THE KILAUEA VOLCANO HEALTH STUDY – PHASE II EPIDEMIOLOGICAL FINDINGS

Long-term residency in active volcanic areas may adversely influence cardiorespiratory health. Effusive eruption has persisted at Kilauea Volcano since 1986 exposing Hawaiian residents to sulfurous air pollution at concentrations above World Health Organization recommendations. The increase in emissions from Kilauea’s summit eruption in 2008, without subsidence at the East Rift eruption site, resulted in elevated ambient levels of sulfur dioxide and fine particulate matter on the island of Hawaii. Phase I of the Kilauea Volcano Health Study was the first to confirm exposure on communities in the downwind geographic region, identify hot spots and altitudinal constraints to the pollutants, and associate adverse cardiorespiratory effects in the population through a door-to-door survey. Phase II of the study is providing important new health data to test the hypothesis that exposure to sulfurous air pollution from active volcanism is associated with a higher risk of cardiorespiratory illness in human populations. A retrospective cohort design using medical records from 2004 to present time is estimating risk of acute and chronic illness in the exposed population compared to an unexposed reference population. Case reviews have documented increased relative risk (p <0.05) associated with pre-2008 exposure levels for medically-diagnosed acute bronchitis (+57%; 656% in children), exacerbations of asthma (+87%; 510% in children), acute pharyngitis (+233%), upper respiratory infections (+12%; 229% in children), and diagnosis of cough (+41%). Recent 2008-2009 effect estimates associated with relatively higher volcanic air pollution exposure show significant effect for acute airway problems, headache, cough, asthma exacerbations, and pharyngitis in age and racial subgroups of the general population. To date, Phase II results have documented an increased burden of disease for the exposed population, especially in exposed children, and have provided an evidence base for health prevention efforts by interdisciplinary environmental health teams.