142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

300048
Medical surveillance of fire fighters post-Katrina

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Jacqueline Moline, MD, MSc, FACP, FACOEM , Population Health, North Shore-LIJ Health System, Great Neck, NY
Francine Smith, MPH , Population Health, North Shore-LIJ Health System, Great Neck, NY
Susan Teitelbaum, PhD , Department of Preventive Medicine, Mount Sinai, New York, NY
Hyun Kim, ScD , Population Health, Hofstra North Shore-LIJ School of Medicine, Great Neck, NY
Background: Hurricanes Katrina and Rita devastated the Gulf Coast in 2005. Many fire fighters had significant exposure to floodwater, mold, combustion products, metals, sewage, human remains and toxic chemicals.

Objective: Evaluate the health status of New Orleans, Louisiana, fire fighters five years later.

Methods: Examinations included an extensive medical questionnaire, physical examination, laboratory and pulmonary function testing, and chest x-rays.

Results: Seventy-one fire fighters completed the online consent and questionnaire; of those, 53 completed all components of their medical exam. There were substantial increases in symptoms of upper and lower airway complaints that persisted after work following Hurricanes Katrina and Rita. Sixty-five percent of fire fighters reported having upper respiratory symptoms, 31% reported lower respiratory symptoms, 37% reported cough, and 23% reported skin irritation during and/or after the Hurricane Katrina rescue period. Respiratory symptoms increased with length of exposure to flood water. Fire fighters with greater than 72 hours of floodwater exposure were more likely to have lower respiratory symptoms [Prevalence Ratio (PR) =1.7 (0.9-3.2 95% CI)] and shortness of breath [PR=3.1 (1.0-9.5 95% CI)]. Mental health symptoms were also persistent, including increased rates of anxiety (38%), irritability (47%), difficulty concentrating (45%), flashbacks (51%), and sleep disturbances (37%).

Conclusion: There was an increase in physical and mental health symptoms post-Hurricane Katrina among the fire fighter participants. Ongoing confidential medical examinations and mental health care support programs for disaster responders are recommended.

Learning Areas:

Chronic disease management and prevention
Clinical medicine applied in public health
Occupational health and safety
Program planning
Provision of health care to the public

Learning Objectives:
Identify persistent medical issues following Katrina. Design medical surveillance years after disasters. Identify challenges of performing medical surveillance after disasters.

Keyword(s): Disasters, Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a board certified physician in both internal and occupational and environmental medicine. I have been principal investigator or co-investigator of multiple federally funded grants focusing on occupational health and medical surveillance of emergency responders. My interests include education in occupational health and safety, and medical evaluation and treatment for environmental and occupational exposures. Additionally, I have authored 47 medical journal articles which focus on these topics.
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.

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