Exploring hospital resilience protective or risk factors: lessons for future disaster response efforts.

Background: Hospital resilience is essential in responding to disasters, but current research focuses mainly on frameworks and models rather than the protection of resilience and analysis of risk factors during public health emergencies. This study aims to examine the development of resilience in Chinese frontline hospitals during the initial COVID-19 outbreak in 2020, providing insights for future disaster response efforts. Objectives: We conducted interviews with 26 hospital staff members who were involved in the initial response to the COVID-19 outbreak in China. We used a semi-structured interview approach and employed purposive sampling and snowball sampling techniques. The interview outline was guided by the 'Action Framework' proposed by the World Health Organization (WHO) for responding to infectious disease emergencies. This framework includes dimensions such as command, surveillance, risk communication, medical response, and public health response. We analyzed the collected data using Colaizzi's seven-step data analysis method and the template analysis method. Results: WHO's 'action framework' effectively highlights the factors that contribute to hospital resilience. While medical response, including the availability of materials and facilities, the use of information technology, and the capacity for infectious disease diagnosis and treatment, remains crucial, other important aspects include awareness and beliefs about infections, treatment experience, interdisciplinary collaboration, and more. Additionally, it is essential to establish an intelligent command system, foster trusting partnerships between teams, improve monitoring capabilities for infectious disease agents, enhance risk communication through information synchronization and transparency, strengthen infection control planning, and improve environmental disinfection capabilities for effective public health emergency response. These contradictions significantly impact the enhancement of hospital resilience in dealing with major infectious disease outbreaks. Conclusion: In responding to sudden major infectious diseases, hospitals play a vital role within the healthcare system. Enhancing hospital resilience involves more than just improving treatment capabilities. It also requires effective command coordination at the hospital level, infection control planning, and the deployment of intelligent equipment. Additionally, planning for effective communication and coordination between hospitals, communities, and the national healthcare system can further enhance hospital resilience.

Manufactured housing communities and climate change: Understanding key vulnerabilities and recommendations for emergency managers.

Manufactured housing communities (MHCs), commonly referred to as mobile home parks, provide an estimated 2.7 million American households with largely unsubsidized, affordable housing. Climate change threatens those who call these communities home by exacerbating known structural and social vulnerabilities associated with this housing type-including but not limited to increased risks to flooding, extreme temperatures, high winds, and wildfires. Climate change requires emergency managers to understand the diverse, integrated, and complex vulnerabilities of MHCs that affect their exposure to climate change risk. This article presents findings from an integrative literature review focused on the climate-related vulnerabilities of these communities described at three levels of scale: household, housing structure, and park community. It then draws on 15 years of engagement and action research with MHC residents and stakeholders in Vermont, including several federally declared flooding disasters, to distill key recommendations for emergency managers for assisting MHCs to prepare for and respond to emergencies. As climate change accelerates, emergency managers can increase efficacy by learning about the MHCs in their jurisdictions by leveraging the best available data to characterize risks, integrating MHCs into planning and mitigation activities, and engaging in conversations with stakeholders, including MHC residents and their trusted partners.

Designing user-centered decision support systems for climate disasters: What information do communities and rescue responders need during floods?

Flooding events are the most common natural hazard globally, resulting in vast destruction and loss of life. An effective flood emergency response is necessary to lessen the negative impacts of flood disasters. However, disaster management and response efforts face a complex scenario. Simultaneously, regular citizens attempt to navigate the various sources of information being distributed and determine their best course of action. One thing is evident across all disaster scenarios: having accurate information and clear communication between citizens and rescue personnel is critical. This research aims to identify the diverse needs of two groups, rescue operators and citizens, during flood disaster events by investigating the sources and types of information they rely on and information that would improve their responses in the future. This information can improve the design and implementation of existing and future spatial decision support systems (SDSSs) during flooding events. This research identifies information characteristics crucial for rescue operators and everyday citizens' response and possible evacuation to flooding events by qualitatively coding survey responses from rescue responders and the public. The results show that including local input in SDSS development is crucial for improving higher-resolution flood risk quantification models. Doing so democratizes data collection and analysis, creates transparency and trust between people and governments, and leads to transformative solutions for the broader scientific community.

Boil water notices as health-risk communication: risk perceptions, efficacy, and compliance during winter storm Uri.

Winter Storm Uri was a disaster that impacted much of the United States during February of 2021. During and after the storm, Texas and Oklahoma experienced massive power grid failures. This led to cascading impacts, including water system disruptions and many boil water notices (BWNs). The breakdown of some communication channels and the inability to enact protective actions due to power outages, as well as travel limitations on public roads, complicated the dissemination and implementation of notifications. This research examined individuals' perceptions of risk, water quality, and BWNs during Uri. Additionally, this study sought to understand if previous experience with a BWN influenced compliance during Uri and how perceived efficacy impacted these variables. Surveying 893 Texans and Oklahomans revealed that most Uri-affected respondents believed the risks associated with BWNs were severe. Income and race were two factors that influenced BWN compliance. Age, gender, and level of education did not influence compliance. Previous experience with BWNs did not increase risk perceptions. Higher levels of perceived efficacy correlated to higher levels of compliance, perceptions of risk, and water quality, much of which support propositions of the Extended Parallel Process Model. Results suggest that pre-disaster planning and communication are imperative to helping reduce risk(s) and enhancing efficacy during a disaster, especially for novel disasters that have cascading risks, like Winter Storm Uri.

Climate Change Adaptation Methods for Public Health Prevention in Australia: an Integrative Review.

PURPOSE OF REVIEW: Climate change poses a serious threat to human health and well-being. Australia is not immune to the public health impacts and continues to be underprepared, putting the population health at risk. However, there is a dearth in knowledge about how the Australian public health system will address the impacts of climate change. RECENT FINDINGS: This integrative review synthesises tools, frameworks, and guidance material suitable for climate change adaptation from a preventive public health perspective. The literature search was conducted in electronic databases MEDLINE, PubMed, CINAHL, and Web of Science. Of 4507 articles identified, 19 articles met the inclusion criteria that focused on operational methods in public health and excluded the clinical context and reactive disaster response approaches. This review revealed that Australia is ill-prepared to manage climate change adverse health impacts due to ineffective adaptation strategies. The review highlights that Australia urgently requires effective adaptation strategies such as undertaking a National Adaptation Plan process and an improved understanding in managing complex health risks. Taking this action will strengthen the public health system and build health resilience especially for vulnerable populations. These findings will help understand and develop of the necessary adaptive strategies in Australia.

Development and demonstration of a data visualization platform of short-term guidelines for ambient air levels of benzene during disaster response in Houston, Texas.

Industrial disasters have caused hazardous air pollution and public health impacts. Response officials have developed limited exposure guidelines to direct them during the event; often, guidelines are outdated and may not represent relevant elevated-exposure periods. The 2019 Intercontinental Terminals Company (ITC) fire in Houston, Texas led to large-scale releases of benzene and presented a public health threat. This incident highlights the need for effective response and nimble, rapid public health communication. We developed a data-driven visualization tool to store, display, and interpret ambient benzene concentrations to assist health officials during environmental emergencies. Guidance values to interpret risk from acute exposure to benzene were updated using recent literature that also considers exposure periodicity. The visualization platform can process data from different sampling instruments and air monitors automatically, and displays information publicly in real time, along with the associated risk information and action recommendations. The protocol was validated by applying it retrospectively to the ITC event. The new guidance values are 6-30 times lower than those derived by the Texas regulatory agency. Fixed-site monitoring data, assessed using the protocol and revised thresholds, indicated that eight shelter-in-place and 17 air-quality alerts may have been considered. At least one of these shelter-in-place alerts corresponded to prolonged, elevated benzene concentrations (~1000 ppb). This new tool addresses essential gaps in the timely communication of air pollution measurements, provides context to understand potential health risks from exposure to benzene, and provides a clear protocol for local officials in responding to industrial air releases of benzene. Integr Environ Assess Manag 2024;20:533-546. © 2023 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Natural disasters: a comprehensive study using EMDAT database 1995-2022.

INTRODUCTION: The frequency, intensity, and geographical reach of natural disasters, fueled in part by factors such as climate change, population growth, and urbanization, have undeniably been escalating concerns around the world. DESIGN AND METHODS: This is a retrospective analysis of natural disasters recorded in the Emergency Events Database from 1995 to 2022. RESULTS: Between 1995 and 2022, 11,360 natural disasters occurred, with a mean of 398 per year. Asia experienced the most disasters (4390) and the highest number of casualties (918,198). Hydrological disasters were the most common subgroup (4969), while geophysical disasters led in terms of deaths (770,644). Biological disasters caused the most injuries (2544), particularly in Africa. CONCLUSION: Recognizing the historical impacts of the various subtypes of natural disasters may help different regions better risk analyze and mitigate the unique risks associated with such events.

INFLUENCE OF IONIZING RADIATION ON THE DEVELOPMENT OF BREAST CANCER. / ВПЛИВ ІОНІЗУЮЧОГО ВИПРОМІНЮВАННЯ НА РОЗВИТОК РАКУ МОЛОЧНОЇ ЗАЛОЗИ.

Breast cancer (BC) is one of the urgent problems of health care, which is due to a constant trend of growth. One of the risk factors for the development of breast cancer is ionizing radiation (IR). Numerous epidemiological and experimental studies have shown the high sensitivity of the mammary gland (MG) to this factor. Consideration of models of absolute and relative risks of the occurrence of radio-induced tumors of the MG in irradiated persons showed the importance of such factors as age at the time of irradiation, multiplicity. frequency of exposure, dose level and concomitant non-neoplastic diseases of the mammary and thyroid gland (TG). Excess radiation-induced cases of cervical cancer were found among irradiated women after the atomic bombings of Hiroshima and Nagasaki.Epidemiological features of the development of breast cancer under the influence of IV are presented in detail, which is one of the environmental factors involved in the formation of the modern carcinogenic situation. In con-nection with the significant sensitivity of the MG to the carcinogenic effect of IR, this form of neoplasms attracted special attention after the Chornobyl accident. The effect of small doses of radiation after the Chornobyl disaster led to a wave-like change in the incidence of breast cancer in certain periods of the year, and the radiation-induced incidence of this pathology can occur spontaneously.

BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT. PART V - ORGANIC AND FUNCTIONAL CHANGES CORRELATION ON THE EXAMPLE OF CERTAIN DISEASES. / ГОЛОВНИЙ МОЗОК ТА ОРГАН ЗОРУ ЯК ПОТЕНЦІЙНІ МІШЕНІ ДЛЯ ВПЛИВУ ІОНІЗУЮЧОГО ВИПРОМІНЮВАННЯ: ЧАСТИНА V ­ СПІВВІДНОШЕННЯ ОРГАНІЧНИХ І ФУНКЦІОНАЛЬНИХ ЗМІН НА ПРИКЛАДІ ОКРЕМИХ ЗАХВОРЮВАНЬ.

The question about correlation between organic and functional changes in persons, exposed to radiation is still insufficiently studied. Dynamics of morbidity for different forms and classes of non-tumour diseases periodisation, proposed by epidemiologists, suggests the identification of three main periods: «early¼ (the first 6 post-Chornobyl accident years); «distant¼ (12-21 years) and «late¼ (22-30 years). However, the correspondence this periodisation to the results of epidemiological data, without taking into account the clinical features of the diseases, may contribute to the impression, that in the first period after a radiation disaster functional disorders (or autonomic regulation disorders, etc.) prevail in all cases. Meanwhile, the data from ophthalmological and neurological studies, which we aim to demonstrate in this paper, rather indicate the presence of a significant morphological basis for the development of functional disorders in early period after a radiation disaster. The objective of this work is analyse modern experimental, epidemiological and clinical data on the correlation between organic and functional changes, characteristic of radiation cerebro-ophthalmological effects - radiation cataracts, age-related macular degeneration, cerebral small vessel disease, and neurocognitive deficits. Materials and methods. The criteria for inclusion in the analytical review were peer-reviewed publications in PubMed/MEDLINE, Scopus, Web of Science, and manually selected papers; the results of our own research were also used. An additional analysis of the results of examinations conducted in 1991-2004 was performed, which included a total of 11 123 persons irradiated as the result of catastrophy at the Chornobyl NPP. Results. In the first period of radiation cataract development, which is a specific consequence of radiation exposure, morphological changes (lens opacities) are observed, which lead to a decrease in visual function only later. Analysing the correlation between organic and functional changes in the development of diseases, for which ionising radiation exposure is a significant risk factor, we observe a similar picture. For example, CSVD associated with arterial hypertension may be a manifestation of accelerated aging associated with exposure to ionising radiation.Similarly, the initial signs of age-related macular degeneration in radiation-exposed individuals are usually manifested by changes in the morphology of the retina, choroid, and pigment epithelium in the macular area, while functional disorders in the form of decreased central vision and metamorphopsia, etc., occur later.

Fenómeno El Niño: acciones de preparación y comunicación de riesgo

Challenges and perspectives in applying the environmental sensitivity index to pipelines: a review on the prevention and management of oil spills disasters.

The oil spill environmental sensitivity index is a key tool for preventing and dealing with environmental disasters caused by oil spills. This study aims to review the available literature on the subject and highlight the importance of methodological advances to improve how the index is applied in continental areas, especially in regions crossed by pipelines. Most current mapping techniques focus on coastal areas and fail to consider the stretches of land that are vulnerable to geodynamic natural disasters. In this context, the need to implement environmental sensitivity indices specific for pipelines has become urgent. This study also presents an overview of the main accidents around the world and a detailed analysis of the history of Brazilian disasters related to oil spills along continental stretches, with a focus on pipelines and natural disasters. In addition, this work highlights the importance of carrying out new research in mountainous areas of Brazil and is aimed at preventing Natechs (natural hazard triggering technological disasters) and improving contingency plans. As a result, several pathways have been identified, which involves the necessity of resolving gaps in terrestrial environmental sensitivity mapping methodologies, particularly as applied to pipelines. Furthermore, solutions must be capable of integrating terrestrial, fluvial, coastal, and maritime environmental sensitivity mapping techniques. Moreover, the need to implement dynamic risk monitoring systems in real time is critical to help manage such a complex problem.

Some observations on perceptions of radiation risks in the context of nuclear power plant accidents.

As highlighted by public reactions to accidents at nuclear plants in the past, such as those that occurred in Chernobyl (1986) and Fukushima (2011), and from numerous opinion surveys, there are considerable differences or gaps between how the public and radiation experts perceive the risks from radiation. Even within the community of experts, radiation risk perception differences can be present. The reasons for differences in radiation risk perceptions between the public and experts are complex and involve sociological, ethical and behavioural aspects of society. This presents significant challenges to authorities in trying to improve radiation risk communications targeted at the public within the context of radiation emergency preparedness planning. Of particular importance is to make the communications more citizen-centred than heretofore by having meaningful two-way communications and dialogue with the public. It is emphasised that such strategies should take into account and address the significant mental health and socio-economic impacts of such accidents on affected populations. In particular, the mental health impacts are inadequately addressed by current international radiation protection recommendations reflecting their long established emphasis only on physical health effects. This approach is no longer acceptable or justified.

Natural disasters resulting from climate change: The impact of hurricanes and flooding on perinatal outcomes.

Although the earth's climate has been continuously changing over billions of years, human influence has accelerated that rate of change. While high latitudes suffer the greatest increase in incremental temperature, moderate latitudes are highly vulnerable due to their temperate/tropical rain storms and hurricanes that bring about extreme flooding events. We and others have shown that there is a link between the occurrence and severity of these climate events and risk of adverse perinatal outcomes. In this review, we will discuss the data and consider interacting near and intermediate sequelae of worsening natural disasters-including food scarcity, disrupted or compromised built environments and infrastructure, and loss of communities with human migration. While certainly tackling these and other proximal mediators of adverse perinatal outcomes will benefit maternal and child health, a failure to meaningfully address the root causes of climate change and resultant environmental chemical exposures will be of little long-term benefit.

Disaster management and environmental policy integration in Pakistan - an evaluation with particular reference to the China-Pakistan Economic Corridor Plan.

Economic and social development, the state of the environment and a propensity for disasters are closely intertwined. Therefore, environmental policy integration (EPI) across development and disaster management (DM) policies and plans is important. Pakistan as a country is highly vulnerable to climate-induced environmental changes and associated disasters. In this paper, the extent to which its national environment and climate change policy, disaster risk reduction (DRR) policy as well as disaster management (DM) plans are aligned is established, based on a review of government documents and expert opinions. In this context, a particular emphasis is put on China's Belt and Road Initiative (BRI) that led the China-Pakistan Economic Corridor Plan (CPEC; 2017-2030). While environmental assessment (EA) is currently not conducted for any DM policies and plans, DM and EA are well integrated into provincial environmental protection acts, in national as well as most provincial DM plans. It is concluded that a regulatory framework to guide EPI in DM for BRI and CPEC projects is needed.

Youth Suicidality in the Context of Disasters.

PURPOSE OF REVIEW: The purpose of this review is to summarize the current literature regarding youth suicidality (suicidal ideation, suicidal behavior, and completed suicide) in the context of disasters. RECENT FINDINGS: There are fewer studies that examine the effect of disasters on suicidality specifically in children and youth than studies that focus on adults or general population. Numerous studies have reported on the effect of disasters on youth mental health in general without zeroing in on suicide risk. Some variables that have shown to increase suicide risk in children and youth after disasters include female gender, age at the time of disaster exposure, dependence on adults, attachments to places and caregivers, family functioning, and vulnerability to mistreatment. Several studies have demonstrated that youth suicidality fluctuates in response to disasters, at times increasing immediately post-disaster and at other times decreasing immediately post-disaster followed by an increase later. Exposure to natural disasters (e.g., earthquakes, typhoons, hurricanes, wildfires, and extremes of temperature and humidity), man-made disasters (e.g., armed conflict, global warming, and pollution), and unique disasters (e.g., the COVID-19 pandemic) have had significant impact on suicidality in children and adolescents. Although there are several promising interventions to mitigate the post-disaster suicide risk among youth, there is no consensus on a single intervention that is superior to others. More research is needed to study youth suicide risk in the context of disasters and develop culturally appropriate and evidence-based interventions.

Impact of wars and natural disasters on emerging and re-emerging infectious diseases.

Emerging Infectious Diseases (EIDs) and Re-Emerging Infectious Diseases (REIDs) constitute significant health problems and are becoming of major importance. Up to 75% of EIDs and REIDs have zoonotic origin. Several factors such as the destruction of natural habitats leading humans and animals to live in close proximity, ecological changes due to natural disasters, population migration resulting from war or conflict, interruption or decrease in disease prevention programs, and insufficient vector control applications and sanitation are involved in disease emergence and distribution. War and natural disasters have a great impact on the emergence/re-emergence of diseases in the population. According to a World Bank estimation, two billion people are living in poverty and fragility situations. Wars destroy health systems and infrastructure, curtail existing disease control programs, and cause population movement leading to an increase in exposure to health risks and favor the emergence of infectious diseases. A total of 432 catastrophic cases associated with natural disasters were recorded globally in 2021. Natural disasters increase the risk of EID and REID outbreaks by damaging infrastructure and leading to displacement of populations. A Generic National Action Plan covering risk assessment, mechanism for action, determination of roles and responsibilities of each sector, the establishment of a coordination mechanism, etc. should be developed.

Outbreaks Following Natural Disasters: A Review of the Literature.

Understanding the relationship between infectious disease outbreaks and natural disasters is important in developing response and disaster risk reduction strategies. The aim of this study was to identify outbreaks associated with natural disasters during the past 20 y, and outline risk factors and mechanisms for postdisaster outbreaks. Review of the international disaster database (EM-DAT) and systematic review of the literature were conducted. The records of disaster events in EM-DAT during the past 20 y were screened. A literature search was carried out in the databases PubMed and Embase. Articles in English language published between 2000 and 2020 were searched. Data were extracted from articles and Narrative synthesis was used to summarize the findings. We found 108 events associated with epidemics, the majority being floods. We found 36 articles, most of them focused on outbreaks after floods. Risk factors and mechanisms that contributed to the outbreaks were mainly related to the consequences of disaster and its impact on the environment and living conditions of population. Infrastructure readiness and postdisaster measures play important roles in controlling the spread of epidemics after natural disasters. More evidence and research are required for better understanding of the association between natural disasters and infectious diseases outbreaks.