After the May 18, 1980 volcanic eruption of Mount St. Helens, increases were observed in the number of patients who, because of asthma or bronchitis, sought medical care at emergency rooms of major hospitals in areas of ashfall. An interview study of 39 asthma and 44 bronchitis patients who became sick during the 4 wk following the eruption and who attended the emergency rooms of two major hospitals in Yakima, Washington, and of healthy matched controls indicated that a history of asthma, and possibly of bronchitis, were risk factors for contracting respiratory problems. The interview study also indicated that the main exacerbating factor was the elevated level of airborne total suspended particulates (in excess of 30,000 micrograms/m3) after the eruption. An interview study of 97 patients who had chronic lung disease and who lived in the same area as the above-mentioned patients, but who did not go to a hospital, showed that the ashfall exacerbated the condition in about one-third of these. Emergency planners and their geologist advisers should be aware that special preventive measures are justified for people with a history of asthma or chronic lung disease who live in communities at risk to volcanic ashfalls.