Health promotion and policy development for public health nursing in communities near active volcanoes

Throughout recorded history humans have been challenged to interact with volcanoes. Today, over 500 million people live near the world's 600 active volcanoes. These volcanoes continuously emit sulfurous gases and particle air pollution into the troposphere during eruption and in states of quiescence. Many of the world's active volcanoes are proximal to urban population centers in developing countries, potentially adding to the local air pollution burden. Sulfurous air pollution is associated with increased morbidity and mortality worldwide. Statistically significant associations have been found between chronic exposure of volcanic emissions and increased prevalence of cardiorespiratory symptoms and diseases. Therefore, long-term residency in active volcanic areas may adversely influence health of the population. At Kilauea Volcano in Hawai`i, nursing research on volcanic health has resulted in new public health policy. Nursing is uniquely qualified to conduct surveillance of disease, provide treatment, educate, and promote health to exposed communities. Public health nursing should survey prevalence and incidence of cardiorespiratory disease, educate in cardiac risk factor reduction, and encourage exercise régimes that reduce exposure to the volcanic emissions. Cardiovascular screenings and pulmonary function testing could allow for early diagnosis and, if appropriate, initiation of treatment. Residents with diagnosed asthma or hypertension should be encouraged to comply with treatment regimens to reduce disease progression. Smoking prevention efforts and cessation protocols are likely the most effective health promotion interventions. Efforts by public health nurses are vital to improving health and ensuring equity of health services to populations residing in volcanic areas around the world.