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PubMed1997

Tools for evaluating disasters: preliminary results of some hundreds of disasters.

Epidemiologic research of disasters is hampered by a lack of uniformity and standardization in describing these events. By applying a classification and scoring system, which recently became available, an analysis could be performed of 416 disasters from the past 40 years. Only 79 references were useful in obtaining reliable figures for a scoring on the Disaster Severity Scale (DSS). The various disaster types show a relationship between the DSS-scoring on the one hand, and the severity factor (S) and the number of dead and wounded (n) on the other. It is concluded that the classification and scoring system used could serve as a tool for evaluating the majority of disasters. A small improvement of this system is recommended.

Disaster Planning↗
PubMed2006

Providing critical care during a disaster: the interface between disaster response agencies and hospitals.

OBJECTIVE: Recent natural disasters have highlighted shortfall areas in current hospital disaster preparedness. These include the following: 1) insufficient coordination between hospitals and civil/governmental response agencies; 2) insufficient on-site critical care capability; 3) a lack of "portability" of acute care processes (i.e., patient transport and/or bringing care to the patient); 4) education shortfalls; and 5) the inability of hospitals to align disaster medical requirements with other competing priorities. CONCLUSIONS: Definition of the roles and responsibilities of a hospital during a disaster requires additional planning precision beyond the prehospital response phase. Planners must also better define plans for circumstances when or if a hospital is rendered unusable. Disaster medical training of hospital personnel has been inadequate. This article details the specifics of these issues and outlines various potential approaches to begin addressing and formulating remedies to these shortfalls.

Critical Care↗
PubMed2004

[Psychosocial care following the firework disaster in Enschede; the lessons from the Bijlmer airline disaster].

When the psychosocial-care scheme for victims of the firework explosion in Enschede, the Netherlands (2000) was set up, lessons learned from the Bijlmer airline disaster (Amsterdam 1992) were put into practice. The aftermath of this incident showed that psychological and physical health problems can still occur many years later. The main failure of the aftercare of the Bijlmer disaster lay in the coordination of aid and the monitoring of health problems. In Enschede steps were taken to redress these problems. An information and advice centre (IAC) was set up to monitor the well-being of the victims, and to provide them with information and, where necessary, assistance. It is responsible for limiting the effects of the disaster. A total of 13,000 people have consulted the IAC. A residents' association was formed. This gave the victims a common voice during the process of attempting to restore normality in their lives. A specialized mental health-care unit was founded to treat disaster-related disorders using evidence-based treatments. So far approximately 1,300 people have consulted this body. A longitudinal study has been set up to map the consequences of the disaster and to advise aid organizations. This will also give information on the extent to which these methods have been able to limit the long-term consequences.

Accidents, Aviation↗
PubMed1991

Psychological impairment in the wake of disaster: the disaster-psychopathology relationship.

The present review examines the relationship between disaster occurrence and psychopathology outcome for 52 studies that used quantitative measures of such a relationship. Descriptive and inferential techniques were used to examine relationships among four sets of variables: (a) the characteristics of the victim population, (b) the characteristics of the disaster, (c) study methodology, and (d) the type of psychopathology. A small but consistently positive relationship between disasters and psychopathology was found. The distribution of effect-size estimates was significantly heterogeneous, and this heterogeneity was partially accounted for by methodological characteristics of the research. When controlling for methodology, victim and disaster characteristics also contributed variance to the disaster-psychopathology relationship. Implications for future research are outlined in view of these results.

Adaptation, Psychological↗
PubMed1997

Disasters, the media and social structures: a typology of credibility hierarchy persistence based on a newspaper coverage of the Love Canal and six other disasters.

The starting-point of this paper is the assumption that credibility and the right to be heard are differentially distributed in any social system and therefore a 'hierarchy of credibility' exists. To test this, the media coverage of the Love Canal, New York, hazardous waste landfill disaster and six other disasters was examined to determine if this hierarchy exists in all cases. A hierarchy of credibility emphasising the views of established news sources with routine and habitual access to the media was demonstrated in the majority of events examined However, the Love Canal disaster was one of two where this hierarchy was disrupted due to a number of factors. These included the contentious or political nature of the event, its duration, the extent of competition of credibility and coverage among news sources, the extent of information shortage, the type of news medium, the degree of sympathetic and representational salience of victims and the extent to which they organized and achieved status as 'newsmakers'. Building on disaster research, a model of the operation of the credibility hierarchy in coverage of disasters is presented and discussed.

Attitude to Health↗
PubMedDate not supplied

Disasters and development: Part 2: Understanding and exploiting disaster-development linkages.

This lesson is a continuation of Disasters and Development: Part 2: Understanding and Exploiting Disaster-Development Linkages published in Prehospital and Disaster Medicine in Volume 17, Number 3. It identifies the goals of a specific damage mitigation project that can be incorporated into a regular development project and the mechanisms for obtaining the mitigation component of such a project. Mechanisms for assessing the success of such a project are discussed. It stresses the importance of the application of building codes, associated training programs, and more extensive use of zoning regulations in urban development that decrease the population at risk and the likelihood of damage to industrial facilities. Disasters can elevate the development potential of a society at risk for damage from a hazard. The political impact of damage and disruption can be a catalyst for change. Development opportunities often are compromised because of an excessive focus on relief assistance. Interventions designed to mitigate the damage from a given hazard are particularly effective when they focus on areas at particularly high risk for actualization of the hazard. Support from the private sector, including the non-formal sector, is a key element of successful reconstruction management. The period of recovery is an opportunity for general assistance to government with administrative procedures, including enhanced management training programs.

Disaster Planning↗
PubMedDate not supplied

Long-term psychiatric morbidity after a natural disaster. Implications for disaster planners and emergency services.

The prevalence and longitudinal course of post-traumatic stress disorder were studied in a group of 459 firefighters who were exposed to the Ash Wednesday bushfires in South Australia. The main finding, that the level of morbidity four months after the disaster remained almost unchanged at 29 months, indicates the long-term nature of post-traumatic stress disorder. Twenty-nine months after the fire, 21% of the firefighters were continuing to experience imagery of the disaster, in a way that interfered with their lives. The failure of present disaster management plans to recognize the psychological impact of natural disasters and the long-term nature of post-traumatic stress disorder is emphasized, and the need for preventive mental health programmes to minimize such morbidity in the future is discussed.

Australia↗
PubMed1999

It's a disaster: emergency departments' preparation for a chemical incident or disaster.

Nurses in the Accident & Emergency (A&E) Department have a significant role to play in the treatment and resuscitation of victims of a chemical disaster. Chemical disasters are unique because casualties are contaminated. Nursing staff triage casualties and they have direct contact with contaminated patients, before and during decontamination. Consequently they require adequate personal protective equipment and information regarding isolation and decontamination. The use of chemicals has increased since the turn of the century. Hazardous chemical emergencies arise from accidents in production, storage, transportation and the disposal of chemical substances. Their illegal manufacture and use by terrorists makes the likelihood of a chemical disaster with mass casualties in Australia very real. Emergency departments are ill-prepared to deal with this scenario, and very few disaster plans include a comprehensive decontamination component. To achieve an effective response with the best utilisation of resources, it is vital for emergency services personnel and A&E departments to be prepared.

Accidents, Occupational↗
PubMed2003

A more rational approach to medical disaster management applied retrospectively to the Enschede fireworks disaster, 13 May 2000.

As in any other medical discipline, developments in disaster medicine have occurred. A model for medical disaster management is briefly discussed and then applied retrospectively to the Enschede fireworks disaster (2000). Differences between the theoretical model and the actual situation are shown with respect to the number of casualties, the average severity of injury sustained, the medical rescue capacity, the medical transport capacity and hospital treatment capacity. It was concluded that the proposed model for the management of disasters with traumatically injured victims worked adequately.

Ambulances↗
PubMedDate not supplied

Medical disaster preparedness of Rotterdam-Europort: an application of methodology for assessing disaster preparedness.

Medical disaster preparedness (MDP) of Rotterdam-Europort has been estimated by grading personnel, materials, and methods utilized in the chain of medical care, from the disaster site to the hospital. On a scale from 1 to 5, this MDP was set at 2.8: the disaster site is the weakest link, which determines the strength of the whole chain. This, in turn, was the result mainly of the methods utilized for which the personnel were not properly educated and trained. By applying the methodology as described in an earlier paper, the MDP of cities, airports, harbors, industrial plants, etc. can be determined in a standardized way. This methodology should facilitate epidemiologic research in the public health aspects of disaster preparedness.

Aircraft↗
PubMed1990

[The dentist as an expert in disasters: dental identification in the disasters with the Zeebrugge ferry].

The Herald of Free Enterprise Disaster on the 6th of March 1987 just outside Zeebrugge harbour was without any doubt a disaster of major proportions. The ferry disaster highlighted different approaches in major incident procedures in both countries involved but nevertheless the identification team which was composed of both British and Belgian specialists did perform good work. The identification of the victims had to be done in three phases each of them with its own specific work and problems. As the process of identification of bodies is an exacting science, and forensic odontology is known to be among the most reliable scientific methods in mass disasters, it is easily understood that forensic odontology took an active part in all three phases of the identification process.

Denture Identification Marking↗
PubMed2004

[Terrorists' target World Cup 2006: disaster medicine on the sidelines?! Aspects of hospital disaster planning].

Focussing on possible mass casualty situations during events such as the soccer world championship in 2006, the Professional Board of Surgeons in Germany and the German Society for Surgery canvassed surgeons-in-chief in the last quarter of 2003 concerning disaster plans for hospitals. The rate of returned questionnaires amounted to 26% covering the following areas of interest: plans-ready to use, known by the employees as well as by the rescue coordination center, performance of exercises, and concepts on decontamination and detoxification. Based on past numbers of casualties during soccer disasters, an excursus into details also includes a description of an approach to reduce the danger of bottleneck effects at doors. A preliminary concept based on the upcoming system for funding hospitals in Germany and including new partnerships is outlined, succeeded by some hopefully helpful hints for a web-based hospital disaster plan.

Disaster Planning↗
PubMedDate not supplied

Definition and classification of disasters: introduction of a disaster severity scale.

In disaster medicine, a meaningful definition of the word disaster is lacking. A simple definition, using only two criteria, is proposed. Added to this, a classification scheme is formulated. Based on this definition and classification, a disaster severity scale is introduced. The methodology used is described, and the significance of these proposals is discussed.

Disaster Planning↗
PubMedDate not supplied

Disasters and development: Part 2: understanding and exploiting disaster-development linkages.

Disasters can impede the effectiveness of development resource allocation. The damage sustained from an event can be classified into four categories: (1) Loss of resources; (2) Interruption of programs and switching of crucial resources to other, shorter-term needs; (3) Negative impacts upon investment climates; and/or (4) Disruption of the non-formal sector (local businesses). Disasters have a particularly destructive economic impact in areas in which there are few alternatives for assets that are destroyed or in areas in which the resources already are at critical levels. Development processes can both increase and/or decrease the vulnerability of a society to hazards. There are dearly established linkages between poverty, marginalization, over-population, and vulnerability. To a large extent, vulnerability derives from poverty. The poor are more likely to live in vulnerable areas (slopes prone to landslides, flood plains, marginal agricultural land), have difficulty accessing education and information, have fewer assets to invest in resources to reduce vulnerability, and are more prone to become malnourished and have chronic illnesses that predispose them to injury and death. Development may be associated with the production of new hazards accepted by a society because the perceived benefits of the development project far exceed the relative risk associated with the project. Therefore, risk assessments must be part of any program planning and evaluation. Training and education are of critical importance in preventing increased vulnerability as a result of development strategies. Development also can progress in a manner that will result in mitigation of the impacts of an event on a given society (increase absorbing capacity and/or buffering capacity, elimination of hazards or the risk of them producing a disaster). Such mitigation measures can be either structural or nonstructural. There exists a wide range of options for incorporating mitigation measures in development projects. Two case studies provide exercises that incorporate the concepts provided in this discussion: (1) The 1985 earthquake in Mexico City; and (2) Agricultural development in northern Sudan.

Agriculture↗
PubMed2004

Post-disaster health effects: strategies for investigation and data collection. Experiences from the Enschede firework disaster.

BACKGROUND: Public health policy is increasingly concerned with the care for victims of a disaster. This article describes the design and implementation of an epidemiological study, which seeks to match care services to the specific problems of persons affected by a large scale incident. The study was prompted by the explosion of a firework depot in Enschede, the Netherlands. STUDY POPULATION: All those directly affected by this incident (residents, emergency services personnel, and people who happened to be in the area at the time), some of whom suffered personal loss or injury. The project investigates both the physical and psychological effects of the disaster, as well as the target group's subsequent call on healthcare services. STUDY DESIGN: A questionnaire based follow up survey of those directly affected and an ongoing monitoring of health problems relying on reports from healthcare professionals. The follow up survey started three weeks after the incident and was repeated 18 months and almost four years after the incident. The monitoring is conducted over a four year period by general practitioners, the local mental health services department, occupational health services, and the youth healthcare services department. It provides ongoing information. RESULTS AND CONCLUSIONS: The results of the study are regularly discussed with healthcare professionals and policy makers, and are made known to the research participants. The paper also explains the considerations that were made in designing the study to help others making up their research plans when confronted with possible health effects of a disaster.

Accidents↗
PubMed2006

Investment in preventing and preparing for biological emergencies and disasters: social and economic costs of disasters versus costs of surveillance and response preparedness.

Biological emergencies such as the appearance of an exotic transboundary or emerging disease can become disasters. The question that faces Veterinary Services in developing countries is how to balance resources dedicated to active insurance measures, such as border control, surveillance, working with the governments of developing countries, and investing in improving veterinary knowledge and tools, with passive measures, such as contingency funds and vaccine banks. There is strong evidence that the animal health situation in developed countries has improved and is relatively stable. In addition, through trade with other countries, developing countries are becoming part of the international animal health system, the status of which is improving, though with occasional setbacks. However, despite these improvements, the risk of a possible biological disaster still remains, and has increased in recent times because of the threat of bioterrorism. This paper suggests that a model that combines decision tree analysis with epidemiology is required to identify critical points in food chains that should be strengthened to reduce the risk of emergencies and prevent emergencies from becoming disasters.

Animal Welfare↗