Exclusive: Maui wildfire survivors face rising rates of depression and lung problems – study

Rates of depression, respiratory problems and kidney abnormalities are rising among Maui wildfire survivors, according to preliminary findings from a landmark study.

The University of Hawaii (UH) is working with community health groups to identify, understand and address the health and social impacts caused by the deadliest U.S. wildfire in more than a century. destroyed the historic city of Lahaina.

In the largest post-disaster exposure study of its kind, researchers hope the 10-year initiative to follow 2,000 survivors will help affected residents access timely medical and psychosocial care to prevent serious conditions such as cancer, cardiovascular disease and childbirth prevent – ​​or intervene early. defects related to the fire.

According to initial results from 224 participants recruited during the first two weeks of the Maui Wildfire Exposure Cohort Study (MauiWes), shared exclusively with the Guardian, nearly half of participants (49%) said their health is now worse than it was before the forest fires.

It was also found:

• 55% experience symptoms of depression – significantly higher than the rate reported by Maui residents (33%) in a 2023 survey. Depression rates were higher among older residents: 75% of fire survivors over 50 reported in addition other symptoms include a gloomy mood, insomnia and poor concentration. About 1.3% of participants reported recent suicidal thoughts.

• 74% experience breathing problems, with 49% showing signs of pulmonary obstruction and 33% experiencing reduced lung function due to low oxygen levels.

• Initial blood biomarker testing showed that 8% to 18% of participants may have reduced kidney function.

• Three out of four participants have an increased risk of cardiovascular disease, of which 21% have high blood pressure at a level that warrants medical attention.

It is still too early to draw firm conclusions as the study uses a convenience sample – people participate voluntarily – and the sample size is still too small to compare the results with the general population. But significant numbers of people present with breathing difficulties, rashes and fatigue to researchers and primary care clinics.

“The observed kidney function problems and respiratory symptoms are of great concern… These health problems are likely related to environmental exposure,” said Dr. Ruben Juarez, co-researcher and professor of economics at the UH Economic Research Organization.

“We want to collect health data in advance to prevent what happened after 9/11 and other disasters, so that political decision makers can intervene early. This is a prevention study and nothing of this magnitude and speed has been done in the past,” Juarez said.

One in eight participants – 13% – do not have health insurance, largely because they lost their jobs due to the fire, the study found. The proportion of uninsured fire survivors is much higher than the general population, which was 1.7% in Maui last year.

Six months after the fires, health – along with housing – is among the top concerns for survivors, especially those with children in schools near the fire zone.

Sonny Galanza, a golf course groundskeeper whose house burned down, is despondent after six months alone in a hotel. “I have lost everything except my car and passport. I feel like there is no hope for us; there is no longer-term housing. It’s hard to be alone here,” said Galanza, 50, whose elderly parents moved to Honolulu to stay with relatives.

At a recent registration event at a luxury resort that continues to house hundreds of survivors, a group filled out the detailed 30-minute health questionnaire online as a line of people waited for blood tests and pulmonary function tests.

Sandi Bridges, 57, and her husband, Channing Bridges, 60, registered to participate last month amid growing concerns about the long-term health impact. The couple escaped the fire on foot, breathing in the black smoke for hours. Their home survived the deadly fire and they say the insurance company is pushing them to return once health officials confirm the water is safe. “I don’t want to go back to the fire zone. I feel like I can’t breathe anymore,” said Sandi, whose oxygen levels and lung function are abnormal. “I want to be controlled.”

Participants will be shown initial test results immediately and those with abnormalities are encouraged to seek medical attention.

There are many potential fire-related toxins in the environment, but trace amounts of them may not show up in standard clinical testing. Some toxins cause acute symptoms such as itchy eyes, rash, coughing or difficulty breathing. Others can cause biochemical or cellular changes linked to poor long-term outcomes, including inflammatory conditions, cancer and cardiovascular disease.

Maui health officials found cobalt and multiple synthetic chemical compounds, linked to serious health problems such as cancer and birth defects, in the ash. Little is known about how these compounds interact with each other.

The second phase of the cleanup – moving the debris, including toxic heavy metals such as lead, asbestos and synthetic carcinogens in the ash – is starting. There are currently 40 state air quality monitors distributed in and around the fire zone, but none in hotels, clinics or colleges where ash particles can blow and settle.

“The disaster after the disaster is the most frightening for human health. We hope that the study will provide us with AS biomarkers so that we know what to take into account. We only have a little time to resolve this, so the more we know, the better prepared we can be for what happens later,” said Dr. Lorrin Pang, member of the study’s scientific steering committee and chief health officer for Maui County. calls for indoor air quality monitors.

The study has received philanthropic seed money from the Maui Strong Fund for 1,000 adult participants – Lahaina residents were present the night of the fire, which displaced more than 10,000 people. Researchers hope to expand the study to children and first responders, and eventually follow 2,000 fire-exposed people through detailed questionnaires, laboratory tests and health checks for at least a decade.

A comparison cohort of 2,000 people statewide who were not exposed to the fire will undergo similar social, psychological and blood tests. Investigators will also be able to access medical records and look for unusual trends and clusters of mental and physical health problems, as well as social and economic impacts that may be related to the fire. Maui Medic Healers Hui and Roots Reborn Lahaina are among the traditional Hawaiian health groups involved in the project.

“We are trying to understand how the exposure and trauma affect long-term health outcomes, which is very important because many of the survivors come from communities – Native Hawaiian, Filipinos, Hispanics and Pacific Islanders – with existing disparities in health field,” says Alika Maunakea. , co-researcher and professor at the UH John A Burns School of Medicine.

“We want to support community-based practitioners with our molecular findings because ‘āina (land) and the environment are closely linked to our health.”