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Invisible threats from storms linger, causes ‘Tornado Cough’ PDF Print E-mail
Monday, July 08, 2013 9:12 PM


Staff Writer

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Demolition and clean up after a devastating storm can cause civilians, rescue and construction workers to suffer from what’s commonly called “tornado cough”, which is allergic reactions to microscopic particles in the air.

On a windy day, clearing property of remaining debris, even the small stuff, can generate clouds of dust comprised of molds, sheet rock and insulation floating around in the air.

Director of Nursing for Allen County Public Health Rebecca Dershem, RN, explains the levels of protection the lungs use to protect themselves from irritants.

• First, the nose acts as a filter when breathing in, preventing large particles of pollutants from entering the lungs.

• If an irritant does enter the lung, it will get stuck in a thin layer of mucus (also called sputum or phlegm) that lines the inside of the breathing tubes. An average of 3 ounces of mucus are secreted onto the lining of these breathing tubes every day. This mucus is “swept up” toward the mouth by little hairs called cilia that line the breathing tubes. Cilia move mucus from the lungs upward toward the throat to the epiglottis. The epiglottis is the gate, which opens allowing the mucus to be swallowed. This occurs without us even thinking about it. Spitting up sputum is not “normal” and does not occur unless the individual has chronic bronchitis or there is an infection, such as a chest cold, pneumonia or an exacerbation of chronic obstructive pulmonary disease (COPD).

• Another protective mechanism for the lungs is the cough. A cough, while a common event, is also not a normal event and is the result of irritation to the bronchial tubes. A cough can expel mucus from the lungs faster than cilia.

• The last of the common methods used by the lungs to protect themselves can also create problems. The airways in the lungs are surrounded by bands of muscle. When the lungs are irritated, these muscle bands can tighten, making the breathing tube narrower as the lungs try to keep the irritant out. The rapid tightening of these muscles is called bronchospasm. Some lungs are very sensitive to irritants. Bronchospams may cause serious problems for people with Chronic Obstructive Pulmonary Disease (COPD) and they are often a major problem for those with asthma, because it is more difficult to breathe through narrowed airways.

After working, visiting or living in a disaster area—tornado, hurricane, or other natural catastrophe—people often have reactions to the irritants floating around in the air containing high levels of molds, sheet rock and insulation. The irritants do not effect everybody in the same way and some people have significant reactions to the particles they take in when they breathe.

Dershem advises people having reactions to the airborne particles to drink lots of fluids since they will be producing a lot of secretions. An over-the-counter antihistamine, like Benadryl, may assist with a potential allergic response their body might be having to the irritants. They may need to see their medical provider for additional evaluation and treatment, in the event they need further medications for the allergic response or if an infection has occurred in addition to the allergic reaction.

“If a person is going to be working in an area known to be at high levels of asbestos, it is recommended that they wear more than a traditional “dust mask” because those particles are usually too small and must be stopped by a finer grade of filtration,” Dershem warned.

It is recommended that work crews wear masks, but many don’t. Normally, their personal protective equipment (PPE) requires glasses, hard hats, vests and gloves. Dershem added that it may be important to shower and remove clothing that may contain or trap irritants. Ongoing exposure to these irritants can prolong the allergic response and delay the body’s ability to clear the irritation.

In addition, Dershem suggests extra precautions be taken for children, who are more susceptible to developing symptoms from allergic irritants because their respiratory systems are still developing and they breathe in more air (and consequently more pollution) per pound of body mass than adults.

Some can develop a bacterial infection on top of the irritation and in those cases, will require a course of antibiotics.

“A medical provider will determine if they need antibiotics,” Dershem explained. “The exact course of treatment is dependent on the specific medication that is ordered to address the individual’s need.”

Dershem explained the length of time required to “cleanse” lungs of the debris depends a lot on the individual’s “normal” lung function. People with lung conditions like COPD or asthma, they may not be able to clear the irritants as readily as someone without those conditions. Within a few hours of being away from the irritants, people should notice a difference. Actual return to their “normal” may take several days depending on the level of insult and their body’s ability to clear it.

“Tornado cough” can be deadly if you breathe in particulates over a long period of time.



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