Respiratory health effects associated with restoration work in post-Hurricane Katrina New Orleans

Abstract

Background: This study examines prevalence of respiratory conditions in New Orleans-area restoration workers after Hurricane Katrina.

Methods: Between 2007 and 2010, spirometry and respiratory health and occupational questionnaire were administered to 791 New Orleans-area adults who mostly worked in the building construction and maintenance trades or custodial services. The associations between restoration work hours and lung function and prevalence of respiratory symptoms were examined by multiple linear regression, χ², or multiple logistic regression.

Results: 74% of participants performed post-Katrina restoration work (median time: 620 hours). Symptoms reported include episodes of transient fever/cough (29%), sinus symptoms (48%), pneumonia (3.7%), and new onset asthma (4.5%). Prevalence rate ratios for post-Katrina sinus symptoms (PRR = 1.3; CI: 1.1, 1.7) and fever and cough (PRR = 1.7; CI: 1.3, 2.4) were significantly elevated overall for those who did restoration work and prevalence increased with restoration work hours. Prevalence rate ratios with restoration work were also elevated for new onset asthma (PRR = 2.2; CI: 0.8, 6.2) and pneumonia (PRR = 1.3; CI: 0.5, 3.2) but were not statistically significant. Overall, lung function was slightly depressed but was not significantly different between those with and without restoration work exposure.

Conclusions: Post-Katrina restoration work is associated with moderate adverse effects on respiratory health, including sinusitis and toxic pneumonitis.

Figure 1

Respiratory symptom prevalence (unadjusted) within quartiles of post-Hurricane Katrina restoration work time. Quartiles are based on study subjects (n = 474) reporting detailed time spent in demolition, trash/debris removal, landscape restoration, sewer repair, or mold remediation. Q0 represents those who reported no time spent in restoration work activities (n = 202). Actual proportions with new onset asthma and with pneumonia are multiplied by 10 for graphical scaling and enhanced visualization of the data.