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Health problems abound months after Katrina roared ashore

BILOXI, Miss.—Three months after Hurricane Katrina raked the Gulf Coast, a major health crisis is emerging as residents struggle with the fouled air, moldy houses and the numbing stress the killer storm left behind.

Across Mississippi and Louisiana, people are afflicted with coughs, infections, rashes and broken limbs and they are jittery, tired, depressed and prone to bizarre outbursts, health professionals said.

Burning storm debris, increased diesel exhaust, runaway mold and fumes from glue and plywood in new trailers are irritating people's lungs and nasal passages. Weary residents trying to clean up and repair their homes are falling off roofs and cutting themselves with chainsaws. And stress is fracturing the psyches of countless storm victims.

"It's a cumulative effect here," said Claire Gilbert, a New Orleans surgical technician who works in a Louisiana occupational medical practice and volunteered at the New Waveland Clinic, a tent shelter complex that just closed in Mississippi. "You get a little cough. You get a nose that runs. You get eye irritation. Then you get falls. And you've got the stress. It's not just little things. It's how they all add up."

Consider Colin Landis of Biloxi. First, he lost his rented home when it filled with six feet of water as part of Katrina's storm surge. Then, his marriage of 16 years, already under stress, collapsed. His wife fled the coast with their three children. He felt alone and strained with only $3,500 in federal help.

Landis ended up living in a borrowed RV on a friend's yard less than a mile from a burning pile of storm debris. With the RV's air conditioner broken, Landis slept with the window open. He'd wake up with a raw throat and irritated eyes.

"It was almost like I had strep throat," Landis said. "It was obviously due to the environment."

Landis, who isn't sleeping much anymore, said that stress is getting to him more now than it did in the first few hectic weeks after Katrina struck. And it's not just him who's under strain. His brother-in-law just hurt his back falling through a storm-damaged deck.

When Katrina bore down on Mississippi and Louisiana, health officials worried about a toxic gumbo of industrial chemicals that might flood the area and about the spread of infectious diseases. Instead, a more subtle health problem developed, said Dr. Howard Frumkin, director of the National Center for Environmental Health, a division of the Centers for Disease Control and Prevention in Atlanta.

"In many ways, this is the major environmental health disaster of our lifetime," Frumkin told Knight Ridder Newspapers. "It's a very complicated set of risk factors people face. ... This is a huge set of environmental health challenges."

Frumkin listed several irritants and carcinogens emitted from burning Katrina's flotsam and from traffic emissions, including acrolein and formaldehyde. Those two chemicals trigger coughs and bad congestion in the short term and are linked to cancer after prolonged exposure. Recent measurements from Mississippi air monitors show that spikes in the chemicals are much higher than what federal standards allow. In October, acrolein levels measured 155 times higher than federal standards and formaldehyde levels were seven times higher than allowed.

Frumkin also mentioned such emissions as polycyclic aromatic hydrocarbons, which cause cancer, and deadly carbon monoxide. Mold is nearly everywhere, and cleanup-related injuries are often overlooked, he said.

But what hurts the Gulf Coast most —and compounds the effects of everything else—is stress, experts said.

"Stress isn't a strong enough word. I'd call it anguish," Frumkin said. "The level of grief and anguish there is palpable."

People can't sleep. They don't remember meetings or what day it is. Vietnam veterans suffer flashbacks and nightmares, psychologists say.

William Gasparrini, a Biloxi clinical psychologist, calls it "Post-Katrina Stress Disorder," in which residents suffer bouts of grief, shock, rapid mood shifts, confusion, anger, marital discord, guilt, escape fantasies and substance abuse.

"The effects are lasting longer than I suspected," Gasparrini said. "I thought everything would be back to normal in three to four weeks. Now, three months later, it looks like it'll be one to two years—if we are lucky. There are a lot of people in pain—a lot of people who cry every day."

Making matters worse is that the devastation is so widespread that people can't escape it. Unlike a tornado or the terrorist attacks on the World Trade Center and Pentagon, the area of destruction in Mississippi and Louisiana is so wide that residents need to drive for miles to find a sense of normalcy.

"When you drive around Biloxi and see all those houses that have been very badly damaged and see people living in the rubble for weeks and weeks, it's easy to understand how traumatizing this has been for these families," said Irwin Redlener, director of the National Center for Disaster Preparedness at the Columbia University Mailman School of Public Health. Redlener has spent time since the storm in New Orleans and Mississippi.

"Because of the prolonged nature of this disaster, it's impossible to guess what rate of PTSD (post-traumatic stress disorder) we will see. It may be much higher than we would normally expect."

After other disasters, between 7 percent and 12 percent of the people directly affected eventually suffered PTSD symptoms, he said. Because Katrina victims number in the hundreds of thousands—all the people who lost homes, lost relatives or were forced into temporary shelters—the mental toll could be huge, he said.

"Because the sheer size of the impact was so large, I think there is a greater sense of despair and loss that people are experiencing," he said. "This experience of dramatic, prolonged displacement will create a toll long into the future."

Before Katrina hit, a Mississippi mental health telephone help line received about 300 calls a month. After Katrina, the help line was flooded with calls: One night, director Jennie Hillman had the line roll over to her home; she was up much of the night fielding 27 calls.

In late September, federal money helped pay for a new mental health help line called Project Recovery. It also has been swamped with calls: In the last four weeks, Project Recovery has received 960 calls, while workers in the field have made contact with an additional 800 people, Hillman said.

The Gulf Coast Mental Health Center lost nearly half its patients during and just after the storm, yet new patients streamed in to replace them and then some, said psychologist Steve Barrilleaux, director of the adult outpatient program. Now nearly half of those the center sees have Katrina-related problems.

Diane Lufreniere, a therapist at the center, developed strange rashes on both arms.

"I was itching all the time and I just couldn't figure it out," she said. She went to three doctors, and they tried different medicines to no avail. Finally, they figured it was the stress of housing friends who were homeless. When the stress went away, so did the rashes.

While the stress is overwhelming, the part of the body that shows the most symptoms is the respiratory system, said directors of local medical centers and makeshift clinics.

In just nine days, from Nov. 9 to Nov. 17, the New Waveland Clinic saw 473 patients—121 of them were for respiratory problems. The second most common symptom was skin problems with 68 patients.

Dave Farragut of DeLisle, Miss., got one of the first new trailers from the Federal Emergency Management Agency. The first couple of days, the smell from the trailer made his eyes burn. When his girlfriend moved in a few days later, she also got sick at first.

For more than a decade, federal health officials have known about irritating chemicals emitted from the glue and plywood of new trailers, said professor Stan Glantz, of the University of California at San Francisco.

Volunteer Claire Gilbert at the Waveland clinic had mold problems of her own in her New Orleans apartment. Nearly every structure touched by the floodwaters has mold growing.

Mold is serious. In addition to irritating people and triggering asthma and allergy attacks, it can cause infections and can be toxic and cause cancer, said Sam Arbes, a scientist who specializes in mold issues at the National Institute of Environmental Health Sciences in North Carolina.

"It doesn't get any worse" than the mold levels Arbes said he saw in New Orleans. Testing there by the Natural Resources Defense Council, an environmental group, found mold levels in New Orleans nearly 13 times higher than what's considered very high levels by allergists.

Increased traffic is also creating breathing problems for vulnerable people, Frumkin said. And diesel exhaust—increased because of ever-present construction and debris-clearing vehicles with diesel engines—causes cancer, he said.

With bridges and roads out, traffic in parts of the Mississippi Gulf Coast is down to a crawl, so it can take two to three times longer than usual to get places, increasing emissions.

For example, on Interstate 10, just west of U.S. 49 in Gulfport, the average daily traffic has increased from about 37,000 last year to 52,000 in October, according to Trung Trinh, a planner for the Mississippi Department of Transportation.

Skin problems are also plentiful. New Waveland Clinic director Brad Stone told of a disabled woman who lived in her car for three months while waiting for FEMA to come up with a handicapped accessible trailer. The woman developed a fungal infection on her body that was "extremely painful and dehumanizing," Stone said.

It all comes down to environmental factors, Stone said.

Take Alicia Heatherton of Biloxi. During Katrina she stayed in her retirement home apartment right on the beach. Even though nearby buildings were obliterated, she survived.

It's the aftermath that's come close to killing her.

Heatherton, a 68-year-old woman with emphysema, got a severe lung infection from the mold spreading in her apartment.

"I love it (in Biloxi), but my life comes first," Heatherton said, gasping for air. In about a week, she's moving to Nevada, saying: "I'm not going to sit here and mold to death."

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(c) 2005, Knight Ridder/Tribune Information Services.

PHOTOS (from KRT Photo Service, 202-383-6099): WEA-STORMS-HEALTH

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