Oil disasters and government actions in the face of social, environmental, and health-related impacts: A scoping review

This article aims to analyze the actions taken by governments to face the social, environmental, and health impacts of oil spill disasters worldwide. This scoping review was conducted in Bireme, Lilacs, SciELO, PubMed, Cochrane Library, and Embase databases, considering articles published between 1973 and 2021. The database search returned 22 articles on ten global oil disasters in three continents (Asia, the Americas, and Europe), whose causes were grounding (03), shipwreck (01), collision (02), spill (03), and explosion (01). The actions developed were characterized as intersectoral, economic, environmental, and health-related, and the most frequent were environmental and economic actions. In the actions developed, we observed criticisms of controlling, mitigating, or preventing instantaneous or future damages resulting from oil disasters, which is still an open agenda for social movements in the struggle to ensure a healthy, health-promoting environment that preserves all its biodiversity. The actions to face oil disasters in different countries seem incipient, revealing a governmental inability to guide the confrontation of the impacts of this unusual event.


Introduction
National and subnational governments have been urged to take responsibility for the environment in a joint action for planetary preservation over the past 50 years. International conferences and treaties were assumed, such as in Stockholm in 1972, the World Climate Summit in 1979, the Sustainable Development Summit in 2012, and the Global Climate Summit in 2021 1,2 . The need for articulation between production and consumption patterns to ensure the environmental-climate balance and the well-being of humanity for current and future generations 3,4 has been observed in all these conferences.
However, the capitalist development project and the preservation of the environment clash since the ostensive consumption pattern is the main catalytic force of this system, implying socially determined environmental risks 5, 6 . The current model of capitalist production is founded on the exploitation of agricultural and mineral commodities, leading to intense environmental contamination and human exposure due to the consumption of pesticides and the exploitation of non-renewable and dirty energy sources, such as oil 7-9 .
The advance of capital over the environment places humanity in a setting where earthquakes, floods, acid rain, landslides, and pandemics will become increasingly frequent 10 . These events are, in part, a reflection of how society is reproduced, how wealth is distributed, and the consumption pattern 2 . Climate change has been on the agenda of international organizations and scientists. However, government consensus still needs to be achieved on which courses to follow regarding alternatives to overcome its effects on the planet, mainly for its primary vector: using pollutant energy sources such as oil 11 .
Oil production has highly polluting characteristics, from extraction, refining, transportation, and consumption, which can cause health, social, economic, cultural, and environmental damage 12 . In 2016 alone, the global estimate of oil consumption was approximately 36 billion barrels 13 . Nevertheless, oil spill disasters are among the events that cause substantial impacts on the environmental balance, aggravated by insufficient or non-existent government responses.
Significant accidents still occur despite the progressive reduction in oil disasters since 1970. These disasters are hardly known when they occur far from the coast. However, they impact populations and ecosystems and require immediate responses 14 when they reach the continent. Thus, governments should establish forms, actions, and instruments in their territories to predict, minimize, and control oil sectorborne disasters.
The 2019 Brazilian coast oil spill, whose origin is unknown, rekindled a global alert about the responsibilities of national governments and their health systems regarding protecting the environment and the populations affected by these disasters. Noronha, Lima, and Machado 15 argue that government macro-functions can be understood as: a) planning; b) financing; c) coordination, regulation, control, and evaluation; d) direct provision of actions and services. In social and environmental crisis settings, such functions must be articulated based on strategic thinking 16 . Therefore, responding efficiently, effectively, and with efficacy to society's demands, the complexity of disaster risks, and the health-disease process. However, even in these settings, what is seen, in practice, is still a form of government based on ideological, authoritarian precepts 17 and negligible intersectoral articulation 18 .
Oil spills studies worldwide prioritize approaches that separately study health 19-21 , environmental 22,23 , economic 24,25 , and social 26 impacts. However, there is a lack of knowledge vis-à-vis studies that systematize the decision-making of government authorities and can support policymakers, managers, health professionals, and civil society in developing appropriate strategic actions targeting comprehensive care and repairing affected populations and the environment 27 . Therefore, this article aims to map the actions taken by governments in the face of social, environmental, and health impacts from oil disasters worldwide.

Material and methods
A scoping review study was conducted, a method proposed to synthesize evidence, map theories, further analyze concepts, and identify knowledge gaps that need further investigation 28 , observing the methodological principles structured similarly to systematic reviews 29 .
The Population, Concept, and Context (PCC, P=Governments; C=Coping; C=Oil disasters) 30 strategy was used in constructing the research question. The following is the central question of the review: How did governments act in the face of the social, environmental, and health impacts of oil disasters?
The electronic search was conducted from February to March 2022 in the following databases: Bireme, Lilacs, SciELO, PubMed (Medline), Cochrane Library/ Cochrane Database of Systematic Reviews, and Embase, using as primary descriptors those referenced in the review of Euzebio et al. 12 referring to oil spills and their variations: Oil spill, Oil spill accident, Oil spill residues, Petroleum Pollution. We selected articles published from January 1, 1973, to December 31, 2021, considering that the 1972 Stockholm Conference was the first event with a predominantly environmental focus and resulted in the Declaration on the Human Environment 2 .
Boolean operators were used as follows: (Oil spill) OR (Oil spill accident)) OR (Oil spill residues)) OR (Petroleum Pollution) AND (Oil spill effects) OR (Socioeconomic vulnerability)) OR (Socioeconomic activities)) OR (Economic impact) (Environmental impact) OR (Health impact) OR (Social impact).
Two independent researchers (R.C.S. and L.S.) performed the search, with the following eligibility criteria: a) inclusion: original works published in English, Spanish, or Portuguese; b) exclusion: book or book chapters, dissertations, monographs, and theses; technical, normative and related reports; and studies that do not provide any information that answers the driving question, although they mention oil spills. Disagreements were resolved by a third researcher (M.O.S.S.). The search process followed the precepts of the Joanna Briggs Institute 30 , widely used by other reviews, as per stages described in figure 1 to establish the research corpus. The selected articles were tabulated in an Excel® table, extracting the information for analysis regarding the author/year of publication of the article, mentioned disaster and year of occurrence, disaster characterization, actions taken, and analysis of actions in each location.

On socioeconomic and environmental damage: What do the studies say?
Environmental oil-borne contamination ranged from 75 tons in India to 626 thousand tons in the United States of America (USA), with a territorial extension of impact ranging from 3.5 km in Taiwan to 4 thousand km in Brazil, considered the largest spill in the world's tropical waters. Intensive contamination in the environment is observed in terrestrial and marine conservation units, beaches, and fishing areas, such as Brazil, Taiwan, Pakistan, and Spain.
At least five studies highlight the social and economic damage caused by the disasters, which affected traditional fishing communities in various aspects, such as food, fishing activity, tourism, and local trade. An estimated 300,000 people were affected in Pakistan, with estimated damage ranging from US$ 1.5 to US$ 2 billion; employment declined by 28% in the region in the US; effects that can last a decade are also being reported in Brazil (

Between actions and criticism: courses undertaken by governments
From a broader perspective and based on the possible harm caused by oil-related disasters, we stratified government actions into intersectoral, economic, environmental, and healthrelated (table 2). We identified measures that guided intersectoral coping actions, such as interministerial commissions, social mobilization, and scientific advisory committees in six disasters in five countries, emphasizing the investment of approximately US$ 60 million in the US for research on the Gulf of Mexico disaster.
Economic actions were found in three disasters (Brazil, Spain, and South Korea), and establishing emergency aid for the affected population was common to all. Besides the aid, Spain offered a special credit line for fishing production and tourism.
Environmental actions, such as cleaning the affected areas, were undertaken in seven disasters. The territory's military or population was the workforce performing the cleanup. In some of these disasters, committees were set up to monitor the environmental cleanup and recovery measures.
Concerning health actions, banning fishing was the most frequent measure used in disasters in Brazil, the US, Spain, and Pakistan as a food exposure precautionary measure. Other actions include analyzing food samples, community surveillance, information dissemination, and epidemiological survey.    Disarticulation between government agencies; political conflicts between the central government and subnational entities; little articulation with academia; lack of ppE; little transparency in the disclosure of health-related information; the bureaucratization of decisions caused delays and escalated the impacts; little control of voluntary actions that exposed the population to the imminent risks of contact with crude oil chemicals and dispersants.
Fragmented and poor capacity of the lebanese government in dealing with pollution, enforcing pollution control legislation, and developing intersectoral strategies.  54 . Implementing contingency plans for disasters in a hierarchical, shared, agile, and specific way, considering the technical, administrative, and political aspects that the situation implies and the attributions of each entity and government agency 55 , is what should occur. When such articulation does not occur, the response that emerges from the setting may be the result of legal clashes, such as in Brazil, where the Federal Public Prosecutor's Office filed public civil actions in several states in the Northeast, as well as a joint action involving all states in the oil-affected region, To ensure, in order of priority, human life safety, the protection of the environment, and the integrity of properties and installations threatened or affected by the oil spill 56 (72) .
In the disasters of Brazil 31,33 , the USA 41,43 , and South Korea 45 , contrary to what the World Health Organization 57 postulates for the communication of risks in public health emergencies, the governments did not move towards a reliable, timely, and transparent communication strategy that would allow decision-making regarding individual, family, and community protection.
However, as Bueno 58 points out, a communicative action through radio, television, internet, and other means guided by health management would be relevant besides considering facts and circumstances of the event, neutralizing dissonance and political and business interference, and facing biased media coverage. In this context, the media would play a vital role during and after the disaster to provide subsidies to the population about the safety and integrity of the actions and means and measures to assist people affected 59 .
Although oil and its derivatives have a high capacity to pollute water, soil, fauna, and flora 12,22,23 , we should highlight that disaster management in Brazil 33 , Lebanon 46 , India 38 , and Pakistan 47 was also characterized by a lack of or inefficient crisis office at the national level, non-compliance with control legislation, and even the non-existence or non-activation of a contingency plan, which would be a national responsibility. As a result of this poor environmental damage mitigation, we could mention the aggravated historical environmental injustice since its harm is not shared homogeneously among individuals, where traditional populations are the most affected, especially fishermen and shellfish gatherers 60, 61 .
Particularly in Brazil, authors mention that this lack of crisis centrality and orientation established a despairing setting in which volunteers, primarily fishermen, defended their territories without knowing the dangers. These individuals immediately worked to remove oil from beaches and mangroves without Personal Protective Equipment (PPE)s, even diving into contaminated waters 33-35, 37 .
Suppose a health policy can be considered State action or omission before society's demands 62 . In that case, the organization of health management in times of crisis, such as in oil disasters, will reflect coping in its technical aspects. The recognition or not of health's social value in its broader context, where the territory where one is born, lives, falls ill, and dies, typical of the water populations, such as fishermen and seafood 63,64 , are determinants and conditions. The articles highlighted that civilians or military personnel were engaged in the cleanup protocols in the mapped disasters. However, Pakistan 47 , South Korea 45 , India 38 , and Brazil 33 were criticized for lack of PPE or loss of control of volunteers exposed to chemical contaminants, which is particularly troubling, because the literature points to the association between exposure to oil components and various acute and chronic effects on human health, such as acute poisoning, cancer, and endocrine changes 65-68 .
For example, the Brazilian and international regulatory framework has recognized a vital oil component, benzene, on toxicological aspects, occupational and environmental exposure, and risk assessment 69 . From this perspective, every individual who came into contact with the substance or minimally with the contaminated areas should be evaluated, adopting follow-up measures and health monitoring due to the likely late/chronic effects 70 . An increase in acute respiratory and neurological symptoms was observed among workers cleaning the contaminated areas through inhalation and dermal exposure 71,72 in the case of the Deepwater Horizon oil rig disaster that caused an oil spill in the Gulf of Mexico.
In another oil spill disaster in Chennai, off the coast of India, researchers identified that Polycyclic Aromatic Hydrocarbons (PAH) can be highly resistant to climate variations, in which the PAH levels detected on the sixth day of the spill were similar to those identified on the 62 nd day 38 , pointing to the dangers inherent to its exposure.
In this sense, it would be urgent to establish health actions, as observed in Brazil 31 , USA 40-44 , Spain 48-50 , Taiwan 51 , and Pakistan 47 , whether in the analysis of seafood and other fish to ascertain food quality and safety or in the epidemiological mapping of the affected or exposed population for developing programs and policies and readjusting health services in the care of these specific populations.
On the other hand, the measures in these same countries were also the target of criticism for the lack of coordination and consensus between agencies and subnational governments in their implementation or for the inefficient dissemination of surveillance, health promotion, and damage prevention information, which may not have generated the expected protective effect in Brazil 31-33 and the USA 41, 43 . Recent research has revealed several criticisms of the lack of availability of baseline health data captured before, during, and on an ongoing basis after a disaster, pointing out that health monitoring is essential to reduce and manage the health impacts of future disasters and that it is also necessary to establish an observation and care system 73 . The Unified Health System (SUS) is internationally recognized for its ability to realize extensive monitoring of human health regarding disasters and may be an example to be followed by other countries 73, 74 .
However, very little of the health potential represented by the SUS was used in Brazil through its primary care units in the territories affected by the oil spill. This system was experiencing funding setbacks, degrading its ability to action 75 . Some authors have reflected on the contributions of Primary Care in this setting 76,77 . Although this level of care can collaborate to provide health care during the disaster and monitor the acute and chronic conditions triggered in these situations, in general, professionals are unprepared, this level of care is not adequately recognized, and its performance is not prioritized, disregarding its power and territorial capillarity 78, 79 .
The literature is consonant with the global deficiencies in preparing health systems to face disasters, especially from the viewpoint of human resources [80][81][82] . When looking at health professionals, inadequate, segmented, and variable training on these unusual events persists, which may have direct implications for the care and healthcare of the affected populations 82 , which makes measures and proposals that consider a robust and consistent training of workers in this field urgent. The economic and symbolic losses of all fishing production and tourism identified 24,25,31,33 -particularly of traditional peoples due to their relationship with the sea and the territory -were also found to generate illness, with outcomes in mental health, alcohol, and other drug abuse 12, 83 , which requires the implementation of mental health care measures for those affected, something that emerges as a strategy for coping with the disaster only in the USA 43 .
Financial compensation through emergency aid in Brazil 31 , Spain 49 , and South Korea 45 was an important step towards repairing the affected population, given the installed financial losses and food insecurity situation 61 . However, the scope of emergency aid, edited by Provisional Measure N° 911, which allocated resources to a restricted portion of those affected by the disaster, thus undermining the compensatory capacity of this emergency aid 31 , was criticized in Brazil. According to Beristain 84(173) , Reparation refers to measures to restore rights, improve the situation of victims, and promote political reforms that prevent the recurrence of violations.
However, the mapped articles have evidenced negligible control, mitigation, or prevention of instantaneous or future damages from oil disasters, which is still an open agenda for social movements in the struggle to ensure a healthy, health-promoting environment that preserves all its biodiversity 4 .
Each disaster mapped here is immersed in a different social, economic, political, and historical context, characteristic of the affected country, besides the existing conception of health 85, 86 . Thus, the actions developed to face the impacts abided by the environmental and health perspectives valued in each context and are more or less equitable, guided by the social, medical-hegemonic, or market-oriented determination 87 , justifying the governmental priorities in crisis management and the State operating logic 88 .
Finally, two assumptions observed in this review are striking. The first is that most of the reported disasters are in the so-called developing countries, which shows a need to "develop an ethical, legal framework and a funding mechanism to conduct research responses" 89(124) about the social, environmental, economic, and health impacts, promoting their sharing among different nations, in a mutual aid of prevention and solidarity.
The second is that only some studies address government actions and the role of health management in coping with the impacts of oil disasters, especially when looking at decision-making. Our results should serve as a warning for a gap in the literature that needs to be suppressed in future research, given the growing and intense number of environmental and health disasters endured by humanity, with generalized and complex consequences that need to be interpreted in the light of policy, planning, management, and assessment in health 89-91 .

Final considerations
Actions to face oil disasters in different countries seem incipient, revealing a governmental inability to guide the confrontation of this unusual event's intersectoral, economic, environmental, and health impacts.
The world has lived with meetings of global leaders, treaties, plans, and international policies that guide environmental protection for the entire human existence for 50 years. However, the agreements still have low capillarity within the very national governments, leading to the establishment of tools, norms, and directive agencies that induce and coordinate actions to defend the environment.
Using energy matrices based on fossil fuels such as oil, the hegemonic development model in the capitalist world requires that national health systems integrate a larger project of coordinated, integrated, and effective responses to environmental disasters and health crises that will be increasingly more frequent.
The limitations of the present study are the lack of political, social, and economic context of the different countries and their disasters, which could help interpret the findings about the courses undertaken in managing each crisis, requiring further analysis.