The alarm bell has been ringed to inform Malaysians on possible exposure to volcanic exposure from the recent eruption of Mount Sinabung in north Sumatra. The volcanic ash along with smog from factories and motor vehicles as well as forest fire due to prolonged drought in several parts of the nation could exacerbate the haze condition in Malaysia. 

Effects of ash on health may be divided into several categories: respiratory effects, eye symptoms, skin irritation and indirect effects.

Respiratory Effects
Inhalation of volcanic ash which depending on the concentration of total suspended particles, size of the dust particles, frequency and duration of exposure, presence of free crystalline silica, and pre-existing health conditions will cause different respiratory symptoms and breathing difficulties. 

Common acute (short-term) symptoms include:

1. Nasal irritation and discharge (runny nose)
2. Throat irritation and sore throat, sometimes accompanied by dry coughing
3. People with pre-existing chest complaints may develop severe bronchitic symptoms if beyond exposure to ash (e.g. hacking cough, production of sputum, wheezing, or shortness of breath).
4. Airway irritation for people with asthma or bronchitis which included shortness of breath, wheezing and coughing.
5. Breathing becomes uncomfortable

Thus, children, elderly people and those who have respiratory problems should avoid or reduce outdoor activities during this time.

Eye Symptoms
Eye irritation is a common health effect as pieces of grit can cause painful scratches in the front of the eye (corneal abrasions) and conjunctivitis. People usually experience eye discomfort or irritation during and after ash fall, especially those using contact lens.

Common symptoms include:

1. Eyes feeling as though there are foreign particles in them
2. Eyes becoming painful, inflammation, itchy or bloodshot
3. Sticky discharge or tearing
4. Corneal abrasions or scratches

Skin Irritation
Skin irritation or inflammation can also result from the exposure to ash, especially if the ash is acidic.

Common symptoms include:

1. Irritation and reddening of the skin
2. Secondary infections due to scratching

Those who may suffer these symptoms should seek immediate medical treatment from the nearest health clinic or hospital.

Indirect Health Effects of Ash Fall
Besides, the short and long term health risks, indirect impacts of large ash falls on health must also be considered. 

For example, effects on road by reduction in visibility from airborne ash alone could result in accidents.

PROTECTION MEASURES
Children can be protected by minimizing outdoor activities and staying indoors more. To clean the air indoors, set-up air-purifying devices at homes as these air purifiers would be able to reduce the amount of fine particles in a room to an acceptable level during severe haze incidents. Instead of using fan, using air-conditioners is more advisable. However, please make sure that they are at good condition by regularly servicing them to avoid the penetration of the fine particulate matters into your indoor air. 

The health risks associated with haze can also be reduced by wearing a mask or respirator when we are outdoors to protect us from breathing the fine haze particulates in the air. Another way is by closing all windows and openings that may allow particles to enter indoor facilities. Also, people are advised to not wear contact lenses during hazy period as this may irritate the eyes and finally end up in blindness. Also, avoid driving when the visibility is severely affected by the haze.

You are advised to drink more water and eat more fruits and vegetables to flush out the toxins from your body. Minimize the intake of coffee and alcohol to avoid body fluid loss. Avoid from smoking indoors which could add up to the level of smoke particle in the indoor air. For those suffering from heart and respiratory illnesses, please take your medication regularly and seek medical attention immediately should you develop any breathlessness.

To not further worsen the air quality, it is within our responsibility to prevent forest/bush fire by refraining from performing any open burning. To report open burning, call JASLine at 1800-88-2727. In an event of forest/bush fire quickly contact BOMBA at 999.

Mathini Arveena Ravee 
Forum Air Malaysia
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