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PubMed1997

Identification by DNA analysis of the victims of the August 1996 Spitsbergen civil aircraft disaster.

Disaster victim identification traditionally relies on the combined efforts of police, dentists and pathologists, comparing ante mortem (AM) information from the missing persons with post mortem (PM) data from the dead bodies. In Western countries, dental evidence has ordinarily played the major role. DNA analysis has been used successfully in a number of large accidents to associate body parts and for purposes of identification, by comparing victims' DNA profiles with those of relatives. However, DNA typing is still not generally regarded as an essential part of disaster victim identification. Facing the August 1996 Spitsbergen aircraft accident in which 141 Russians and Ukrainians died and anticipating scanty ante mortem dental data, it was decided to use DNA profile analysis as the primary identification method. Material collected at the scene from all body parts, and blood sample from relatives were analysed at eight polymorphic microsatellite and minisatellite loci, DNA profile comparisons enabled us to sort the 257 typed body parts into 141 individuals, as well as identifying the 139 victims for whom reference samples were available. Identification by DNA analysis was then followed by comparisons of traditional AM and PM data, and within day 20 of the accident the identities of all victims were confidently established. This investigation indicates that it might be feasible to replace traditional identification efforts with DNA typing.

Aircraft↗

PubMed2001

Traumatic stress and ways of coping of community residents exposed to a train disaster.

OBJECTIVES: The aims of this study were to examine the degree of traumatic stress and the coping strategies employed by community residents who lived on both sides of a rail track where a train collision occurred in 1996 in Stafford, UK. The hypothesis was that there would be a high level of traumatic stress and that emotion-focused coping would be the predictor to distress. METHOD: This was a cross-sectional survey with a retrospective design in which 66 community residents, who lived between 30 and 100 feet away from the crash site, were interviewed. The study began approximately 7 months after the disaster. The Impact of Event Scale (IES), the General Health Questionnaire (GHQ-28) and the Ways of Coping Checklists (WOC) were administered to the residents. RESULTS: On the whole, the results did not entirely support the hypothesis. The residents were found to have experienced some intrusive thoughts and avoidance behaviour but their mean scores were significantly lower than those of standardized samples. Thirty-five per cent scored at 4 or above on the GHQ-28. Traumatic stress was predicted by both emotion-focused and problem-focused coping strategies. CONCLUSION: Although community residents were not on the train or related to the dead or injured in any way, they could, after being exposed to a train disaster, manifest traumatic stress symptoms which had long-lasting effects. Such traumatic stress was found to be associated with coping strategies of community residents characterized by their efforts to manage or alter the source of stress, and by their efforts to regulate stressful emotions.

Adaptation, Psychological↗

PubMed1995

[Education of the medical student in first aid, emergency and disaster medicine--the Graz model].

In Austria emergency and disaster medicine is a young interdisciplinary subject. It is only a borderline discipline encompassing different medical subjects and was subdivided into emergency medicine for medical doctors only and first-aid for lay people and emergency technicians. In fact, since emergency medicine without first-aid can't be successful, the Department of Anaesthesiology at the University of Graz let all students of the medical faculty have a comprehensive education in the treatment of injured of acutely ill patients. According to the three steps of the study lectures and practices, all parts of first-aid, emergency and disaster medicine were offered. In spite of the short time since this has been running, we found a good acceptance and we hope to increase the interest evinced by medical students in our training programme.

Austria↗

PubMed2001

Disaster epidemiology and medical response in the Chi-Chi earthquake in Taiwan.

STUDY OBJECTIVE: We examine the mortality and morbidity associated with earthquakes in the Chi-Chi earthquake in Taiwan in 1999. METHODS: Crude casualty data were collected from the reports of the government, local health bureaus, and 97 hospitals. The demographic data from the annual report of the Department of Interior were also employed for data analysis. Cross tables showing incidence of deaths and injuries by age, sex, time, and geographic distribution were generated to compare the mortality among different subgroups. Multiple regression models were established to explore the risk factors related to the mortality caused by earthquakes. RESULTS: The following results were found: the mortality rate increased with proximity to the epicenter, mortality was higher among the elderly than among young people, 30% of the victims died from head injuries caused by the collapse of dwellings, and the peak of medical demand was 12 hours after the earthquake and significantly increased demand for care lasted as long as 3 days. Furthermore, the regression model indicated that 78.5% of the variation of locality-age-sex-specific mortality was explained by the intensity of the earthquake, age, population density, distance to epicenter, medical beds per 10,000 people, and physicians per 10,000 people. CONCLUSION: The results implied that fragile minorities, specifically the elderly and children, require special consideration and attention in regard to disaster rescue and emergency medical care allocation. Epidemiologic analysis can guide disaster response and preparation.

Adolescent↗

PubMed2004

Air levels of carcinogenic polycyclic aromatic hydrocarbons after the World Trade Center disaster.

The catastrophic collapse of the World Trade Center (WTC) on September 11, 2001, created an immense dust cloud followed by fires that emitted soot into the air of New York City (NYC) well into December. The subsequent cleanup used diesel equipment that further polluted the air until the following June. The particulate air pollutants contained mutagenic and carcinogenic polycyclic aromatic hydrocarbons (PAHs). By using an assay developed for archived samples of fine particles, we measured nine PAHs in 243 samples collected at or near Ground Zero from September 23, 2001, to March 27, 2002. Based on temporal trends of individual PAH levels, we differentiated between fire and diesel sources and predicted PAH levels between 3 and 200 d after the disaster. Predicted PAH air concentrations on September 14, 2001, ranged from 1.3 to 15 ng/m(3); these values are among the highest reported from outdoor sources. We infer that these high initial air concentrations resulted from fires that rapidly diminished over 100 d. Diesel sources predominated for the next 100 d, during which time PAH levels declined slowly to background values. Because elevated PAH levels were transient, any elevation in cancer risk from PAH exposure should be very small among nonoccupationally exposed residents of NYC. However, the high initial levels of PAHs may be associated with reproductive effects observed in the offspring of women who were (or became) pregnant shortly after September 11, 2001. Because no PAH-specific air sampling was conducted, this work provides the only systematic measurements, to our knowledge, of ambient PAHs after the WTC disaster.

Air Pollution↗

PubMed2005

Degassing Lakes Nyos and Monoun: defusing certain disaster.

Since the catastrophic releases of CO(2) in the 1980s, Lakes Nyos and Monoun in Cameroon experienced CO(2) recharge at alarming rates of up to 80 mol/m(2) per yr. Total gas pressures reached 8.3 and 15.6 bar in Monoun (2003) and Nyos (2001), respectively, resulting in gas saturation levels up to 97%. These natural hazards are distinguished by the potential for mitigation to prevent future disasters. Controlled degassing was initiated at Nyos (2001) and Monoun (2003) amid speculation it could inadvertently destabilize the lakes and trigger another gas burst. Our measurements indicate that water column structure has not been compromised by the degassing and local stability is increasing in the zones of degassing. Furthermore, gas content has been reduced in the lakes approximately 12-14%. However, as gas is removed, the pressure at pipe inlets is reduced, and the removal rate will decrease over time. Based on 12 years of limnological measurements we developed a model of future removal rates and gas inventory, which predicts that in Monoun the current pipe will remove approximately 30% of the gas remaining before the natural gas recharge balances the removal rate. In Nyos the single pipe will remove approximately 25% of the gas remaining by 2015; this slow removal extends the present risk to local populations. More pipes and continued vigilance are required to reduce the risk of repeat disasters. Our model indicates that 75-99% of the gas remaining would be removed by 2010 with two pipes in Monoun and five pipes in Nyos, substantially reducing the risks.

Cameroon↗

PubMed1990

Sympathy and altruism in response to disasters.

Canadian students provided ratings of the degree of sympathy they felt for those involved in each of 20 world disasters. Playing the role of taxpayer, they also apportioned monies from a disaster relief fund to assist in such emergencies. A single dimension, Culpability, was found to underlie the sympathy ratings. Sympathy was related to giving aid only in the case of female subjects. Women also expressed greater sympathy and recommended more financial aid than did men.

Adult↗

PubMed2006

Disaster preparedness in the South East Asia region.

This article presents an overview of risks and hazards in the South East Asia Region, as well as disaster preparedness and response in countries in South East Asia (SEA) before and after the Tsunami of 26 December 2004. This event has become a reference point and turning point for most countries and organizations in improving and reforming disaster risk management. Changes have been put in place as to how emergencies are managed and these were largely brought about by taking forward lessons that were drawn from the Tsunami experience. Benchmarking for preparedness and response has been a critical step in the standardization of systems for emergency preparedness and response.

Asia, Southeastern↗

PubMedDate not supplied

A comparative analysis of two external health care disaster responses following Hurricane Katrina.

OBJECTIVE: Hurricane Katrina severely disrupted the health services in the U.S. Gulf Coast, necessitating an external health care response. The types and needs of patients following such an extensive event have not been well described. The objective of this study was to analyze the types of patients treated in two temporary clinics and to identify differences between them. METHODS: Two temporary sites were established: a disaster medical assistance team-based site in Mississippi and a volunteer-based site near New Orleans. Data were abstracted from patient charts for the two days of simultaneous operation: September 11 and 12, 2005. Each patient's age group, disposition, and primary discharge diagnosis was categorized and analyzed with descriptive and comparative statistics. RESULTS: There were a total of 501 patient encounters. The most common presentation overall was for chronic health conditions such as medication refills (20.6%), immunizations (11.0%), obtaining community resources (6.0%). and management of acute exacerbation of chronic hypertension (4.6%). There were important differences; the Mississippi site treated more acute conditions than the Louisiana site, including lacerations (13.7% vs. 0%; p < 0.001), musculosketal injuries (9.4% vs. 2.6%; p < 0.001), and other nonspecified injuries (3.0% vs. 0.4%; p = 0.020). CONCLUSIONS: With extensive damage to a health care system, these temporary clinics staffed by out-of-state volunteers provided needed health care. The most common health problems were related to chronic disease, primary health care, and routine emergency care, not to the direct impact of the hurricane. In addition to treating minor injuries, disaster planners should prepare to provide primary health care, administer vaccinations, and provide missing long-term medications.

Acute Disease↗

PubMedDate not supplied

Strange bedfellows? Reflections on bioethics' role in disaster response planning.

This essay considers the potential role of bioethics in disaster response planning and preparedness. Bioethicists can make substantial contributions, by ensuring that decision-making and distribution of resources during crises is carried out in a fair and just manner, as well as by examining the assumptions upon which disaster planning are based. Bioethicists should also be aware of potential pitfalls of overly-hasty engagement with this new field.

Bioethical Issues↗

PubMed2006

Interpreting anonymous DNA samples from mass disasters--probabilistic forensic inference using genetic markers.

MOTIVATION: The problem of identifying victims in a mass disaster using DNA fingerprints involves a scale of computation that requires efficient and accurate algorithms. In a typical scenario there are hundreds of samples taken from remains that must be matched to the pedigrees of the alleged victim's surviving relatives. Moreover the samples are often degraded due to heat and exposure. To develop a competent method for this type of forensic inference problem, the complicated quality issues of DNA typing need to be handled appropriately, the matches between every sample and every family must be considered, and the confidence of matches need to be provided. RESULTS: We present a unified probabilistic framework that efficiently clusters samples, conservatively eliminates implausible sample-pedigree pairings, and handles both degraded samples (missing values) and experimental errors in producing and/or reading a genotype. We present a method that confidently exclude forensically unambiguous sample-family matches from the large hypothesis space of candidate matches, based on posterior probabilistic inference. Due to the high confidentiality of disaster DNA data, simulation experiments are commonly performed and used here for validation. Our framework is shown to be robust to these errors at levels typical in real applications. Furthermore, the flexibility in the probabilistic models makes it possible to extend this framework to include other biological factors such as interdependent markers, mitochondrial sequences, and blood type. AVAILABILITY: The software and data sets are available from the authors upon request.

Algorithms↗

PubMed1978

Managing the psychosocial factor in disaster programs.

In developing disaster plans, hospital administrators are not always aware that the psychosocial needs of victims and their families can be greater than their medical needs. The author outlines a program to deal with the psychosocial factor in disasters, emphasizing the role of the social work department.

Adaptation, Psychological↗

PubMed1980

Natural disasters.

This presentation covers the various types of natural disasters which are faced by investigators throughout the world. Each geophysical substance is discussed, including earth, air and water, and secondary effects including fire. Additionally, four myths associated with disasters are reviewed.

Atmosphere↗

PubMed1991

Reactions of medical students affected by a major disaster.

This report describes the concerns and reactions of medical students who were affected by a major disaster at a football game in Sheffield in 1989. Some reactions were related to their stage of training, especially their feelings of guilt, doubts about their competence, and concern that they would not be able to cope with the stresses of doctoring. Relationships with fellow students were also problematic. Four months after the disaster, two students were still experiencing considerable distress. Staff can ameliorate such effects by providing formal teaching about posttraumatic stress disorder and by being prepared to offer support.

Adaptation, Psychological↗

PubMed2000

Disaster recovery planning by HMOs: theoretical insights.

HMOs are becoming increasingly reliant on health management information systems (HMISs) for their effective functioning, competitive viability, and survival. Because of this critical dependence, HMOs must use disaster recovery planning (DRP) to safeguard their HMIS assets from natural as well as man-made disasters. This article purposes a theoretical framework, based on the theory of organizational innovation, to explain the factors involved in the adoption of DRP by HMOs.

Administrative Personnel↗

PubMed1993

Industrial disaster and mental health of children and their parents.

OBJECTIVE: We report the findings of research conducted a year after an industrial disaster (PCB fire), which occurred on Montreal's South Shore in 1988. A total of 1,663 families were evacuated for a period of 18 days. The study evaluated 174 children between the ages of three and eleven years: 87 in the exposed group and 87 in the control sample. METHOD: Structured questionnaires were administered to the children and their mothers and fathers during home visits. RESULTS: Based on the responses of the children and the mothers, children aged 6 to 11 years displayed more overall internalized and post-traumatic stress disorder (PTSD) symptoms than did those in the control group. CONCLUSIONS: The study demonstrates that the mental health of fathers as well as mothers correlates with children's symptoms and that parents are able to accurately observe their child's reaction to a disaster.

Adaptation, Psychological↗

PubMed1994

Children of disaster in the second decade: a 17-year follow-up of Buffalo Creek survivors.

OBJECTIVE: To conduct a long-term follow-up of child survivors of a devastating human-caused disaster. METHOD: Child survivors (2-15) of the Buffalo Creek dam collapse, first evaluated in 1974, 2 years postdisaster, were reevaluated 17 years postdisaster when they were adults. Of the original 207 children, 99 were located and reevaluated using ratings on the Psychiatric Evaluation Form, the Impact of Event Scale, and the SCL-90 and lifetime and current diagnoses from the Structured Clinical Interview for DSM-III-R. RESULTS: Ratings of psychiatric symptoms at the two points in time showed significant decreases in overall severity ratings and in anxiety, belligerence, somatic concerns, and agitation. A few symptoms, not present in the child sample, increased over time (substance abuse, suicidal ideation). The current rate of disaster-related post-traumatic stress disorder (PTSD) was 7%, down from a postflood rate of 32%. There were no differences by age group in current psychological status; however, women evidenced more PTSD-related symptoms than did men. All current PTSD cases were women. Comparisons with similar subjects from a nonexposed community showed no differences. CONCLUSIONS: The findings indicated that the children studied, although having shown earlier effects, had "recovered" from the event by the time of long-term follow-up.

Adaptation, Psychological↗

PubMed1994

Children exposed to disaster: I. Epidemiology of post-traumatic symptoms and symptom profiles.

OBJECTIVE: To determine the range and severity of post-traumatic stress disorder (PTSD) symptoms exhibited by children after exposure to a natural disaster. METHOD: Three months after Hurricane Hugo struck Berkeley County, South Carolina, 5,687 school-aged children were surveyed about their experiences and reactions related to the storm. Self-reports of PTSD symptoms were obtained by use of a PTSD Reaction Index. RESULTS: Significant variation in the prevalence of PTSD symptoms was found across race, gender, and age groups. Self-reported symptoms were used to derive a post-traumatic stress syndrome classification according to DSM-III-R guidelines for the diagnosis of PTSD. More than 5% of the sample reported sufficient symptoms to be classified as exhibiting this post-traumatic stress syndrome. Females and younger children were more likely to receive this classification. At the symptom level, females reported more symptoms associated with emotional processing and emotional reaction to the trauma. Males were more likely to report symptoms related to cognitive and behavioral factors. Younger children were more likely to report symptoms overall. CONCLUSIONS: Children exposed to a high magnitude natural disaster report sufficient symptoms to establish a DSM-III-R derived classification of a PTSD syndrome. Differences between gender, age, and race groups appear to be related to differential risk of exposure, reporting biases, as well as a differential risk for developing post-traumatic symptoms.

Adolescent↗