DOH provides health risk guidance on reentry to Maui wildfire impact zone

Monday, Sept. 25 marks the beginning of reentry for some two dozen addresses in Zone 1C within the inundation zone on Kaniau Road in Lahaina. As residents and owners are allowed reentry to their properties in the impacted areas of the Maui wildfires, the state Department of Health is sharing information on the health risks and potential emotional impacts involved.

The Hawai’i Department of Health offers evidence-based guidance which included input from the Environmental Protection Agency, the Centers for Disease Control and Prevention, and mental health professionals.

The DOH provides the following guidance so the public can be informed of and understand the risks of reentry to the impacted areas, available at the link below.

Reentry Guidance & Hazard Advisory for Temporary Visits

Highlights from the guidance document include:

Know Before You Go to the Impacted Area

• Re-entering the impacted areas can be very difficult emotionally, and these feelings may occur in the moment or after your visit.
• It is NOT recommended that parents bring their children on their initial visit to their impacted properties.
  • This may help limit the traumatic impact on kids and give parents an opportunity to grieve and process the visit by themselves.
• The impacted area may be hazardous with unstable structures, sharp metal objects, and ash with potentially toxic substances. However, with proper protective gear that is worn and removed correctly, it is possible to visit the impacted area safely.
• Children and pregnant people are at higher risk from the debris hazards and should NOT enter the impacted area or help with clean-up.
• We recommend bringing an extra change of clothes and shoes with you, so you can immediately change after your visit.
• Bring trash bags to put your used personal protective equipment and clothes in after your visit.
• Bring water to drink as it may be very hot. Risk of heat-related illness may be greater when wearing PPE, so rest often and drink lots of water.
• Bring tissues or a small towel to wipe away tears and sweat.

Behavioral health support will be available during the re-entry visits. Support is also available at the Lahaina Comprehensive Health Center, open 7 days a week from 9 a.m. to 4 p.m. and can be reached at 808-495-5113. For after-hours mental health support, please call Hawaiʻi CARES toll free at 1-800-753-6879.

Reduce Exposure to Ash and Debris

Ash, dust, and debris from burned residential areas may contain hazardous materials. The hazards may include but are not limited to asbestos, arsenic, lead, polycyclic aromatic hydrocarbons (PAHs), dioxins, and the particulate matter itself. Exposure to these toxins may cause cancer, respiratory problems, and other health issues. These hazards are not free floating in the air, but rather adhere to the particulate matter such as dust and ash. Exposure can occur from direct contact with ash or dust through skin, eyes, nose or mouth by inhaling or ingestion (by getting ash or dust on one’s hands and then touching food/water). The best way to remain safe from these hazards is to wear protective gear to prevent exposure.

Optional PPE kits will be offered by non-profits during the County of Maui’s vehicle pass distribution. Re-entry kits will include NIOSH-approved face masks, goggles, gloves, coveralls, and disposable shoe covers.  

Choosing a Face Mask

DOH recommends wearing at least a properly fitting N95 mask, also known as an N95 respirator, to filter ash and dust, which protects the wearer from exposure to ash and dust through inhalation.

More highly rated masks may provide marginally better filtration, but if poorly-fitting, can allow more unfiltered air in, leading to inhalation of ash and dust. They may also be harder on those with existing breathing problems. A higher rated mask, such as a P100, may be more important for those with extended exposure to very high levels of disturbed ash, such as recovery workers. N95 masks have consistently been recommended for PPE following wildfires.

A N95 mask means that 95% of particles 0.3 microns in size get filtered. Smaller and larger particles will be filtered at even higher rates. A micron is 0.001 millimeters. For reference, a bacteria is about 5 microns, a mist droplet is about 10 microns, and a strand of human hair is about 70 microns. Household dust is reported to range from 0.5 to 100 microns in size. 

• Choose a size that will fit over your nose and under your chin and seal tightly to your face. Any leakage around the edge of the mask may cause unfiltered air to enter and be inhaled.
• Please note that cloth masks will NOT protect you from ash.

Other online resources on PPE and re-entry guidance:

• EPA – Choosing the respirator and proper fit
• CDC – Worker safety during fire cleanup
• California Dept. of Public Health – N95 Respirator Mask FAQs
• MinutePhysics – How N95 masks work

“Unfortunately, there have been many reports of misinformation and even disinformation aimed at Maui residents. When viewing information, individuals should look for the source of the information, see if the information references any peer-reviewed research, and if the organization publishing the information has any existing biases,” DOH reports.