Volcanic air pollution from both explosive and effusive activity can affect large populations as far as thousands of kilometers away from the source, for days to decades or even centuries. Here, we summarize key advances and prospects in the assessment of health hazards, effects, risk, and management. Recent advances include standardized ash assessment methods to characterize the multiple physicochemical characteristics that might influence toxicity; the rise of community-based air quality monitoring networks using low-cost gas and particulate sensors; the development of forecasting methods for ground-level concentrations and associated public advisories; the development of risk and impact assessment methods to explore health consequences of future eruptions; and the development of evidence-based, locally specific measures for health protection. However, it remains problematic that the health effects of many major and sometimes long-duration eruptions near large populations have gone completely unmonitored. Similarly, effects of prolonged degassing on exposed populations have received very little attention relative to explosive eruptions. Furthermore, very few studies have longitudinally followed populations chronically exposed to volcanic emissions; thus, knowledge gaps remain about whether chronic exposures can trigger development of potentially fatal diseases. Instigating such studies will be facilitated by continued co-development of standardized protocols, supporting local study teams and procuring equipment, funding, and ethical permissions. Relationship building between visiting researchers and host country academic, observatory, and agency partners is vital and can, in turn, support the effective communication of health impacts of volcanic air pollution to populations, health practitioners, and emergency managers.

There are justifiable health concerns regarding the potential adverse effects associated with human exposure to volcanic ash (VA) particles, especially when considering communities living in urban areas already exposed to heightened air pollution. The aim of this study was, therefore, to gain an imperative, first understanding of the biological impacts of respirable VA when exposed concomitantly with diesel particles. A sophisticated in vitro 3D triple cell co-culture model of the human alveolar epithelial tissue barrier was exposed to either a single or repeated dose of dry respirable VA (deposited dose of 0.26 ± 0.09 or 0.89 ± 0.29 μg/cm2, respectively) from Soufrière Hills volcano, Montserrat for a period of 24 h at the air-liquid interface (ALI). Subsequently, co-cultures were exposed to co-exposures of single or repeated VA and diesel exhaust particles (DEP; NIST SRM 2975; 0.02 mg/mL), a model urban pollutant, at the pseudo-ALI. The biological impact of each individual particle type was also analysed under these precise scenarios. The cytotoxic (LDH release), oxidative stress (depletion of intracellular GSH) and (pro-)inflammatory (TNF-α, IL-8 and IL-1β) responses were assessed after the particulate exposures. The impact of VA exposure upon cell morphology, as well as its interaction with the multicellular model, was visualised via confocal laser scanning microscopy (LSM) and scanning electron microscopy (SEM), respectively. The combination of respirable VA and DEP, in all scenarios, incited an heightened release of TNF-α and IL-8 as well as significant increases in IL-1β, when applied at sub-lethal doses to the co-culture compared to VA exposure alone. Notably, the augmented (pro-)inflammatory responses observed were not mediated by oxidative stress. LSM supported the quantitative assessment of cytotoxicity, with no changes in cell morphology within the barrier model evident. A direct interaction of the VA with all three cell types of the multicellular system was observed by SEM. Combined exposure of respirable Soufrière Hills VA with DEP causes a (pro-)inflammatory effect in an advanced in vitro multicellular model of the epithelial airway barrier. This finding suggests that the combined exposure to volcanic and urban particulate matter should be further investigated in order to deduce the potential human health hazard, especially how it may influence the respiratory function of susceptible individuals (i.e. with pre-existing lung diseases) in the population.

The population of the semi-arid areas of the countries in the East African Rift Valley (EARV) is faced with serious problems associated with the availability and the quality of the drinking water. In these areas, the drinking water supply largely relies on groundwater characterised by elevated fluoride concentration (> 1.5 mg/L), resulting from interactions with the surrounding alkaline volcanic rocks. This geochemical anomaly is often associated with the presence of other naturally occurring potentially toxic elements (PTEs), such as As, Mo, U, V, which are known to cause adverse effects on human health. This study reports on the occurrence of such PTEs in the groundwater on the populated flanks of Mt. Meru, an active volcano situated in the EARV. Our results show that the majority of analysed PTEs (Al, As, Ba, Cd, Cr, Cu, Fe, Mn, Ni, Se, Sr, Pb, and Zn) are within the acceptable limits for drinking purpose in samples collected from wells, springs and tap systems, suggesting that there is no immediate health risk associated with these PTEs. However, some of the samples were found to exceed the WHO tolerance limit for U (> 30 μg/L) and Mo (> 70 μg/L). The sample analysis also revealed that in some of the collected samples, the concentrations of total dissolved solids, Na⁺ and K⁺ exceed the permissible limits. The concerning levels of major parameters and PTEs were found to be associated with areas covered with debris avalanche deposits on the northeast flank, and volcanic ash and alluvial deposits on the southwest flanks of the volcano. The study highlights the need to extend the range of elements monitored in the regional groundwater and make a more routine measurement of PTEs to ensure drinking water safety and effective water management measures.

Communities resident in urban areas located near active volcanoes can experience volcanic ash exposures during, and following, an eruption, in addition to sustained exposures to high concentrations of anthropogenic air pollutants (e.g., vehicle exhaust emissions). Inhalation of anthropogenic pollution is known to cause the onset of, or exacerbate, respiratory and cardiovascular diseases. It is further postulated similar exposure to volcanic ash can also affect such disease states. Understanding of the impact of combined exposure of volcanic ash and anthropogenic pollution to human health, however, remains limited. The aim of this study was to assess the biological impact of combined exposure to respirable volcanic ash (from Soufrière Hills volcano (SHV), Montserrat and Chaitén volcano (ChV), Chile; representing different magmatic compositions and eruption styles) and freshly-generated complete exhaust from a gasoline vehicle. A multicellular human lung model (an epithelial cell-layer composed of A549 alveolar type II-like cells complemented with human blood monocyte-derived macrophages and dendritic cells cultured at the air-liquid interface) was exposed to diluted exhaust (1:10) continuously for 6 h, followed by immediate exposure to the ash as a dry powder (0.54 ± 0.19 μg/cm2 and 0.39 ± 0.09 μg/cm2 for SHV and ChV ash, respectively). After an 18 h incubation, cells were exposed again for 6 h to diluted exhaust, and a final 18 h incubation (at 37 °C and 5% CO2). Cell cultures were then assessed for cytotoxic, oxidative stress and (pro-)inflammatory responses. Results indicate that, at all tested (sub-lethal) concentrations, co-exposures with both ash samples induced no significant expression of genes associated with oxidative stress (HMOX1, NQO1) or production of (pro-)inflammatory markers (IL-1β, IL-8, TNF-α) at the gene and protein levels. In summary, considering the employed experimental conditions, combined exposure of volcanic ash and gasoline vehicle exhaust has a limited short-term biological impact to an advanced lung cell in vitro model.