counts, low air temperatures, influenza outbreaks, high pollen counts, and tourist visits helped explain the number of respiratory-specific ED diagnoses. The capitalized estimated marginal costs of illness for ED respiratory illnesses associated with K. brevis blooms in Sarasota County, Florida, alone ranged from $0.5 to $4 million, depending on bloom severity. Blooms of K. brevis lead to significant economic impacts. The costs of illness of ED visits are a conservative estimate of the total economic impacts. It will become increasingly necessary to understand the scale of the economic losses associated with K. brevis blooms to make rational choices about appropriate mitigation.
The human health effects of Florida Red Tide (FRT) blooms : an expanded analysis

( 2014-03) Hoagland, Porter ; Jin, Di ; Beet, Andrew R. ; Kirkpatrick, Barbara ; Reich, Andrew ; Ullmann, Steven G. ; Fleming, Lora E. ; Kirkpatrick, Gary

Human respiratory and digestive illnesses can be caused by exposures to brevetoxins from blooms of the marine alga Karenia brevis, also known as Florida red tide (FRT). K. brevis requires macro-nutrients to grow; although the sources of these nutrients have not been resolved completely, they are thought to originate both naturally and anthropogenically. The latter sources comprise atmospheric depositions, industrial effluents, land runoffs, or submerged groundwater discharges. To date, there has been only limited research on the extent of human health risks and economic impacts due to FRT. We hypothesized that FRT blooms were associated with increases in the numbers of emergency room visits and hospital inpatient admissions for both respiratory and digestive illnesses. We sought to estimate these relationships and to calculate the costs of associated adverse health impacts. We developed environmental exposure-response models to test the effects of FRT blooms on human health, using data from diverse sources. We estimated the FRT bloom-associated illness costs, using extant data and parameters from the literature. When controlling for resident population, a proxy for tourism, and seasonal and annual effects, we found that increases in respiratory and digestive illnesses can be explained by FRT blooms. Specifically, FRT blooms were associated with human health and economic effects in older cohorts (≥ 55 years of age) in six southwest Florida counties. Annual costs of illness ranged from $60,000 to $700,000 annually, but these costs could exceed $1.0 million per year for severe, long-lasting FRT blooms, such as the one that occurred during 2005. Assuming that the average annual illness costs of FRT blooms persist into the future, using a discount rate of 3%, the capitalized costs of future illnesses would range between $2-24 million.
Testing for the potential effects of Karenia brevis on school absences [poster]

( 2015-11-15) Moore, Tamecia ; Diaz, Roberto E. ; Ullmann, Steven G. ; Hoagland, Porter ; Beet, Andrew R. ; Jin, Di ; Kirkpatrick, Barbara ; Kirkpatrick, Gary ; Fleming, Lora E. ; Hitchcock, Gary ; Drennon, Michael ; Kumar, Naresh

We analyzed a potential relationship between changes in school absences in Sarasota County and Karenia brevis (Kb) count data. Brevetoxins released during Kb blooms could be a reason for students experiencing increased respiratory or gastrointestinal illnesses, causing an increase in absence rates. We designed a map to relate the locations of Sarasota County schools and the distributions of those Kb counts with a minimum of 10,000 cell counts per liter and above. Due to the proximity of Kb counts, we hypothesized that brevetoxins could have a greater effect on the schools near the coast of Florida rather than the schools inland. Because individuals could be affected by brevetoxins up to several days after being exposed, we expected to find a lagged effect of a bloom occurrence on school absences. Using a regression approach, we were unable to detect an association between Kb counts and student absences. In some cases, the direction of the effects were opposite to what would be expected (i.e., an increase in Kb counts was associated with a reduction in the percent absent rate). The results indicated that over 70% of the variation in the school percent absent rate could be explained by the latent characteristics of individual schools (such as variations in student populations across different schools), by school week, by month (such as the effects of flu outbreaks or and other seasonal factors), and by year.
CHANS : modeling the dynamics of HABs, human communities, and policy choices along the Florida Gulf Coast

( 2015-11-19) Hoagland, Porter ; Kirkpatrick, Barbara ; Kirkpatrick, Gary ; Hitchcock, Gary ; Ullmann, Steven G. ; Reich, Andrew ; Fleming, Lora E. ; Jin, Di ; Beet, Andrew R. ; Li, Cathy ; Garrison, Bruce ; Lovko, Vince ; Kohler, Kate ; Rudge, Katrin

Coupled human-nature systems (CHANS) involve dynamic interactions between humans and nature, often influenced by and affecting the distinct dynamic characteristics of each component. We present an overview of an ongoing interdisciplinary research program focused on a specific type of systems that couple expanding and fluctuating human coastal populations to episodic blooms of toxic marine algae, drawing examples primarily from human interactions with blooms of the toxic dinoflagellate Karenia brevis from the eastern Gulf of Mexico (“Florida red tides”). We introduce a set of HAB Symposium “speed” presentations and associated posters based on multi-disciplinary research. Using extant, but extraordinary, data to specify empirical models, this program of research has focused on characterizing the influence of anthropogenic sources on K. brevis blooms, assessing the public health and economic impacts of these blooms in an exposure-response framework, and defining the choice of appropriate human policy responses to the hazard. We present examples of the generic aspects of CHANS systems in the context of Florida red tides, and we discuss also some of the challenges involved in compiling and analyzing the relevant data to support our positive and normative analytical efforts.
Impacts of Hurricanes Katrina and Rita on the microbial landscape of the New Orleans area

( 2007-03-20) Sinigalliano, Christopher D. ; Gidley, M. L. ; Shibata, T. ; Whitman, D. ; Dixon, T. H. ; Laws, Edward A. ; Hou, A. ; Bachoon, D. ; Brand, Larry E. ; Amaral-Zettler, Linda A. ; Gast, Rebecca J. ; Steward, Grieg F. ; Nigro, Olivia D. ; Fujioka, Roger S. ; Betancourt, W. Q. ; Vithanage, G. ; Mathews, J. ; Fleming, Lora E. ; Solo-Gabriele, Helena M.

Floodwaters in New Orleans from Hurricanes Katrina and Rita were observed to contain high levels of fecal indicator bacteria and microbial pathogens, generating concern about long-term impacts of these floodwaters on the sediment and water quality of the New Orleans area and Lake Pontchartrain. We show here that fecal indicator microbe concentrations in offshore waters from Lake Pontchartrain returned to prehurricane concentrations within 2 months of the flooding induced by these hurricanes. Vibrio and Legionella species within the lake were more abundant in samples collected shortly after the floodwaters had receded compared with samples taken within the subsequent 3 months; no evidence of a long-term hurricane-induced algal bloom was observed. Giardia and Cryptosporidium were detected in canal waters. Elevated levels of fecal indicator bacteria observed in sediment could not be solely attributed to impacts from floodwaters, as both flooded and nonflooded areas exhibited elevated levels of fecal indicator bacteria. Evidence from measurements of Bifidobacterium and bacterial diversity analysis suggest that the fecal indicator bacteria observed in the sediment were from human fecal sources. Epidemiologic studies are highly recommended to evaluate the human health effects of the sediments deposited by the floodwaters.
Anthropogenic nutrients and harmful algae in coastal waters

(Elsevier, 2014-08-28) Davidson, Keith ; Gowen, Richard J. ; Harrison, Paul J. ; Fleming, Lora E. ; Hoagland, Porter ; Moschonas, Grigorios

Harmful algal blooms (HABs) are thought to be increasing in coastal waters worldwide. Anthropogenic nutrient enrichment has been proposed as a principal causative factor of this increase through elevated inorganic and/or organic nutrient concentrations and modified nutrient ratios. We assess: 1) the level of understanding of the link between the amount, form and ratio of anthropogenic nutrients and HABs; 2) the evidence for a link between anthropogenically generated HABs and negative impacts on human health; and 3) the economic implications of anthropogenic nutrient/HAB interactions. We demonstrate that an anthropogenic nutrient-HAB link is far from universal, and where it has been demonstrated, it is most frequently associated with high biomass rather than low biomass (biotoxin producing) HABs. While organic nutrients have been shown to support the growth of a range of HAB species, insufficient evidence exists to clearly establish if these nutrients specifically promote the growth of harmful species in preference to benign ones, or if/how they influence toxicity of harmful species. We conclude that the role of anthropogenic nutrients in promoting HABs is site-specific, with hydrodynamic processes often determining whether blooms occur. We also find a lack of evidence of widespread significant adverse health impacts from anthropogenic nutrient-generated HABs, although this may be partly due to a lack of human/animal health and HAB monitoring. Detailed economic evaluation and cost/benefit analysis of the impact of anthropogenically generated HABs, or nutrient reduction schemes to alleviate them, is also frequently lacking.
The neurological effects of Florida Red Tide (FRT) blooms [poster]

( 2015-11-15) Diaz, Roberto E. ; Moore, Tamecia ; Ullmann, Steven G. ; Hoagland, Porter ; Beet, Andrew R. ; Jin, Di ; Kirkpatrick, Barbara ; Kirkpatrick, Gary ; Fleming, Lora E. ; Hitchcock, Gary

Karenia brevis is a marine dinoflagellate responsible for Florida red tide (FRT) blooms off the west coast of Florida. K. brevis contains brevetoxins, a neurotoxin that is absorbed by shellfish as well as released into the air. Brevetoxins are known to cause disruptions in normal neurological functions and are associated with neurotoxic shellfish poisoning (NSP). Previous research has emphasized the effect of FRT blooms on human health, from gastrointestinal to respiratory illnesses. However, there has been little research examining the effect of FRT blooms on neurological illnesses. There is research highlighting the biochemical effects of brevetoxins on mammalian nervous systems, so these symptoms can be matched to hospital codes that describe a hospital patient’s affliction. With these hospitalization codes, it is possible to study the relationship between FRT blooms and the occurrence of neurological illnesses in affected counties. The hospital data consists of inpatient data from 1988-2010 and emergency room data from 2005-2010. We will also use data containing K. brevis cells per liter as a measure of red tide occurrences.

Fleming Lora E.

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