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

BMC Public Health

Research Article

Alexander Stazharau¹  Andrey Bushmanov²  Nailya Mazitova²  Jacqueline M. Moline³  Dana Hashim⁴  William Holden⁴  Philip J. Landrigan⁴  Michael Crane⁴  Andrew C. Todd⁴  Roberto G. Lucchini⁵  Sushma Acquilla⁶  Angela Basanets⁷  Dori B. Reissman⁸  David Prezant⁹  James Melius^1,10  Joan Reibman^1,11  Denise J. Harrison^1,12  Iris G. Udasin^1,13  Benjamin J. Luft^1,14  Paolo Mocarelli^1,15  Pier Alberto Bertazzi^1,16  Koji Mori^1,17  Ken Takahashi^1,17 

[1] Belarus National Commission on Radiation Protection, Minsk, Belarus;Federal Medical Biophysical Center, Moscow, Russia;Hofstra North Shore-LIJ School of Medicine at Hofstra University, Hempstead, NY, USA;Icahn School of Medicine at Mount Sinai, New York, NY, USA;Icahn School of Medicine at Mount Sinai, New York, NY, USA;University of Brescia, Brescia, Italy;Imperial College London, London, UK;National Academy of Medical Sciences, Kiev, Ukraine;National Institute for Occupational Safety and Health, Atlanta, Georgia, USA;New York City Fire Department, Brooklyn, NY, USA;New York State Laborers’ Health and Safety Trust Fund, New York, NY, USA;New York University School of Medicine, New York, NY, USA;New York University, New York, USA;Robert Wood Johnson Medical Center, Piscataway, NJ, USA;Stony Brook University Medical Center, Stony Brook, NY, USA;University Milano-Bicocca, Milan, Italy;University of Milan, Milan, Italy;University of Occupational and Environmental Health, Kitakyushu, Japan;

关键词: Major accidents;    Disaster epidemiology;    Disaster exposure assessment;    Epidemiological health surveillance;    Emergency preparedness;   

DOI  :  10.1186/s12889-016-3939-3

 received in 2016-08-13, accepted in 2016-12-13,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsComparative 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.ResultsExposure 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.ConclusionsGiven 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.

【 授权许可】

CC BY   
© The Author(s). 2017