Respiratory Illness Rose in Children After Katrina Hit

The CDC study did not resolve concerns raised by doctors about the effects of elevated formaldehyde levels in government-supplied trailers.
The CDC study did not resolve concerns raised by doctors about the effects of elevated formaldehyde levels in government-supplied trailers. (By Tim Mueller -- Associated Press)
By Spencer S. Hsu
Washington Post Staff Writer
Friday, May 9, 2008

Hurricane Katrina provoked increased complaints to doctors of pneumonia, bronchitis and other lower respiratory illnesses among 144 children studied in Mississippi, according to a report released yesterday by the Centers for Disease Control and Prevention.

But the researchers said they could not determine the reason.

They reported finding no difference in the patterns of visits to doctors by children who lived in disaster housing provided by the Federal Emergency Management Agency and those who did not. However, they said the findings could not be generalized beyond the small sample.

The study's limited conclusions did not resolve broader concerns raised by health officials and pediatricians, who previously reported heightened complaints of breathing problems among children on the Gulf Coast after Katrina. Those experts had voiced suspicions about a link to elevated levels of formaldehyde found in FEMA-financed temporary housing.

"The issue of what, if any, effects did the hurricane -- and the changes that occurred in its aftermath -- have on the children of the Gulf Coast is one that we remain very much interested in," said Ed Thompson, state health officer for Mississippi.

"People whose children were not part of the study can't draw any conclusions, positive or negative, from it," he said. "It did not answer whether exposure to indoor air contaminants, including formaldehyde, has any effect on health."

The study was based on a review of medical charts and interviews with 144 children between 2 and 12 years old who were treated at Hancock Medical Center and four physician practices in Hancock County from August 2004 to August 2007. Two-thirds of the children lived in FEMA housing.

However, the storm destroyed thousands of records at four of the five facilities, and researchers were unable to determine how many children lived in the county, the CDC reported. Researchers also were unsure whether the results were skewed because the study included only children who reported health problems before Katrina, or because families increased visits after FEMA housing problems were publicized.

"Basic medical information systems in Hancock County were severely compromised . . . creating a particularly challenging environment for performing a retrospective investigation," according to a summary of the 49-page CDC report. "The nature and . . . effects resulting from these issues are unmeasured and remain unknown."

The study said the total number of medical visits to the five facilities by the children during the year before Katrina -- 411 -- was about the same as the number during the second year after the storm -- 414. Researchers discounted the year after the storm, because damage to medical facilities was severe and the community was disrupted.

The study said the proportion of doctors' visits prompted by cold-like symptoms fell from 63 percent to 52 percent, while the share of bronchitis-like symptoms increased from 22 percent to 31 percent. The shift was similar for children in both FEMA-supplied homes and other dwellings.

Michael A. McGeehin, director of the CDC division that oversaw the report, said the findings could not be applied to other children living in or out of FEMA housing along the Gulf Coast. "I don't want this study generalized," McGeehin said. "The numbers were very small."

"I really don't think it answers a lot," said Keith Perrin, a New Orleans physician and past president of the Louisiana chapter of the American Academy of Pediatrics.

Formaldehyde, a colorless gas released by glues used to make wood products such as plywood, particle board, furniture and cabinets, can cause nasal cancer and eye, nose and throat irritation, and can worsen respiratory diseases such as asthma.

CDC testing found the chemical in high levels in 519 FEMA housing units tested last year, 18 months after the first resident complaints in March 2006. In follow-up tests, FEMA has continued to find elevated levels in nearly 40 percent of 1,241 units tested.

CDC has recommended that all families leave trailers as soon as possible, saying formaldehyde levels were found to be three times higher than those in conventional homes, but about 25,000 trailers and mobile homes remain occupied. FEMA has received 11,069 health complaints since July 21 and relocated 4,052 families because of formaldehyde problems.

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