A comparative assessment of major international disasters: the need for exposure assessment, systematic emergency preparedness, and lifetime health care.

BACKGROUND: The disasters at Seveso, Three Mile Island, Bhopal, Chernobyl, the World Trade Center (WTC) and Fukushima had historic health and economic sequelae for large populations of workers, responders and community members. METHODS: Comparative data from these events were collected to derive indications for future preparedness. Information from the primary sources and a literature review addressed: i) exposure assessment; ii) exposed populations; iii) health surveillance; iv) follow-up and research outputs; v) observed physical and mental health effects; vi) treatment and benefits; and vii) outreach activities. RESULTS: Exposure assessment was conducted in Seveso, Chernobyl and Fukushima, although none benefited from a timely or systematic strategy, yielding immediate and sequential measurements after the disaster. Identification of exposed subjects was overall underestimated. Health surveillance, treatment and follow-up research were implemented in Seveso, Chernobyl, Fukushima, and at the WTC, mostly focusing on the workers and responders, and to a lesser extent on residents. Exposure-related physical and mental health consequences were identified, indicating the need for a long-term health care of the affected populations. Fukushima has generated the largest scientific output so far, followed by the WTCHP and Chernobyl. Benefits programs and active outreach figured prominently in only the WTC Health Program. The analysis of these programs yielded the following lessons: 1) Know who was there; 2) Have public health input to the disaster response; 3) Collect health and needs data rapidly; 4) Take care of the affected; 5) Emergency preparedness; 6) Data driven, needs assessment, advocacy. CONCLUSIONS: Given the long-lasting health consequences of natural and man-made disasters, health surveillance and treatment programs are critical for management of health conditions, and emergency preparedness plans are needed to prevent or minimize the impact of future threats.

A Flexible Hierarchical Bayesian Modeling Technique for Risk Analysis of Major Accidents.

Safety analysis of rare events with potentially catastrophic consequences is challenged by data scarcity and uncertainty. Traditional causation-based approaches, such as fault tree and event tree (used to model rare event), suffer from a number of weaknesses. These include the static structure of the event causation, lack of event occurrence data, and need for reliable prior information. In this study, a new hierarchical Bayesian modeling based technique is proposed to overcome these drawbacks. The proposed technique can be used as a flexible technique for risk analysis of major accidents. It enables both forward and backward analysis in quantitative reasoning and the treatment of interdependence among the model parameters. Source-to-source variability in data sources is also taken into account through a robust probabilistic safety analysis. The applicability of the proposed technique has been demonstrated through a case study in marine and offshore industry.

A novel major accidents evolution model and its application in Chinese industrial accident.

The accident mortality rate of major accidents (MAs) show that China is still in the bottleneck period of accident prevention and control. To further promote the MAs prevention and control, this paper presents a novel major accidents evolution model from the theoretical perspective of information processing (IP). Firstly, based on the safety science paradigm of accident prevention and the emergency management paradigm of accident control, a safety information processing (SIP) process is proposed. Secondly, established the SIP model for different stages of accident prevention and control, which involves danger information processing (DIP), potential hazard information processing (PHIP), risk information processing (RIP), and emergency information processing (EIP). Thirdly, revealed the SIP of various management subject and the failure principle of accident prevention and control, that is, MAs occur under the premise of continuous failures of DIP, PHIP, RIP, and EIP under the social-technical system. Finally, the DPRE-IP model is proposed from the whole evolution path of "danger-potential hazard-risk-accident". To demonstrate the viability of the model, this model is applied to the "6·13" Wenling major explosion accident. The results show that the proposed DPRE-IP model can provide new ideas for the formulation of accident prevention and control measures and accident analysis.

Post-traumatic stress disorder in major accidents: systematic review and meta-analysis.

Major accidents are defined as accidents whose consequences spread spatially and temporally from acute events related to production activities. Exposure to these accidents has psychological impacts on individuals, including the development of mental disorders such as posttraumatic stress disorder. Thus, the aim of this study was to identify and analyze the evidence available in the literature on the relationship between exposure to major accidents and the development of posttraumatic stress disorder. To that end, a systematic literature review was conducted using the Web of Science and Google Scholar databases, followed by a meta-analysis based on the results of the selected studies. Twenty-six articles were selected, related to 14 major accidents, including 11 longitudinal and 15 cross-sectional studies. The studies were conducted from 2 months to 36 years after the major accident, comprising 24,276 participants. The methods, techniques and instruments used varied between studies. The meta-analysis indicated a prevalence of posttraumatic stress disorder of 18.57% (confidence interval 13.80-23.87; I2 = 96.22%). Posttraumatic stress disorder symptoms persisted over the years after the accident. The prevalence of posttraumatic stress disorder after exposure to major accidents was found to be higher compared to that of the general population. Risk factors for posttraumatic stress disorder included intensity of exposure, occurrence of physical damage, lack of social support, and economic losses. The results indicate the need for planned, rapid start and long-term interventions.

Acidentes ampliados - mais do que um conceito, uma história de luta que precisa ser atualizada / Major accidents: more than a concept, a history of struggle that must be updated

Resumo Os eventos definidos como acidentes ampliados surgem com o próprio processo de industrialização, assim como junto ao desenvolvimento de novas tecnologias de produção, tornando-se mais complexos neste início de século XXI. O objetivo deste ensaio foi apresentar e contextualizar a formulação de um conceito que buscou integrar os temas relacionados à segurança e saúde dos trabalhadores com os de saúde ambiental, bem como as lutas que envolviam os trabalhadores e o processo de democratização no país, em um cenário de divisão internacional do trabalho, riscos e benefícios. Considerando os acidentes e desastres ocorridos nos anos 1980 do século XX e, também, os recentes, envolvendo barragens de mineração, derrames de petróleo e uma usina nuclear de Fukushima, são apontados cenários mais complexos e novos desafios para enfrentamento desta questão no século XXI. Para além das disfunções dos sistemas tecnológicos e organizacionais encontradas, a intensificação das vulnerabilidades institucionais, somada às vulnerabilidades produzidas pelas desigualdades sociais, potencializam ocorrências e agravam os efeitos dos acidentes, ampliados para além de suas fronteiras espaciais e temporais, afetando sobretudo países do Sul Global. Conclui-se que os eventos recentes constituem expressões sistêmicas, indo além das disfunções organizacionais e revelando camadas mais profundas de sistemas organizacionais e sociotécnicos, como as que forjam a economia global e suas profundas assimetrias.

Abstract Events defined as major accidents emerged with the very industrialization process and alongside the development of new production technologies, becoming more complex in the early 21st century. This essay aimed to describe and contextualize the formulation of a concept that has sought to integrate topics related to workers' safety and health with those of environmental health, workers' struggles, and the democratization process in Brazil in a scenario of international division of labor, risks, and benefits. Considering the accidents and disasters in the 1980s and the more recent ones involving mine tailings dams, oil spills, and the Fukushima nuclear power plant, the authors identify more complex scenarios and new challenges for tackling this issue in the 21st century. Beyond dysfunctions in technological and organizational systems, the intensification of institutional vulnerabilities, added to the vulnerabilities produced by social inequalities, fuel the occurrence of major accidents and aggravate their effects, which, by being amplified beyond their spatial and temporal boundaries, especially affect countries in the Global South. We conclude that the recent events represent systemic expressions beyond organizational dysfunctions, revealing deeper layers of organizational and sociotechnical systems such as those forging the global economy and its profound asymmetries.