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| Sunday, 23 January 2005 |
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Features |  |
| News Business Features Editorial
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Compiled by Carol Aloysius Aftermath of post tsunami debris : Air pollution and health hazards
Q: What is Post Tsunami Debris? A: It consists of, construction and demolition material, plastics wraps, plastic bags, PVC, wet card board, asbestos, piping, flooring, glue in particle boards, treated wood, trash, household garbage, leaves, metal, rubber and tyres. Q: How does air get polluted by debris? A: By the open burning of debris. Q: What is open burning? A: It is the method by which the debris, and all combustible substances are disposed of by burning in an open area where there is no proper air pollution control in place. Q: How does open burning pollute the air? A: Burning releases smoke, soot, vapors of toxic gases, and solid matter suspended in air "the particulate matter". These can be a health hazard. Q: Who is affected by air pollution? A: People sensitive to pollutants, people with heart disease, asthmatics, emphysema and respiratory diseases. Q: How will it manifest in the affected people? A: Cough, eye, nose and throat irritant, allergies, breathing difficulty, headaches, heart irregularities, and angina, heart attack, premature death, cancer, and development failure in children. Q: What determines the chance of harmful effects the air pollutants will have? A: The amount of pollutants in the people's breathing zone (ie the air around the mouth and nose). Q: What other factors, will aggravate the severity of adverse effects? A: Closeness to the smoke, wind, the amount of air diluting the smoke. Q: What is the effect of particulate matter in the smoke, produced as a result of burning trash and wood? A: These particles get trapped in the lungs, causing cell damage in the lung, leading to inflammatory changes in the lungs. Particulate matter can cause heart irregularities (arrhythmias) heart attacks. People with lung disease, heart disease, the elderly, and children are at highest risk from exposure to particulate matter. Q: How does the particulate matter affect heart patients? A: The particulate matter prevents oxygen from reaching the tissues, thus causing low oxygen available to the tissues. Q: What are the toxic gases emitted by open burning? A: Smoke, nitrogen dioxide, sulphur dioxide, formaldehyde, polycyclic organic matter, volatile organic compounds, dioxine etc. Q: What is the health hazard caused by inhaling smoke? A: It causes breathing difficulty, in asthmatics, lung inflammation an active pneumonia and bronchiolitis. Allergies can be worsened. Q: What are the adverse effects on the human body due to inhaling toxic gases? A: Nitrogen dioxide is an irritant to the respiratory system, and will subject a child more prone to respiratory diseases. Sulphur dioxide causes diseases of the lung, wheeze and shortness of breath. Formal dehyde-irritant to eye, nose, throat, Volatile organic matter causes irritation to eyes, throat, nausea, headaches, loss of co-ordination, damage to liver and other parts of the body. Q: What is the worst toxic air pollutant? A: DIOXIN Q: What is dioxin? A: It consists of a whole class of chemicals, It is a colour-less (odourless) solid. Q: How is dioxin produced? A: By burning material containing high levels of chlorine and PVC. Q: What chemicals are included in dioxin? A: Dioxin, PCBE, furan, etc. Q: Are all dioxins deadly? A: No, only 7 out of 75 different types are deadly. Q: What is so bad about dioxin? A: It lasts for centuries as there is no breakdown. Animals eat plants and drink water contaminated with dioxin, which accumulates in the animal fat. People eating foods containing high fats, beef, dairy products, are exposed to dioxin. Q: What are the adverse effects of dioxin? A: Causes CANCER Affects human immune system. Affects human reproductive system, endocrine, glands, and hormone production. Q: How can we avoid air pollution from debris? A: By proper environmental friendly disposal methods: Land filling, Composting; Recycling; Other options. Acute bronchitis in tsunami survivors by Dr. C. G. Uragoda Acute bronchitis is a respiratory disease that may occur in refugee camps, but its incidence is likely to be increased in people who are tsunami victims. It is an infection of the bronchial tree in which large bronchi divide and sub-divide until the smallest bronchioles are reached. Inflammation of the inner lining layers of the bronchi caused by pathogenic bacteria would result in bronchitis. The usual way by which bacteria may enter the respiratory tract is by inhalation of contaminated droplets of saliva given off through coughing by an infected person. However, the method is quite different in a tsunami victim who manages to survive drowning. In his attempts to save himself, seawater may get into his lungs. This water may be highly contaminated with bacteria, which tend to multiply rapidly within the bronchi, thus causing bronchitis. Such cases of bronchitis would usually occur within a couple of days of survival. A person who has contracted bronchitis in this manner may transmit the disease to a contact of his in a crowded refugee camp, by coughing out tiny globules of infected saliva. In this way, the disease could travel from one person to another, unless the trend is broken by proper control measures. Symptoms and treatment The chief symptoms of acute bronchitis are fever, which may be high or low, a hacking cough, wheezing, and difficulty in breathing. The sputum that is coughed up is usually green or yellow in colour, and rarely bloodstained. A survivor from the tsunami catastrophe, who develops these symptoms, should consult a doctor for treatment. Treatment consists of a broad-spectrum antibiotic for controlling infection. With the antibiotic the fever may come down, but the cough may remain, and it may give rise to much discomfort. Some patients may develop a wheeze and this may remain even after the fever has subsided. A few may have had a wheeze in the past, even several years ago, and such people tend to get a relapse of the wheeze. The cough and the wheeze should be treated with drugs that widen the lumen of the bronchial tree. These could be administered by mouth or by inhalation. In uncomplicated acute bronchitis, short term therapy lasting from 10 to 20 days would suffice. Inhalation therapy is used mainly for asthma, but it has a place in some cases of bronchitis too. This form of treatment, which was introduced about 40 years ago in western medicine, has gradually become more and more sophisticated. It should not be forgotten that a sort of inhalation therapy was used in ancient Sinhala medicine for over a thousand years. Patients were asked to smoke dried leaves of attana (Datura metel) rolled into a cigar. This plant has been found to contain atropine, which has the power of dilating the bronchi. Smoking brings this active principle into contact with the lung tissue, and thus produces results. Incidentally inhalers containing atropine are now used in western medicine for the same purpose. Patients with bronchitis could usually be treated as outpatients, but a few, such as those with severe difficulty in breathing, may require admission to a hospital. The vast majority of patients with bronchitis recover completely without any permanent damage. A very small number may develop broncopneumonia, where pneumonic patches are scattered throughout both lungs. It is a more severe condition and may often need hospitalisation and end up with some permanent damage to the lungs. Tsunami survivors..... : Injury-prevention measures when returning home Learn proper safety procedures and operating instructions before operating any gas-powered or electric chain saw; When using any power equipment, always wear a safety face shield or eyeglasses, and gloves; Avoid all power lines, particularly those in water; Avoid wading in water. Broken glass, metal fragments, and other debris may be present in the water, and be careful of nails and broken glass when removing boards covering the windows. Cleanup Once you have established that no structural, electrical or gas-related hazards exist in your home, dry and disinfect all materials inside the house to prevent the growth of mold and mildew. Walls, hard-surfaced floors, and many other household surfaces should be cleaned with soap and water and disinfected with a solution of one cup of bleach to five gallons of water. Be particularly careful to thoroughly disinfect surfaces that may come in contact with food, such as counter tops, pantry shelves and refrigerators. Areas where small children play should also be carefully cleaned. Wash all linens and clothing in hot water, or dry clean them. For items that cannot be washed or dry cleaned, such as mattresses and upholstered furniture, air dry them in the sun and then spray them thoroughly with a disinfectant. Steam clean all carpeting. If there has been a backflow of sewage into the house, wear rubber boots and waterproof gloves during cleanup. Remove and discard contaminated household materials that cannot be disinfected such as wall coverings, cloth, rugs and drywall. Please note: Several deaths following past disasters have occurred due to fires. In many cases, fires were caused by the careless use of candles to light homes without electrical power. Use battery-powered lanterns, if possible, rather than candles. If you use candles, make sure they are in safe holders away from curtains, paper, wood, or other flammable items. Never leave a candle burning when you are out of the room. Doing too many tasks at the same time may not be good for your health, says Dr. R. A. Perera, a clinical psychologist. : The health hazards of multi-tasking As the holiday season ends and people try to cram more activities into already tight schedules, it is important to slowdown and concentrate on only one task at a time. Researchers at the University of Michigan have shown that multitasking takes its toll not only on the tasks but on the health of the taskers, too. For example, if you are on the phone and driving your car at the same time, the quality of both these tasks could be less efficient than when you do these tasks separately, one at a time. Recent studies show that multitasking can lower efficiency and create errors in the tasks performed, but it also compromises memory, causes back pain, can leave one susceptible to the flu and indigestion, and it even hurts teeth and gums. Psychologists say that when someone does many things at the same time or multitasking, the body releases hormones to cope with extra challenging task situations, and that this can cause brain damage. Studies conducted at the American National Institute of Science showed that different parts of the brain are activated during certain tasks. For instance, when people are presented with a visual task, nerves in the brain, which deals with visual tasks, are working. When people are listening to something, the nerves responsible for hearing in the brain are working. But when people try to do both - such as drive and talk on a cell phone - the efficiency of both parts of the brain reduces. The brain actually begins to shut down. The brain can't do it and it refuses to do it. Poor task completion and lowered efficiency results. Studies conducted in University of Pittsburgh in 2002 found that it is hard for people to perform two language tasks at once - that is, listen to two conversations at the same time. They found that brain activity generated by listening to sentences decreased by 53 per cent, if the person also tried to perform a visual task. Other factors do influence task efficiency. First, some people's brains are better suited for performing several tasks than others. Also, the more automatic a task becomes, the easier the brain can do something else at the same time. Thus, an experienced driver can function better in distracting traffic than a beginner. Psychologists have been focusing less on the public health risks and more on the personal health risks, which they describe as potentially considerable. One of the difficulties in multitasking is that the brain and the body are not designed to handle a wide array of tasks at once. When the brain becomes stressed from overload, other parts of the body release stress hormones such as adrenaline. The hormones however, are not supposed to flow freely or regularly. A one shot output of the hormones, in fact, can help an animal escape a predator's claws. But a prolonged release of these hormones will take a physical toll on the body. The results of these continuous hormonal increase can cause sleep loss, depression and anxiety. Psychologists say behaviour that results in stress will result in a whole range of 21st century diseases. Electronic advances such as cellphones and laptops contribute to brain overuse, too. When a person tries to multitask, there is an extra cost involved in each mental shift. As a result, the productivity goes down, and so does the rate at which you do the task. So it is better to slow down, relax, and do only one task at a time. Medical aspects of the aftermath of tsunami by Dr. Sampath R. Nanayakkara, Family Physician - Talawatugoda Sri Lanka experienced, for the first time an unprecedented and massive flood, caused by the Tsunami waves, which devastated more than 75 per cent of the coastal belt. The merciless sea waves sent at least about 8 1/2 lakhs of people of all walks of life, to refugee camps, loss of lives in thousands and extensive damage to properties. Even though the acute phase of this natural disaster is gradually fading off, the aftermath of it seems to be more serious and complicated than expected, because the victims being the poor, or the middle class, who have lost their homes, livelihood and the precious little things they possessed, are more vulnerable to disease. The health authorities have already warned of an outbreak of bowel related diseases. The other diseases which may spread among them are: common colds, typhoid fever, viral fever, Infectious diseases, (such as chicken pox and mumps), hepatitis, infective skin diseases such as of parasitic and fungal origin, worm diseases in children, amoebiasis and other parasitic bowel diseases and food poisoning. The commonest skin disease one can expect, is 'scabies' (caused by a mite called sarcoptes scabeii) which is highly contagious. More than these acute diseases, the health personnel should be prepared to meet an upsurge of more psychological illnesses among the victims in the future. The most serious among them would be 'Depressive Disorders' and 'Psychosomatic illnesses.' The affected families have witnessed how their loved ones being washed away and drowned in the sea. Some of their relatives are still missing. They do not know whether they are dead or alive. They have not seen their bodies yet. So how can these helpless, grief stricken people go through their physiological 'Grief Reaction' in a normal way.' In bereavement, one has to go through a normal Grief Reaction until at the end of it, he/she does accept the death, and settles down to a normal life pattern. Therefore the mental impact on them is terrible. It may take many months or even years, for them to erase those traumatic memories from their minds; or even they may carry those memories with them throughout their lives giving rise to bodily illnesses from time to time. At the present moment all those affected may show only symptoms of shock and stress, but as they go on, these traumatic memories can lead to the developnent of real mental and psychological disorders, in the vulnerable groups. In Sri Lanka the available psychiatrists are grossly inadequate to meet situations of this nature. Therefore it is the duty of the General Practitioners or the family doctors to deal with the mental aspects as well, whenever they treat these people for their physical problems, if they are to be saved from becoming mentally depressed in future. In this aspect the younger generation is more vulnerable to develop mental disorders such as - phobic states, (fear), depression and anxiety. Apart from the physical and mental problems mentioned, the health providers should pay same attention to the social problems which especially the parentless and homeless children, are prone to. Little girls in these refugee camps run the risk of being sexually abused by unsuspected adults who come forward to help them as guardians. Therefore measures should be taken, as early as possible, to evacuate all parentless children from these camps to a secure place until they find suitable children's homes. This will prevent another major problem in our society, i.e. spread of sexually transmitted diseases. |
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| Produced by Lake House |
Air pollution is currently a serious health risk for survivors in the
tsunami affected areas, due to burning of debris from the floods. Dr. Rani
Goonewardene discusses this issue with Carol Aloysius.
