A survey was conducted to describe the characteristics of patients treated for hypothermia after the Great East Japan Earthquake.

Written questionnaires were distributed to 72 emergency medical hospitals in Miyagi Prefecture. Data were requested regarding inpatients with a temperature less than 36ºC admitted within 72 hours after the earthquake. The availability of functional heating systems and the time required to restore heating after the earthquake were also documented.

A total of 91 inpatients from 13 hospitals were identified. Tsunami victims comprised 73% of the patients with hypothermia. Within 24 hours of the earthquake, 66 patients were admitted. Most patients with a temperature of 32ºC or higher were treated with passive external rewarming with blankets. Discharge without sequelae was reported for 83.3% of patients admitted within 24 hours of the earthquake and 44.0% of those admitted from 24 to 72 hours after the earthquake. Heating systems were restored within 3 days of the earthquake at 43% of the hospitals.

Hypothermia in patients hospitalized within 72 hours of the earthquake was primarily due to cold-water exposure during the tsunami. Many patients were successfully treated in spite of the post-earthquake disruption of regional social infrastructure.(Disaster Med Public Health Preparedness. 2014;0:1-11)

This study assessed the health-related quality of life (HRQOL) and the adaptation to harsh conditions (APHC) of residents living in post-earthquake zones in Sichuan Province, China, as well as the effect of HRQOL on APHC.

A sample survey was conducted in 5 counties in Sichuan in May and June 2013 (N=2000). The 12-item Short Form Health Survey (SF-12) was used to measure HRQOL. The APHC scale was self-developed and was based on real-life conditions in China. Confirmatory factor analysis and structural equation model were used to analyze how HRQOL affected APHC.

Cronbach α coefficients indicated that the internal reliability of both scales were good. Results showed that the physical component summary significantly affected APHC, while the effect of the mental component summary was insignificant. APHC had the greatest effect on the adaptation to poor infrastructures (r=0.721) and the least effect on the adaptation to poor social security systems (r=0.608).

The HRQOL of residents living in post-earthquake zones positively affected APHC, particularly physical health. These findings suggested the need for governmental improvement of infrastructures in post-disaster areas. (Disaster Med Public Health Preparedness. 2014;0:1-7)

To identify factors that affected well-being among British embassy staff based in Japan after the 2011 earthquake, tsunami, and nuclear meltdown.

In-depth qualitative interviews were conducted with 36 members of staff 8 to 9 months after the earthquake.

Participants described their crisis work as stressful, exciting, and something of which they were proud. Aside from disaster-specific stressors, factors identified as stressful included unclear roles, handing over work to new personnel, being assigned to office-based work, feeling that work was not immediately beneficial to the public, not taking good-quality breaks, and difficulties with relatives. The radiation risk provoked mixed feelings, with most participants being reassured by contact with senior scientists.

Interventions to safeguard the well-being of personnel during crisis work must consider the impact of a broad range of stressors.(Disaster Med Public Health Preparedness. 2014;0:1-7)

Occupational injury and illness rates for volunteer responders have not been well documented. We analyzed data specific to volunteers from the American Red Cross (ARC).

Data collected by the ARC between 2008 and 2012 were analyzed to identify disaster factors associated with responder injuries and illnesses. We focused on disaster-relief operation (DRO) level (indicating operational costs, ranging from 3 [lower] to 5+ [higher]); disaster type; region; and year. We calculated injury and illness rates and estimated rate ratios (RR) with 95% CI, using negative binomial regression. Also, we analyzed a total of 113 disasters.

Hurricanes had the highest rates of injuries (14/1000 responders) and illnesses (18/1000 responders). In the adjusted model for injuries, RRs were higher for DRO levels 4 (3.6 [CI, 2.0–6.7]) and 5+ (4.9 [CI, 2.2–11.0]) than for level 3. In the adjusted model for illnesses, RRs also were higher for DRO levels 4 (4.4 [CI, 2.6–7.3]) and 5+ (8.6 [CI, 4.1–17.7]) than for level 3.

Higher DRO levels were a significant predictor of greater rates of occupational injuries and illnesses. Careful selection of responders, including volunteers, has been warranted for deployments to such disasters. (Disaster Med Public Health Preparedness. 2014;0:1-7)

In Cambodia, a highly landmine-contaminated country with endemic malaria, symptomatic falciparum malaria has been observed in patients presenting with traumatic landmine injuries. Because a link between recrudescence of symptomatic Plasmodium falciparum malaria and severe trauma is well established, we explored whether a link could be demonstrated between the geolocation of landmine amputations and malaria cases.

Landmine amputation data in Cambodia (2005–2008) were compared with predicted measures of malaria endemicity. Data of injuries that had resulted in amputation were plotted over a surface of P falciparum parasite rates.

No statistically significant correlation was found, possibly because the P falciparum endemicity surface was drawn from a model-based geostatistical prediction of infection prevalence and did not distinguish cases of recrudescence. The implication of this finding is that where symptomatic falciparum malaria has been observed in patients with landmine injuries, the cases were likely to be reactivated falciparum infections and not new cases.

Further research is needed to understand the relationship between P falciparum and trauma. To distinguish P falciparum recrudescence from new cases, a prospective registry is needed. Also, practitioners need to be aware of the possibility of post-injury malaria recrudescence in complex emergencies. (Disaster Med Public Health Preparedness. 2014;0:1-5)

On April 27, 2011, a train derailed and crashed in Taiwan, causing a mass casualty incident (MCI) that was similar to a previous event and with similar consequences. In both disasters, the emergency operating centers (EOCs) could not effectively integrate associated agencies to deal with the incident. The coordination and utilization of resources were inefficient, which caused difficulty in command structure operation and casualty evacuation.

This study was designed to create a survey questionnaire with problem items using disaster management phases mandated by Taiwan’s Emergency Medical Care Law (EMCL), use statistical methods (t test) to analyze the results and issues the EOCs encountered during the operation, and propose solutions for those problems.

Findings showed that EOCs lacked authority to intervene or coordinate with associated agencies. Also, placing emphasis on the recovery phase should improve future prevention and response mechanisms.

To improve the response to MCIs, the EMCL needs to be amended to give EOCs the lead during disasters; use feedback from the recovery phase to improve future disaster management and operation coordination; and establish an information-sharing platform across agencies to address all aspects of relief work.(Disaster Med Public Health Preparedness. 2014;0:1-6)

This report aimed to examine the literature regarding evidence about community-based interventions that use the concept of resilience to increase positive health outcomes after disaster.

A search was conducted of databases; gray literature, public health journals, and available key journals focused on disaster, emergency, and trauma from inception to December 2013. Excluded were non-English publications, only about children or adolescents, or a commentary or theoretical discussion on resilience.

From a total of 1880 records, excluding duplicates, 8 studies were found. Exclusions included participants younger than age 18 years (n=74), non-English (n=40), nonempirical (n=265), not referring to disaster (n=188), not a public health intervention (n=319), and not related to an intervention targeting resilience (n=890).

This systematic review highlighted a gap in the evidence relating to interventions targeting the resilience of adults who have experienced a disaster. The results were mixed in relation to information provision but promising for strategies that promote social interactions or develop community competence. Future studies could explore the ability of interventions to build the intrinsic capacity of a system, community, or society at risk of a disaster to adapt and survive. (Disaster Med Public Health Preparedness. 2014;0:1-9)