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Struggling with the Vog?

As the current Kilauea eruption rages on, residents on the Kona side are struggling with ongoing effects from elevated volcanic emissions (Vog). I wanted to share an article with recommendations that I wrote up in hope that you may find some relief in dealing with this ongoing environmental hazard (scroll to the end for a naturopathic approach to vog symptoms). These recommendations do not take the place of a doctor's prescription, so please schedule an appointment with your provider to put together a tailor-made plan for you!

In sickness and in health,

Dr. De Soto

Photo credit: Chelsea Jensen/West Hawaii Today

Health Effects from Vog and Recommendations for Kona Coast

Volcanic Emissions (Vog) from Kilauea Volcano on Hawaii Island have been a public health concern for many years. With new volcanic activity increasing on May 3rd, 2018, output has increased 4 times more than the average emissions in the years prior since 2008 according to a presentation from USGS at a Public Volcanic Ash and Vog Community Meeting held in Kailua Kona on June 6th 2018. For the first time on May 30th, the Kona area experienced “red” days as determined by EPA air quality monitoring stations. A red rating signifies an Air Quality Index (AQI) rating of 151-200 and is unhealthy for all populations, not just those with previous respiratory diseases. Prior to that week, air quality had never exceeded “yellow” or “orange” signifying that only sensitive populations, or people with pre-existing respiratory and cardiovascular conditions, needed to limit activity.

Official recommendations from the Department of Health include staying indoors and avoiding exercise and any activities that cause increased breathing on red or orange days. However, unless indoor air is being filtered appropriately, there is minimal difference between the quality of indoor air as compared to outdoor air (1). The following is a summary of information about the vog and recommendations for how to protect yourself from negative health-effects from vog exposure.

Summary of Vog composition:

  1. When vog is released from the vents, it is primarily a combination of Water vapor, Carbon Dioxide, Sulphur Dioxide (S02) and Hydrogen Sulfide (H2SO4) gasses, and ash (small rock, crystal and glass particles) (2).

  2. There are small amounts of other metal elements including hydrogen chloride and hydrogen fluoride, and small amounts of toxic metals, including selenium, mercury, and lead but these do not reach significant levels away from the area around the vent (2).

  3. When vog goes up in to the atmosphere, the gases react with water and other elements in the air and the SO2 and H2SO4 turn in to sulfate aerosols, or small sulfate particles and droplets. These aerosols are larger in diameter than the SO2 gas (2).

  4. Within 6 hours, the majority of SO2 has converted in to sulfate aerosols (3)

  5. When the vog reaches the Kona coast, it is predominantly made up of particulate matter and has minimal amounts of SO2 gas. (2)

  6. The particulates in vog are measured by PM2.5, which is the number of particles that are smaller than 2.5 microns.

Summary of Health Effects from Vog:

  1. The main health effects from vog are on the respiratory tract. Larger particles irritate the nose, sinuses and throat, while smaller particles make it deeper in to the lungs and can cause exacerbations of pre-existing conditions like asthma, COPD, emphysema and Cardiovascular diseases (4)

  2. It’s possible that long-term vog exposure can increase blood pressure, but this needs to be studied further to determine if it is really true (5)

  3. Vog does not cause asthma, but may cause a person who previously did not know they had asthma to now experience asthma-like symptoms (5)

  4. Children are considered to be sensitive to the vog because their lungs are small and they spend a lot of time running and playing which makes them breathe harder and inhale more of the small particles (4)

  5. The most important air-quality monitoring systems to pay attention to in Kona are the PM2.5 monitors and can be found at these sites:






USGS Vog Monitoring Site

  1. When air quality is rated at “orange” it is considered unhealthy for sensitive populations. People with asthma and other conditions that are sensitive to the vog, may be more reactive on these days. It is recommended that children do not spend much time playing outside on these days.

  2. When air quality is rated as “red” it is considered unhealthy for all people. The Dept of Health recommends that both children and adults do not exercise outdoors on these days and stay inside with an air-filtration device as much as possible.

  3. Most of our days in Kona since this recent eruption has been in the yellow with a few days in the orange or red.

AQI Rating System

Summary of Recommendations for Protecting Yourself from the Vog

  1. The Hawaii Dept of Health does NOT recommend the use of respirators for the general public as they need to be appropriately fit to the individual in order to be effective

  2. Using a respirator or mask while breathing heavily can be harmful for people with asthma or other respiratory disease as it increases the amount of carbon dioxide that a person breathes

  3. On days when it is recommended that you minimize vog exposure, the best recommendation is to only do exercise inside an air conditioned building and minimize activity outside

  4. Minimize exposure at home and while sleeping by purchasing a HEPA Air purifier that has a rating down to below PM2.5 (and ideally down to 0.3 microns or below) and also matches the right size for your bedroom’s square footage.

  5. In Kona, it is not necessary to get a filter that also filters out SO2 gases (which are much, much smaller) as there is minimal SO2 in Kona’s vog

  6. See these guides to purchasing the correct air purifier:



  9. Make sure that your HEPA Filter does not produce Ozone (you should be able to find this in the manufacturer specifications)

  10. If your home or office has air conditioning, then make sure that the air conditioning is not bringing fresh air in from the outside on a high vog day, but rather recirculating the air (much like the recirculation option in a car)

  11. If your home or office does not have windows that close, then consider replacing them or covering with a plastic cover so that you can minimize the amount of new air coming in the house while the air filter is running.

Naturopathic Recommendations for Vog Support

  • For irritation to eyes, sinuses and throat: This is likely due to larger particles​​ that are irritating the sensitive mucus membranes. Using a saline eyewash and nasal lavage twice daily will help clean away particles from these tissues.

  • If you experience respiratory symptoms, then it is due to the smaller particles entering the lungs and causing irritation. This is best managed by staying in an air-filtered room on bad days and using aromatherapy combinations that include eucalyptus and peppermint to help open up airways. It may also be necessary for you to achieve better asthma control with medications and you should speak with your doctor.

  • Many people also experience the following systemic symptoms of fatigue, headache and brain fog. These symptoms are related to the absorption of sulfate particles in to your body. Your body processes the sulfur in the liver via sulfation enzymes. When there is a lot of sulfur ongoing, the sulfation enzymes cannot keep up causing symptoms.

  • People who are sensitive to other sulfates in food such as in red wine or chocolate are likely to have worse symptoms. There are many nutrients that help support the liver to get rid of the extra sulfate including molybdenum, Vitamin B-complex, milk thistle, dandelion, burdock and other liver supportive herbs. Speak with your naturopathic doctor about how to appropriately use these natural liver and sulfation support nutrients (6).


  1. Longo, B. M., Yang, W., Green, J. B., Longo, A. A., Harris, M. & Bibilone, R. (2010) 'An Indoor Air Quality Assessment for Vulnerable Populations Exposed to Volcanic Vog From Kilauea Volcano', Family & Community Health, 33(1), 21-31.

  2. Elias, T., and Sutton, A.J., 2017, Volcanic air pollution hazards in Hawaii: U.S. Geological Survey Fact Sheet 2017–3017, 4 p.,

  3. Anderson, B., Bronsetin, A., Tam, E. et al. Volcanic Ash and Vog Community Meeting. Kailua Kona, HI. June 2016.

  4. “Health Effects of Vog.”Hawaii Interagency Vog Information Dashboard. May 2018. Date Accessed: 7 June 2018

  5. Tam E, et al. Volcanic air pollution over the Island of Hawai'i: Emissions, dispersal, and composition. Association with respiratory symptoms and lung function in Hawai'i Island school children. Environment International. 2016:92-93(543-552).


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