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Consultation to Integrate Indigenous Traditional Knowledge in Disaster Risk Reduction for Health, Mexico, 30 July to 1 August 2018

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Consultation to Integrate Indigenous Traditional Knowledge in Disaster Risk Reduction for Health, Mexico, 30 July to 1 August 2018 News and Information for the International Community Perspective 4 Spotlight 5 Interview 6 Member Countries 8 ISASTERS Information Resources 14 Upcoming Events 16 Preparedness and Mitigation in the Americas September 2018 Issue 127 Photo: Alex Camacho PAHO/WHO Camacho Alex Photo: Participants in the Consultation to Integrate Indigenous Traditional Knowledge in Disaster Risk Reduction for Health, Mexico, 30 July to 1 August 2018. Consultation to integrate indigenous traditional Editorial knowledge in disaster risk reduction for health What we know about the salud carried out in Mexico impact of volcanic ash in the respiratory system n 2014, within the framework of a con- of their Plan of Action for Disaster Risk Isultation in Canada concerning disaster Reduction 2016-2021. The inclusion of he health impact of volcanic erup- risk reduction in the health sector in indig- indigenous populations also plays a vital Ttions is of major significance, and enous communities, 20 delegates from ten role in the PAHO/WHO Strategic Plan and the effects of volcanic ash on the respi- countries in the American hemisphere in a number of national mandates in areas ratory system and on general health are issued a number of recommendations for including but not limited to the Ethnicity especially important. national and international action, but with and Health Policy, the Health Research Pol- Several volcanoes are currently in a special focus on indigenous populations. icy, and the Strategy for Universal Access to eruption in the Region of the Ameri- In 2016, the Member States of the Pan Health and Universal Health Coverage. cas, including, among others, Kilauea, American Health Organization incorpo- For this purpose, in fulfillment of the in the United States (in the state of rated ethnicity as a cross-cutting aspect 2014 recommendations, PAHO/WHO held (continued on page 2) >> (continued on page 5) >> PHOTO Agung Santoso Agung PHOTO (from page 1) Editorial What we know about the impact of volcanic ash in the respiratory system Hawaii); Popocatépetl, in Mexico; Volcán vides, some of the main lessons learned up of particles under 10 microns in diam- de Fuego, Pacaya, and Santiaguito, in Gua- about protecting health in the face of volca- eter (PM10), and especially those of less temala; and Reventador, Cotopaxi, and nic eruptions can be outlined today. than 2.5 microns in diameter (PM2.5), can Sangay, in Ecuador. It has become clear that the breathable exacerbate preexisting respiratory diseases The Volcán de Fuego eruption in Gua- particles produced by eruptions are not as and increase premature mortality among temala in June 2018 took the lives of over acutely dangerous for respiratory health as patients with chronic diseases. Longer 100 people and left 197 missing, a number the smoke from fossil fuels. One of the dis- exposure, perhaps as little as a few years, injured, and hundreds in shelters. In addi- coveries of research on the eruption of the has been shown to contribute to increased tion, the emission and fall of volcanic ash Mount Saint Helens volcano in 1980 is that mortality from respiratory and cardiovas- have been continuous since the eruption. volcanic ash can contain unusually high cular diseases and cancer. The volcanic Although volcanic eruptions are much quantities of a mineral called crystalline sil- ash from eruptions normally includes a less frequent than other natural events that ica that is present in breathable particulate, large proportion by weight of PM2.5. The cause disasters, such as earthquakes and and that can reach the lungs. Substantial concentration of these particulates in the floods, most volcanoes do have the poten- exposure to this compound may lead to the air can greatly exceed the air quality limits tial for dangerous eruptions that release development of silicosis, a pulmonary dis- recommended by the World Health Orga- large quantities of gases and ash in the ease that is normally diagnosed in workers nization (WHO) and can do so for months space of a few hours, sometimes followed by with severe exposure to silica powder in in the case of short eruptions, and for years intermittent activity lasting weeks or even mines and quarries. following longer eruptions. Symptoms in months. These gases normally disperse in Advances in epidemiology in the last people with asthma or other chronic pul- the atmosphere and pose little risk for local decade on the health effects of air pollution monary diseases are also seen to recur after populations. An ash plume, however, can in the middle- and high-income countries acute exposure to the ash, as observed in affect extensive areas. have shown that the finest particles play a the Mount Saint Helens case. Most of the communities in volcanic fundamental role as the most toxic of all When erupting volcanoes continue regions are not prepared for these events. components in traffic-related emissions. emitting ash for months, concerns about Given the examples that history pro- Short-term exposure to fractions made (continued on page 3) >> 2 September 2018 Issue 127 Editorial (from page 2) age exposure to PM2.5 rose significantly in silica and quantify the size of the particles. the entire range of non-respiratory health this arid environment during the months Effective respiratory protection is also impacts related to PM2.5 particulate mat- and even years following the eruption. necessary in any heavy ashfall, especially ter increase, and this prompts as much or Nevertheless, studies were not conducted for people with pre-existing respiratory and more anxiety in terms of public health as to monitor the health of the population, or cardiovascular diseases, who should remain crystalline silica has in the past. An import- children’s health in particular. indoors to the extent possible. As to types of ant example highlighting the caution that More research is needed to determine protection, recent research has shown that should be exercised in events of this type is whether PM2.5 particles in volcanic ash light high-efficiency masks are most effec- the eruption of the Cordón Caulle volcano are as toxic as similar fractions of the same tive in reducing the inhalation of PM2.5 in Chile, in 2010, with ashfall extending size in traffic-related air pollution. In the from volcanic ash, and that they are prefer- into Argentina, in particular the dry areas past, it was assumed that volcanic emis- able to the household protective measures of the Patagonian steppes. It was only three sions were less dangerous since they consist that people normally use to cover the face. months later that conditions in some of of natural mineral particles. However, we In addition, children should be prevented the area’s cities improved enough to allow cannot guarantee that today. For this and from playing in places where ash has been normal life to resume. However, some very other reasons, populations and authorities deposited, or near dusty roads. thick deposits of ash remained on the land in areas with ashfall are advised to reduce for many months and were then born aloft exposure as much as possible, starting Peter J. Baxter, MD, Cambridge University, by strong winds, in some cases produc- with withdrawal from inhabited areas and United Kingdom. E-mail: pjb21@medschl. ing powerful ash storms that temporarily protection for workers. Also, ash samples cam.ac.uk. reduced visibility to zero. Although that should be analyzed in experienced labora- ash did not contain crystalline silica, aver- tories to rule out the presence of crystalline PAHO recommendations on ashfall and protection of the respiratory system The health impact of volcanic eruptions, spe- Respiratory Protection cifically the effects of volcanic ash on the respiratory system and on general health, is of major importance. People should know that breathing ashes can be harmful and that protec- In consultation with various experts, PAHO offers rec- tion is recommended for everyone. ommendations for the general public on what to do For people in general who have to leave home for short periods, any type of common surgical mask can be effective. when volcanic ash begins to fall or is ongoing, on how Care should be taken to adjust the mask to the face properly people can protect themselves if they need to go out- by adjusting the clips and nose straps. doors, what to do if ash is in the home, and on how to Two types of populations should receive special advice on respiratory protect the respiratory system, both for members of the protection: general population and for those who are most vulner- People who work outdoors and are much exposed to the ash (such as cleaning teams, emergency and rescue teams, and able to ash particulate. police). PAHO also explains the principal health effects of ash fall in terms of the respiratory system, toxicity, and People who are particularly vulnerable to ash particles (for example, patients with serious illnesses, asthma patients, the eyes. children, and the elderly). For complete information, visit: http://bit. ly/2CwS462. Editorial September 2018 Issue 127 3 The Emergency Medical Teams (EMT) initiative moves forward in the Americas 26 professionals trained as EMT coordinators to bolster capacity during emergencies and disasters he Pan American Health During the course, the partici- TOrganization held the IV pants were required to work with the Regional Meeting of Emergency response coordination mechanisms Medical Team Coordinators, on that bring together national and inter- 16-20 July in Virginia (United national efforts, to understand and States), with 26 participants from harmonize the guidelines of the Med- Haiti, Brazil, Uruguay, Canada, the ical Information and Coordination United States, Jamaica, Barbados, Cell (CICOM) with national emer- Puerto Rico, and Panama. gency operations centers procedures, Led by a team of eight experts from their own EMTs at the national level.
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