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PubMed2005

Public health issues in disasters.

OBJECTIVE: This article outlines a number of important areas in which public health can contribute to making overall disaster management more effective. This article discusses health effects of some of the more important sudden impact natural disasters and potential future threats (e.g., intentional or deliberately released biologic agents) and outlines the requirements for effective emergency medical and public health response to these events. CONCLUSION: All natural disasters are unique in that each affected region of the world has different social, economic, and health backgrounds. Some similarities exist, however, among the health effects of different natural disasters, which if recognized, can ensure that health and emergency medical relief and limited resources are well managed.

Communicable Disease Control↗
PubMed2005

Crush syndrome.

The assessment, management, and treatment of the entrapped victim are critical skills needed to ensure a successful outcome. Individuals have been trapped in the "rubble" for even short periods of time only to succumb to predictable consequences of muscle compression injury. The clinician should be prepared to address issues of crush syndrome (including compartment syndrome) proactively and aggressively. The history of this disease is clear and well documented both in the military literature and in the earthquake rescue reviews. The key to management is managing and predicting clinical conditions before they present themselves. The potential exists in the urban environment (with the potential of building collapses) to have patients with crush syndrome that far exceed local medical capabilities should be part of modern disaster planning. This article reviews the various body systems and presents management and assessment strategies for the clinician.

Adult↗
PubMed2006

Hurricanes Katrina and Rita: evacuee healthcare efforts remote from hurricane affected areas.

Hurricanes Katrina and Rita produced the largest evacuation due to a natural disaster in United States history. Many people were evacuated or rescued from New Orleans and the Gulf Coast, resulting in a need for mass disaster shelters and medical care for months following the storms. The shelter healthcare system that was successfully developed in the Shreveport-Bossier City, Louisiana area was accomplished with little support from customary sources. This report is written after much discussion and introspection of community leaders involved "on the ground," who organized and provided medical services to evacuees of south Louisiana. Its purpose is to compile "lessons learned" in preparation for the next disaster recovery effort that might affect this or any other region of our country.

Community Health Services↗
PubMed2002

Ecological response to and management of increased flooding caused by climate change.

River channels and their flood plains are among the most naturally dynamic ecosystems on earth, in large part due to periodic flooding. The components of a river's natural flood regime (magnitude, frequency, duration and timing of peak flows) interact to maintain great habitat heterogeneity and to promote high species diversity and ecosystem productivity. Flood regimes vary within and among rivers, depending on catchment size, geology and regional hydroclimatology. Geographic variation in contemporary flood regimes results in river-to-river variation in ecosystem structure, and therefore in potential river ecosystem response to increased future flooding. The greater the deviation in flood regime from contemporary or recent historical conditions, the greater the expected ecological alteration. Ecological response will also depend on how extensively humans have altered natural river dynamics through land-use practices. Examples of human-caused changes in flood regime (e.g. urbanization, agricultural practices) provide analogues to explore the ecological implications of region-specific climate change. In many settings where humans have severely modified rivers (e.g. through leveeing), more frequent larger floods will work to re-establish connections with severed flood-plain and riparian wetlands in human-dominated river valleys. Developing and implementing non-structural flood-management policies based on ecological principles can benefit river ecosystems, as well as human society.

Climate↗
PubMed2005

The Big Flood: North Sea storm surge.

In the 50 years since the catastrophic southern North Sea storm surge of 31 January-1 February 1953, there have been technological advances in the engineering of flood protection, increased understanding of physical processes in shallow seas and estuaries, and developments in the mathematical statistics of extreme events. This introductory paper reviews how the scientific understanding of surge events, their impacts and the human responses to them is evolving on many fronts, often across disciplinary boundaries. The question of how the long-term nature of the problem itself will be influenced by possible climate, land use and policy changes is addressed, along with their associated uncertainties.

Computer Simulation↗
PubMed2005

The east coast Big Flood, 31 January-1 February 1953: a summary of the human disaster.

The Big Flood was the worst natural disaster to befall Britain during the twentieth century, and the scale of its human impact was due to the lack of adequate disaster preparedness. The 307 deaths on land were caused by drowning or from the effects of exposure. Two-thirds occurred in four clusters along the shoreline and mainly comprised inhabitants of post-war prefabricated buildings, bungalows and chalets, with the highest mortality among the elderly. The emergency response was spontaneous and community led, with the main search and rescue completed before central government became involved. No individuals or agencies were blamed for the neglected state of the flood defences or the absence of warnings, along with the post-war shortage of adequate housing, which were the main causes of vulnerability. The media played a limited role, and television was in its infancy. Mental health impacts were either self-limiting or failed to be articulated in a society recovering from the Second World War. The major mitigating factors included the empathetic response of people, locally and nationally, as well as the availability of armed forces personnel based in East Anglia, whose actions played a decisive part in the battle against the sea. The major legacies of the Big Flood were a coastal flood forecasting system, a more scientific approach to sea defences and the building of the Thames barrier.

Computer Simulation↗
PubMed2005

The effects of climate change on storm surges around the United Kingdom.

Coastal flooding is often caused by extreme events, such as storm surges. In this study, improved physical models have been used to simulate the climate system and storm surges, and to predict the effect of increased atmospheric concentrations of greenhouse gases on the surges. In agreement with previous studies, this work indicates that the changes in atmospheric storminess and the higher time-average sea-level predicted for the end of the twenty-first century will lead to changes in the height of water levels measured relative to the present day tide. However, the details of these projections differ somewhat from earlier assessments. Uncertainty in projections of future extreme water levels arise from uncertainty in the amount and timing of future greenhouse gas emissions, uncertainty in the physical models used to simulate the climate system and from the natural variability of the system. The total uncertainty has not yet been reliably quantified and achieving this should be a priority for future research.

Climate↗
PubMed2005

Towards a vulnerability assessment of the UK and northern European coasts: the role of regional climate variability.

Within the framework of a Tyndall Centre research project, sea level and wave changes around the UK and in the North Sea have been analysed. This paper integrates the results of this project. Many aspects of the contribution of the North Atlantic Oscillation (NAO) to sea level and wave height have been resolved. The NAO is a major forcing parameter for sea-level variability. Strong positive response to increasing NAO was observed in the shallow parts of the North Sea, while slightly negative response was found in the southwest part of the UK. The cause of the strong positive response is mainly the increased westerly winds. The NAO increase during the last decades has affected both the mean sea level and the extreme sea levels in the North Sea. The derived spatial distribution of the NAO-related variability of sea level allows the development of scenarios for future sea level and wave height in the region. Because the response of sea level to the NAO is found to be variable in time across all frequency bands, there is some inherent uncertainty in the use of the empirical relationships to develop scenarios of future sea level. Nevertheless, as it remains uncertain whether the multi-decadal NAO variability is related to climate change, the use of the empirical relationships in developing scenarios is justified. The resulting scenarios demonstrate: (i) that the use of regional estimates of sea level increase the projected range of sea-level change by 50% and (ii) that the contribution of the NAO to winter sea-level variability increases the range of uncertainty by a further 10-20cm. On the assumption that the general circulation models have some skill in simulating the future NAO change, then the NAO contribution to sea-level change around the UK is expected to be very small (<4cm) by 2080. Wave heights are also sensitive to the NAO changes, especially in the western coasts of the UK. Under the same scenarios for future NAO changes, the projected significant wave-height changes in the northeast Atlantic will exceed 0.4m. In addition, wave-direction changes of around 20 degrees per unit NAO index have been documented for one location. Such changes raise the possibility of consequential alteration of coastal erosion.

Climate↗
PubMed2005

Modelling waves and surges during the 1953 storm.

Waves and sea levels have been modelled for the storm of 31 January-1 February 1953. Problems in modelling this event are associated with the difficulty of reconstructing wind fields and validating the model results with the limited data available from 50 years ago. The reconstruction of appropriate wind fields for surge and wave models is examined. The surges and waves are reproduced reasonably well on the basis of tide-gauge observations and the sparse observational information on wave heights. The maximum surge coincided closely in time with tidal high water, producing very high water levels along the coasts of the southern North Sea. The statistics of the 1953 event and the likelihood of recurrence are also discussed. Both surge and wave components were estimated to be approximately 1 in 50 year events. The maximum water level also occurred when the offshore waves were close to their maximum. The estimation of return period for the total water level is more problematic and is dependent on location. A scenario with the 1953 storm occurring in 2075, accounting for the effects of sea level rise and land movements, is also constructed, suggesting that sea level relative to the land could be 0.4-0.5m higher than in 1953 in the southern North Sea, assuming a rise in mean sea level of 0.4m.

Computer Simulation↗
PubMed2005

Uncertainties in extreme surge level estimates from observational records.

Ensemble simulations with a total length of 7540 years are generated with a climate model, and coupled to a simple surge model to transform the wind field over the North Sea to the skew surge level at Delfzijl, The Netherlands. The 65 constructed surge records, each with a record length of 116 years, are analysed with the generalized extreme value (GEV) and the generalized Pareto distribution (GPD) to study both the model and sample uncertainty in surge level estimates with a return period of 104 years, as derived from 116-year records. The optimal choice of the threshold, needed for an unbiased GPD estimate from peak over threshold (POT) values, cannot be determined objectively from a 100-year dataset. This fact, in combination with the sensitivity of the GPD estimate to the threshold, and its tendency towards too low estimates, leaves the application of the GEV distribution to storm-season maxima as the best approach. If the GPD analysis is applied, then the exceedance rate, lambda, chosen should not be larger than 4. The climate model hints at the existence of a second population of very intense storms. As the existence of such a second population can never be excluded from a 100-year record, the estimated 104-year wind-speed from such records has always to be interpreted as a lower limit.

Computer Simulation↗
PubMed2005

Bayesian modelling of extreme surges on the UK east coast.

The catastrophic surge event of 1953 on the eastern UK and northern European coastlines led to widespread agreement on the necessity of a coordinated response to understand the risk of future oceanographic flood events and, so far as possible, to afford protection against such events. One element of this response was better use of historical data and scientific knowledge in assessing flood risk. The timing of the event also coincided roughly with the birth of extreme value theory as a statistical discipline for measuring risks of extreme events, and over the last 50 years, as techniques have been developed and refined, various attempts have been made to improve the precision of flood risk assessment around the UK coastline. In part, this article provides a review of such developments. Our broader aim, however, is to show how modern statistical modelling techniques, allied with the tools of extreme value theory and knowledge of sea-dynamic physics, can lead to further improvements in flood risk assessment. Our long-term goal is a coherent spatial model that exploits spatial smoothness in the surge process characteristics and we outline the details of such a model. The analysis of the present article, however, is restricted to a site-by-site analysis of high-tide surges. Nonetheless, we argue that the Bayesian methodology adopted for such analysis enables a risk-based interpretation of results that is most natural in this setting, and preferable to inferences that are available from more conventional analyses.

Bayes Theorem↗
PubMed2005

Catastrophe loss modelling of storm-surge flood risk in eastern England.

Probabilistic catastrophe loss modelling techniques, comprising a large stochastic set of potential storm-surge flood events, each assigned an annual rate of occurrence, have been employed for quantifying risk in the coastal flood plain of eastern England. Based on the tracks of the causative extratropical cyclones, historical storm-surge events are categorized into three classes, with distinct windfields and surge geographies. Extreme combinations of "tide with surge" are then generated for an extreme value distribution developed for each class. Fragility curves are used to determine the probability and magnitude of breaching relative to water levels and wave action for each section of sea defence. Based on the time-history of water levels in the surge, and the simulated configuration of breaching, flow is time-stepped through the defences and propagated into the flood plain using a 50 m horizontal-resolution digital elevation model. Based on the values and locations of the building stock in the flood plain, losses are calculated using vulnerability functions linking flood depth and flood velocity to measures of property loss. The outputs from this model for a UK insurance industry portfolio include "loss exceedence probabilities" as well as "average annualized losses", which can be employed for calculating coastal flood risk premiums in each postcode.

Computer Simulation↗