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Health Risks in Disaster Responders: A Conceptual Framework

Published online by Cambridge University Press:  03 May 2019

Jyoti Khatri ,
Gerard Fitzgerald  and
Meen B. Poudyal Chhetri
Jyoti Khatri*
Affiliation:
School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
Gerard Fitzgerald
Affiliation:
School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
Meen B. Poudyal Chhetri
Affiliation:
Nepal Center for Disaster Management (NCDM), Kathmandu, Nepal
*
Correspondence: Jyoti Khatri KC, MPH, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia E-mail: [email protected]
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Abstract

Introduction:

Disasters cause severe disruption to socio-economic, infrastructural, and environmental aspects of community and nation. While the impact of disasters is strongly felt by those directly affected, they also have significant impacts on the mental and physical health of relief/recovery workers and volunteers. Variations in the nature and scale of disasters necessitate different approaches to risk management and hazard reduction during the response and recovery phases.

Method:

Published articles (2010-2017) on the quantitative and quantitative relationship between disasters and the physical and mental health of relief/recovery workers and volunteers were systematically collected and reviewed. A total of 162 relevant studies were identified. Physical injuries and mental health impacts were categorized into immediate, short-term, and chronic conditions. A systematic review of the literature was undertaken to explore the health risks and injuries encountered by disaster relief workers and volunteers, and to identify the factors contributing to these and relating mitigation strategies.

Results:

There were relatively few studies into this issue. However, the majority of the scrutinized articles highlighted the dependence of nature and scope of injuries with the disaster type and the types of responders, while the living and working environment and socio-economic standing also had significant influence on health outcomes.

Conclusion:

A conceptual framework derived from the literature review clearly illustrated several critical elements that directly or indirectly cause damage to physical and mental health of disaster responders. Pre-disaster and post-disaster risk mitigation approaches may be employed to reduce the vulnerability of both volunteers and workers while understanding the identified stressors and their relationships.

Khatri KC J, Fitzgerald G, Poudyal Chhetri MB. Health risks in disaster responders: a conceptual framework. Prehosp Disaster Med. 2019;34(2):209–216

Keywords

disasterdisaster respondershealth outcomesvolunteers
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 34 , Issue 2 , April 2019 , pp. 209 - 216
Copyright
© World Association for Disaster and Emergency Medicine 2019 

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Footnotes

Conflicts of interest: none

References

Costa, M, Oberholzer-Riss, M, Hatz, C, Steffen, R, Puhan, M, Schlagenhauf, P. Pre-travel health advice guidelines for humanitarian workers: a systematic review. Travel Med Infect Dis. 2015;13(6):449–465.CrossRefGoogle ScholarPubMed
Sim, MR. Disaster response workers: are we doing enough to protect them? Occup Environ Med. 2011;68(5):309–310.CrossRefGoogle Scholar
Eiser, JR, Bostorm, A, Burton, I, et al. Risk interpretation and action: a conceptual framework for responses to natural hazards. Int J Disaster Risk Reduction. 2012;1:5–16.CrossRefGoogle Scholar
Eriksson, C, Cardozo, B, Foy, D, et al. Pre-deployment mental health and trauma exposure of expatriate humanitarian aid workers: risk and resilience factors. Traumatology. 2012;19(1):41–98.CrossRefGoogle Scholar
UNISDR. 2015 Disasters in Number. UN Office for Disaster Risk Reduction. https://www.unisdr.org/we/inform/publications/47804. Accessed April 21, 2017.Google Scholar
Garbern, S, Ebbeling, L, Bartels, S. A systematic review of health outcomes among disaster and humanitarian responders. Prehosp Disaster Med. 2016;31(6):635–642.CrossRefGoogle ScholarPubMed
Newman, DM. Protecting disaster responders’ health: lessons (not yet?) learned. New Solut. 2012;21(4):573–590.CrossRefGoogle Scholar
Ocak, T, Duran, A, Ozdes, T, et al. Problem encountered by volunteers assisting the relief efforts in Van, Turkey and the Surrounding Earthquake area. JAEM. 2013;12(2):66–70.CrossRefGoogle Scholar
Zhang, W, Liu, C, Sun, T, et al. Physical and mental health status of soldiers responding to the 2008 Wenchuan earthquake. Aust NZ J Public Health. 2011;35(3):207–211.CrossRefGoogle ScholarPubMed
Subra, W. Evaluation of the results of whole blood volatile solvents testing. Louisiana Environmental Action Network. 2011. http://leanweb.org/news/latest/bp-spill-blood-test-results-louisianaresidents. Accessed May 21, 2017.Google Scholar
Pearson, J, Weinstock, D. Minimizing safety and health impacts at disaster sites: the need for comprehensive worker safety and health training based on an analysis of national disasters in the US. JHSEM. 2011;8(1):1547–7355.Google Scholar
Lee, K, Lee, S, Park, T, et al. Stressors of Korean Disaster Relief Team members during the Nepal Earthquake dispatch: a consensual qualitative research analysis. J Korean Med Sci. 2017;32(3):507–513.CrossRefGoogle ScholarPubMed
Holcer, NJ, Jeličić, P, Bujević, MG, et al. Health protection and risks for rescuers in cases of floods. Arh Hig Rada Toksikol. 2015;66(1):9–13.CrossRefGoogle Scholar
Johanning, E, Auger, P, Morey, PR, et al. Review of health hazards and prevention measures for response and recovery workers and volunteers after and volunteers after natural disasters, flooding and water damage: mold and dampness. Environ Health Prev Med. 2014;19(2):93–99.CrossRefGoogle ScholarPubMed
Rusiecki, J, Thomas, D, Chen, L, et al. Disaster-related exposures and health effects among US Coast Guard responders to Hurricanes Katrina and Rita. JOEM. 2014;56(8):820–833.Google ScholarPubMed
Sone, T, Nakaya, N, Sugawara, Y, et al. Longitudinal association between time-varying social isolation and psychological distress after the Great East Japan Earthquake. Social Sci Med. 2016;152:96–101.CrossRefGoogle ScholarPubMed
Thormar, S, Sijbrandij, M, Gersons, B, et al. PTSD symptom trajectories in disaster volunteers: self-efficacy, social acknowledgement, and tasks carried out: PTSD symptom trajectories in volunteers. J Trauma Stress. 2016;29(1):17–25.CrossRefGoogle ScholarPubMed
Xu, J, Dai, J, Rao, R, et al. The association between exposure and psychological health in earthquake survivors from the Long Shan Fault area: the mediating effect of risk perception. BMC Public Health. 2016;16:417.CrossRefGoogle Scholar
Kang, P, Lv, Y, Hao, L, et al. Psychological consequences and quality of life among medical rescuers who responded to the 2010 Yushu earthquake: a neglected problem. Psychiatry Res. 2015;230(2):517–523.CrossRefGoogle ScholarPubMed
Nagamine, M, Harada, N, Shigemura, J, et al. The effects of living environment on disaster workers: a one–year longitudinal study. BMC Psychiatry. 2016;16(1):358.CrossRefGoogle ScholarPubMed
Connorton, E, Perry, M, Hemenway, D. Humanitarian relief workers and trauma-related mental illness. Epidemiol Rev. 2012;34:145–155.CrossRefGoogle ScholarPubMed
Dobashi, K, Nagamine, M, Shigemura, J, et al. Psychological effects of disaster relief activities on Japan Ground Self-Defense Force personnel following the 2011 Great East Japan Earthquake. Psychiatry. 2014;77(2):190–198.CrossRefGoogle ScholarPubMed
Schenk, EJ, Yuan, J, Martel, LD, et al. Risk factors for long-term post-traumatic stress disorder among medical rescue workers appointed to the 2008 Wenchuan earthquake response in China. Disasters. 2017;41(4):788–802.CrossRefGoogle Scholar
Suzuki, Y, Fukasawa, M, Obara, A, et al. Burnout among public servants after the Great East Japan Earthquake: decomposing the construct aftermath of disaster. J Occup Health. 2017;59(2):156–164.CrossRefGoogle ScholarPubMed
Guan, S, Xiaerfuding, X, Li, N, et al. Effect of job strain on job burnout, mental fatigue and chronic diseases among civil servants in the Xinjiang Uygur autonomous region of China. Int J Environ Res Public Health. 2017;14(8):872.CrossRefGoogle ScholarPubMed
Azuma, T, Seki, N, Tanabe, N, et al. Prolonged effects of participation in disaster relief operations after the Mid-Niigata earthquake on increased cardiovascular risk among local governmental staff. J Hypertension. 2010;28(4):695–702.CrossRefGoogle ScholarPubMed
Fukasawa, M, Suzuki, Y, Obara, A, et al. Relationships between mental health distress and work-related factors among prefectural public servants two months after the Great East Japan Earthquake. Int J Behavioral Med. 2015;22(1):1–10.CrossRefGoogle ScholarPubMed
RajBhandari, AK, Dhital, R, Pradhan, PM, et al. After-shocks of a mega earthquake on occupational health in Nepal. Ann Glob Health. 2015;81(4):482–486.CrossRefGoogle Scholar
Durocher, E, Chung, R, Rochon, C, et al. Ethical questions identified in a study of local and expatriate responders’ perspectives of vulnerability in the 2010 Haiti earthquake. J Med Ethics. 2017;43(9):613–617.CrossRefGoogle Scholar
Remington, CL, Ganapati, NE. Recovery worker skills in post-earthquake Haiti: the disconnect between employer and employee perspectives. Nat Hazards. 2017;87(3):1673.CrossRefGoogle Scholar
Jia, H, Pan, D. Tornado disaster impacts and management: learning from 2016 tornado catastrophe in Jiangsu Province, China. Nat Hazards. 2017;89(1):457–471.CrossRefGoogle Scholar
Shepherd, D, McBride, D, Lovelock, K. First responder well-being following the 2011 Canterbury earthquake. Disaster Prev Manag. 2017;26(3):286–297.CrossRefGoogle Scholar
Haraldsdottir, H, Gudmundsdottir, D, Romano, E, et al. Volunteers and professional rescue workers: traumatization and adaptation after an avalanche disaster. J Emerg Manag. 2014;12(6):457–66.CrossRefGoogle ScholarPubMed
Godderis, R, Rossiter, K. If you have a soul, you will volunteer at once: gendered expectations of duty to care during pandemics. Sociol Health Illn. 2013;35(2):304–308.CrossRefGoogle ScholarPubMed
Lyu, HM, Wang, GF, Cheng, WC, et al. Tornado hazards on June 23 in Jiangsu Province, China: preliminary investigation and analysis. Nat Hazards. 2017;85(1):597–604.CrossRefGoogle Scholar
Klappa, S, Audette, J, Do, S. The roles, barriers and experiences of rehabilitation therapists in disaster relief: post-earthquake Haiti 2010. Disabil Rehabil. 2014;36(4):330–338.CrossRefGoogle Scholar
Matsuoka, Y, Nishi, D, Nakaya, N, et al. Concern over radiation exposure and psychological distress among rescue workers following the Great East Japan Earthquake. BMC Public Health. 2012;12(249):1471–2458.CrossRefGoogle ScholarPubMed
Soliman, HH, Gillespie, DF. A test of stress theory: relief workers in refugee camps. Disasters. 2011;35(4):789–800.CrossRefGoogle ScholarPubMed
Sato, M, Atogami, F, Nakamura, Y, et al. Committed to working for the community: experiences of a public health nurse in a remote area during the Great East Japan Earthquake. HealthC Women Int. 2015;36(11):1224–1238.CrossRefGoogle Scholar
Springgate, B, Wennerstorm, A, Carriere, C. Capacity building for post-disaster mental health since Katrina: the role of community health workers. Rev Black Polit Econ. 2011;38(4):363–368.CrossRefGoogle Scholar
Hauswald, M. International emergency medicine and global health: training and career paths for emergency medicine residents. Ann Emerg Med. 2011;58(6):576–577.CrossRefGoogle ScholarPubMed
Jobe, K. Disaster relief in post-earthquake Haiti: unintended consequences of humanitarian volunteerism. Travel Med Infect Dis. 2011;9(1):1–5.CrossRefGoogle ScholarPubMed
Quevillon, R, Gray, B, Erickson, S, et al. Helping the helpers: assisting staff and volunteer workers before, during, and after disaster relief operations. J Clin Psychol. 2016;72(12):1348–1363.CrossRefGoogle ScholarPubMed
FitzGerald, G, Tarrant, M, Aitken, P, et al. Disaster Heath Management: A Primer for Students and Practitioners. New York, USA: Taylor & Francis Group, Abingdon, Oxon; 2017: 4–33.Google Scholar
Jiang, L, He, HG, Zhou, WG, et al. Knowledge, attitudes and competence in nursing practice of typhoon disaster relief work among Chinese nurses: a questionnaire survey. Int J Nurs Pract. 2015;21(1):60–69.CrossRefGoogle ScholarPubMed
Ager, A, Pasha, E, Yu, G, Duke, T, Eriksson, C, Cardozo, B. Stress, mental health, and burnout in national humanitarian aid workers in Gulu, Northern Uganda. J Trauma Stress. 2012;25(6):713–720.CrossRefGoogle ScholarPubMed
Agarawal, V, Buzzanell, P. Communicative reconstruction of resilience labor: identity/identification in disaster-relief workers. J App Comm Res. 2015;43(4):408–428.CrossRefGoogle Scholar
Bayer, RG. Altitude illness: a risk factor for humanitarian aid workers that are deployed to high-altitude disaster scenarios. Disaster Prev Manag. 2017;26(1):55–64.CrossRefGoogle Scholar
IFRC 2017. http://www.ifrc.org/en/what-we-do/disaster-management/about-disasters/what-is-a-disaster/. Accessed May 21, 2017.Google Scholar
Yan, YE, Turale, S, Stone, T, et al. Disaster nursing skills, knowledge and attitudes required in earthquake relief: implications for nursing education. Int Nurs Rev. 2015;62(3):351–359.CrossRefGoogle ScholarPubMed
Lu, J, Yang, N, Ye, J, et al. The influence paths of emotion on the occupational safety of rescuers involved in environmental emergencies - systematic review article. Iran J Public Health. 2014;43(11):1478–1485.Google ScholarPubMed
Luong, T, Laopaiboon, M, Koh, D, et al. Behavioral interventions to promote workers’ use of respiratory protective equipment. Cochrane Database Syst Rev. 2016;12:CD010157.Google Scholar
Rando, R, Lefante, J, Freyder, L, et al. Respiratory health effects associated with restoration work in post-Hurricane Katrina New Orleans. J Environ Public Health. 2012:1–8.CrossRefGoogle ScholarPubMed
Gushulak, BD. Care for care givers-the importance of supporting the health of humanitarian workers. Travel Med Infect Dis. 2015;13(6):447–448.CrossRefGoogle ScholarPubMed
Brooks, SK, Dunn, R, Sage, CA, et al. Risk and resilience factors affecting the psychological well-being of individuals deployed in humanitarian relief roles after a disaster. J Ment Health. 2015;24(6):385–413.CrossRefGoogle ScholarPubMed
Velden, PG, Loon, PV, Benight, CC, et al. Mental health problems among search and rescue workers deployed in the Haiti earthquake 2010: a pre-post comparison. Psychiatry Res. 2012;198(1):100–105.CrossRefGoogle ScholarPubMed
Cardozo, B, Crawford, C, Eriksson, C, et al. Psychological distress, depression, anxiety, and burnout among international humanitarian aid workers: a longitudinal study. PLoS ONE. 2012;7(9):e44948.CrossRefGoogle Scholar
Noguchi, N, Inoue, S, Shimanoe, C, et al. Factors associated with nursing activities in humanitarian aid and disaster relief. PLoS ONE. 2016;11(3):e0151170.CrossRefGoogle ScholarPubMed
Cianelli, R, Wilkinson, C, Mitchell, E, et al. Mental health training experiences among Haitian healthcare workers post-earthquake 2010. Int Nurs Rev. 2013;60(1):528–535.CrossRefGoogle ScholarPubMed
Lucchini, RG, Hashim, D, Acquilla, S, et al. A comparative assessment of major international disasters: the need for exposure, systematic emergency preparedness and life-time health care. BMC Public Health. 2017;17(1):46.CrossRefGoogle Scholar
Stein, C, Wallenstein, S, Shapiro, M, et al. Mortality among World Trade Center rescue and recovery workers, 2002–2011. Am J Int Med. 2016;59(2):87–95.CrossRefGoogle ScholarPubMed
North, CS, Pfefferbaum, B. Mental health responses to community disasters. JAMA. 2013;310(5):507–518.CrossRefGoogle ScholarPubMed
Wang, X, Chan, C, Shi, Z, et al. Mental health risks in the local workforce engaged in disaster relief and reconstruction. Qual Health Res. 2013;23(2):207–217.CrossRefGoogle ScholarPubMed
Kleim, B, Westphal, M. Mental health in first responders: a review and recommendation for prevention and intervention strategies. Traumatology. 2011;17(4):17–24.CrossRefGoogle Scholar
Hugelius, K, Adolfsson, A, Örtenwall, P, et al. Being both helpers and victims: health professionals’ experiences of working during a natural disaster. Prehosp Disaster Med. 2017;32(2):117–123.CrossRefGoogle ScholarPubMed
Sartori, R, Fave, A. First-aid activities and well-being: the experience of professional and volunteer rescuers. J Soc Serv Res. 2014;40(2):242–254.CrossRefGoogle Scholar
Whittaker, J, McLennan, B, Handmer, J. A review of informal volunteerism in emergencies and disasters: definition, opportunities and challenges. Int J Dis Risk Red. 2015;13:358–368.Google Scholar
Paul, BK, Acharya, B, Ghimire, K. Effectiveness of earthquakes relief efforts in Nepal: opinions of the survivors. Nat Hazards. 2017;85(2):1169–1188.CrossRefGoogle Scholar