Of 1,243 participants, the median age was 5.8 years (interquartile range [IQR] = 2.0, 11.9) and the majority of participants (72.2%) were aged <10 years (). Males comprised 50.3% of participants, and 46.9% of participants were Caucasian. Of participants, 78.7% of their parents or guardians had a high school education or less. Nearly two-thirds (65.4%) presented at pediatric emergency rooms; the primary reason for seeking health care was a new health problem (59.3%). A preexisting chronic condition (diagnosed or existing before August 2005) was reported by 40.6% of participants, with 17.2% reporting preexisting asthma and 11.5% reporting preexisting allergies (data not shown).
Demographic and clinical characteristics of participants in a pediatric and adolescent health survey in New Orleans, Louisiana, October 2005–February 2006 (n=1,243)a
The majority of participants evacuated the New Orleans area (91.3%), and most (78.8%) did so before Hurricane Katrina made landfall on August 29, 2005; 34.9% reported returning to their original residence in the months immediately following the hurricane. Many experienced health-care disruptions due to the hurricane: 37.8% missed doctor appointments, 19.7% ran out of medications, and 8.0% missed an immunization. Of all children with preexisting conditions, asthma was the most common, representing 43.6% of all those with such conditions. Children with preexisting conditions were less likely than children without preexisting conditions to present at the clinic for new conditions (39.1% vs. 61.5%, p
<0.001), more likely to be in school at the time the survey was conducted (74.8% vs. 58.7%, p
<0.001), more likely to have repeated a grade (14.7% vs. 7.1%, p
<0.001), and more current in vaccinations (87.0% vs. 76.2%, p
<0.001). As reported previously,13
children with chronic conditions experienced increased disruptions in care and negative consequences of the hurricane. Of the 81 children who evacuated and who ran out of medications, 19 (23.5%) specified that they ran out of asthma medications or were afraid of running out of asthma medications (data not shown).
The prevalence of self-reported URS and LRS post-Katrina was 75.6% and 36.0%, respectively, a significant increase over self-reported URS and LRS pre-Katrina (21.7% and 9.4%, respectively, p<0.0001) (). Increases in prevalence after the hurricane were identified for runny nose (12.7% vs. 58.4%; p<0.0001), stuffy nose (10.8% vs. 49.0%; p<0.0001), sore throat (3.6% vs. 30.7%; p<0.0001), flu-like illness (0.8% vs. 13.1%; p<0.0001), ear infection (6.6% vs. 16.1%; p<0.0001), new-onset cough (2.4% vs. 21.7%; p<0.0001), new-onset headache (1.3% vs. 10.5%; p<0.0001), red eye or eye drainage (1.3% vs. 4.7%; p<0.0001), shortness of breath (3.0% vs. 12.5%; p<0.0001), pneumonia/bronchitis (2.6% vs. 5.5%; p<0.001), asthma attack (4.4% vs. 9.1%; p<0.0001), cough >2 weeks (2.1% vs. 21.0%; p<0.0001), and difficulty breathing (1.9% vs. 10.9%; p<0.0001) (data not shown). Of those who reported symptoms after the hurricane, the symptom was not present before the hurricane in the majority of participants, including 49.9% of those reporting runny nose, 42.4% reporting stuffy nose, and 19.9% reporting cough of >2 weeks' duration (data not shown).
Participants reported substantial residential environmental exposures: 50.0% reported roof/glass/storm damage, 20.5% reported inside mold, and 15.0% reported flood damage (). Outside exposures were also commonly reported, including outside mold (21.9%), dust (17.9%), chemicals (6.6%), and smoke/fumes (5.4%). Duration of exposures varied with exposure via touch to sewage (median = 2.5 days; IQR 1, 5) or floodwater (median = 2 days; IQR 1, 4), breathing something that seemed unhealthy (e.g., mold, chemicals, dust, smoke, or fumes: median = 5.5 days; IQR 3, 30), drinking non-potable water (median = 4.5 days; IQR 2, 8), or eating spoiled food (median = 3 days; IQR 1, 5) (data not shown).
Residential exposure to roof/glass/storm damage was significantly associated with URS and LRS in both unadjusted and adjusted logistic regression analyses (); residential exposure to mold was significantly associated with only LRS both before and after adjustment for confounders. Outside environmental exposures during or after the hurricane were associated with both URS and LRS. URS was significantly associated with outside-home exposure to mold and dust (); LRS was significantly associated with reported outside exposure to mold, dust, and smoke/fumes. After adjustment for confounders, child age as a continuous variable was associated with URS and LRS, with decreasing odds for every year increase in age.
Unadjusted and adjusted characteristics associated with URS and LRS in children and adolescents after Hurricane Katrina and residential exposures in New Orleans, Louisiana, October 2005–February 2006 (n=1,243)
Unadjusted and adjusted characteristics associated with URS and LRS in children and adolescents after Hurricane Katrina and outdoor exposures in New Orleans, Louisiana, October 2005–February 2006 (n=1,243)
The total number of days of exposure to harmful environmental contaminants during the evacuation or since returning to New Orleans was associated with both URS (AOR=1.02; 95% CI 1.00, 1.04; p<0.05) and LRS (AOR=1.03; 95% CI 1.02, 1.04; p<0.0001). Among participants with preexisting chronic conditions, the total number of days of exposure to environmental contaminants was significantly associated only with LRS (AOR=1.03; 95% CI 1.01, 1.05; p<0.001) (data not shown).