Impact of Legacy Pollutants on Cardiopulmonary Health Following Natural Disasters - PROJECT SUMMARY/ABSTRACT Hawaii’s historic sugarcane industry has left a lasting environmental footprint, contaminating soils and water sources with persistent pollutants, including heavy metals (inorganic arsenic, lead, mercury) and dioxins. Additionally, canec board, a sugarcane-derived construction material treated with arsenic-based pesticides, contributed to residential and commercial exposures. Despite these pollutants being well- established cardiopulmonary (CP) toxicants, their long-term health effects in Hawaii’s diverse population remain understudied. Further, increasing wildfire disasters, such as the 2023 Maui wildfires, pose new threats by potentially mobilizing these legacy pollutants, exacerbating CP health risks. The primary goal of this study is to address a critical gap in understanding how legacy pollutant exposure, both independently and in conjunction with wildfires, contributes to CP disease risk. To achieve this goal, we propose to establish the Health and Environment Assessment Longitudinal (HEAL) cohort, a community-engaged study integrating citizen science, environmental sampling, biomarker analyses, and geospatial modeling. Over five years, we will recruit 1,000 participants across four exposure groups to examine the independent and combined effects of wildfire and legacy pollutant (LP) exposures on CP health. These groups include: (1) unexposed controls (n=200); (2) LP-exposed residents near sugarcane plantations with presumed pollutant exposure but no wildfire exposure (n=300); (3) wildfire-exposed individuals without LP exposure (n=200); and (4) individuals with both LP and wildfire exposure (n=300). This fourth group includes wildfire survivors returning to Lahaina, Kula, Kihei, and Olinda, where abandoned sugarcane mills and arsenic-treated structures burned during the 2023 wildfires. Participants will be recruited in part from the Maui Wildfire Exposure Study (MauiWES), a cohort of 2,000 wildfire survivors, ~30% of whom have known heavy metal exposures. Given our hypothesis that legacy pollutant exposure is associated with CP disease risk and that wildfires at the urban interface can mobilize these pollutants and increase CP risk, we aim to a characterize environmental contamination by legacy pollutants and assess their contribution to human exposure (Aim 1), investigate the relationship between legacy pollutant exposure and CP health (Aim 2), and assess the role of legacy pollutants in wildfire-associated CP health risks (Aim 3). This study represents the first systematic investigation of CP health risks linked to LP exposure in Hawaii. Data from the HEAL cohort will identify contamination hotspots near former sugarcane plantations and link residential proximity to higher pollutant levels in soil, water, and human biomarkers. We expect LP exposure to be associated with poorer CP health, including reduced lung function, high blood pressure, and systemic inflammation. Wildfire exposure is also anticipated to increase CP disease risk, with heavy metals and dioxins mediating these effects. These findings will inform public health interventions and disaster recovery strategies, with significant implications for mitigation efforts as wildfires become more frequent and severe nationwide.
