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Indoor dust, immune activation, and household exposure risk after Hurricane Maria: a two-year pilot prospective cohort study in Puerto Rico

Journal of Exposure Science & Environmental Epidemiology (2025)Cite this article

Abstract

Background

Hurricane Maria left many homes in Puerto Rico with prolonged flooding, structural damage, and indoor microbial growth, conditions that can drive respiratory illness and immune dysregulation.

Objective

To assess the pro-inflammatory potential of post-flooding indoor dust and track two-year shifts in household risk profiles by integrating pro-inflammatory biomarkers, fungal exposure, and self-reported structural damage, mental health, and respiratory outcomes.

Methods

Dust samples were collected from 50 households in a San Juan community one year and again from 35 of those same households two years after the hurricane. Dust sample extracts (DSEs) were prepared and incubated with pooled peripheral blood from volunteers residing outside Puerto Rico. Pro-inflammatory cytokines interleukin-1β (IL-1β), IL-6, and IL-8 were quantified using ELISA; airborne fungal abundance was assessed on malt extract and G25N agars. Survey data captured self-reported respiratory and mental-health scores using the SF-12v2 Health Survey, structural water damage, and remediation efforts. Principal component analysis (PCA) and k-means clustering were applied to identify household clusters, while Sankey plots were used to visualize the transitions of household risk.

Results

IL-1β emerged as the most responsive cytokine, showing the greatest median reduction from Year 1 to Year 2 and across household water-damage categories. Three clusters emerged in Year 1, driven by structural damage, IL-1β, and fungal load. By Year 2, only two clusters remained, shaped more by self-reported respiratory and psychological distress than by structural damage. Sankey analysis revealed that some households transitioned into higher-risk profiles over time despite apparent household structural recovery.

Impact

  • Indoor environmental hazards persist long after floodwaters in the aftermaths of hurricanes recede, yet few studies integrate biological, environmental, structural, psychosocial, and respiratory health data to track household risk over time.

  • Using a human whole-blood pyrogen assay and multivariate clustering, this two-year study of Hurricane-María–affected homes in Puerto Rico shows that dust-induced IL-1β is a sensitive pro-inflammatory biomarker and that residual risk shifts from structural-microbial drivers to psychosocial-respiratory burdens during recovery.

  • The multidomain “risk-profile” framework provides a reproducible template for post-disaster exposure assessment and can help public-health officials prioritize targeted remediation, health surveillance, and mental-health support as climate-related disasters increase.

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Fig. 1: Community of San Juan from where household dusts were collected.
Fig. 2: Dose-response and role of endotoxin in the IL-1β-inducing potential of the dust sample extracts (DSEs).
Fig. 3: Principal Component Analysis (PCA) biplots household-level variables for Year 1 and Year 2 and Sankey plot of household transitions from Year 1 to Year 2.

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Data availability

The metadata for this study can be found at the following link: https://osf.io/fmkhj/?view_only=9fe2324f73c24c82b745f5bc5e3f143d.

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Acknowledgements

We are grateful to all the families that participated in this study, and the volunteers who participated in the blood draws. We also want to acknowledge Summer Pellechio and Ruslan Fomenko, who contributed to performing human whole blood and immunological assays. We are also grateful to the field team for their remarkable job administering the surveys and carrying out the indoor sampling of the homes.

Funding

This work was supported by the National Institute of Environmental Health Sciences of the National Institute of Health (R21ES029762). The funding body was not involved in study design; data collection, analysis, or interpretation; manuscript preparation; or the decision to submit for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.

Author information

Authors and Affiliations

  1. College of Arts and Sciences, Lynn University, Raton, FL, USA

    Felix E. Rivera-Mariani

  2. RIPLRT Institute, Fort Lauderdale, FL, USA

    Felix E. Rivera-Mariani, Hayat Srour & Lorraine N. Vélez-Torres

  3. Department of Microbiology, School of Medicine, University of Puerto Rico - Medical Sciences Campus, San Juan, PR, USA

    Filipa Godoy-Vitorino, Benjamín Bolaños-Rosero & Lorraine N. Vélez-Torres

  4. Massey Comprehensive Cancer Center, Virginia Commonwealth University, Richmond, VA, USA

    Lorraine N. Vélez-Torres

  5. Division of Cancer Control and Population Sciences, Comprehensive Cancer Center, University of Puerto Rico, San Juan, PR, USA

    Lorraine N. Vélez-Torres

  6. Department of Civil, Architectural, and Environmental Engineering, Cockrell School of Engineering, University of Texas at Austin, Austin, TX, USA

    Juan P. Maestre & Kerry Kinney

  7. School of Architecture, University of Puerto Rico - Rio Piedras Campus, Rio Piedras, PR, USA

    Humberto Cavallin

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Contributions

Conceptualization: Felix E. Rivera-Mariani, Hayat Srour, Filipa Godoy-Vitorino, Benjamín Bolaños-Rosero, Lorraine N. Vélez-Torres, Juan P. Maestre, Kerry Kinney, Humberto Cavallin. Funding Acquisition: Humberto Cavallin, Kerry Kinney, Juan P. Maestre, Felix E. Rivera-Mariani, Filipa Godoy-Vitorino, Benjamín Bolaños-Rosero. Field Sampling: Humberto Cavallin, Juan P. Maestre, Lorraine N. Vélez-Torres, Benjamín Bolaños-Rosero. Project Administration: Humberto Cavallin, Kerry Kinney. Immunological Analysis: Felix E. Rivera-Mariani, Hayat Srour. Data Analysis: Felix E. Rivera-Mariani, Hayat Srour. Writing: Felix E. Rivera-Mariani, Hayat Srour, Filipa Godoy-Vitorino, Benjamín Bolaños-Rosero, Lorraine N. Vélez-Torres, Juan P. Maestre, Kerry Kinney, Humberto Cavallin.

Corresponding author

Correspondence to Felix E. Rivera-Mariani.

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Competing interests

The authors declare no competing interests.

Ethics approval

All procedures involving human participants were performed in accordance with relevant guidelines and regulations, including the Declaration of Helsinki and institutional policies. The household recruitment, survey administration, and in-home environmental sampling (dust/air) were approved by the University of Puerto Rico–Río Piedras Institutional Review Board (IRB #1718-058). Whole-blood draws for the human whole-blood pyrogen assay (HWBPA) was approved by the Larkin University Institutional Review Board (IRB protocol LCH-1-022018). Only adults (≥21 years) were enrolled. Informed consent was obtained from all participants, including the primary household respondent for survey and sampling, and all blood donors for phlebotomy and use of de-identified samples. This manuscript contains no identifiable images or personal data of individual participants.

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Rivera-Mariani, F.E., Srour, H., Godoy-Vitorino, F. et al. Indoor dust, immune activation, and household exposure risk after Hurricane Maria: a two-year pilot prospective cohort study in Puerto Rico. J Expo Sci Environ Epidemiol (2025). https://doi.org/10.1038/s41370-025-00835-6

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