Our thoughts and prayers go out to the families whose homes and livelihoods have been lost and to those who are at risk as result of the ongoing eruption of Kilauea. We have seen that nature is an unstoppable force whose effects can only be ameliorated by kindness and mutual support. As nurses, we need to consider the health risks resulting from the on-going eruptions, and help educate our patients, families, and colleagues to minimize the risks.
We all know that volcanic ash is dangerous because of what it contains: Tiny fragments of jagged rock, minerals, and volcanic glass. Inhaling these particles can result in pneumoconiosis, the name given to lung disease caused by inhalation of particles. Typically considered an occupational illness, pneumoconiosis can be caused by inhaling coal dust (“black lung disease”) asbestos fibers (asbestosis), sand and rock (silicosis) and a number of small particles.
When a person breathes in the volcanic ash with its tiny fragments of rock, minerals and volcanic glass ejected by Kilauea, their respiratory tract becomes irritated. The irritation most immediately impacts people with asthma or other respiratory diseases, and smokers. Cough, wheezing, and shortness of breath can result. Needless to say, those effected should seek treatment from their doctor or nurse practitioner. Symptoms can often be managed with medication and inhalers. These fragments of rock and glass can also become deposited in the lungs, eliciting an immune response. This causes inflammation and formation of scar tissue known as fibrosis. Fortunately, pneumoconiosis can take years to develop and symptoms may not appear immediately after the dust particles enter the lungs. Sadly, these effects are not reversible and can only be arrested by removing the exposure. Pneumoconiosis can result in scarring of the lungs and disability. This is what we need to prevent. How? By limiting exposure and use of personal protective gear.
We are all familiar with vog, or volcanic smog, the hazy air pollution we experience when lava flows and the wind blows. Vog is made up of water vapor, carbon dioxide and sulfur dioxide. Sulfur dioxide + water = sulfuric acid, and this is why vog is irritating to our eyes and respiratory tracts. The concentration of vog is worst at Kilauea’s vents and it dissipates with distance. But people on other Hawaiian islands also suffer the effects of vog from a distance. Effects also depend on the wind direction: Trade winds come from the North and blow vog away from land but Kona winds come from the South and send vog to other Hawaiian islands.
The people who are most vulnerable to vog include those with respiratory problems and allergy, as well as children, older folks, and pregnant women. When suffering from the effects of vog, including headaches, stinging eyes, sore throats, runny noses, and coughs, the best thing to do is limit exposure. Find a closed, air-conditioned space and wait it out. If symptoms persist, sufferers should check with their doctor or nurse practitioner, but the best way to deal with vog, like volcanic ash, is to avoid it or limit exposure.
A very dangerous area around Kilauea is where the lava hits the ocean. The volcanic shelf is unstable and can slide without warning, even in older formerly-secure areas. The interaction of the ocean and the lava creates Laze, a plume composed of hydrochloric acid and volcanic particles that are extremely irritating to the eyes, skin, throats, & respiratory tracts. Inhalation of laze can be potentially life-threatening.
So, what can we do against the unstoppable force of nature? We need to stay alert, stay informed, and work together. Take steps to avoid or minimize exposure. Resources can be found below or on our Hawaii Nurse Helpful Links page.