Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Disasters”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,423 records · Page 79Linked to original sources

The influence of caesium-137 distribution in Poland's north-eastern ecosystem on effective dose 10 years after the Chernobyl disaster.

A comparison is presented of particular methods of exposure in the first year after the Chernobyl disaster and ten years later. This comparison shows that the population exposure due to the presence of radiocaesium in the environment results from the presence of caesium contained in the soil, which provides 68% of the dose (as compared to 32% in 1987) while the influence of diet has been reduced to 32% (from 68%). The exposure from caesium-137 contained in the air has dropped from 14% to 0. The effective dose from caesium has been 50 times smaller than that from environmental sources of the natural radiation estimated for the region under study to be 1.61 mSv x y(-1).

Accidents↗

Escherichia coli O157 infection disaster in Japan, 1996.

Escherichia coli O157 infection disaster occurred in Sakai in the summer of 1996, in which over 6000 infections and three deaths occurred. Seventeen patients, including four girls with haemolytic uraemic syndrome, were treated successfully in our hospital and information was published, as quickly as possible, on our internet home page.

Child↗

Management of multiple burn casualties from the Volendam disaster in the emergency departments of general hospitals.

OBJECTIVE: To establish the level of medical care provided in the emergency department of general hospitals to the victims of the Volendam café fire on 1 January 2001. METHODS: A retrospective review was done based on a standardized chart, for all victims seen at the emergency departments of 19 hospitals. Diagnostic findings and logistic aspects were inventoried. Treatment described in the Emergency Management of Severe Burns protocol was used as a gold standard against which the care provided to the victims was assessed. RESULTS: Data from 233 patients were included in the analysis. The documentation rate was low. Suspected inhalation injury and burns were the most frequently documented diagnoses. Most patients with suspected inhalation injury, for whom treatment records were available, received oxygen therapy (81%). Intubation was performed in 43% of patients with suspected inhalation injury and 14% of the remaining patients required intubation after admission to the intensive care unit. Most patients with circulatory problems (83%) and/or more than 15% of total body surface area burned (97%), for whom treatment records were available, received intravenous lines. Pain treatment seemed to have had low priority. Two patients (3%) were re-admitted after having been released earlier from the emergency department. CONCLUSION: Treatment and triage of the burn casualties after the Volendam café fire was adequate. The documentation rate was low. Not all steps in diagnosis and treatment may be of equal importance in disaster circumstances.

Adolescent↗

A propensity score analysis of brief worksite crisis interventions after the World Trade Center disaster: implications for intervention and research.

BACKGROUND: Postdisaster crisis interventions have been viewed by some as appropriate to enhance the mental health status of persons affected by large-scale traumatic events. However, studies and systematic reviews have challenged the effectiveness of these efforts. OBJECTIVES: The focus of this study was to examine the impact of brief mental health interventions received by employees at the worksite after the World Trade Center disaster (WTCD) among workers in New York City (NYC). RESEARCH DESIGN: The data for the present study come from a prospective cohort study of 1121 employed adults interviewed by telephone in a household survey 1 year and 2 years after the WTCD. All study participants were living in NYC at the time of the attacks. For the current study, we used propensity scores to match intervention cases (n = 150) to nonintervention controls (n = 971) using a 1:5 matching ratio based on a bias-corrected nearest-neighbor algorithm. RESULTS: Approximately 7% of NYC adults (approximately 425,000 persons) reported receiving employer-sponsored, worksite crisis interventions related to the WTCD provided by mental health professionals. In addition, analyses indicated that attending 1 to 3 brief worksite sessions was associated with positive outcomes up to 2 years after the WTCD across a spectrum of results, including reduced alcohol dependence, binge drinking, depression, PTSD severity, and reduced anxiety symptoms. CONCLUSIONS: Although our study had limitations, it is one of the few to suggest that brief postdisaster crisis interventions may be effective for employees after mass exposure to psychologically traumatic events. The reasons for the effectiveness of these interventions are unclear at this time and warrant further investigation.

Adult↗

Risk factors for depression after a disaster.

Environmental stressors such as mass disasters may contribute to an increased prevalence of depression within the population affected. We examined the prevalence of probable major depression and risk factors for depression in the 6-month period after the September 11, 2001, attacks on the World Trade Center among New York City (NYC) metropolitan residents. A total of 2700 persons who were representative of the NYC metropolitan area were included in this cross-sectional telephone survey. The prevalence of probable major depression in the 6 months after the attacks was 9.4%. Multivariate logistic regression covariates associated with the likelihood of probable major depression included being directly affected by the attacks, having a perievent panic attack, experiencing multiple life stressors, and having been exposed to previous traumatic events. Mass traumatic event exposure appears to be an independent environmental risk factor for depression in the postdisaster context; specific reactions such as perievent panic attacks may have prognostic value.

Adolescent↗

Dead letter or living document? Ten years of the Code of Conduct for disaster relief.

This paper examines the present value of the Code of Conduct for the International Red Cross and Red Crescent Movement and Non-Governmental Organizations (NGOs) in Disaster Relief, in view of discussions on neutrality and the Western bias of the humanitarian aid system, and assesses how it can retain its relevance in future. The Code of Conduct was launched just after the Rwanda genocide of April 1994. A decade later, the crises in Afghanistan and Iraq have sparked renewed interest in humanitarian principles and in whether the code can serve as an instrument to define humanitarianism and guide humanitarian decision-making and coordination. More than 300 organisations have now subscribed to it. This paper is based on the findings of a survey of code signatories and the outcomes of a conference on the value and future of the code, held in The Hague, Netherlands, in September 2004 to mark its tenth anniversary.

Altruism↗

The aftermath of an industrial disaster.

An explosion in a Danish supertanker under construction in 1994 caused the death of six workers and injured 15. Six months later 270 workers took part in this study, which analyses the relationships between objective stressors, the workers' own feelings and the reactions of their families after the explosion together with training, attitude to the workplace, general out-look, and received crisis help. Traumatisation, coping style and crisis support was assessed via the Impact of Event Scale (IES), the Coping Styles Questionnaire (CSQ) and the Crisis Support Scale (CSS). Emotionally, workers and their families were strongly affected by the explosion. The IES-score was 17.6 and the invasion score 9.1. The degree of traumatisation was higher in the group who had an 'audience position' than in the group who was directly hit by the explosion. Training in rescue work did not protect against adverse effects. Rescue work had a strong impact on the involved. Social support was a significant factor, that seems to buffer negative effects. High level of social integration, effective leadership in the situation, and professional crisis intervention characterised the disaster situation. All the same, 41 per cent of the workers reached the caseness criteria by Horowitz (IES > or = 19).

Accidents, Occupational↗

Lightning-strike disaster among children.

Thirty-eight children playing or observing a soccer game were the victims of a lightning strike which killed one other child. Interviews with the children and their families documented a number of emotional effects of this disaster, chiefly situational adjustment reactions. The most common reactions involved anxiety, particularly at times of storms. However, the most severely upset children exhibited sleep disturbances, separation anxiety, and nocturnal enuresis. One of two side-flash victims experienced depression for several months; the other experienced no significant emotional upset. Both suffered medical complications and had no memory for the incident. While all children reached at follow-up were doing quite well, those who were most upset by the incident were more likely to refuse to play soccer during the follow-up interval. Stories told to pictures of lightning revealed projections of the children's emotional upset, various defensive reactions to the incident and an increased sense of subjective probability for lightning injuries.

Adaptation, Psychological↗

Symposium--commemoration of the liberation of the Bergen-Belsen Concentration Camp and medical management of disasters study period.

Over the period 15/16 April 1998 a commemorative dinner and study period was held to recognise the role of the medical services in the management of the victims of the Bergen-Belsen Concentration Camp. Having been presented with a framework for planning medical support to these situations, one of the London medical students at Belsen in 1945 related his own experience at this unprecedented and horrific scene. Following this, the lessons that may be drawn were examined, the key factor being the need to create order out of chaos. The system used by the military for analysing what has to be achieved in a given situation, and the deductions that can be made from the prevailing factors, called the Estimate Process, emerged as a model for planning the medical contribution to disaster relief.

Concentration Camps↗

Occupational exposures during the World Trade Center disaster response.

Upon the request of the New York City Department of Health, the Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health (NIOSH) monitored occupational exposures among emergency response workers during the rescue and recovery activities at the World Trade Center disaster site from September 18 through 4 October 2001. During this period, over 1,200 bulk and air samples were collected to estimate or characterize workers' occupational exposures. Samples were collected and analyzed for asbestos, carbon monoxide (CO), chlorodifluoromethane (Freon 22), diesel exhaust, hydrogen sulfide, inorganic acids, mercury and other metals, polynuclear aromatic hydrocarbons, respirable particulate not otherwise regulated (PNOR), respirable crystalline silica, total PNOR, and volatile organic compounds. Exposures to most of these potential hazards did not exceed NIOSH Recommended Exposure Limits or Occupational Safety and Health Administration Permissible Exposure Limits. However, one torch cutter was overexposed to cadmium and another worker (and possibly three others) was overexposed to CO. The elevated cadmium and CO levels were the result of workers using oxy-acetylene cutting torches and gasoline-powered cutting saws. Recommendations were made to ensure adequate ventilation and worker understanding when using these tools and, where possible, to substitute rechargeable, battery-powered cutting saws for gasoline-powered ones. Toxicology

Air Pollutants↗

First response, rehabilitation, and outcomes of hand and upper limb function: survivors of the bali bombing disaster. A case series report.

In October 2002, two bombs exploded in Bali injuring hundreds, and killing 202 people. The purpose of this paper is to report the organization of the first response, rehabilitation strategies, and outcome of a series of patients evacuated to the Royal Perth Hospital (RPH), a civilian hospital in Australia. The initial medical response in Bali was primarily conducted by holidaying health professionals supporting the hospital on the island. The Australian Defence Force was primarily responsible for the ongoing acute clinical management during the evacuation and repatriation of survivors to all major burn units in Australia. At the RPH, hospital adaptations included novel staffing and treatment strategies to sustain a team effort beyond the acute phase of the disaster to manage the surge of 28 patients (15% of yearly admissions) in 7 days. Data collected were related to service delivery and patient outcomes (shoulder active range of motion, grip strength, and the Burns Specific Health Scale). Data were compared to baseline, similar data collected during normal practice and population norms. Bali patients received 3.2% more therapy treatment sessions and 6.8% less contact hours than usual protocols. Shoulder AROM recovered to normal limits by 3 months postdischarge. Grip strength for women was shown to reach population norms by 1 month after discharge and by 6 months for males. Self-rated physical recovery exceeded major burn population norms at 6 months postdischarge. Physical therapy outcome measures demonstrated upper limb recovery as usual in the Bali group, despite a mass casualty situation. To achieve this required support from the multidisciplinary team, in combination with community, government, and hospital administrative assistance.

Adolescent↗

Thyroid lesions in children and adolescents after the Chernobyl disaster: implications for the study of radiation tumorigenesis.

Eight years after the Chernobyl nuclear accident, the most obvious effect is manifested by an increase in the prevalence of thyroid gland diseases in the exposed children and adolescents. In this study, we describe a comparative analysis of epidemiological, clinical, and morphological features of 92 malignant and 59 benign thyroid lesions from patients 5-18 yr of age exposed to radiation in Belarus as a result of the Chernobyl disaster. All of them were operated at the same institution during the period from September 1991 through December 1992. The highest number of patients that subsequently developed thyroid carcinomas was in the group that was less that 1 yr of age at the time of Chernobyl, and this number decreased progressively through age 12 yr. Conversely, none of the patients with benign lesions only was less than 2 yr old at the time of the accident, and an exposure age of 5-6 yr was a threshold separating significant prevalence of malignant tumors in younger children from the more frequent benign lesions in older patients (P < 0.001). Fifty-two percent of children with carcinomas and only 24% with benign lesions (P < 0.005) were residents of the Gomel region, which is the most contaminated in Belarus. The morphology of thyroid tissue adjacent to carcinomas showed a high prevalence of multinodular and diffuse changes, but not of adenomas or solitary adenomatoid nodules. There was a high prevalence of focal micropapillary hyperplasia with graded degrees of severity, which we hypothesize may correspond to precursors for papillary thyroid carcinoma in post-Chernobyl radiation-associated tumors.

Adolescent↗

Personal exposure and long-term health effects in survivors of the union carbide disaster at bhopal.

Nine years after the Bhopal methyl isocyanate disaster, we examined the effects of exposures among a cross-section of current residents and a subset of those with persistent symptoms. We estimated individual exposures by developing exposure indices based on activity, exposure duration, and distance of residence from the plant. Most people left home after the gas leak by walking and running. About 60% used some form of protection (wet cloth on face, splashing water). Mean and median values of the exposure indices showed a declining trend with increasing distance from the plant. For those subjects reporting any versus no exposure, prevalence ratios were elevated for most respiratory and nonrespiratory symptoms. We examined exposure-response relationships using exposure indices to determine which were associated with health outcomes. The index total exposure weighted for distance was associated with most respiratory symptoms, one measure of pulmonary function in the cross-sectional sample [mid-expiratory flow (FEF)(25-75), p = 0.02], and two measures of pulmonary function in the hospitalized subset [forced expiratory volume (FEV)(1), p = 0.02; FEF(25-75), p = 0.08). Indices that correlated with FEV(1) and forced vital capacity in the hospitalized subset did not correlate with the cross-sectional sample, and most indices (except total exposure) that correlated with the hospitalized subset did not correlate with the cross-sectional sample. Incorporation of distance into every index increased the number of symptoms associated; an improvement was also noted in the strength of the association for respiratory symptoms, but not for pulmonary function. The sum of duration (p = 0.02) and total exposure (p = 0.03) indices independently demonstrated stronger associations with percent predicted FEF(25-75) than the distance variable (p = 0.04). The results show that total exposure weighted for distance has met the criteria for a successful index by being associated with most respiratory symptoms as well as FEF(25-75), features of obstructive airways disease.

Adult↗

The World Trade Center disaster and the health of workers: five-year assessment of a unique medical screening program.

BACKGROUND: Approximately 40,000 rescue and recovery workers were exposed to caustic dust and toxic pollutants following the 11 September 2001 attacks on the World Trade Center (WTC). These workers included traditional first responders, such as firefighters and police, and a diverse population of construction, utility, and public sector workers. METHODS: To characterize WTCrelated health effects, the WTC Worker and Volunteer Medical Screening Program was established. This multicenter clinical program provides free standardized examinations to responders. Examinations include medical, mental health, and exposure assessment questionnaires; physical examinations; spirometry; and chest X rays. RESULTS: Of 9,442 responders examined between July 2002 and April 2004, 69% reported new or worsened respiratory symptoms while performing WTC work. Symptoms persisted to the time of examination in 59% of these workers. Among those who had been asymptomatic before September 11, 61% developed respiratory symptoms while performing WTC work. Twenty-eight percent had abnormal spirometry; forced vital capacity (FVC) was low in 21%; and obstruction was present in 5%. Among nonsmokers, 27% had abnormal spirometry compared with 13% in the general U.S. population. Prevalence of low FVC among nonsmokers was 5-fold greater than in the U.S. population (20% vs. 4%). Respiratory symptoms and spirometry abnormalities were significantly associated with early arrival at the site. CONCLUSION: WTC responders had exposure-related increases in respiratory symptoms and pulmonary function test abnormalities that persisted up to 2.5 years after the attacks. Longterm medical monitoring is required to track persistence of these abnormalities and identify late effects, including possible malignancies. Lessons learned should guide future responses to civil disasters.

Adolescent↗

[Incidence- and reaction-related predictors of the acute and posttraumatic stress disorder in disaster workers].

OBJECTIVES: This recent study assesses the correlation of incidence- and reaction-related variables to predict acute and posttraumatic stress disorder in rescue workers after the catastrophe of Kaprun (2000) in Austria, Europe. METHODS: In a prospective longitudinal study, 250 emergency medical personnel, crisis intervention teams and police officers were assessed using the Acute Stress Disorder Scale (ASD), the Posttraumatic Stress Diagnostic Scale (PDS) and an incidence- and reaction-related questionnaire 6 weeks and 6 months after their mission. RESULTS: After 6 weeks, 7.3 % of the emergency medical personnel, 22.2 % of the crisis intervention team workers and 25.7 of police officers suffered from ADS. At 6 months after the disaster, 6.3 % of all rescue workers showed PTSD. The incidence-related predictors of PTSD assessed in the study were duration of the mission and early arrival at the site. Uncertainty about the help given was found to be a reaction-related predictor. CONCLUSIONS: This study provides further support for the usefulness of incidence- and reaction-related factors to predict acute and posttraumatic stress disorder in rescue workers. These results will aid in the development of special prevention strategies for rescue workers.

Adult↗

Differences in mental health outcomes among Whites, African Americans, and Hispanics following a community disaster.

A number of studies have assessed the association between race and ethnicity and psychological health status following exposure to a stressful event. However, some of these studies indicate racial and ethnic minorities have poorer mental health relative to Whites, while others show no differences or that minorities may actually have better psychological health. One year after the terrorist attacks on the World Trade Center, we collected data on a random sample of city residents (N = 2368). The dependent variables were posttraumatic stress disorder (PTSD), PTSD symptom severity, major depression, panic attack, and general physical and mental well-being. We categorized our respondents as Non-Hispanic White, Non-Hispanic African American, Dominican, Puerto Rican, and Other Hispanics. Bivariate results indicated racial/ethnic differences for PTSD symptom severity, depression, general physical and mental health, and panic attack. Using logistic regression and controlling for possible confounding factors, most of these associations were rendered non-significant. That is, we found no post-disaster racial/ethnic differences for PTSD, PTSD symptom severity, or physical health. African Americans and Other Hispanics were less likely to meet criteria for major depression or to be classified as unhealthy on the self-report SF-12 mental health scale compared to Whites. Only for panic attack were African Americans and Puerto Ricans more likely to meet criteria for this outcome. Thus, our study found little support for the hypothesis that Latinos or African Americans consistently suffered from poorer psychological and physical well-being in the aftermath of traumatic events, relative to Whites.

Adolescent↗

Probable cigarette dependence, PTSD, and depression after an urban disaster: results from a population survey of New York City residents 4 months after September 11, 2001.

Disaster exposure may exacerbate psychopathology and substance-related disorders. Four months after September 11, 2001, using random-digit dialing to contact a representative sample of adults (N = 2001) living in New York City, we assessed cigarette smoking and symptoms of probable cigarette dependence using measures from the National Survey on Drug Use and Health. A total of 36.8% of smokers reported increased cigarette use; 10.4% of respondents reported three or more symptoms of cigarette dependence and were considered cases of probable cigarette dependence based on DSM-IV criteria. Cases were more likely to report an increase in cigarette use since September 11 than non-cases (69.4% among cases vs. 2.2% among non-cases, p < 0.001). Cases were more likely to have probable posttraumatic stress disorder (PTSD) and depression than non-cases (18.1% vs. 5.7% for PTSD, p < 0.001; 23.6% vs. 6.0% for depression, p < 0.001). Increased cigarette use since September 11 was associated with probable PTSD among cases (23.4% vs. 6.4%, p = 0.011) and non-cases (15.1% vs. 5.5%, p = 0.034) but was associated with probable depression only among cases of probable cigarette dependence (28.3% vs. 13.3%, p = 0.027). This study showed the co-occurrence of probable cigarette dependence with increased cigarette use and the co-occurrence of probable cigarette dependence with probable PTSD and depression after September 11.

Adolescent↗

Safety and industrial relations in the Newfoundland offshore oil industry since the Ocean Ranger disaster in 1982.

Based on an examination of safety and industrial relations since the Ocean Ranger disaster, the article argues that government and industry changes have not fully addressed the problems that emerged from the investigation. Although the establishment of a single regulatory agency in the province is an improvement, some jurisdictional ambiguity remains and occupational health and safety regulations are still in draft form after their introduction more than ten years ago. Unionization is seen as an important step toward a safe workplace offshore, particularly in view of some current concerns: working schedules, training, evacuation, and search-and-rescue helicopters.

Journal Article↗