Medical effects of volcanic eruptions
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Excluding famine and tsunamis, most deaths in volcanic eruptions have been from pyroclastic flows and surges (nuées ardentes) and wet debris flows (lahars). Information on the causes of death and injury in eruptions is sparse but the available literature is summarised for the benefit of volcanologists and emergency planners. In nuées, thermal injury may be at least as important as asphyxia in causing immediate deaths. The high temperature of the gases and entrained particles readily causes severe burns to the skin and the air passages and the presence of both types of injury in an individual may combine to increase the delayed mortality risk from respiratory complications or from infection of burns. Trauma from missiles or body displacement is also common, but the role of asphyxiant or irritant gases, and steam, remains unclear. The ratio of dead: injured is much higher than in other natural disasters. At the periphery of a nuée being protected inside buildings which remain intact appears to greatly increase the chances of survival. In lahars, infected wounds and crush injury are the main delayed causes of death, and the scope for preventive measures, other than evacuation, is small. The evidence from Mount St. Helens, 1980, and other major eruptions indicates that, although mortality is high within the main zone of devastation and in the open, emergency planning should concentrate on the periphery of a nuée where preventive measures are feasible and could save many lives in densely populated areas.
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