Hurricane Readiness and Environmental Risks on the Bayous\-\-an NIEHS Community-Based Pilot Project in South Terrebonne-Lafourche Parishes, Louisiana

After Hurricane Rita devastated the western Louisiana and east Texas Gulf coasts, the National Institute of Environmental Health Sciences (NIEHS) Community Outreach and Education Core (COEC) at the University of Texas Medical Branch (UTMB) responded by delivering medical supplies to Larose, Louisiana, and deploying an outreach survey team that videotaped a series of interviews with public health advocates, environmental activists and citizens involved in rescue and recovery efforts. Between October 4th and December 17th, 2005, this team asked respondents to identify and prioritize perceived environmental health risks due to storm damage, and to suggest outreach strategies that would assist recovery and increase community readiness for future storms.

Questions posed to survey respondents included:

• • What significant damage did your region sustain during or because of hurricanes Katrina and Rita?

• • What is the most significant threat to human health in your area, post-Katrina (or Rita)?

• • How has the hurricane evacuation, reentry, and recovery process disrupted the social fabric of your area, and Louisiana generally?

• • What environmental health projects—involving collaborations among environmental scientists, health care and social service providers, and communities – do you think are most important to safeguard the health of people and the environment in your region and the state?

• • Describe your organization's response to this disaster. How have you modified your mission to make an effective response? How have these modifications affected your organization's capacity to realize your original mission? [only asked in interviews with staff or members of environmental organizations]

The results of this video survey were compiled and edited (with an emphasis on suggestions for collaborative projects among, researchers, clinicians, and communities) for presentation in November, 2005. The footage was further edited, with the title that it now has, ". . . after the wind, child, after the water's gone . . . ;" it is included in the present issue of JHCPU as a DVD.

In April 2006, the UTMB-NIEHS COEC's Public Forum and Toxics Assistance Division received funding for an NIEHS pilot project to create and implement a site-specific community environmental risk curriculum that incorporates major areas of concern identified in the survey with a primary focus on the health consequences of large storms. Analysis of video transcripts identified the following responses as significant (by frequency and emphasis):

• • exposure to mold: concentrations, direct exposure effects, possible immuno-suppression and recommended precautions;

• • extent of threat from pathogens in water; ongoing monitoring of pathogen levels in bayou surface water and major bodies such as Lake Salvador; rashes and lesions as consequences of immersion in flood water;

• • flooding/overflow risk to surface water from Resource Conservation and Recovery Act exempt waste pits and compromised sewage treatment facilities;

• • dispersion patterns and health effects of toxic releases from submerged automobiles, agricultural chemicals, non-petrochemical industrial sites;

• • levels of metals, diesel, and hydrocarbon residues in desiccated sludge, and change in levels over time;

• • respiratory and other health effects of wind-borne sludge dust (Katrina cough);

• • transport patterns of petrochemical toxicants and metal residues moved from previously contaminated areas by storm surges;

• • need for specific re-entry safety gear not clearly indicated, lack of information on re-entry procedures, safety equipment unavailable, price-gouging;

• • effects of damage to coastal marsh on subsistence food supply and health of the estuarine eco-system;

• • massive loss of marsh and wetlands, loss of marshland's hurricane dampening effect;

• • depression, disorientation, post-traumatic stress effects of disaster;

• • effects of disaster stressors on the most vulnerable segments of the population: children, the elderly, people with low incomes, disabled individuals.

The project's organization, education, and outreach derive from a merger of two survey suggestions for collaborative disaster preparedness projects that were mentioned with some frequency, and also fit the parameters of our available infrastructure and limited funding:

• • Conduct a comprehensive survey of industrial and hazardous waste sites in affected area to assess extent of structural damage to facilities, especially as damage might affect fugitive emissions, seepage, or emergency flaring procedures; and

• • Develop a comprehensive, but site-specific, disaster management plan and procedures that incorporate environmental health, state and local environmental risk communication...