Suchergebnisse

The 2014 explosive eruption of Kelud volcano, Indonesia ejected fine-grained volcanic ash in a plume which travelled westwards across the island of Java. In Yogyakarta, without warning, up to 5 cm of ash was deposited within a few hours. This paper investigates the community and organizational response to the respiratory hazard of the ashfall, in the city of Yogyakarta. In any location where ashfall is a rare event, people located away from the primary volcanic hazards will be concerned about whether volcanic ash in their environment is dangerous to inhale, and how they should protect themselves. The World Health Organization primarily recommends that people stay indoors, or use light-weight face masks if outdoors. In the first study of its kind, we undertook a rapid questionnaire survey (with 125 respondents) on the use of community respiratory protection when ash is in the air. We documented the types of masks people wore, where they had got the mask from, why people wore masks, who advised them to wear a mask, and whether people thought their respiratory protection was effective. We also conducted informal interviews with a range of emergency management and health agencies, NGOs and a children's charity, to understand how those involved in mask procurement and distribution responded to the crisis, and to determine their understanding of the effectiveness of the masks that they provide. The study showed that a wide range of respiratory protection is used by those who choose to protect themselves, from cloth through to highly-efficient face masks, but with most people wearing surgical masks. Masks are widely available, from street stalls and shops, but are also distributed by government agencies, NGOs and employers. The organizations interviewed mainly distribute surgical masks to the public. Most people wore masks through their own initiative because they understood that there could be a health hazard, although some people wear them anyway when riding scooters (to protect from inhaling vehicle exhaust and street dust). Around 40% of the respondents thought that their existing protection was not sufficiently effective and around 30% of the respondents took measures to try to improve the effectiveness of their chosen protection method (e.g., wearing two types concurrently). This pilot paves the way for the Health Interventions in Volcanic Eruptions (HIVE) project which aims to provide an evidence base on effective respiratory protection for community use when ash is airborne, so that health agencies and other suppliers can provide reliable protection for the general population. The HIVE project will experimentally test the effectiveness of the range of types of respiratory protection identified in this study, as well as understanding the behaviours and environmental and cultural issues which affect whether people will wear masks when ash is in the air.

Inhalation of ash can be of great concern for affected communities, during and after volcanic eruptions. Governmental and humanitarian agencies recommend and distribute a variety of respiratory protection (RP), commonly surgical masks but, also, industry-certified N95-style masks. However, there is currently no evidence on how wearable they are within affected populations or how protective wearers perceive them being against volcanic ash (which will influence the likelihood of uptake of recommended interventions). Volunteers living near Mt. Sinabung, Sumatra, Indonesia, participated in a field wearability study, which included a high-efficiency mask certified to industry standards (N95-equiv.); a standard, pleated surgical mask (Surgical); a Basic flat-fold mask (Flat-fold), and the surgical mask plus a scarf tied over the top (Surgical Plus) to improve fit. These types of RP had all performed well during earlier laboratory filtration efficiency tests. The N95-equiv. mask had performed significantly better than the other RP in the subsequent total inward leakage volunteer trials, whilst the Flat-fold and Surgical masks performed poorly, letting in a third of PM2.5 particles (data published elsewhere). Thirty volunteers wore each mask for a 15-min walk before being asked to rate the comfort, breathability and perceived protection and fit of each. After wearing all of the masks, volunteers compared and identified their preferred type of protection. The feedback received from the volunteers suggested that the Surgical Plus and N95-equiv. masks were rated as being significantly hotter and more humid than other masks. The Flat-fold was rated to have better breathability than the other masks. The N95-equiv. mask was ranked as providing the best level of effectiveness of the four masks tested. Ultimately, when asked which type of mask they would choose to wear during ashfall, 33% selected the Flat-fold mask due to its comfort and simplicity, with the Surgical Plus being the least likely to be chosen of the four tested. The study findings are of benefit to agencies who need to make informed decisions on the procurement and distribution of RP for use by those affected in future eruptions and the provision of advice to communities on their usage.