Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-23T21:58:32.177Z Has data issue: false hasContentIssue false
  • English
  • Français

A Systematic Review of Health Outcomes Among Disaster and Humanitarian Responders

Published online by Cambridge University Press:  19 September 2016

Stephanie C. Garbern ,
Laura G. Ebbeling  and
Susan A. Bartels
Stephanie C. Garbern
Affiliation:
Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts USA
Laura G. Ebbeling
Affiliation:
Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts USA
Susan A. Bartels*
Affiliation:
Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts USA Harvard Medical School, Boston, Massachusetts, USA Harvard Humanitarian Initiative, Cambridge, Massachusetts USA Queen’s University, Departments of Emergency Medicine, Kingston, Ontario, Canada
*
Correspondence: Susan Bartels, MD, MPH Department of Emergency Medicine Queen’s University 76 Stuart Street, Empire 3 Kingston General Hospital Kingston, Ontario, Canada K7L 2V7 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Disaster and humanitarian responders are at-risk of experiencing a wide range of physical and psychological health conditions, from minor injuries to chronic mental health problems and fatalities. This article reviews the current literature on the major health outcomes of responders to various disasters and conflicts in order to better inform individuals of the risks and to inform deploying agencies of the health care needs of responders.

Methods

In March 2014, an EMBASE search was conducted using pre-defined search criteria. Two reviewers screened the resultant 2,849 abstracts and the 66 full-length manuscripts which are included in the review.

Results

The majority of research on health outcomes of responders focused on mental health (57 of 66 articles). Posttraumatic stress disorder (PTSD) and depression were the most studied diagnoses with prevalence of PTSD ranging from 0%-34% and depression from 21%-53%. Physical health outcomes were much less well-studied and included a wide range of environmental, infectious, and traumatic conditions such as heat stroke, insect bites, dermatologic, gastrointestinal, and respiratory diseases, as well as burns, fractures, falls, and other traumatic injuries.

Conclusions

The prevalence of mental health disorders in responders may vary more and be higher than previously suggested. Overall health outcomes of responders are likely poorly monitored and under-reported. Improved surveillance systems and risk mitigation strategies should be employed in all disaster and conflict responses to better protect individual responders.

GarbernSC , EbbelingLG , BartelsSA . A Systematic Review of Health Outcomes Among Disaster and Humanitarian Responders. Prehosp Disaster Med. 2016;31(6):635–642.

Keywords

disasterhealthhumanitarianoutcomesresponders
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 6 , December 2016 , pp. 635 - 642
Copyright
© World Association for Disaster and Emergency Medicine 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Inter-Agency Standing Committee. Response to The Humanitarian Crisis in Haiti Following the 12 January 2010 Earthquake. http://www.unicef.org/evaldatabase/files/IASC-Haiti_6Mos_Review_USA-2010-005-1.pdf. Published 2010. Accessed January 18, 2016.Google Scholar
2. American Red Cross. Nepal - Disaster Management & Emergency Relief - American Red Cross. 1. http://www.redcross.org/what-we-do/international-services/where-we-help/asia/nepal. Published 2015. Accessed January 16, 2016.Google Scholar
3. Swygard, H, Stafford, RE. Effects on health of volunteers deployed during a disaster. Am Surg. 2009;75(9):743-747.Google Scholar
4. Thoresen, S, Tønnessen, A, Lindgaard, CV. Stressful but rewarding: Norwegian personnel mobilized for the 2004 tsunami disaster. Disasters. 2009;33(3):353-368.Google Scholar
5. van der Velden, PG, van Loon, P, Benight, CC, Eckhardt, T. 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
6. Sundin, EC, Horowitz, MJ. Horowitz’s Impact of Event Scale evaluation of 20 years of use. Psychosom Med. 2003;65(5):870-876.Google Scholar
7. American Psychiatric Association [APA]. Diagnostic and Statistical Manual of Mental Disorders. 2013.CrossRefGoogle Scholar
8. Frank, DI, Adkinson, LF. A developmental perspective on risk for compassion fatigue in middle-aged nurses caring for hurricane victims in Florida. Holist Nurs Pract. 2007;21(2):52-55.CrossRefGoogle ScholarPubMed
9. Berger, R, Gelkopf, M. An intervention for reducing secondary traumatization and improving professional self-efficacy in well-baby clinic nurses following war and terror: a random control group trial. Int J Nurs Stud. 2011;48(5):601-610.Google Scholar
10. Van der Auwera, M, Debacker, M, Hubloue, I. Monitoring the mental well-being of caregivers during the Haiti-earthquake. PLoS Curr. 2012;4:e4fc33066f1947.CrossRefGoogle ScholarPubMed
11. Guo, YJ, Chen, CH, Lu, ML, Tan, HK, Lee, HW, Wang, TN. Posttraumatic stress disorder among professional and non-professional rescuers involved in an earthquake in Taiwan. Psychiatry Res. 2004;127(1-2):35-41.CrossRefGoogle Scholar
12. Hagh-Shenas, H, Goodarzi, MA, Dehbozorgi, G, Farashbandi, H. Psychological consequences of the Bam Earthquake on professional and nonprofessional helpers. J Trauma Stress. 2005;18(5):477-483.CrossRefGoogle Scholar
13. Armagan, E, Engindeniz, Z, Devay, AO, Erdur, B, Ozcakir, A. Frequency of posttraumatic stress disorder among relief force workers after the tsunami in Asia: do rescuers become victims? Prehosp Disaster Med. 2006;21(3):168-172.Google Scholar
14. Review, A, Thormar, SB, Paul, B, et al. The mental health impact of volunteering in a disaster setting: a review. J Nerv Ment Dis. 2010;198(8):529-538.Google Scholar
15. Liao, S-CC, Lee, M-BB, Lee, Y-JJ, et al. Association of psychological distress with psychological factors in rescue workers within two months after a major earthquake. J Formos Med Assoc. 2002;101(3):169-176.Google ScholarPubMed
16. Huang, J, Liu, Q, Li, J, et al. Posttraumatic stress disorder status in a rescue group after the Wenchuan Earthquake relief. Neural Regen Res. 2013;8(20):1898-1906.Google Scholar
17. Chang, C-MM, Lee, L-CC, Connor, KM, Davidson, JRT, Jeffries, K, Lai, T-JJ. Posttraumatic distress and coping strategies among rescue workers after an earthquake. J Nerv Ment Dis. 2003;191(6):391-398.Google Scholar
18. Weiss, DS, Marmar, CR, Metzler, TJ, Ronfeldt, HM. Predicting symptomatic distress in emergency services personnel. J Consult Clin Psychol. 1995;63(3):361-368.Google Scholar
19. Marmar, CR, Weiss, DS, Metzler, TJ, Delucchi, KL, Best, SR, Wentworth, KA. Longitudinal course and predictors of continuing distress following critical incident exposure in emergency services personnel. J Nerv Ment Dis. 1999;187(1):15-22.Google Scholar
20. Kaspersen, M, Matthiesen, SB, Götestam, KG, Girolamo, D. Social network as a moderator in the relation between trauma exposure and trauma reaction: a survey among UN soldiers and relief workers. Scand J Psychol. 2003;44(5):415-423.Google Scholar
21. Marmar, CR, Weiss, DS, Metzler, TJ, Ronfeldt, HM, Foreman, C. Stress responses of emergency services personnel to the Loma Prieta Earthquake Interstate 880 freeway collapse and control traumatic incidents. J Trauma Stress. 1996;9(1):63-85.Google Scholar
22. Berk, JH. Trauma and resilience during war: a look at the children and humanitarian aid workers of Bosnia. Psychoanal Rev. 1998;85(4):640-658.Google Scholar
23. Riba, S, Reches, H. When terror is routine: how Israeli nurses cope with multi-casualty terror. Online J Issues Nurs. 2002;7(3):1.Google Scholar
24. Clukey, L. Transformative experiences for Hurricanes Katrina and Rita disaster volunteers. Disasters. 2010;34(3):644-656.Google Scholar
25. Wang, XL, Chan, CLW, Shi, ZB, Wang, B. Mental health risks in the local workforce engaged in disaster relief and reconstruction. Qual Health Res. 2013;23(2):207-217.Google Scholar
26. Fayard, GM. Fatal work injuries involving natural disasters, 1992-2006. Disaster Med Public Heal Prep. 2009;3(4):201-209.CrossRefGoogle ScholarPubMed
27. Morita, N, Miura, M, Yoshida, M, et al. Spatiotemporal characteristics of internal radiation exposure in evacuees and first responders after the radiological accident in Fukushima. Radiat Res. 2013;180(3):299-306.Google Scholar
28. Delinger, A, Kachur, P, Sternber, E, et al. Risk of heat-related injury to disaster relief workers in a slow-onset flood disaster. J Occup Env Med. 1996;38(7):689-692.CrossRefGoogle Scholar
29. Sullivent, EE, West, CA, Noe, RS, et al. Nonfatal injuries following Hurricane Katrina—New Orleans, Louisiana 2005. J Safety Res. 2006;37(2):213-217.Google Scholar
30. Bernard, BP, Driscoll, RJ, Kitt, M, West, CA, Tak, SW. Health hazard evaluation of police officers and firefighters after Hurricane Katrina--New Orleans, Louisiana, October 17-28 and November 30-December 5, 2005. MMWR Morb Mortal Wkly Rep. 2006;55(16):456-458.Google Scholar
31. Morantz, CA. CDC reports on illnesses in hurricane Katrina evacuees and relief workers. Am Fam Physician. 2005;72(10):2126-2134.Google Scholar
32. Jablecki, J, Norton, SA, Keller, R, et al. Infectious disease and dermatologic conditions in evacuees and rescue workers after hurricane Katrina - multiple states, August-September, 2005. Morb Mortal Wkly Rep. 2005;54(38):961-964.Google Scholar
33. Lopez, C, Bergeron, T, Ratard, R, et al. Injury and illness surveillance in hospitals and acute-care facilities after Hurricanes Katrina and Rita--New Orleans area, Louisiana, September 25-October 15, 2005. MMWR Morb Mortal Wkly Rep. 2006;55(2):35-38.Google Scholar
34. Tak, S, Driscoll, R, Bernard, B, West, C. Depressive symptoms among firefighters and related factors after the response to Hurricane Katrina. J Urban Heal. 2007;84(2):153-161.Google Scholar
35. Haraoka, T, Hayasaka, S, Murata, C, Ojima, T. Prevention of injuries and diseases in non-professional disaster volunteer activities in the Great East Japan Earthquake areas: a preliminary study. Public Health. 2013;127(1):72-75.Google Scholar
36. Sibbald, B. Physicians, health facilities targeted in war-torn Syria. Can Med Assoc. 2013;185(9):755-756.Google Scholar
37. O’Leary, DR, Rigau-Pérez, JG, Hayes, EB, et al. Assessment of dengue risk in relief workers in Puerto Rico after Hurricane Georges, 1998. Am J Trop Med Hyg. 2002;66(1):35-39.CrossRefGoogle ScholarPubMed
38. Zhen, Y, Huang, ZQ, Jin, J, Deng, XY, Zhang, LP, Wang, JG. Posttraumatic stress disorder of Red Cross nurses in the aftermath of the 2008 Wenchuan China Earthquake. Arch Psychiatr Nurs. 2012;26(1):63-70.CrossRefGoogle ScholarPubMed
39. Aid Worker Security Database. Aid Worker Security Report 2014: Unsafe passage - road attacks and their impact on humanitarian operations. https://aidworkersecurity.org/reports. Published 2014. Accessed January 18, 2016.Google Scholar
40. Aid Worker Security Database. Aid Worker Security Report 2013: The New Normal - coping with the kidnapping threat. https://aidworkersecurity.org/sites/default/files/ AidWorkerSecurityReport_2013_web.pdf. Published 2013. Accessed January 18, 2016.Google Scholar
41. Overseas Development Institute. World Humanitarian Day: counting the costs. http://www.odi.org/comment/7745-aid-worker-attack-world-humanitarian-day-whd. Published 2013. Accessed January 18, 2016.Google Scholar
42. Aid Worker Security Database. Aid Worker Security Report 2012: Host states and their impact on security for humanitarian operations. https://aidworkersecurity.org/sites/default/ files/AidWorkerSecurityReport2012.pdf. Published 2012. Accessed January 18, 2016.Google Scholar