Standardized epidemiological protocols for populations affected by volcanic eruptions.

Volcanic eruptions can have far-reaching consequences for human health, including injuries, illnesses and deaths. One study estimates that over 270 000 people lost their lives in volcanic episodes between 1600 and 2010, with 600 million people currently living in areas of risk.1 Following an eruption, air quality can be significantly deteriorated. Since airborne ash and gases from volcanic emissions may affect the respiratory system,2 the public may be concerned over the potential health effects, particularly those most exposed or most vulnerable.3 Studies of the health impacts associated with volcanic hazards started with the eruption of Mount St. Helens, United States of America, in 1980. Since then, studies, mainly conducted in high-income countries, have identified mostly reversible, short-term respiratory outcomes, with few studies undertaken for chronic outcomes.4

A key challenge to identifying and quantifying health impacts from volcanic eruptions has been the lack of consistent epidemiological protocols that can be rapidly deployed at eruption onset, which is an issue across disaster epidemiology.5 Conducting health research in settings of volcanic eruptions is inherently difficult because it involves disaster zones with highly mobile populations and temporary shelters.6 The lack of consistent data means that we still have a relatively poor understanding of the extent of health impacts from exposure to volcanic emissions, due to the challenges of interpreting studies of variable designs and robustness.

To address these difficulties and assist with the generation of health evidence from volcanic contexts, the International Volcanic Health Hazard Network has developed standardized protocols to facilitate epidemiological studies of populations that have been, or may be in the future, exposed to volcanic ash and gases. We describe here the process, content and suggested use of these protocols to help promote awareness and build the health evidence base of acute volcanic exposures. These protocols are available for free download on the network’s website.7 Although we focus on volcanic eruptions, all acute exacerbations of air quality, such as from wildfires, warrant study, which may be facilitated by adapting the network’s protocols to other such exposure scenarios.