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At least 1,063 records · Page 59Linked to original sources
PubMed1994

A critical analysis of the fatal injuries resulting from the Continental flight 1713 airline disaster: evidence in favor of improved passenger restraint systems.

OBJECTIVE: To examine the mechanisms of injury and death in a commercial airline disaster and to propose preventative safety measures based on this analysis. DATA SOURCE: Denver County Coroner's Office and the National Transportation Safety Board. STUDY SELECTION: Those patients suffering fatal injuries as a result of the Continental Flight 1713 Airline crash. DATA EXTRACTION: Autopsy records from the Denver County Coroner's Office were reviewed with the causes of death determined. In many instances there was significant injury to more than one anatomic region in a single individual, each analyzed independently. DATA SYNTHESIS: There were 28 fatalities: nine died of mechanical asphyxiation, one of a penetrating cranial injury, and 18 of blunt trauma. The blunt injuries were remarkably similar to the deceleration injuries seen in high-speed motor vehicle crashes. Head trauma was the most common fatal blunt injury, followed by injuries to the chest and the abdomen. Thirty-six percent of the head injuries and 27% of the chest injuries had associated cervical and thoracic spine fractures, respectively. Analysis revealed a marked similarity in injury pattern sustained by seatmates, with a high incidence of fatal and serious injuries suffered by those passengers sitting in the front half of the airplane. CONCLUSIONS: Fatal blunt injury secondary to deceleration forces was the most common cause of death seen in this analysis. The use of a lap belt restraint system alone is not adequate to protect passengers against these forces as shown convincingly in the automotive industry literature. What impact a better passenger restraint system may have had on survival in this disaster is unknown, however, at a minimum, it would have significantly improved survival for 6 of 28 passengers dying of isolated blunt head trauma. Minor alterations in aircraft design (secure bolting of passenger seats to the airplane superstructure) and passenger restraints (3-point lap and shoulder harness system) is proposed to positively influence survival during an airplane crash at negligible increased airline expense or passenger inconvenience.

Accidents, Aviation↗
PubMed1999

Critical analysis of injuries sustained in the TWA flight 800 midair disaster.

BACKGROUND: Previous reports of commercial airline disasters have reviewed incidents occurring at takeoff and landing. The purpose of the present study, which represents the first analysis of aviation injuries incurred during a midflight incident, was to examine the injuries sustained by the victims of the TWA Flight 800 disaster and to determine any correlation of injuries with structural damage and seat location. METHODS: Complete autopsy records, toxicology screening, and forensic analysis were reviewed. Injuries were assessed by anatomic region and severity by using the Abbreviated Injury Scale. The National Transportation Safety Board report of the investigation was applied to correlate individual injuries with seat location and structural damage. A comparison was performed against injury data from takeoff and landing incidents. RESULTS: All 230 passengers of TWA Flight 800 were recovered as fatalities. Head, thoracic, and abdominal injuries were multiple and severe, contributing to the mortality of the occupants. Analysis revealed that the severity of injury and anatomic injury pattern did not generally correlate with seating position or structural damage. A comparison of these injuries with those of takeoff and landing crashes showed differences in injury pattern and severity. CONCLUSION: Passengers of Flight 800 sustained instantaneous fatal blunt force injury. Analysis of the data revealed no global correlation between seat position and pattern of injury. In contrast to injuries incurred during crashes at takeoff and landing, these midflight injuries were too extreme to warrant a reappraisal of current passenger protective safety measures or standards.

Abbreviated Injury Scale↗
PubMed2006

Perceived safety in disaster workers following 9/11.

The perception of being safe, perceived safety, is an important component of health and the ability to work after exposure to traumatic events of all kinds. The relationship of perceived safety to posttraumatic stress disorder and depression has rarely been examined. This study examined symptoms of posttraumatic stress disorder, depression, and perceived safety in disaster workers 2 weeks after the 9/11 terrorist attacks. Perceived safety was lower in those with greater exposure (e.g., those who felt they were in physical danger, worked with dead bodies, or witnessed someone being killed or seriously injured). Lower perceived safety was associated with greater symptoms of intrusion and hyperarousal but not avoidance. Safety was negatively correlated with depression and peritraumatic dissociation. Lowered perceptions of safety following terrorist events have implications for social and work-related behaviors that can affect long-term health, morale, and productivity in disaster workers and other first responders.

Adult↗
PubMed2006

Predictors of PTSD and delayed PTSD after disaster: the impact of exposure and psychosocial resources.

In the present study we sought to identify factors associated with posttraumatic stress disorder (PTSD) following the World Trade Center Disaster (WTCD) and examine changes in PTSD status over time. Our data come from a two-wave, prospective cohort study of New York City adults who were living in the city on September 11, 2001. We conducted a baseline survey 1 year after the attacks (year 1), followed by a survey 1 year later (year 2). Overall, 2368 individuals completed the year 1 survey, and 1681 were interviewed at year 2. Analyses for year 1 indicated that being younger, being female, experiencing more WTCD events, reporting more traumatic events other than the WTCD, experiencing more negative life events, having low social support, and having low self-esteem increased the likelihood of PTSD. For year 2, being middle-aged, being Latino, experiencing more negative life events and traumas since the WTCD, and having low self-esteem increased the likelihood of PTSD. Exposure to WTCD events was not related to year 2 PTSD once other factors were controlled. Following previous research, we divided study respondents into four categories: resilient cases (no PTSD years 1 or 2), remitted cases (PTSD year 1 but not year 2), delayed cases (no PTSD year 1 but PTSD year 2), and acute cases (PTSD both years 1 and 2). Factors predicting changes in PTSD between year 1 and year 2 suggested that delayed PTSD cases were more likely to have been Latino, to have experienced more negative life events, and to have had a decline in self-esteem. In contrast, remitted cases experienced fewer negative life events and had an increase in self-esteem. We discuss these findings in light of the psychosocial context associated with community disasters and traumatic stress exposures.

Adolescent↗
PubMed1998

The nature of psychiatric problems among disaster victims.

One-quarter of the residents (about 52,000) in the disaster area around the volcanic eruption area of Mt Unzen-Fugen have been forced to evacuate over a 3 year period. We conducted a psychological controlled study using the GHQ-30 for evacuees. As a result, the percentage of people with a high score over 8 points was 67% of evacuees, markedly higher than 10% of the control group. Some mental support activities, such as counseling by community nurses and crisis intervention/medication by psychiatrists and others, have been promoted. Subjects who received a psychiatric intervention had good outcome as a whole. The nature of psychiatric problems among disaster evacuees and the necessity of long-term support are discussed in this paper.

Adolescent↗
PubMed1995

Bhopal-A Case Study of International Disaster.

This paper outlines what is known about the probable events leading up to the disaster in Bhopal, India, in 1984, wherein release of a gas cloud from an industrial plant killed over 3,800 people. It briefly reviews the toxicology of methyl isocyanate, a major component of the cloud; presents an overview of the acute and chronic health effects of the gas exposure from published human and animal studies; identifies some of the clinical dilemmas and medical management and epidemiologic issues being debated; provides an insight into national and transnational implications; and summarizes the lessons learned or not learned from this disaster of global significance.

Journal Article↗
PubMed1997

Health effects of the Chernobyl disaster: illness or illness behavior? A comparative general health survey in two former Soviet regions.

Results are described of a general health survey (n = 3044) that was conducted 6.5 years after the Chernobyl accident in 1986 in a seriously contaminated region in Belarus and a socioeconomically comparable, but unaffected, region in the Russian Federation. The purpose of the study was to investigate whether there are differences in the general health status of the inhabitants of the two regions that may be attributed to the Chernobyl disaster. A broad-based population sample from each of these regions was studied using a variety of self-report questionnaires. A subsample (n = 449) was further examined with a standardized physical and psychiatric examination. The results show significantly higher scores on the self-report questionnaires and higher medical service utilization in the exposed region. No significant differences were observed in global clinical indices of health. Although there were trends for some disorders to be more prevalent in the exposed region, none of these could be directly attributed to exposure to ionizing radiation. The results of this study suggest that the Chernobyl disaster had a significant long-term impact on psychological well-being, health-related quality of life, and illness behavior in the exposed population.

Adolescent↗
PubMed2000

Injury toll following the 1997 Maccabiah Games bridge collapse: implications of major disasters for sports medicine teams.

A major disaster was encountered at the 1997 Maccabiah Games in Israel. As the Australian team was about to enter the main stadium for the opening ceremony, a pedestrian bridge they were crossing collapsed, killing 4 athletes and injuring many others. The aim of this paper is to establish the rates, types and anatomical locations of musculoskeletal injuries incurred by members of the Australian Maccabiah Games team, with particular reference to the impact of the bridge collapse. In total, the 410 members of the team (360 athletes and coaches and 50 team officials) reported 166 injuries from their participation in sport and 30 musculoskeletal injuries associated with the collapse of the bridge. The most common sports-related injuries were sprains and strains to the hip/thigh, lumbar spine and ankle/foot regions, while the bridge collapse resulted in, most commonly, sprains and contusions to the hip/thigh, knee, lower leg and ankle/foot regions. In addition, team members incurred many medical and psychological conditions. This paper makes several recommendations for sports medicine staff based on the experience of this significant sport disaster.

Accidents↗
PubMedDate not supplied

Effects of radiation on the production of immunoglobulins in children subsequent to the Chernobyl disaster.

Studies on the immediate and long-term effects of radiation on the B-system immunity of children who were affected by radiation after the Chernobyl disaster (from 1986-1992) are summarized in this paper. Complete clinical and immunological examination of more than 6000 children have been carried out. The dynamics of the immune system, with ongoing reactions of cell proliferation and differentiation, gene amplification, transcription, translation, biosynthesis and switching production of isotypes and subclasses of immunoglobulins, as well as specific and nonspecific (natural) antibodies, make it highly susceptible to the action of radiation in addition to other ecological factors. B-system of immunity (B-cel level, concentration of immunoglobulins-M, G, A, E; subclasses of IgG (IgG1-IgG4) in the serum and saliva, and the level of nonspecific heterophilic autoantibodies (RF, antithyroglobulin) were investigated in children of differing ages and sex living in the territories of the Republic of Belarus contaminated with radionuclides. Research showed decreased levels of B-cell and IgM and IgG isotopes 40-50 days after the disaster and increased levels of IgA immunoglobulins at that time. Long-term effects of low doses of radiation showed increased concentrations of IgM and IgG, correlating changes in the B-system of immunity with the level of 137Cs contamination in the territory of residence and also with the amount of 137Cs found in the children.

Adolescent↗
PubMed2006

The impact of disasters and their aftermath on mental health.

Hurricanes Katrina and Rita were the latest disasters involving trauma to individuals and displacement of significant populations. As a consequence, those of us in health care fields often are affected both as professionals with critical skills and as individuals with families under intense stress. This Commentary, which appears in the January 2006 issue of The Journal of Clinical Psychiatry (2006;67:7-14), provides first-hand insight into the "at-the-front" realities faced by primary care professionals as disasters evolve, as well as the preparations we can make with our families and the key priorities to be addressed in our professional roles with individuals, affected groups of people, and response systems. While it is rare for us to dually publish material, we deem the importance of this information to merit joint publication in The Journal of Clinical Psychiatry and The Companion.-Larry Culpepper, M.D.

Journal Article↗
PubMed1999

Disaster-related bereavement: acute symptoms and subsequent depression.

Despite the large body of literature on bereavement, gaps remain in our current understanding of disaster-related bereavement. We examined acute (1 wk post-disaster) and subsequent (2 mo) bereavement in 71 members of an Air Force community after the loss of 7 crewmembers and 1 passenger in a plane crash. Relative to a comparison group, the subjects had higher levels of acute intrusive and avoidant symptoms, and higher levels of depressive symptoms at 2 mo. High acute intrusive and avoidant symptoms were associated with higher levels of depressive symptoms at 2 mo. Single subjects with significant others had higher intrusive, avoidant, and depressive symptoms at 2 mo than singles without significant others and married subjects. Closer community ties (less transience) predicted higher acute intrusive and avoidant symptoms, and approached significance for depressive symptoms. After controlling for initial symptoms, the best predictors of depression at 2 mo were: low hardiness, being single, and low perceived support from friends.

Accidents, Aviation↗
PubMedDate not supplied

Measures for increased nutrition and utilization of non-conventional food resources during disasters in Africa.

The basic causes of the poor performance of the food and agricultural sector in the different parts of Africa are external, internal, and natural. The general recession in the Continent limits the capacity of the respective countries to import food to supplement inadequate domestic production and supplies. There are a number of nutritious food resources, both cultivated and gathered in the different ecological zones of Africa, whose production and consumption can be increased to ensure adequate food security and a nutritious diet, especially during disasters. These food resources could include: cereals, legumes, fruits, vegetables, fish, and insects. These food resources already are available over wide geographical areas in Africa and are utilized or utilized to a limited extent. Therefore, strategies to increase food supply, eradicate hunger and malnutrition, and keep people alive in times of disasters should have as a priority, the cultivation and consumption of non-conventional food resources in the respective communities and countries.

Africa↗
PubMed2000

[Why is malaria in Vietnam under control, but Africa is threatened with a malaria disaster?].

In Africa malaria parasites are increasingly developing resistance to the 3 affordable and tolerable drugs: chloroquine, amodiaquine and sulfadoxine-pyrimethamine. Alternative products are much more expensive and more toxic. A malaria disaster is looming. On the contrary, in Vietnam a disaster appears to have been averted. Data on malaria epidemiology, on the mosquito, the parasite and the host, man, give insight into the differences and the possibilities of control. Artemisinin derivatives can play an important role in malaria control, also in Africa. Without improvement of care which will require considerable investment and attention, the prospects are bleak.

Africa↗
PubMedDate not supplied

Community collaboration in disaster: the role of voluntary agencies.

Although the United States has been impacted by numerous devastating disasters over the last 10 years, there have been only limited efforts between the governmental and non-profit/voluntary organizations to meet the multiple disaster health and mental health needs of the community. Too often, responding organizations compete to provide services, duplicate efforts, and frequently under-estimate the need for services. Recent efforts have been undertaken by The American Red Cross and other groups to resolve this issue. Governmental and community-based organizations have been invited to participate in planning sessions to pre-identify roles and responsibilities, as well as to exchange key information about the services each group can and does provide. These efforts have lead to an increased awareness of the potential problems and the development of cohesive plans to provide medical and emotional support services to impacted communities. This has led to improved care for those with serious injuries or psychological crisis, while those with less critical problems have been managed appropriately without needing to be immediately referred to overcrowded emergency departments or physician's offices.

Community Participation↗
PubMed2001

Outbreaks of medically unexplained physical symptoms after military action, terrorist threat, or technological disaster.

Medically unexplained physical symptoms (MUPS) may present a challenge to clinicians, disaster response organizations, and scientists after future military actions, terrorist threats, or technological disasters. Polarized public discussion over science, policy, and media evidence following such incidents may reinforce the notion of cover-ups, create mutual doctor-patient mistrust, amplify symptom-related psychosocial distress and disability, and lead to unnecessary use of services. Under these circumstances, the clinician must always show respect, empathy, and validation for a patient's concerns. A skeptical attitude may induce efforts by patients to "prove" their symptoms are "real." If MUPS are discounted as a "non-problem," they may become a much bigger public health problem when patients feel their symptoms and concerns have been discounted by unfeeling government clinicians, and patient "horror stories" become grist for media and political mills.

Disease Outbreaks↗
PubMed1992

Forensic investigation of deaths due to fire in mass disaster.

When a body is recovered from a fire site, it is essential to determine if death occurred before or after the fire started. Foul play is suspected when there is an alternative cause of death not due to the fire. In cases of mass disaster due to fire, the forensic pathologist has an additional task of identifying the bodies. This is important in medico-legal investigations. The severity of the burnt injuries sustained may be useful in the reconstruction of the incidence. Examples will be given in this paper on the identification of the burnt victims and the forensic investigations on death by fire in mass disasters.

Accidents, Occupational↗
PubMed1992

Seasickness in totally-enclosed motor-propelled survival craft: five offshore oil rig disasters.

Five mobile offshore drilling unit disasters--Alexander L. Kielland, Ocean Ranger, Vinland, Ocean Odyssey, and Rowan Gorilla I--were studied to assess the degree to which seasickness occurs and endangers the lives of occupants of totally-enclosed motor-propelled survival craft (TEMPSC). Thousands of other peacetime marine incidents were reviewed and a literature search was conducted to assess the same seasickness problem. The one reported death in the Vinland abandonment appears to be the only one that could be associated, even remotely, with seasickness. It cannot be established whether or not seasickness contributed to the cause of death in the case of the Ocean Ranger victims, but it did occur in 75% or more of TEMPSC occupants in the other four rig disasters. It has occurred both in relatively calm waters of 1-m wave height and in severe seas of 15-m heights. Evacuees in an intact TEMPSC are able to survive many hours of severe seas; consequently, they should not be rescued until the weather and sea conditions improve. Moreover, practical survival training and good leadership is a principal cornerstone in the amelioration of seasickness.

Accidents↗