A New Evidence Base for Respiratory Health Interventions in Volcanic Eruption Crises

Purpose

Volcanic ash inhalation can trigger respiratory illness and cause acute anxiety, leading to increased vulnerability during eruptions. Agencies distribute facemasks which, likely, have poor facial seals and inadequately filter fine-grained particles. High-efficiency masks, though, may underperform if not fit-tested, are costly and uncomfortable.

The study aimed to investigate respiratory protection (facemasks) used in volcanic eruptions. Through a clinical trial and laboratory experiments, the research team sought to establish whether some forms of protection were better than others, and if some protection is better than no protection. The research also aimed to explore behavioural factors influencing mask use in different societies, and help inform how advice about protection should be modified for different cultures, climates and economies.

Outcomes

The study successfully completed laboratory testing of a number of facemasks, and undertook wearability trials of masks amongst communities affected by volcanic ash. Social surveys were completed in three country settings – Indonesia, Mexico and Japan – alongside anthropological research to explore behavioural factors and how to tailor effective messages around protection. A wide range of communication products and guidance on the use of facemasks has been produced and disseminated, and train-the-trainer courses have been delivered and tested in Indonesia.

The study had intended to undertake a clinical trial in Japan to test the respiratory outcomes of wearing different facemasks, amongst patients with asthma living close to an active volcano. The trail was not able to be undertaken, but the study team instead designed two epidemiology protocols for rapid deployment in future eruptions and a clinical protocol for laboratory-based work to test the health benefits of wearing masks when exposed to ash.

Key Findings:

• Laboratory experiments demonstrated that some forms of respiratory protection are more effective against volcanic ash than others.
• Whilst all types of respiratory protection studied provided some level of protection, this varied greatly depending on the material.
• The social research found that contextual factors influence the motivation to use respiratory protection during eruptions and these should be taken into account when agencies and governments develop communication strategies to promote mask use and other protective actions.

Key outputs:

• 4 peer reviewed articles have been published, and a further 13 are planned
• New epidemiology protocols published on the IVHHN and HIVE websites
• New guidelines on facemask use: www.ivhhn.org/ash-protection
• 6 videos, pamphlets, leaflets and posters on protecting yourself from volcanic ash
• Supplement of PAHO’s Bulletin, on the HIVE study, planned for late 2019.