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Learning Objective 1: identify risks to respiratory health in populations exposed to volcanic air pollution.
Learning Objective 2: understand why certain age groups or populations are vulnerable to health effects from air pollution.
Methods: A retrospective cohort design compared prevalence of acute respiratory cases during 14 weeks of low exposure to prevalence during 14 weeks of high exposure from the increased volcanic activity. All patient visits (N = 1,189) presenting to a clinic located in the exposed area were reviewed for diagnostic accuracy, symptomology and demographical information. Effect was estimated by odds ratio (OR) using the 95% confidence interval (CI) of the point estimate for significance testing. Logistic regression analysis adjusted the OR for a priori-selected potential confounders.
Results: Significantly elevated odds were estimated for visits of acute airway problems during high exposure (OR = 7.53; 95% CI: 2.26 – 25.16). The youngest age group experienced airway problems observed as tachypnea, shortness of breath, abnormal lung sounds, or de-saturated oxygen levels. Most cases of pediatric and adult airway problems responded to immediate therapies of oxygen or inhaled medications. Seven patients from the youngest age group with Marshallese ethnicity were triaged to emergency departments.
Conclusion: This finding demonstrates increased prevalence of acute respiratory effects associated with exposure to sulfurous volcanic air pollution. The disease burden was experienced by the youngest members of the exposed population. Hawai`i is experiencing immigration of Marshallese who live in marginalized open-aired conditions nearby Kilauea. Public health nursing has increased health promotion efforts with the population.