Air pollution disasters: liability issues in negligence associated with the provision of Personal Protective Interventions (facemasks)

Disasters may impact air quality through the generation of high levels of potentially pathogenic particulate matter (PM), for example, in a volcanic eruption. Depending on the concentrations of particles in the air, their size and composition, and the duration of exposure, high levels of PM can create significant public health issues. It has been argued that air pollution, in and of itself, is a public health crisis. One possible intervention to reduce exposure to high levels of PM during an air pollution disaster (APD) is using facemasks. However, agencies may be reluctant to recommend or distribute facemasks for community use during APDs for a variety of reasons, including concerns about liability. There has been no analysis of these concerns. This paper analyzes whether agencies may have a legal duty of care in negligence to provide warnings about the health risks associated with APDs and/or to recommend facemasks as a protective mechanism for community use to reduce exposure to PM. It is also the first to examine the potential for liability in negligence, when a decision is made to distribute facemasks for community use during an APD and the receiver alleges that they sustained a personal injury and seeks compensation

The structure of volcanic cristobalite in relation to its toxicity; relevance for the variable crystalline silica hazard

BACKGROUND: Respirable crystalline silica (RCS) continues to pose a risk to human health worldwide. Its variable toxicity depends on inherent characteristics and external factors which influence surface chemistry. Significant population exposure to RCS occurs during volcanic eruptions, where ashfall may cover hundreds of square km and exposure may last years. Occupational exposure also occurs through mining of volcanic deposits. The primary source of RCS from volcanoes is through collapse and fragmentation of lava domes within which cristobalite is mass produced. After 30 years of research, it is still not clear if volcanic ash is a chronic respiratory health hazard. Toxicological assays have shown that cristobalite-rich ash is less toxic than expected. We investigate the reasons for this by determining the physicochemical/structural characteristics which may modify the pathogenicity of volcanic RCS. Four theories are considered: 1) the reactivity of particle surfaces is reduced due to co-substitutions of Al and Na for Si in the cristobalite structure; 2) particles consist of aggregates of cristobalite and other phases, restricting the surface area of cristobalite available for reactions in the lung; 3) the cristobalite surface is occluded by an annealed rim; 4) dissolution of other volcanic particles affects the surfaces of RCS in the lung. METHODS: The composition of volcanic cristobalite crystals was quantified by electron microprobe and differences in composition assessed by Welch's two sample t-test. Sections of dome-rock and ash particles were imaged by scanning and transmission electron microscopy, and elemental compositions of rims determined by energy dispersive X-ray spectroscopy. RESULTS: Volcanic cristobalite contains up to 4 wt. % combined Al(2)O(3) and Na(2)O. Most cristobalite-bearing ash particles contain adhered materials such as feldspar and glass. No annealed rims were observed. CONCLUSIONS: The composition of volcanic cristobalite particles gives insight into previously-unconsidered inherent characteristics of silica mineralogy which may affect toxicity. The structural features identified may also influence the hazard of other environmentally and occupationally produced silica dusts. Current exposure regulations do not take into account the characteristics that might render the silica surface less harmful. Further research would facilitate refinement of the existing simple, mass-based silica standard by taking into account composition, allowing higher standards to be set in industries where the silica surface is modified.Natural Environment Research Council (NERC)Moyes Foundation - studentshi

Facemask use for community protection from air pollution disasters: An ethical overview and framework to guide agency decision making

Disasters involving severe air pollution episodes create a pressing public health issue. During such emergencies, there may be pressure on agencies to provide solutions to protect affected communities. One possible intervention to reduce exposure during such crises is facemasks. Ethical values need to be considered as part of any decision-making process to assess whether to provide advice on, recommend and/or distribute any public health intervention. In this paper, we use principles from public health ethics to analyse the critical ethical issues that relate to agencies providing advice on, recommending and/or distributing facemasks in air pollution disasters, given a lack of evidence of both the specific risk of some polluting events or the effectiveness of facemasks in community settings. The need for reflection on the ethical issues raised by the possible recommendation/use of facemasks to mitigate potential health issues arising from air pollution disasters is critical as communities progressively seek personal interventions to manage perceived and actual risks. This paper develops an ethical decision-making framework to assist agency deliberations. We argue that clarity around decision-making by agencies, after using this framework, may help increase trust about the intervention and solidarity within and between populations affected by these disasters and the agencies who support public health or provide assistance during disasters

The α–β phase transition in volcanic cristobalite

Cristobalite is a common mineral in volcanic ash produced from dome-forming eruptions. Assessment of the respiratory hazard posed by volcanic ash requires understanding the nature of the cristobalite it contains. Volcanic cristobalite contains coupled substitutions of Al3+ and Na+ for Si4+; similar co-substitutions in synthetic cristobalite are known to modify the crystal structure, affecting the stability of the [alpha] and [beta] forms and the observed transition between them. Here, for the first time, the dynamics and energy changes associated with the [alpha]-[beta] phase transition in volcanic cristobalite are investigated using X-ray powder diffraction with simultaneous in situ heating and differential scanning calorimetry. At ambient temperature, volcanic cristobalite exists in the [alpha] form and has a larger cell volume than synthetic [alpha]-cristobalite; as a result, its diffraction pattern sits between ICDD [alpha]- and [beta]-cristobalite library patterns, which could cause ambiguity in phase identification. On heating from ambient temperature, volcanic cristobalite exhibits a lower degree of thermal expansion than synthetic cristobalite, and it also has a lower [alpha]-[beta] transition temperature (~473 K) compared with synthetic cristobalite (upwards of 543 K); these observations are discussed in relation to the presence of Al3+ and Na+ defects. The transition shows a stable and reproducible hysteresis loop with [alpha] and [beta] phases coexisting through the transition, suggesting that discrete crystals in the sample have different transition temperatures

Health‐Damaging Climate Events Highlight the Need for Interdisciplinary, Engaged Research

In 2023 human populations experienced multiple record‐breaking climate events, with widespread impacts on human health and well‐being. These events include extreme heat domes, drought, severe storms, flooding, and wildfires. Due to inherent lags in the climate system, we can expect such extremes to continue for multiple decades after reaching net zero carbon emissions. Unfortunately, despite these significant current and future impacts, funding for research in climate and health has lagged behind that for other geoscience and biomedical research. While some initial efforts from funding agencies are evident, there is still a significant need to increase the resources available for multidisciplinary research in the face of this issue. As a group of experts at this important intersection, we call for a more concerted effort to encourage interdisciplinary and policy‐relevant investigations into the detrimental health effects of continued climate change

The post-2016 long-lasting Vulcanian activity of Sabancaya volcano (Peru) and associated aeolian remobilisation of volcanic ash

The characterisation of tephra deposits resulting from almost simultaneous sedimentation and wind remobilisation is complex, and multidisciplinary strategies are required in order to accurately constrain associated processes and eruptive parameters. We present a multifaceted study that aims to characterise the recent eruptive activity and the subsequent aeolian remobilisation of tephra deposits at Sabancaya volcano (Peru), which started erupting in November 2016 with frequent and relatively small explosions (plume heights <6 km above the vent). First, we estimated the bulk volume of tephra deposit produced between November 2016 and August 2018 at 0.04 ± 0.02 km3, and the dense rock equivalent (DRE) volume at 0.02 ± 0.01 kilometros3. This corresponds to a tephra production rate of 1.1 ± 0.5 x 10−3 km3 DRE per month. Second, continuous sampling in a dedicated tephra collector network between April 2018 and November 2019 allowed estimation of the tephra volume at 2.3 ± 1.1 x 10−5 km3 DRE per month, indicating a significant decrease in the mass eruption rate since 2018. Third, by characterising the pulsatory activity through the repose interval between explosions and magma characteristics, Sabancaya's activity was classified as Vulcanian. Finally, aeolian remobilisation phenomena were studied using high-resolution videos, measurements of the airborne concentration of particulate matter with a diameter of ≤10 μm (PM10) and particle physical characterisation. Subtle morphological differences are identified between remobilised particles and those in primary deposits, and we found that particles moving at ground level and above 1.5 m have grainsizes transportable by saltation and suspension, respectively

Assessment of leachable elements in volcanic ashfall : a review and evaluation of a standardized protocol for ash hazard characterization.

Volcanic ash presents a widespread and common hazard during and after eruptions. Complex interactions between solid ash surfaces and volcanic gases lead to the formation of soluble salts that may be mobilized in aqueous environments. A variety of stakeholders may be concerned about the effects of ash on human and animal health, drinking water supplies, crops, soils and surface runoff. As part of the immediate emergency response, rapid dissemination of information regarding potentially hazardous concentrations of soluble species is critical. However, substantial variability in the methods used to characterize leachable elements makes it challenging to compare datasets and eruption impacts. To address these challenges, the International Volcanic Health Hazard Network (www.ivhhn.org) organized a two-day workshop to define appropriate methods for hazard assessment. The outcome of this workshop was a ‘consensus protocol’ for analysis of volcanic ash samples for rapid assessment of hazards from leachable elements, which was subsequently ratified by leading volcanological organizations. The purpose of this protocol is to recommend clear, standard and reliable methods applicable to a range of purposes during eruption response, such as assessing impacts on drinking-water supplies and ingestion hazards to livestock, and also applicable to research purposes. Where possible, it is intended that the methods make use of commonly available equipment and require little training. To evaluate method transferability, an interlaboratory comparison exercise was organized among six laboratories worldwide. Each laboratory received a split of pristine ash, and independently analyzed it according to the protocol for a wide range of elements. Collated results indicate good repeatability and reproducibility for most elements, thus indicating that the development of this protocol is a useful step towards providing standardized and reliable methods for ash hazard characterization. In this article, we review recent ash leachate studies, report the outcomes of the comparison exercise and present a revised and updated protocol based on the experiences and recommendations of the exercise participants. The adoption of standardized methods will improve and facilitate the comparability of results among studies and enable the ongoing development of a global database of leachate information relevant for informing volcanic health hazards assessment

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries