This study addresses a crucial gap in the literature concerning the respiratory health of search and rescue workers operating in earthquake zones. Its primary objective was to evaluate the pulmonary functions in volunteers and assigned personnel who engaged in search and rescue or logistical activities during the early and late stages following a severe earthquake. The researchers specifically aimed to assess the real-life exposure of these teams to earthquake conditions, such as high levels of dust and other environmental factors, and to facilitate discussions on essential protective measures against these hazards.
The research was designed as a longitudinal cohort study, involving a total of 287 individuals, predominantly male (95.1%) with an average age of 31.9 ± 6.7 years. These participants traveled from Düzce province, Western Turkey, to the earthquake-affected areas, including Hatay, Kahramanmaraş, Adıyaman, or Gaziantep, following the devastating 2023 Kahramanmaraş earthquakes. The study population comprised various professions, including gendarmerie officers, security guards, police officers, firefighters, and search and rescue technicians. Data collection encompassed demographic information, reported respiratory symptoms, the use of protective equipment, and the specific tasks performed. Pulmonary function tests (PFTs), including spirometry and carbon monoxide diffusion capacity (DLCO) tests, were conducted twice: initially within the first 45 days of their return from the earthquake zone and then repeated at least three months later. A total of 113 participants (39.3% follow-up rate) completed the second evaluation. The study was conducted in accordance with ethical standards, receiving approval from the Duzce University ethics committee (decision number: 2023/40) and ensuring informed consent from all participants. Funding for this research was provided by the Turkish Thoracic Society. Notably, no AI-assisted technologies were utilized at any stage of the research, data collection, analysis, or manuscript preparation.
Key findings indicate that environmental conditions in earthquake zones, particularly dust exposure, can significantly impair respiratory functions and increase respiratory symptoms. The most commonly reported symptoms among participants included nasal discharge and throat irritation (35.5%), coughing (28.2%), sputum production (19.9%), sneezing (16.4%), and eye irritation or stinging (12.9%). Nearly one-quarter (23%) of participants experienced health issues in the earthquake zone, with upper respiratory tract infections being the most frequent condition (11.5%). Importantly, nasal discharge and eye irritation were significantly more prevalent in the search and rescue group compared to those involved in other activities.
Analysis of pulmonary functions revealed that individuals engaged in search and rescue activities had significantly lower forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) ratios, absolute maximum mid flow rate (MMFR), and percentage predicted MMFR values compared to those performing other tasks. Furthermore, smokers exhibited significantly lower absolute and percentage predicted carbon monoxide diffusion capacity (DLCO) values. Longitudinal comparisons demonstrated that DLCO values measured at least three months after working in the earthquake zone were significantly lower than initial measurements. Multiple regression analysis confirmed that the time of arrival in the earthquake zone, the duration of stay, and smoking status independently and significantly affected DLCO values both in the initial assessments and at the three-month follow-up. This suggests that earlier arrival and longer exposure contribute to persistent declines in lung function, reflecting dust accumulation. The study also highlighted concerns regarding protective equipment use, noting that only 48.1% of individuals used surgical masks and 28.6% used N95 or equivalent masks, which is believed to be due to a lack of training and insufficient provision of protective materials.
In conclusion, the authors emphasize that their findings demonstrate a deterioration in the respiratory health of rescue workers in occupational settings within earthquake zones. These insights are crucial for policymakers and field professionals, underscoring the critical need for timely protective measures and long-term health monitoring to prevent lasting respiratory damage in disaster response personnel. The study advocates for the development and implementation of practices aimed at preventing or reducing dust exposure, including the use of appropriate personal protective equipment, continuous training on its use, and effective dust suppression methods like wetting operations at debris sites.
Reference: Arbak, P. M., Balbay, E. G., Gulhan, P. Y., Balbay, O., Annakkaya, A. N., & Bayram, H. (2023). Assessment of Respiratory Health Among Volunteers Involved in Search and Rescue Operations During a Severe Earthquake. Journal of Occupational and Environmental Medicine. Advance online publication. https://doi.org/10.1097/JOM.0000000000003489
