219620 Acute exacerbations of asthma associated with vog exposure at Kilauea Volcano, Hawai`i

Wednesday, November 10, 2010 : 10:50 AM - 11:05 AM

Bernadette M. Longo, PhD, RN , Orvis School of Nursing, University of Nevada-Reno, Reno, NV
Wei Yang, PhD, MD , School of Community Health Sciences, University of Nevada Reno, Reno, NV
Joshua Green, MD , 3rd Senatorial District, Hawaii State Capitol, Honolulu, HI
Emissions of sulfur dioxide gas (SO2) and sulfuric acid aerosol called vog have been venting for over 25 years on Kilauea Volcano's east rift. Alarmingly, in 2008 a new eruption vent opened at the summit increasing SO2 emissions up to 3,000 5,000 metric tonnes per day (tpd), in contrast to previous average emissions of 1,700 tpd. This retrospective cohort study estimated the incidence rate and relative risk of diagnosed exacerbations of asthma in exposed and unexposed communities on the island over a 5-year period. Case records of clinic and emergency room visits by local residents were reviewed for evidence of clinical presentation and diagnostic accuracy. Relative risk (RR) estimates for exacerbations of asthma were standardized for age and gender, revealing an 87% elevated risk [RR = 1.87 (95% CI = 1.50-2.33)] in exposed communities prior to the summit eruption (2004-2007), and a doubling of risk [RR = 2.90 (95% CI = 2.13-3.96)] with the relatively higher volcanic emissions (2008-2009). Moreover, disease burden on the exposed communities increased 3-fold (+71 visits per 1,000 residents/per year) with the increased volcanic activity. This ongoing study is the first to demonstrate that communities continuously exposed to vog have a higher risk and disease burden of acute exacerbations of asthma. Therefore, a community-level assessment of asthma management practices and continued investigations are recommended.

Learning Areas:
Chronic disease management and prevention
Environmental health sciences
Epidemiology
Public health or related nursing

Learning Objectives:
1. Identify asthma health effects associated with exposure to volcanic air pollution. 2. Articulate the environmental health concerns for communities living near active volcanoes. 3. Utilize these epidemiological findings in the development of health promotion policy in Hawai`i and other communities proximal to active volcanoes around the world.

Keywords: Asthma, Environmental Health Hazards

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the study design, analysis and writing.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5104.0: Asthma epidemiology