An environmental health nursing assessment of indoor air quality in a community exposed to vog from Kilauea Volcano, Hawai`i

Background: After 26 years, the eruption at Kilauea Volcano continues to expose nearby communities to sulfurous air pollution called vog. In March of 2008, the volcano increased activity resulting in higher concentrations of vog. In an environmental health nursing effort to assess exposure on the most vulnerable members of the population, an indoor air quality assessment was promptly conducted at the nearby district hospital and schools. This study was part of the Kilauea Volcano Health Study, an ongoing investigation testing the hypothesis that exposure to sulfurous air pollution from active volcanism is associated with a higher risk of cardiorespiratory illness in exposed populations.

Methods: Average indoor and outdoor concentrations of sulfur dioxide (SO₂) were measured by 25 long-term exposed passive diffusion tubes placed at the district's hospital, schools, and community library. Reliability was ±2%, and criterion validity was within 5% for these measures. Indoor/outdoor penetration ratios were calculated.

Results: All indoor SO₂ concentrations at the hospital and schools were above the World Health Organization's average 24-hour recommendations. Penetration ratios were as high as 94% of ambient levels and dependent upon building construction or use of air conditioning.

Conclusions: Kilauea's vog is penetrable indoors based on building construction, air conditioning, and human behaviors. Health promotion efforts by nursing and other disciplines at the hospital and schools are underway to improve indoor air quality and respond effectively to those affected by vog. These data provide evidence for health policy development.