La mortalidad por desastres en España: Un análisis del periodo 1950-2012 / Disaster mortality in Spain: An analysis of the period 1950-2012

Objetivo principal: Estimar el impacto en mortalidad de los desastres en España y sus tendencias epidemiológicas entre 1950 y 2012. Metodología: Estudio observacional retrospectivo con análisis de tendencias mediante análisis de regresión y suavizado exponencial. Resultados principales: Se estudiaron 284 desastres ocurridos en España entre 1950 y 2012. 57% fueron desastres tecnológicos, 39% desastres naturales (64% biológicos) y 4% deliberados (atentados terroristas). Aumentaron significativamente (p<0,05) la frecuencia total de desastres, los naturales, los tecnológicos y los subgrupos de desastres biológicos, climatológicos y de transporte. Disminuyó significativamente (p<0,05) la mortalidad total por desastres y la más alta por episodio fue por tecnológicos. Conclusión principal: España tiene un patrón mixto de desastres, con predominio de los tecnológicos. Aumentaron la frecuencia de episodios, específicamente biológicos, climatológicos y de transporte. La mortalidad está condicionada por los eventos de alto impacto

Objective: To estimate the impact on mortality due to disasters in Spain since1950 to 2012 and its epidemiological trends. Methods: Retrospective observational study with trend analysis by regression analysis and exponential smoothing. Results: We studied 284 events during the period. 57% were technological disasters (81% transport accidents), 39% were natural disasters (64% biological disasters) and 4% deliberated events. We found a significant (p<0,05) increasing trend in the total number of disasters, as well in natural and technological disaster groups, and also in the biological, climatological and transport accident subgroups. Technological disasters show highest average mortality per episode. Decreasing mortality trend was found significant (p<0,05). Conclusions: Spain showed a mixed pattern of disaster type although technological ones are the most frequent. There is an upward trend of disaster frequency, especially in biological, climatological and transport accident subgroups. Mortality is determined by high-impact events

[Terrorism, public health and health services]. / Terrorismo, salud pública y sistemas sanitarios.

Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

Terrorismo, Salud Pública y Sistemas Sanitarios / Terrorism, Public Health and Health Services

El terrorismo es hoy un problema de distribución global e interés creciente para la salud pública internacional. La violencia que comporta afecta a la salud pública y los servicios sanitarios de manera importante y en diferentes ámbitos, entre ellos, aumenta la mortalidad, morbilidad y discapacidad, genera un contexto de miedo y ansiedad que hace muy frecuentes los trastornos psicopatológicos, altera gravemente el funcionamiento de los servicios sanitarios y produce importantes daños sociales, políticos y económicos. Estos efectos son, además, especialmente intensos cuando el fenómeno se produce de manera crónica en una comunidad. El objetivo de este trabajo es examinar la relación entre terrorismo y salud pública, particularmente en cuanto a sus efectos sobre esta y sobre los servicios sanitarios, así como examinar los posibles marcos de abordaje del terrorismo como problema de salud pública, con especial referencia a la situación en España.Frente a este problema, tanto los sistemas de salud pública como los servicios sanitarios, deberían adaptar sus enfoques y funcionamiento especialmente en seis ámbitos prioritarios relacionados con: (1) La coordinación entre las diferentes agencias de respuesta sanitaria y no sanitaria; (2) El refuerzo de los sistemas de vigilancia epidemiológica; (3) La mejora de las capacidades de los laboratorios de salud pública y de los sistemas de respuesta sanitaria a tipos específicos de terrorismo como son el terrorismo químico o biológico; (3) Los servicios de salud mental; (4) La planificación y coordinación de la respuesta de emergencia de los servicios sanitarios; (5) Las relaciones con la población y los medios de comunicación y, finalmente; (6) Una mayor transparencia en la difusión de la información y un mayor grado de análisis de las acciones sanitarias llevadas a cabo en el ámbito de la respuesta de emergencia (AU)

Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain.To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response (AU)

Mortalidad y morbilidad por desastres en España / Mortality and morbidity from disasters in Spain

Objetivo: Este estudio analiza los episodios de desastres ocurridos en España entre 1950 y 2005, para conocer su distribución y estimar su impacto en la mortalidad y la morbilidad. Métodos: Estudio observacional retrospectivo en el que se ha utilizado la definición de Naciones Unidas y se ha considerado desastre al episodio, natural o tecnológico, con más de 15 muertos y/o más de 50 heridos, excluidos los desastres medioambientales y los fenómenos epidémicos. Resultados: La frecuencia de desastres en España ha aumentado durante el período estudiado, especialmente en las últimas 4 décadas, y son el doble en el segundo semestre del año, con una gran variabilidad geográfica. España tiene un perfil de desastre mixto, con predominio de los desastres tecnológicos, que son 4,5 veces más frecuentes que los naturales. El desastre natural más frecuente en nuestro país es la inundación y el tecnológico, el accidente de tránsito

Objective: To analyze disaster episodes in Spain between 1950 and 2005 in order to characterize their pattern and evaluate their impact on morbidity and mortality. Methods: We performed an observational retrospective study using the United Nations' definition of disaster. A disaster was considered as each episode, natural or technological, causing more than 15 deaths and/or more than 50 wounded persons. Epidemic and environmental disasters were excluded. Results: The frequency of disasters has increased in Spain, especially during the four last decades. The frequency of disasters doubles in the second semester of the year and shows wide geographical variation. Spain has a mixed disaster pattern, with a predominance of technological disasters, which are 4.5 times more frequent than natural disasters. The most frequent type of natural disaster in Spain is flooding and most frequent technological disasters are traffic accidents

[Mortality and morbidity from disasters in Spain]. / Mortalidad y morbilidad por desastres en España.

OBJECTIVE: To analyze disaster episodes in Spain between 1950 and 2005 in order to characterize their pattern and evaluate their impact on morbidity and mortality. METHODS: We performed an observational retrospective study using the United Nations' definition of disaster. A disaster was considered as each episode, natural or technological, causing more than 15 deaths and/or more than 50 wounded persons. Epidemic and environmental disasters were excluded. RESULTS: The frequency of disasters has increased in Spain, especially during the four last decades. The frequency of disasters doubles in the second semester of the year and shows wide geographical variation. Spain has a mixed disaster pattern, with a predominance of technological disasters, which are 4.5 times more frequent than natural disasters. The most frequent type of natural disaster in Spain is flooding and most frequent technological disasters are traffic accidents.