International Scholarly Research Notices / 2013 / Article / Tab 4

Research Article

Adverse Health Effects Associated with Increased Activity at Kīlauea Volcano: A Repeated Population-Based Survey

Table 4

Public health recommendations for the Kīlauea volcano and other degassing volcanoes.

Level of preventionGoalsInterventions

Primary
(1) Reduce exposureAdvise and encourage: self-care activities on heavy vog days: no exercise, stay indoors, and AC
Educate the residents on:
(a) The pattern of “clean air” hours for each geographic area during typical meteorological conditions to allow planning of daily activities [16]
(b) The use of “real-time” air quality data accessible on the internet
(c) The emergency response plan for high vog events
Establish:
(a) Disaster shelters and renovate hospitals as needed to ensure clean indoor air [16]
(b) A policy of notification for new building/construction permits of the potential structural effects on indoor air quality [16]
Continue and enhance:
(a) The school system’s vog response plan (air quality equipment, training of personnel) [16]
(b) Assistance to senior centers (air testing, air quality equipment)
(c) The emergency response plan (revise as needed for current evidence, equipment needs, and evacuation activities for homebound or disabled residents)
(d) Communication between public health and healthcare agencies with volcanologists
(e) Opportunities for community participation from residents
(f) Health notices on air quality for tourists visiting vog-exposed areas
(2) Promote general healthAdvise and encourage:
(a) “Heart healthy” lifestyles [17]
(b) Prevent initiation of smoking with evidence-based interventions
Support and develop:
(a) Ongoing educational and resource needs of health care clinicians in vog-exposed areas
(b) The Rural health association
(c) The role of public health nursing [18]
(d) Policies for nonsmoking in public areas

Secondary (1) Identify disease in early stage(s)
(2) Treat promptly
Screen the population for disease:
(a) Conduct community health nursing fairs with screening and referral [19]
(b) Clinicians should include spirometry as part of regular assessment during annual physicals
Educate:
(a) Importance of annual health screening regardless of age
(b)Parents on subtle symptoms of respiratory illness in children
(c) On increasing awareness and not ignoring adverse symptoms needing clinical assessment (e.g., stroke, heart attack, SOB, chronic cough)
Treat: smoking using a family disease perspective and evidence-based interventions
Enhance: Access to culturally-responsive healthcare and follow-up services

Tertiary (1) Prevent disease progression
(2) Maintain quality of life
Persons with asthma:
(a) Clinicians implement guidelines from the National Heart Lung and Blood Institute [17]
(b) Ensure all patients have a current “asthma action plan” and carry emergency medications as advised [17]
(c) Provide innovative asthma education and support for children and their parents (e.g., camps, web-based activities)
(d) Continue the public health nursing asthma plan for schools
(e) Enhance the Hawaii Asthma Initiative to address the unique challenge of vog [20]
Persons with cardiovascular disease:
(a) Encourage self-care behaviors of monitoring BP and eating “heart healthy”
(b) Educate on the importance of taking their prescribed medications and communicating with their practitioner about annoying side effects, instead of not taking the medicine

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