Around the world, there have been a number of epidemiological and clinical studies but all use different methodologies so it is hard to compare results. Here, we will design standardised protocols for use during volcanic crises, to enable rapid initiation of medical studies as well as comparison amongst future findings.
In addition, we will conduct a review of issues relevant to a full health impact assessment (HIA) of volcanic ash. Currently HIA of particulate matter (PM) focuses on background urban concentrations of air pollution. Issues to interpret exposures to volcanic ash include: adjustment to reflect personal exposures, applicability of associations from Europe/US to elsewhere, relative toxicity of respirable-sized ash compared to urban PM and time-course of elevated ash exposures. The review will identify knowledge gaps and produce comprehensive guidance for future HIAs of the health benefits of improved use of RP in volcanic crises.