Don't Be Indifferent After an Eruption, Volcanic Ash Can Trigger Suffocation to Eye Irritation

JAKARTA - The eruption of the Anak Krakatau volcano does not necessarily end the threat to public health. After the eruption activity subsided, volcanic ash left on the road, the roof of the house, and the ground surface can still fly back and be inhaled by residents. Deputy Chairman I of the Indonesian Association of Internal Medicine Specialists (PAPDI) Dr. dr. Sukamto Koesnoe, Sp.PD, K-A.I, FINASIM, reminded the public to remain vigilant as long as volcanic ash is still in the surrounding environment. According to him, the ash that has settled can return to the air when it is blown by the wind. Vehicle activities and environmental cleaning processes also have the potential to make ash particles fly back. "So the risk continues for days to weeks, until the ash is completely cleaned or washed away by rain," said Sukamto as quoted by ANTARA, Tuesday, September 8. Volcanic ash has different characteristics from household dust. Its particles can be sharp and angular, contain silica, and some are so small that they can enter deep into the respiratory system. This exposure can cause various complaints, ranging from the nose and throat to the lower respiratory tract. "Disruption of the respiratory tract most often in the form of nasal irritation, dry throat and pain, dry cough, tightness, and chest tightness," he said. People who already have chronic respiratory diseases need to pay more attention. Volcanic ash can worsen the condition of people with asthma, Chronic Obstructive Pulmonary Disease (COPD), chronic bronchitis, and allergic rhinitis. In this group, exposure to particles can trigger a relapse or aggravate symptoms that were previously under control. Irritation of the respiratory tract can also interfere with local defense mechanisms, making a person more susceptible to acute respiratory tract infections. Therefore, protection for vulnerable groups is not enough just by avoiding exposure to ash. "Therefore, for patients with chronic lung disease and the elderly, the status of influenza and pneumococcal vaccination should be updated, this is part of the protection that is often forgotten," said a permanent lecturer at the Division of Clinical Immunology Allergy of the Department of Internal Medicine, Faculty of Medicine, University of Indonesia (FKUI). The effects of volcanic ash are not limited to the respiratory organs. The eyes are also a vulnerable part of the body that can be disturbed because the ash particles can irritate the surface. Complaints can range from red eyes, irritation, to conjunctivitis. In certain conditions, ash particles with sharp surfaces can even cause corneal injuries. "Contact lens users are most at risk and should temporarily switch to glasses," he said. The skin can also experience problems if exposed to ash directly. Irritation, itching, and dermatitis can appear, especially when the ash has acidic properties or is mixed with sweat. The public also needs to ensure that food and drinking water are always in a closed state. Ash that enters food or unprotected water sources has the potential to cause disturbances in the digestive tract. The impact of volcanic ash also needs to be considered on the cardiovascular system. Very small-sized particles such as PM2.5 can have an impact on the heart and blood vessels, especially in people who already have heart disease. Although silica exposure is often associated with the risk of silicosis, Sukamto emphasized that the condition is more related to exposure in the long term and repeatedly. "Silicosis is indeed mentioned, but it is a long-term risk from repeated exposure over the years; what is more relevant for the general public today is the acute impact above," said Sukamto. Thus, the public's attention after the eruption should be directed first to preventing exposure and recognizing the acute symptoms that may appear. For people with asthma and COPD, preparing medicines is an important thing when in an area affected by volcanic ash. Control drugs and relief drugs should be available and easy to carry when traveling. The public also needs to recognize the warning signs that require immediate medical examination. "Immediately go to the health facility if there is shortness of breath that is getting worse or wheezing that does not subside with an inhaler, chest pain, fever with persistent cough with phlegm, or eye pain and blurred vision," said the Primary Clinic Educator, Division of Endocrinology, Immunology, and Infection, Department of Internal Diseases, RSCM. One of the main steps to reduce the entry of volcanic ash into the respiratory tract is to use a mask that is capable of filtering small-sized particles. Sukamto recommends N95, KN95, or FFP2 masks. However, the effectiveness of masks does not only depend on the ability of the filter material. Masks must also fit tightly to the face so that there are no gaps around the nose and cheeks. In other words, the use of the right mask needs to pay attention to the fit or density of the mask, not just the type of mask used. In addition to wearing respiratory protection, the public should limit outdoor activities when the ash concentration is still high. When cleaning the settled ash, caution is also needed so that the activity does not make the particles fly again. This vigilance is becoming increasingly important considering that a number of volcanoes in Indonesia have erupted in a close period, including Mount Anak Krakatau, Ibu, Semeru, Lewotobi Laki-laki, Ili Lewotolok, and Sinabung. Based on information shared by the Meteorology, Climatology, and Geophysics Agency (BMKG), the distribution of volcanic ash due to the eruption of Mount Anak Krakatau in the waters of the Sunda Strait on September 7, 2026 at 15.00 WIB was identified towards a number of areas, including Banten, West Java, Lampung, and Bengkulu.