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PubMed2002

The day that the START triage system came to a STOP: observations from the World Trade Center disaster.

The Fire Department of the City of New York--Emergency Medical Services (EMS) Operations is one of the largest EMS systems in the country. On a daily basis, this system responds to approximately 3,000 to 3,500 calls for ambulance requests. This equates to 1.2 to 1.5 million calls annually. As part of its response, EMS deals on a daily basis with multiple casualty and disaster-type situations. The magnitude of the attacks on the World Trade Center, however, was on a scale not previously seen by any system. This article is a case report of the September 11, 2001, incident.

Disaster Planning↗
PubMed1987

Screening for the psychological consequences of a major disaster in a developing country: Armero, Colombia.

Seven months following the volcanic eruption that destroyed the small town of Armero, 200 victims were screened for emotional problems with the Self-Reporting Questionnaire, a simple and reliable instrument. Fifty-five percent of the victims were found to be emotionally distressed. Variables associated with the presence of emotional distress included living alone, having lost previous job, feeling not being helped, not knowing date for leaving temporary shelter, being dissatisfied with living arrangements, complaining of non-specific physical symptoms or epigastric pain, and presenting several physical problems. The high prevalence of emotional distress supports the need to deliver mental care to disaster victims in developing countries through the primary level of care. Our findings provide guidelines for early detection of individuals at risk for developing emotional problems.

Adolescent↗
PubMed1992

Crisis support and psychiatric symptomatology in adult survivors of the Jupiter cruise ship disaster.

The aim of the present study was to explore the relationship between crisis support and psychiatric symptomatology among adult survivors in the year following the Jupiter cruise ship disaster. Evidence is presented that support decreases over the following year, and that higher levels of crisis support are strongly related to better psychological outcome. Crisis support is shown to retain its association with symptomatology even when satisfaction with support is partialled out. These data are discussed with reference to the debate over the relative importance of received vs. perceived support.

Adaptation, Psychological↗
PubMed1993

Crisis support in the aftermath of disaster: a longitudinal perspective.

Crisis support was assessed over an 18-month period with survivors of the Jupiter cruise ship disaster. It was found that the support received from family and friends decreased significantly over time. In addition, higher crisis support in the immediate aftermath was found to predict less post-traumatic symptomatology at a later period. The results are thought to have implications for the assessment and treatment of survivors at high risk of disturbance.

Adaptation, Psychological↗
PubMed1993

Increased substance use in survivors of the Herald of Free Enterprise disaster.

Cross-sectional data are reported on 73 survivors of the Herald of Free Enterprise disaster. Many reported an increase in their consumption of alcohol, cigarettes, sleeping tablets, antidepressants and tranquillizers at six and 30 months. The level of increased use was, however, lower at 30 months than at six months, although this was less evident for alcohol and cigarettes than the other substances. In addition, self-reports of increased substance use are associated with higher levels of psychological distress as measured by the General Health Questionnaire and the Impact of Events Scale. It is suggested that substance use might help to maintain subsequent psychological distress.

Adolescent↗
PubMed1996

Psychological responses to a marine disaster during a recoil phase: experiences from the Estonia shipwreck.

The sinking of the car ferry, Estonia, was one of the world's most devastating marine disasters that has ever occurred in peace time. Altogether 138 passengers and crew members were rescued, and 38 of them were taken to the Turku University Central Hospital in Finland. The present article describes the various psychological reactions among the survivors during the first three days of the recoil phase.

Adjustment Disorders↗
PubMed1989

Lake Nyos disaster, Cameroon, 1986: the medical effects of large scale emission of carbon dioxide?

Carbon dioxide was blamed for the deaths of around 1700 people in Cameroon, west Africa, in 1986 when a massive release of gas occurred from Lake Nyos, a volcanic crater lake. The clinical findings in 845 survivors seen at or admitted to hospital were compatible with exposure to an asphyxiant gas. Rescuers noted cutaneous erythema and bullae on an unknown proportion of corpses and 161 (19%) survivors treated in hospital; though these lesions were initially believed to be burns from acidic gases, further investigation suggested that they were associated with coma states caused by exposure to carbon dioxide in air. The disaster at Lake Nyos and a similar event at Lake Monoun, Cameroon, two years previously provide new information on the possible medical effects of large scale emissions of carbon dioxide, though the presence of other toxic factors in these gas releases cannot be excluded.

Blister↗
PubMed1970

Bristol floods 1968. Controlled survey of effects on health of local community disaster.

An investigation into the health of people in Bristol flooded in July 1968 was made by means of a controlled survey and a study of mortality rates. There was a 50% increase in the number of deaths among those whose homes had been flooded, with a conspicuous rise in deaths from cancer.Surgery attendances rose by 53%, referrals to hospital and hospital admissions more than doubled. In all respects the men appeared less well able to cope with the experience of disaster than the women.

Adolescent↗
PubMed1975

Moorgate tube train disaster. Part II. Clinicopathological review.

A review of the injuries sustained by the 113 casualties of the Moorgate tube train disaster has shown the need for rapid evacuation of casualties. Recognition of the "crush syndrome" and its early consequence, hyperkalaemia, is important and a radical surgical approach is suggested. Chest injuries were common and contributed to many of the deaths.

Abdominal Injuries↗
PubMed1998

Edinburgh's Hogmanay celebrations: beyond a major disaster.

OBJECTIVE: To assess the impact of Edinburgh's Hogmanay celebrations on the city's accident and emergency (A&E) service. METHODS: Retrospective analysis. RESULTS: A crowd estimated at more than 350,000 attended the celebrations. During the three day period between 00.01 h on 31 December and 23.59 h on 2 January, 1151 new patients presented to the A&E department and of these half arrived in the first 24 hours. Thirty six patients required emergency resuscitation and eight died in the department during the study period. CONCLUSIONS: The absolute number of patients presenting during the study period greatly exceeded most of the "major disasters" in contemporary UK experience. No deaths were directly attributable to the event, but the spectrum of patient pathologies, their severity and presentation is analogous to several recent major incidents. It is doubtful whether the Hogmanay celebrations are safe.

Alcoholic Intoxication↗
PubMed1998

Persistent respiratory effects in survivors of the Bhopal disaster.

OBJECTIVE: To examine the role of exposure to the 1984 Bhopal gas leak in the development of persistent obstructive airways disease. DESIGN: Cross sectional survey. SETTING: Bhopal, India. SUBJECTS: Random sample of 454 adults stratified by distance of residence from the Union Carbide plant. MAIN OUTCOME MEASURES: Self reported respiratory symptoms; indices of lung function measured by simple spirometry and adjusted for age, sex, and height according to Indian derived regression equations. RESULTS: Respiratory symptoms were significantly more common and lung function (percentage predicted forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory flow between 25% and 75% of vital capacity (FEF25-75), and FEV1/FEV ratio) was reduced among those reporting exposure to the gas leak. The frequency of symptoms fell as exposure decreased (as estimated by distance lived from the plant), and lung function measurements displayed similar trends. These findings were not wholly accounted for by confounding by smoking or literacy, a measure of socioeconomic status. Lung function measurements were consistently lower in those reporting symptoms. CONCLUSION: Our results suggest that persistent small airways obstruction among survivors of the 1984 disaster may be attributed to gas exposure.

Adult↗
PubMed2004

[The impact of the Prestige disaster on human health].

The worst environmental disaster of the history of Spain favoured a renewed social awareness of the intimate relationships that exist between the state of the environment and the health of human beings. However, the health of the populations most involved in the Prestige oil spill was initially not the chief concern of political authorities. The main aims of the present paper are: first, to comment succinctly on some of the most significant activities conducted by a variety of social actors during the Prestige crisis; and second, to suggest the main potential objectives and characteristics of the epidemiological studies necessary to assess with a sound rational basis the possible impact of the accident on the health of workers, volunteers and residents in the spill areas. The authors hope that in the near future it will be possible to scientifically assess the results and implications of several studies (epidemiological and of other sorts) well designed and conducted.

Disasters↗
PubMedDate not supplied

[A primary healthcare strategy in disaster situations].

The present article describes the experience of the Cuban Medical Team in the Colombian Coffee Area after the earthquake of January 25, 1999. The interventions were directed at the areas of primary health care, primary environmental care, environmental health, and epidemiological surveillance, bearing in mind the organization of earthquake victims sheltered in emergency settlements in the affected municipality. Active epidemiological surveillance showed that the main causes of morbidity were acute diarrheic diseases, acute respiratory infections, and skin diseases. Evaluation of the settlements showed a correlation between poor environmental health conditions and associated diseases. The results of this field study could serve as a guide for health professionals in the event of disasters and displaced populations.

Colombia↗
PubMed1992

Post-traumatic stress disorder in child survivors of shipping disasters: the sinking of the 'Jupiter'.

334 of over 400 children who survived the sinking of the cruise ship, Jupiter, in Athens harbour in October 1988 completed a battery of questionnaires 5-9 months later. Compared with age- and sex-matched controls, they show significantly higher scores on depression and anxiety. They also report more fears, particularly of stimuli related to the trauma. Overall, their scores on the Impact of Events Scale are as high as those reported by adults in other disasters. Follow-up studies a year after the accident reveal that nearly half the children meet the DSM-III-R criteria for PTSD. The usefulness of this screening battery is discussed. Some evidence for the effects of early intervention in schools is presented.

Child↗
PubMed1976

Disaster at Buffalo Creek. From chaos to responsibility.

The litigation initiated by the 625 survivors of the Buffalo Creek flood who refused to settle with the coal company claims office was a landmark case. For the first time, individuals who were not present at the scene of a disaster were allowed to recover for mental injuries. Psychic impairment, the term coined for these injuries, was found in virtually all of the survivor-plaintiffs. In an out of court settlement, the survivors were awarded $13.5 million, $6 million of which was distributed on the basis of a point system as compensation for the psychological damages.

Disasters↗
PubMed1976

Disaster at Buffalo Creek. Loss of communality at Buffalo Creek.

The survivors of the Buffalo Creek disaster suffered both individual and collective trauma, the latter being reflected in their loss of communality. Human relationships in this community had been derived from traditional bonds of kinship and neighborliness. When forced to give up these long-standing ties with familiar places and people, the survivors experienced demoralization, disorientation, and loss of connection. Stripped of the support they had received from their community, they became apathetic and seemed to have forgotten how to care for one another. This was apparently a community that was stronger than the sum of its parts, and these parts--the survivors of the Buffalo Creek flood--are now having great difficulty finding the personal resources to replace the energy and direction they had once found in their community.

Disasters↗
PubMed1985

Secondary disaster victims: the emotional effects of recovering and identifying human remains.

The author conducted a questionnaire survey of the 592 U.S. Air Force personnel involved in transporting and identifying the bodies of the almost 1,000 persons who died in Jonestown, Guyana; 225 (38%) of the personnel involved returned the questionnaire, as well as 76 (22%) of 352 individuals who were not involved in the operation. The Guyana respondents reported significantly more short-term dysphoria, which was more pronounced in those younger than 25 years of age, those who were black, those who were enlisted men rather than officers, and those with more exposure to the bodies. The author discusses the implications of these findings in planning future disaster relief programs.

Adaptation, Psychological↗