BACKGROUND: Vulnerable populations are susceptible to acute health effects from hurricanes but long-term impacts are less clear. We characterized asthma morbidity in a cohort of children seven years after they experienced Hurricanes Katrina and Rita.
METHODS: We performed a descriptive analysis of children enrolled in a feasibility study designed to inform longitudinal research. Questionnaires, medical record abstractions, laboratory tests, and pulmonary function tests were conducted in 2012-2013. Of 152 participants who experienced the hurricanes, we limited inclusion to children diagnosed with asthma after their second birthday based on caregiver report of doctor diagnosis or ICD-9 codes 493.00-493.93.
RESULTS: Fifty-four children (36%) had asthma; their mean age was 11.8 years (standard deviation: 2.9). Most identified as black/African American (57%) and non-Hispanic (96%); 69% were from families earning less than $35,000 yearly. The majority (52%) reported hurricane-related residential water damage and/or mold. Of 32 children tested, 44% were sensitized to at least one of five common indoor allergens including mold. Over half of families (53%) reported smoking in the home; 96% of children had detectable urine cotinine, a biomarker of environmental tobacco smoke exposure. Symptoms were not well-controlled in 22% of those screened using the Asthma Control Test. Nine (17%) had FEV1/FVC <80% and 15 (28%) had FEF25-75 <60%, indicating suboptimal asthma control. Most (52%) reported not currently taking asthma medications. Twenty-two children (41%) made at least one asthma-related outpatient or emergency department visit in the prior year.
CONCLUSIONS: Although we did not assess asthma before the storms, preliminary findings indicate high asthma prevalence and suboptimal symptom control in this cohort of hurricane-affected children seven years later. Disaster recovery planning should address long-term health needs of vulnerable populations.