Analyze

“Since asthma surveillance data were not available at the census tract level for most of Louisiana, we estimated asthma burden using the inpatient discharge data available through LDH.”  (4)

“Case counts are not provided for CTs with a 2018 population of less than 800 to safeguard privacy.” (4)

“To minimize the need for suppression, inpatient discharge data was aggregated for the three most recent years available (2017–2019) and average annual crude rates were calculated for cases where asthma (ICD-10 code J45) was the primary diagnosis, as well as where asthma was any diagnosis.” (4)

“Spearman’s Rank Correlation was utilized to analyze the correlation between various social and environmental vulnerability factors, COVID-19 incidence, and the measures of asthma risk by CT.” (4)

“This was performed by first ranking the values in each dataset using RANK.AVG function in MS Excel 2016, followed by applying the PEARSON function to compare two datasets. Significance was set at alpha less than 0.05 (α < 0.05), with degrees of freedom (df) equal to two less than the total number of data points represented in both datasets” (4)

The research team works for the Section of Environmental Epidemiology and Toxicology, Office of Public Health, Louisiana Department of Health in Baton Rouge. Team members included Arundhati Bakshi; Shanon Soileau; Collete Stewart; Kate Friedman; Collete Maser; Alexis Williams; Kathleen Aubin; and Alicia Van Doren. 

“Currently, much of the environmental focus of the pandemic remains on PM2.5 levels; however, we noted that higher levels of ozone was consistently associated with higher incidence rates of COVID-19, and it was the only environmental factor that appeared to have an additive effect over SVI on COVID-19 incidence (Fig 1).” (11)

“Specifically, our data show a moderately strong positive correlation between SVI due to minority status/language barrier and three health data variables: asthma hospitalization; estimated asthma prevalence; and cumulative COVID-19 incidence at 3 months (Table 2). Interestingly, SVI measures were either negatively or not significantly correlated COVID-19 incidence at the 9-and 12-month time points, indicating that social vulnerability factors may have played a greater role in COVID-19 spread early in the pandemic, but may have been of diminishing importance as the pandemic wore on (Fig 1 and Table 2).” (9)

Bakshi A, Van Doren A, Maser C, Aubin K, Stewart C, Soileau S, et al. (2022) Identifying Louisiana communities at the crossroads of environmental and social vulnerability, COVID-19, and asthma. PLoS ONE 17(2): e0264336. https:// doi.org/10.1371/journal.pone.0264336. 

This document uses data resources from the Center for Disease Control/Agency for Toxic Substances and Disease Registry (CDC/ATSDR), the Environmental Protection Agency (EPA), and the Louisiana Department of Health (LDH).

These data resources include the Social Vulnerability Index (2018 - CDC/ATSDR), the NATA Respiratory Hazard Index (EPA 2014), PM2.5level (average annual concentration in ug/m3, EPA 2016), ozone level (summer seasonal average of daily maximum 8-hour concentration in air in parts per billion, EPA 2016), indoor mold concerns reported to IEQES program (average annual number of calls, LDH 2017-2019), cumulative COVID-19 incidence rate at 3-, 6-, 9- and 12-month increments (LDH March 2020 - March 2021), asthma hospitalization (average annual crude rate, where asthma was a primary diagnosis among hospitalization cases, LDH 2017-2019), and estimated asthma prevalence (average annual crude rate, where asthma was any diagnosis among hospitalization cases, LDH 2017-2019).

The film is primarily the narratives of many first responders, so they play a large roll in the meassage being protrayed. They are seen as heros but also paid the price of their decisions through health issues.

The film is geared towards the general public, all medical terms are explained fairly well. No medical or first response background is necessary, and it is fairly educational for viewers.

The real threats of air quality were covered up due to politics and other reasons, wanting to get america back to work. Instead, the reports were edited and people were sent back into the dirty air to clean up the scene or back to office jobs in the area, with contaminated air surrounding everything. Decontanimation efforts did not start until very late in the process. Bush did not wear a mask and the workers were told they didn't need to, so they didn't. As a result, there were severe health problems afterwards.

The first hand interviews from first responders are compiled in a way that goes through the stories of what heppened, how health information was released and changed. The first repsonder stories are intermixed with testimonies from the EPA workers, showing differences in the science that was found and the press releases disclosing the health concerns. Many tear up upon realizing how their health will hurt their families. The doctors in the area caught onto the trends in poor health and started a monitoring program to make sure everyone got the medical screening and help they needed. The lives of all of the first responders and their families were changed drastically from their public service.

First responders share their experiences, how they responded, how they realized there weren't going to be many survivors. Many of them suffered from health issues afterwards. The air was very toxic and led to cancers. It makes you wonder how other safety information is given to first responders. They weren't even doing a rescue mission at the point that asbestos was being hidden in reports, so their lives should not have been risked like that for simply cleaning up rubble. Was it worth it for them to shovel the debris and pull out parts of bodies at that point, while putting their well being and lives at risk? If they had waited a few months for the dust to settle and be cleaned up, would that have saved many of the first responders? Offices in the area and houses nearby weren't inspected until even later. Schools opened as a sign of American strength led to asthma, bronchitis, etc. Are those lives worth the public image?

The school parent was interesting - explaining that the public image of resiliance was paid for by the lungs of the children being sent back into the uncleaned schools.

The person in charge of sending out the EPA press releases (and heavily editing them) had previously fought against the EPA for large companies.

The doctors eventually noticed the issues and tried to get more of the first responders evaluated and treated.

The first responders that risked their lives saving others now can't get fair treatment or benefits to help recover. They want to work but can't.

They needed to testify that they were on the scene in front of a judge to get benefits.

The government and politicians that released the information do not share their defense of why they cut information out, at the cost of the people and responders.