Disaster Metrics: Evaluation of de Boer's Disaster Severity Scale (DSS) Applied to Earthquakes.

INTRODUCTION: Quantitative measurement of the medical severity following multiple-casualty events (MCEs) is an important goal in disaster medicine. In 1990, de Boer proposed a 13-point, 7-parameter scale called the Disaster Severity Scale (DSS). Parameters include cause, duration, radius, number of casualties, nature of injuries, rescue time, and effect on surrounding community. Hypothesis This study aimed to examine the reliability and dimensionality (number of salient themes) of de Boer's DSS scale through its application to 144 discrete earthquake events. METHODS: A search for earthquake events was conducted via National Oceanic and Atmospheric Administration (NOAA) and US Geological Survey (USGS) databases. Two experts in the field of disaster medicine independently reviewed and assigned scores for parameters that had no data readily available (nature of injuries, rescue time, and effect on surrounding community), and differences were reconciled via consensus. Principle Component Analysis was performed using SPSS Statistics for Windows Version 22.0 (IBM Corp; Armonk, New York USA) to evaluate the reliability and dimensionality of the DSS. RESULTS: A total of 144 individual earthquakes from 2003 through 2013 were identified and scored. Of 13 points possible, the mean score was 6.04, the mode = 5, minimum = 4, maximum = 11, and standard deviation = 2.23. Three parameters in the DSS had zero variance (ie, the parameter received the same score in all 144 earthquakes). Because of the zero contribution to variance, these three parameters (cause, duration, and radius) were removed to run the statistical analysis. Cronbach's alpha score, a coefficient of internal consistency, for the remaining four parameters was found to be robust at 0.89. Principle Component Analysis showed uni-dimensional characteristics with only one component having an eigenvalue greater than one at 3.17. The 4-parameter DSS, however, suffered from restriction of scoring range on both parameter and scale levels. CONCLUSION: Jan de Boer's DSS in its 7-parameter format fails to hold statistically in a dataset of 144 earthquakes subjected to analysis. A modified 4-parameter scale was found to quantitatively assess medical severity more directly, but remains flawed due to range restriction on both individual parameter and scale levels. Further research is needed in the field of disaster metrics to develop a scale that is reliable in its complete set of parameters, capable of better fine discrimination, and uni-dimensional in measurement of the medical severity of MCEs.

An analysis of seismic risk from a tourism point of view.

Global awareness of natural calamities increased after the destructive Indian Ocean tsunami of December 2004, largely because many foreigners lost their lives, especially in Thailand. This paper explores how best to communicate the seismic risk posed by different travel destinations to crisis management personnel in tourists' home countries. The analysis of seismic risk should be straightforward enough for non-specialists, yet powerful enough to identify the travel destinations that are most at risk. The output for each location is a point in 3D space composed of the natural and built-up environment and local tourism. The tourism-specific factors can be tailored according to the tourists' nationality. The necessary information can be collected from various directories and statistics, much of it available over the Internet. The output helps to illustrate the overall seismic risk conditions of different travel destinations, allows for comparison across destinations, and identifies the places that are most at risk.

The nature of the public health emergency preparedness literature 2000-2008: a quantitative analysis.

OBJECTIVES: This study characterizes the nature, size, and knowledge gaps of the public health emergency preparedness (PHEP) literature. METHODS: Systematic review of PHEP articles published in 10 relevant journals from 2000 through 2008 was conducted. An inclusion process and coding sheet was developed; articles were coded on the basis of abstract content for variables, including type of methods used, disaster type, disaster life cycle focus, and article focal point. Descriptive analyses and cross-tabulations were used to characterize the nature of the literature. RESULTS: The sample included 823 articles; human-made disasters (39.4%, n = 323) were the most common, followed by natural disasters (30.7%, n = 252). The preparedness life cycle phase represented 60.5% (n = 497) of articles. Overall, 67.8% (n = 558) of articles were nonempirical; however, this differed by disaster type and focal point. DISCUSSION: Most of the PHEP literature is based on commentaries and other nonempirical articles forcing policymakers and practitioners to rely on weak anecdotal evidence or opinions for decision making. Several literature gaps are identified and presented as areas for future research. More research utilizing diverse methods and data sets is needed to build a strong evidence-based knowledge base on many PHEP topics.

Resilience to Climate-Induced Disasters and Its Overall Relationship to Well-Being in Southern Africa: A Mixed-Methods Systematic Review.

The available literature suggests that natural disasters, especially droughts and floods, were occurring in southern Africa in the early 1900s. However, their frequency and intensity increased during the 1980s. The aim of this systematic review was to assess the relationship between resilience to droughts and people's well-being in southern Africa. A combination of keywords was used to search the following 13 electronic bibliographic databases: Africa Journal Online (AJOL), MEDLINE, Academic Search Complete, Environment Complete, Humanities International Complete, Psychology and Behavioral Sciences Collection, PsycINFO, Embase, Scopus, Web of Science, Applied Social Science Index and Abstracts, ProQuest Central, and CINAHL. Relevant websites were also searched and potential studies for inclusion were downloaded in an EndNote database and screened for eligibility using pre-determined criteria. Quality assessment of the studies was undertaken using the Joana Briggs Qualitative Assessment and Review Instrument, the National Institutes of Health (NIH) checklist, and the Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) checklist. Resilience and well-being scales used in the studies for inclusion were also assessed using pre-defined criteria. Nineteen studies met the inclusion criteria. Poverty alleviation policies were important in strengthening resilience and well-being outcomes. Resilience and well-being were connected by old age, gender, race, adaptive farming and livelihoods diversification, security, and knowledgeability. Resilience and well-being outcomes were advanced by the synergistic effect of household, community and governance level capacities encapsulated in knowledgeability. This systematic review is critical to improving southern Africa context-specific resilience, and well-being policies and interventions.

Modelling the spatial distribution of five natural hazards in the context of the WHO/EMRO Atlas of Disaster Risk as a step towards the reduction of the health impact related to disasters.

BACKGROUND: Reducing the potential for large scale loss of life, large numbers of casualties, and widespread displacement of populations that can result from natural disasters is a difficult challenge for the individuals, communities and governments that need to respond to such events. While it is extremely difficult, if not impossible, to predict the occurrence of most natural hazards; it is possible to take action before emergency events happen to plan for their occurrence when possible and to mitigate their potential effects. In this context, an Atlas of Disaster Risk is under development for the 21 Member States that constitute the World Health Organization's (WHO) Eastern Mediterranean (EM) Region and the West Bank and Gaza Strip territory. METHODS AND RESULTS: This paper describes the Geographic Information System (GIS) based methods that have been used in order to create the first volume of the Atlas which looks at the spatial distribution of 5 natural hazards (flood, landslide, wind speed, heat and seismic hazard). It also presents the results obtained through the application of these methods on a set of countries part of the EM Region before illustrating how this type of information can be aggregated for decision making. DISCUSSION AND CONCLUSION: The methods presented in this paper aim at providing a new set of tools for GIS practitioners to refine their analytical capabilities when examining natural hazards, and at the same time allowing users to create more specific and meaningful local analyses. The maps resulting from the application of these methods provides decision makers with information to strengthen their disaster management capacity. It also represents the basis for the reflection that needs to take place regarding populations' vulnerability towards natural hazards from a health perspective.

Infectious diseases in disaster areas/catastrophes.

There is very little data and no prospective research possible in the field of catastrophic medicine (disaster medicine) including infectious diseases. This minireview tries to contribute to the pathogenesis and outcome of infectious diseases in areas after anthropogenic (war, genocide, terrorist attack, industrial disasters) and non anthropogenic (natural) catastrophes (earthquake, floods, tsunamis, hurricanes, volcano eruptions). Therefore ISC received a proposal to create a working group on infectious diseases in areas after catastrophes, better to understand epidemiology, prevention and therapy of infectious diseases occurring in conjunction to various anthropogenic and non anthropogenic (natural) disasters.

[Strategic preparedness of selected hospitals to act during massive chemical disasters]. / Strategiczne przygotowanie wybranych szpitali do dzialan w warunkach masowych skaien chemicznych.

The aim of our study was the evaluation of strategic preparedness of twelve hospitals in Kraków, Warsaw and the Triple City to give aid during massive chemical accidents. The study was carried on 146 persons, including 9 managers, 31 ward heads, 75 assistants, and 31 ward nurses. In statistical analysis the generalized linear model extended by random factors, particularly the Poisson's regression has been used. In any of the investigated hospitals, there were no plans regarding of action in case of chemical accidents. The knowledge about sources of possible contamination as well as environment threats were insufficient. The majority of the medical staff did not know their role as well as the role of their hospitals in case of a chemical accident. There is an urgent need for courses about the procedures which should be used during chemical accidents. The lack of hospital preparedness to act during chemical disasters in the big cities suggests that a similar situation is common in other such medical units all over the country. Further investigations, especially in the hospitals which are placed near the potentially dangerous factories, should be carried on in the near future.

Mother nature's disasters and their health effects: a literature review.

Each year global warming and climate changes are affecting Mother Nature, causing extreme weather events to occur (Patz & Khaliq, 2002). The impact of these disasters uproots populations, causes massive infrastructure destruction, and sets the stage for an increase of population mortality and morbidity. Before, during, and after the disaster, nurses provide health care to those in need. Nurses should be aware of the anticipated diseases, traumas, and short- and long-term illnesses that occur following the different types of natural disasters. The purpose of this article is to review existing data and alert nurses to the potential threats they may face following a natural disaster.

[Mass casualty events]. / Zdarzenia masowe.

Authors present problems concerning mass--casualty accidents, specificity of action rescue-system on different levels of co-operation, kind of segregation of victims and efficiency of the medical rescue system in Poland. Attention has been paid to the continuous instructions and education of life-saving services, preferably by simulation of events without earlier information of the interested. It is necessary to establish and abide official dependence by the rules of co-operation of components of life-saving system. A separate problem is the implementation of rescue--activities in special situations: nuclear, biological and chemical contamination, and with very important safety measures for people taking part in rescue action.

Major Natural Disasters in China, 1985-2014: Occurrence and Damages.

This study aimed to describe the characteristics of natural disasters and associated losses from 1985 to 2014. The Mann-Kendall method was used to detect any long-term trends and abrupt changes. Hotspot analysis was conducted to detect the spatial clusters of disasters. We found an increasing trend in the occurrence of integrated natural disasters (tau = 0.594, p < 0.001), particularly for floods (tau = 0.507, p < 0.001), landslides (tau = 0.365, p = 0.009) and storms (tau = 0.289, p = 0.032). Besides, there was an abrupt increase of natural disasters in 1998-2000. Hotspots of droughts, floods, landslides and storms were identified in central, southern, southwest and southeast areas of China, respectively. Annual deaths from integrated natural disasters were decreasing (tau = -0.237, p = 0.068) at about 32 persons/year, decreasing at 17 persons/year for floods (tau = -0.154, p = 0.239), and decreasing at approximately 12 persons/year for storms (tau = -0.338, p = 0.009). No significant trend was detected in inflation-adjusted damages while a declining trend was detected in the ratio of year damage against GDP (gross domestic product). In conclusion, there has been an increasing trend in occurrence of natural disasters in China with the absence of an increase in life and economic losses. Despite the progress in the disaster adaption, there will be great challenges in disaster control for China in the future.

Assessment of major and minor events that occurred in Italy during the last century using a Disaster Severity Scale score.

INTRODUCTION: Epidemiological research about disasters is difficult to perform. Most often, it must be completed retrospectively, since data collection may not be feasible or possible during the disaster. Now, there is a recognized need for a standard method to assess the severity of a disaster. OBJECTIVES: The aim of this paper is to assess the severity of the disasters that occurred in Italy during the 20th century, using a Disaster Severity Scale (DSS). Another goal is to find a standard method for the classification of previous disasters, test the feasibility and reliability of the use of the DSS, and improve disaster management and planning. METHODS: Data were obtained from formal reports of the Civil Defence Unit (Italy) and were used to calculate the DSS score. Disasters were classified into major and minor disasters, according to the numbers of deaths and severity of the damage. The number of deaths was compared with the obtained DSS score. A seasonal trend for different types of events was obtained to assess if there is a relationship between the type of event and the time of the year in which it occurred, as related to the weather conditions existing at that time. RESULTS: There were enough data to calculate a DSS score for 26 major events that caused death and economic damage, and occurred in Italy between 18 March 1944 and 11 November 1999, and for 82 minor events, that occurred between October 1982 and December 1999. There were some significant peaks varying from different types of events during particular seasons, but the cause for those with the highest incidence is not clear. Events related to natural hazards were the only type of event that reached the highest DSS when considering the number of deaths, while no events associated with man-made hazards had a DSS score >8. CONCLUSION: The DSS score could be a reliable index for the assessment of events related to either natural or man-made disasters. Use of the DSS allows researchers to classify previous hazards by scoring each disaster's severity. Further studies in other countries could be useful to further validate the DSS.

Uniform emergency codes: will they improve safety?

There are pros and cons to uniform code systems, according to emergency medicine experts. Uniformity can be a benefit when ED nurses and other staff work at several facilities. It's critical that your staff understand not only what the codes stand for, but what they must do when codes are called. If your state institutes a new system, be sure to hold regular drills to familiarize your ED staff.

What Occupational Health Needs Arise in Workplaces Following Disasters? A Joint Analysis of Eight Cases of Disaster in Japan.

OBJECTIVE: To identify occupational health needs arising after disasters. METHODS: Using semistructured interviews with expert informants, we jointly analyzed the needs arising in eight disaster cases that threatened the lives or health of workers in Japan. RESULTS: Various types of health issues occurred in a wide range of employees. In total, we identified 100 needs in six phases after disasters and classified them across nine categories of worker characteristics. The proportion of health needs on the list that were applicable in each case varied from 13% to 49%. More needs arose when the companies were responsible for the disaster and when employee lives were lost. We also assessed the list as fairly comprehensive. CONCLUSIONS: The list developed in this study is expected to be effective for anticipating occupational health needs after disasters.

Assessing disaster-attributed mortality: development and application of a definition and classification matrix.

BACKGROUND: A useful step in developing and implementing sound policies to prevent disaster-attributed mortality is to classify the relationship between disasters and mortality. While there are classification methods for specific health outcomes, there is no standard method that includes all potential outcomes from exposure to a natural disaster. Without standards, our ability to assess health effects from disasters and implement prevention programmes is limited. METHODS: We present a method for ascertaining and classifying disaster-attributed mortality which includes a case definition, flow chart, and matrix. The matrix is used for coding, reporting, and evaluating information about manner, cause, and circumstance of disaster-attributed deaths and geographical location and time of the disaster. To illustrate its use, two readers determine and classify deaths attributed to Hurricane Andrew (1992, USA). RESULTS: Of 322 deaths investigated by the Dade County Medical Examiner's Office, our readers showed 97% (313/322) agreement on case status and 83% (35/42) agreement on case classification. CONCLUSIONS: Our definition allows for a liberal interpretation of what constitutes disaster-related circumstances and the conditions or diseases that might arise from these circumstances. The inclusion of the flow chart and matrix provides a framework for consistent case classification and reporting. It also provides information about relationships between exposures and health effects, thereby identifying prevention policy needs.

Australian major incident nomenclature: it may be a 'disaster' but in an 'emergency' it is just a mess.

BACKGROUND: A standardized major incident nomenclature has practical applications for medical communication and audit of the medical response to incidents. METHODS: A telephone and fax survey of major incident nomenclature in State and Territory health service emergency management plans and 'disaster' legislation was carried out on 13 August 1999. RESULTS: Within Australia there were a total of 13 different terms to describe incidents that could produce casualties: there were four definitions of the word 'disaster', eight definitions of the word 'emergency' and one definition of the word 'incident'. CONCLUSION: Australia lacks a uniform system of classifying and recording mass casualty incidents. This prevents both the independent clinical audit of the medical response to an incident and the cross-border comparison of the effectiveness of trauma systems to deal with multiple casualties. Australia's geography highlights the need to develop a nomenclature that allows medical practitioners, in isolated environments, to accurately describe an incident and the medical support that is required. The Potential Injury-Creating Event (PICE) nomenclature is a simple system to describe the functional impact of an event upon a community and the level of medical support required. It can be used to provide the basis for the uniform reporting of the medical management of major incidents within Australia.

Disaster planning, Part I. Overview of hospital and emergency department planning for internal and external disasters.

The definition and causes for internal and external disasters are discussed in this article. Features of a hospital disaster plan are outlined with special reference to the role of the emergency department. Examples of previous disasters involving hospitals are presented to demonstrate problems that disaster planners should anticipate.

Disaster management in India: the case of livestock and poultry.

Developing countries are becoming increasingly aware of the importance of disaster management systems, and increasing efforts are being made to streamline preparedness, response and recovery mechanisms at all levels. It is well known that many developing countries, including India, are not always well-prepared to deal with disasters. A lack of well-developed disaster management plans results in a severe loss of human life, animal life and property, which could be saved if the necessary mechanisms were in place. A lot needs to be done to improve the situation, particularly in regard to livestock. This paper describes in detail, with particular reference to India, what can be done to care for animals when natural disasters occur. The authors review various types of natural disasters and their impact on livestock, and outline different preparedness, response, recovery, and mitigation strategies. The roles of different agencies, including veterinarians, are also considered.

Order in chaos: modelling medical management in disasters.

The medical aspects of disaster management, also referred to as disaster medicine, is a relatively new medical specialty, the roots of which are to be found in war surgery and traumatology. The main content of disaster medicine is based on empiricism. During the past couple of years, a mathematical approach to some aspects has been added. This may well result in the creation of some order in chaos. This modelling of medical disaster management is important not only in the preparedness phase, but also during the disaster itself and its evaluation. This may in turn result in a decrease in mortality, morbidity and disability amongst disaster casualties.

Tools for evaluating disasters: preliminary results of some hundreds of disasters.

Epidemiologic research of disasters is hampered by a lack of uniformity and standardization in describing these events. By applying a classification and scoring system, which recently became available, an analysis could be performed of 416 disasters from the past 40 years. Only 79 references were useful in obtaining reliable figures for a scoring on the Disaster Severity Scale (DSS). The various disaster types show a relationship between the DSS-scoring on the one hand, and the severity factor (S) and the number of dead and wounded (n) on the other. It is concluded that the classification and scoring system used could serve as a tool for evaluating the majority of disasters. A small improvement of this system is recommended.