The 2014 explosive eruption of Kelud volcano, Indonesia ejected fine-grained volcanic ash in a plume which travelled westwards across the island of Java. In Yogyakarta, without warning, up to 5 cm of ash was deposited within a few hours. This paper investigates the community and organizational response to the respiratory hazard of the ashfall, in the city of Yogyakarta. In any location where ashfall is a rare event, people located away from the primary volcanic hazards will be concerned about whether volcanic ash in their environment is dangerous to inhale, and how they should protect themselves. The World Health Organization primarily recommends that people stay indoors, or use light-weight face masks if outdoors. In the first study of its kind, we undertook a rapid questionnaire survey (with 125 respondents) on the use of community respiratory protection when ash is in the air. We documented the types of masks people wore, where they had got the mask from, why people wore masks, who advised them to wear a mask, and whether people thought their respiratory protection was effective. We also conducted informal interviews with a range of emergency management and health agencies, NGOs and a children's charity, to understand how those involved in mask procurement and distribution responded to the crisis, and to determine their understanding of the effectiveness of the masks that they provide. The study showed that a wide range of respiratory protection is used by those who choose to protect themselves, from cloth through to highly-efficient face masks, but with most people wearing surgical masks. Masks are widely available, from street stalls and shops, but are also distributed by government agencies, NGOs and employers. The organizations interviewed mainly distribute surgical masks to the public. Most people wore masks through their own initiative because they understood that there could be a health hazard, although some people wear them anyway when riding scooters (to protect from inhaling vehicle exhaust and street dust). Around 40% of the respondents thought that their existing protection was not sufficiently effective and around 30% of the respondents took measures to try to improve the effectiveness of their chosen protection method (e.g., wearing two types concurrently). This pilot paves the way for the Health Interventions in Volcanic Eruptions (HIVE) project which aims to provide an evidence base on effective respiratory protection for community use when ash is airborne, so that health agencies and other suppliers can provide reliable protection for the general population. The HIVE project will experimentally test the effectiveness of the range of types of respiratory protection identified in this study, as well as understanding the behaviours and environmental and cultural issues which affect whether people will wear masks when ash is in the air. (C) 2018 The Authors. Published by Elsevier B.V.
