Yeatts, K; Shy, C
Epidemiology: September 2003

Background: On September 16, 1999, Hurricane Floyd hit the coast of North Carolina and left up to 20 inches of rain. This rain combine with the additional rain received from Hurricane Dennis and Irene causes extensive flooding along the Neuse, Tar, Roanoke, Lumbar, and Cape Fear rivers, affecting an estimated 2.1 million persons (MMWR 2000, 49(17):369-372). Since the flood there has been no evaluation of the long term affects of the flood on the respiratory health of the affected population. The purpose of this project was to evaluate if the respiratory health of asthmatics living in areas that were flooded was adversely affected in the months after the flood.

Methodology: An ecologic time series study was conducted which compared asthma outcomes before and after the flood among the Medicaid population with asthma (n = 9,003) living in the 13 county flood zone. Comparisons were also made among zipcode areas with high proportion of flood damage housing versus zipcode areas with little flood damaged housing. Asthma outcomes included physician visits, emergency room visits, hospitalizations, and costs.

Results: There were a larger number of asthma outcomes in the year after the flood compared to the year before the flood. However, the increase peaked in the first 60-90 days after the flood, and by 12 months there was little difference in the before and after time periods. There was a very consistent trend in that the most exposed groups had a greater net increase in asthma outcomes compared to the total population of Medicaid enrollees with asthma.

Conclusions: The respiratory effects of the hurricane were signficant, particularly in the most exposed groups.

(C) 2003 Lippincott Williams & Wilkins, Inc.