How Kilauea volcano's toxic vog worsens asthma, other respiratory illnesses

Volcanic fog or volcanic smog, also known as vog, has posed significant health threats to residents of Hawaii for years during Kilauea volcano's continued activity. Those with pre-existing respiratory issues, including asthma, are especially at risk, although healthy people are also susceptible to vog-related symptoms.

Vog is the hazy air pollution emitted by Kīlauea. It's made up of primarily water vapor, carbon dioxide and sulfur dioxide, which is a colorless gas that smells like fireworks or a struck match, according to the International Volcanic Health Hazard Network.

The volcano's summit and east rift eruptive vents release sulfur dioxide into the atmosphere, where it reacts with oxygen, moisture, sunlight and other gases and particles. The resulting haze is known as vog.

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Images of Kilauea volcano eruption
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Images of Kilauea volcano eruption
Lava erupts on the outskirts of Pahoa during ongoing eruptions of the Kilauea Volcano in Hawaii, U.S., May 19, 2018. REUTERS/Terray Sylvester
Lava flows through trees on the outskirts of Pahoa during ongoing eruptions of the Kilauea Volcano in Hawaii, U.S., May 19, 2018. REUTERS/Terray Sylvester
Lava erupts on the outskirts of Pahoa during ongoing eruptions of the Kilauea Volcano in Hawaii, U.S., May 19, 2018. REUTERS/Terray Sylvester
Lava erupts on the outskirts of Pahoa during ongoing eruptions of the Kilauea Volcano in Hawaii, U.S., May 18, 2018. REUTERS/Terray Sylvester TPX IMAGES OF THE DAY
Lava flows through forest on the outskirts of Pahoa during ongoing eruptions of the Kilauea Volcano in Hawaii, U.S., May 18, 2018. REUTERS/Terray Sylvester
Gas erupts from a lava flow on the outskirts of Pahoa during ongoing eruptions of the Kilauea Volcano in Hawaii, U.S., May 18, 2018. REUTERS/Terray Sylvester
Lava flows past trees on the outskirts of Pahoa during ongoing eruptions of the Kilauea Volcano in Hawaii, U.S., May 18, 2018. REUTERS/Terray Sylvester
Lava flows through forest on the outskirts of Pahoa during ongoing eruptions of the Kilauea Volcano in Hawaii, U.S., May 18, 2018. REUTERS/Terray Sylvester
Lava erupts on the outskirts of Pahoa during ongoing eruptions of the Kilauea Volcano in Hawaii, U.S., May 18, 2018. REUTERS/Terray Sylvester
KAPOHO, HI - MAY 20: A lava fountain from a Kilauea volcano fissure erupts, while forming a new cone, on Hawaii's Big Island on May 20, 2018 in Kapoho, Hawaii. The U.S. Geological Survey said the volcano erupted explosively on May 17 launching a plume about 30,000 feet into the sky. (Photo by Mario Tama/Getty Images)
KAPOHO, HI - MAY 19: Residents view lava erupting from a Kilauea volcano fissure, at a small viewing party on a neighbor's porch, on Hawaii's Big Island on May 19, 2018 in Kapoho, Hawaii. Some local residents have held small viewing parties to view lava. The U.S. Geological Survey said the volcano erupted explosively on May 17 launching a plume about 30,000 feet into the sky. (Photo by Mario Tama/Getty Images)
KAPOHO, HI - MAY 19: A bird rests on a wire as lava from a Kilauea volcano fissure erupts on Hawaii's Big Island on May 19, 2018 in Kapoho, Hawaii. The U.S. Geological Survey said the volcano erupted explosively on May 17 launching a plume about 30,000 feet into the sky. (Photo by Mario Tama/Getty Images)
KAPOHO, HI - MAY 19: Lava from a Kilauea volcano fissure flows on Hawaii's Big Island on May 19, 2018 in Kapoho, Hawaii. The U.S. Geological Survey said the volcano erupted explosively on May 17 launching a plume about 30,000 feet into the sky. (Photo by Mario Tama/Getty Images)
KAPOHO, HI - MAY 19: A young resident keeps an eye on lava from a Kilauea volcano fissure erupting and flowing near her home on Hawaii's Big Island on May 19, 2018 in Kapoho, Hawaii. The U.S. Geological Survey said the volcano erupted explosively on May 17 launching a plume about 30,000 feet into the sky. (Photo by Mario Tama/Getty Images)
KAPOHO, HI - MAY 18: A man takes a photo of a lava fountain from a Kilauea volcano fissure on Hawaii's Big Island on May 18, 2018 in Kapoho, Hawaii. The U.S. Geological Survey said the volcano erupted explosively on May 17 launching a plume about 30,000 feet into the sky. (Photo by Mario Tama/Getty Images)
KAPOHO, HI - MAY 18: Lava erupts and flows from a Kilauea volcano fissure as trees burn on Hawaii's Big Island on May 18, 2018 in Kapoho, Hawaii. The U.S. Geological Survey said the volcano erupted explosively on May 17 launching a plume about 30,000 feet into the sky. (Photo by Mario Tama/Getty Images)
KAPOHO, HI - MAY 18: Lava erupts and flows from a Kilauea volcano fissure on Hawaii's Big Island on May 18, 2018 in Kapoho, Hawaii. The U.S. Geological Survey said the volcano erupted explosively on May 17 launching a plume about 30,000 feet into the sky. (Photo by Mario Tama/Getty Images)
KAPOHO, HI - MAY 18: Lava erupts and flows from a Kilauea volcano fissure on Hawaii's Big Island on May 18, 2018 in Kapoho, Hawaii. The U.S. Geological Survey said the volcano erupted explosively on May 17 launching a plume about 30,000 feet into the sky. (Photo by Mario Tama/Getty Images)
KAPOHO, HI - MAY 18: Lava erupts and flows from a Kilauea volcano fissure on Hawaii's Big Island on May 18, 2018 in Kapoho, Hawaii. The U.S. Geological Survey said the volcano erupted explosively on May 17 launching a plume about 30,000 feet into the sky. (Photo by Mario Tama/Getty Images)
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The International Volcanic Health Hazard Network reports that people living far downwind of the volcano, such as on Hawaii Island's west side, are mostly affected by fine particles, but areas in close proximity to the volcano's eruptive vents also face threats from vog exposure.

"There is sulfur dioxide, but also remember that the lava is causing homes [and vegetation] to burn," said Dr. Elizabeth Tam, a pulmonologist and Chair of Medicine at the University of Hawaii John A. Burns School of Medicine.

"You not only have vog, you have smoke, and when homes burn, there are plastics and all kinds of things," Tam said. "It's a toxic mix that is much more than just the volcanic emissions."

Tam and fellow researchers at the University of Hawaii John A. Burns School of Medicine recently published a 10-year study of about 2,000 Hawaii Island school children between ages 8 and 10 at the time the study began in 2002. Their schools were located at least 20 miles from Kīlauea, according to Tam. The children were followed for the full decade or until they graduated.

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Volcano erupts behind golfers in Hawaii
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Volcano erupts behind golfers in Hawaii
HAWAII VOLCANOES NATIONAL PARK, HI - MAY 15: People play golf as an ash plume rises in the distance from the Kilauea volcano on Hawaii's Big Island on May 15, 2018 in Hawaii Volcanoes National Park, Hawaii. The U.S. Geological Survey said a recent lowering of the lava lake at the volcano's Halemaumau crater 'has raised the potential for explosive eruptions' at the volcano. (Photo by Mario Tama/Getty Images)
HAWAII VOLCANOES NATIONAL PARK, HI - MAY 15: People watch at a golf course as an ash plume rises in the distance from the Kilauea volcano on Hawaii's Big Island on May 15, 2018 in Hawaii Volcanoes National Park, Hawaii. The U.S. Geological Survey said a recent lowering of the lava lake at the volcano's Halemaumau crater 'has raised the potential for explosive eruptions' at the volcano. (Photo by Mario Tama/Getty Images)
HAWAII VOLCANOES NATIONAL PARK, HI - MAY 15: A man drives a golf cart at a golf course as an ash plume rises in the distance from the Kilauea volcano on Hawaii's Big Island on May 15, 2018 in Hawaii Volcanoes National Park, Hawaii. The U.S. Geological Survey said a recent lowering of the lava lake at the volcano's Halemaumau crater 'has raised the potential for explosive eruptions' at the volcano. (Photo by Mario Tama/Getty Images)
HAWAII VOLCANOES NATIONAL PARK, HI - MAY 15: Kids play at a golf course as an ash plume rises in the distance from the Kilauea volcano on Hawaii's Big Island on May 15, 2018 in Hawaii Volcanoes National Park, Hawaii. The U.S. Geological Survey said a recent lowering of the lava lake at the volcano's Halemaumau crater 'has raised the potential for explosive eruptions' at the volcano. (Photo by Mario Tama/Getty Images)
HAWAII VOLCANOES NATIONAL PARK, HI - MAY 15: Boys play at a golf course as an ash plume rises in the distance from the Kilauea volcano on Hawaii's Big Island on May 15, 2018 in Hawaii Volcanoes National Park, Hawaii. The U.S. Geological Survey said a recent lowering of the lava lake at the volcano's Halemaumau crater has raised the potential for explosive eruptions at the volcano. (Photo by Mario Tama/Getty Images)
HAWAII VOLCANOES NATIONAL PARK, HI - MAY 15: A man drives a golf cart at a golf course as an ash plume rises in the distance from the Kilauea volcano on Hawaii's Big Island on May 15, 2018 in Hawaii Volcanoes National Park, Hawaii. The U.S. Geological Survey said a recent lowering of the lava lake at the volcano's Halemaumau crater �as raised the potential for explosive eruptions�at the volcano. (Photo by Mario Tama/Getty Images)
HAWAII VOLCANOES NATIONAL PARK, HI - MAY 15: People watch at a golf course as an ash plume rises in the distance from the Kilauea volcano on Hawaii's Big Island on May 15, 2018 in Hawaii Volcanoes National Park, Hawaii. The U.S. Geological Survey said a recent lowering of the lava lake at the volcano's Halemaumau crater 'has raised the potential for explosive eruptions' at the volcano. (Photo by Mario Tama/Getty Images)
HAWAII VOLCANOES NATIONAL PARK, HI - MAY 15: A woman hold her dog Tzippy at a golf course as an ash plume rises in the distance from the Kilauea volcano on Hawaii's Big Island on May 15, 2018 in Hawaii Volcanoes National Park, Hawaii. The U.S. Geological Survey said a recent lowering of the lava lake at the volcano's Halemaumau crater 'has raised the potential for explosive eruptions' at the volcano. (Photo by Mario Tama/Getty Images)
HAWAII VOLCANOES NATIONAL PARK, HI - MAY 15: A family gathers at a golf course as an ash plume rises in the distance from the Kilauea volcano on Hawaii's Big Island on May 15, 2018 in Hawaii Volcanoes National Park, Hawaii. The U.S. Geological Survey said a recent lowering of the lava lake at the volcano's Halemaumau crater 'has raised the potential for explosive eruptions' at the volcano. (Photo by Mario Tama/Getty Images)
VOLCANO, HI - Foreign tourists climb trees on the 18th hole of the Volcano Golf and Country Club to view the plumes of smoke coming from the Halemaumau Vent of the Kilauea Volcano in Volcano, HI on May 15, 2018. It is reportedly spewing only ash at this time and no large rocks. (Photo by Linda Davidson / For The Washington Post via Getty Images)
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While vog has been known to trigger asthma symptoms, the vog itself does not result in new asthma cases, experts say. Researchers found that asthma's prevalence is higher in areas where intermittent smoke was present, according to Tam.

"We were surprised to find that vog maybe doesn't cause asthma; we did find that if they already had asthma for a variety of reasons, it was a big factor," Tam said. "The vog definitely would affect those with [developed] asthma more, and they were more likely to get upper-airway symptoms and cough."

Vog can trigger additional short-term symptoms including eye, nose, throat or skin irritation, chest tightness, shortness of breath or dizziness and fatigue, according to the International Volcanic Health Hazard Network.

The health of physically active asthma sufferers is most likely to be negatively impacted by inhaling sulfur dioxide, and it only takes a brief exposure to narrow the airways, which exacerbates asthma symptoms. The long-term health effects of vog exposure are not yet known, according to experts.

The risk extends beyond asthmatics, as vog can harm the health of children, people with chronic lung diseases like COPD, those with cardiovascular issues as well as diabetics, according to the American Lung Association.

"We recommend that people stay indoors or evacuate the area, as is recommend by the protective agencies," said Janice Nolen, the American Lung Association's assistant vice president of national policy. Experts agree that masks only offer limited protection.

"Aerosols created by volcanic smog are very small particles, and respirator masks do not really prevent them entering the lungs," said Dr. Yesim Demirdag, assistant professor of pediatrics at Columbia University Medical Center.

Demirdag also recommended using an air purifier at home, and avoiding other asthma triggers such as smoking, burning candles, wood and strong smells.

"[It's also important to] take controller medications regularly and emergency medications as needed to minimize symptoms," Demirdag added.

 


 

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