Community health impacts after a jet fuel leak contaminated a drinking water system: Oahu, Hawaii, November 2021.

BACKGROUND: In 2021, a large petroleum leak contaminated a water source that supplied drinking water to military and civilians in Oahu, Hawaii. METHODS: We conducted an Assessment of Chemical Exposures (ACE) survey and supplemented that information with complementary data sources: (1) poison center caller records; (2) emergency department visit data; and (3) a key informant questionnaire. RESULTS: Among 2,289 survey participants, 86% reported ≥1 new or worsening symptom, 75% of which lasted ≥30 days, and 37% sought medical care. Most (n = 1,653, 72%) reported new mental health symptoms. Among equally observable symptoms across age groups, proportions of children ≤2 years experiencing vomiting, runny nose, skin rashes, and coughing (33, 46, 56, and 35%, respectively) were higher than other age groups. Poison center calls increased the first 2 weeks after the contamination, while emergency department visits increased in early December 2021. Key informant interviews revealed themes of lack of support, mental health symptoms, and long-term health impact concerns. DISCUSSION: This event led to widespread exposure to petroleum products and negatively affected thousands of people. Follow-up health surveys or interventions should give special consideration to longer-term physical and mental health, especially children due to their unique sensitivity to environmental exposures.

Uneven paths: Soft Policy's benefits to recovery in Louisiana Parishes after Hurricanes Katrina and Rita.

Factors driving community recovery trajectories after disaster are not well understood. We assess why some communities show stronger recoveries from disaster than others, examining the role of four policy toolkits that U.S. county governments frequently adopt to recover from disaster. Using mixed methods, we examine the cases of Hurricanes Katrina and Rita with a novel dataset of recovery policies adopted within each Louisiana parish following the disasters. We typologize recovery strategies and analyze policy adoption patterns after crises. To compare which policy toolkit leads to the best recovery outcomes, we use synthetic control experiments on the 20 parishes hit by Hurricanes Katrina and Rita between August and September 2005, tracking net income inflow and net in-migration measures from 1997 to 2018 over 1408 parish-year observations, paired with qualitative case studies of parish policies and recovery outcomes. On average, soft and local recovery policies focused on community policies and feedback helped parishes stem the flow of finances away from the disaster-zone, as did infrastructural 'hard' policies, to a degree. in comparison, state policies focused on top-down planning experienced weaker recovery. Evidence shows that soft and local policy toolkits can accelerate recovery and that governments seeking to rebuild infrastructure should invest in locally-engaged community development in order to attain better overall recovery.