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Background The 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. Methods Comparative 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. Results Exposure 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. Conclusions Given 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.

'Catastrophe Risk Financing in Developing Countries' provides a detailed analysis of the imperfections and inefficiencies that impede the emergence of competitive catastrophe risk markets in developing countries. The book demonstrates how donors and international financial institutions can assist governments in middle- and low-income countries in promoting effective and affordable catastrophe risk financing solutions. The authors present guiding principles on how and when governments, with assistance from donors and international financial institutions, should intervene in catastrophe insurance markets. They also identify key activities to be undertaken by donors and institutions that would allow middle- and low-income countries to develop competitive and cost-effective catastrophe risk financing strategies at both the macro (government) and micro (household) levels. These principles and activities are expected to inform good practices and ensure desirable results in catastrophe insurance projects. 'Catastrophe Risk Financing in Developing Countries' offers valuable advice and guidelines to policy makers and insurance practitioners involved in the development of catastrophe insurance programs in developing countries.

Past nuclear disasters, such as the atomic bombings in 1945 and major accidents at nuclear power plants, have highlighted similarities in potential public health effects of radiation in both circumstances, including health issues unrelated to radiation exposure. Although the rarity of nuclear disasters limits opportunities to undertake rigorous research of evidence-based interventions and strategies, identification of lessons learned and development of an effective plan to protect the public, minimise negative effects, and protect emergency workers from exposure to high-dose radiation is important. Additionally, research is needed to help decision makers to avoid premature deaths among patients already in hospitals and other vulnerable groups during evacuation. Since nuclear disasters can affect hundreds of thousands of people, a substantial number of people are at risk of physical and mental harm in each disaster. During the recovery period after a nuclear disaster, physicians might need to screen for psychological burdens and provide general physical and mental health care for many affected residents who might experience long-term displacement. Reliable communication of personalised risks has emerged as a challenge for health-care professionals beyond the need to explain radiation protection. To overcome difficulties of risk communication and provide decision aids to protect workers, vulnerable people, and residents after a nuclear disaster, physicians should receive training in nuclear disaster response. This training should include evidence-based interventions, support decisions to balance potential harms and benefits, and take account of scientific uncertainty in provision of community health care. An open and joint learning process is essential to prepare for, and minimise the effects of, future nuclear disasters.

Maps of population exposure, vulnerability and risk to natural hazards are useful tools for designing and implementing disaster risk mitigation programs in China. The ranking of provinces by relative risk to natural hazards would provide a metric for prioritizing risk management strategies. Using provinces as our study unit, from the perspectives of hazard exposure, susceptibility, coping capacity and adaptive capacity, this study first constructed China’s disaster risk index for five types of major natural hazards: earthquakes, floods, droughts, low temperatures/snow and gale/hail. Then, the relative risk level at the provincial scale in China was assessed. Finally, the hotspots with the highest hazard exposure, vulnerability and risk were identified. The results showed that high exposure was a significant risk driver in China, whereas high vulnerability, especially social vulnerability, amplified the risk levels. Similar to the population exposure to disasters, the relative risk levels in the southwestern, central and northeastern regions of China were significantly higher than those in the eastern, northern and western regions. The high-risk regions or hotspots of multi-hazards were concentrated in southern China (less-developed regions), while the low-risk regions were mainly distributed in the eastern coastal areas (well-developed regions). Furthermore, a nonlinear relationship existed between the disaster risk level and poverty incidence as well as per capita GDP, demonstrating that disaster losses in middle-income areas are likely to increase if economic policies are not modified to account for the rising disaster risk. These findings further indicated that research on disaster risk should focus not only on hazards and exposure but also on the vulnerability to natural disasters. Thus, reducing vulnerability and population exposure to natural hazards would be an effective measure in mitigating the disaster risk at hotspots in China.

There is a potential risk of human exposure to radiation owing to the March 2011 Fukushima Daiichi Nuclear Power Plant accident. In this study, we evaluated radiation dose rates from deposited radiocesium in three areas neighboring the restricted and evacuation areas in Fukushima. The mean annual radiation dose rate in 2012 associated with the accident was 0.89–2.51 mSv/y. The mean dose rate estimates in 2022 are comparable with variations of the average 2 mSv/y background radiation exposure from natural radionuclides in Japan. Furthermore, the extra lifetime integrated dose after 2012 is estimated to elevate lifetime risk of cancer incidence by a factor of 1.03 to 1.05 at most, which is unlikely to be epidemiologically detectable. Radiation dose rates were evaluated in three areas neighboring a restricted area within a 20- to 50-km radius of the Fukushima Daiichi Nuclear Power Plant in August–September 2012 and projected to 2022 and 2062. Study participants wore personal dosimeters measuring external dose equivalents, almost entirely from deposited radionuclides (groundshine). External dose rate equivalents owing to the accident averaged 1.03, 2.75, and 1.66 mSv/y in the village of Kawauchi, the Tamano area of Soma, and the Haramachi area of Minamisoma, respectively. Internal dose rates estimated from dietary intake of radiocesium averaged 0.0058, 0.019, and 0.0088 mSv/y in Kawauchi, Tamano, and Haramachi, respectively. Dose rates from inhalation of resuspended radiocesium were lower than 0.001 mSv/y. In 2012, the average annual doses from radiocesium were close to the average background radiation exposure (2 mSv/y) in Japan. Accounting only for the physical decay of radiocesium, mean annual dose rates in 2022 were estimated as 0.31, 0.87, and 0.53 mSv/y in Kawauchi, Tamano, and Haramachi, respectively. The simple and conservative estimates are comparable with variations in the background dose, and unlikely to exceed the ordinary permissible dose rate (1 mSv/y) for the majority of the Fukushima population. Health risk assessment indicates that post-2012 doses will increase lifetime solid cancer, leukemia, and breast cancer incidences by 1.06%, 0.03% and 0.28% respectively, in Tamano. This assessment was derived from short-term observation with uncertainties and did not evaluate the first-year dose and radioiodine exposure. Nevertheless, this estimate provides perspective on the long-term radiation exposure levels in the three regions.

River deltas globally are highly exposed and vulnerable to natural hazards and are often over-exploited landforms. The Global Delta Risk Index (GDRI) was developed to assess multi-hazard risk in river deltas and support decision-making in risk reduction interventions in delta regions. Disasters have significant impacts on the progress towards the Sustainable Development Goals (SDGs). However, despite the strong interlinkage between disaster risk reduction and sustainable development, global frameworks are still developed in isolation and actions to address them are delegated to different institutions. Greater alignment between frameworks would both simplify monitoring progress towards disaster risk reduction and sustainable development and increase capacity to address data gaps in relation to indicator-based assessments for both processes. This research aims at aligning the GDRI indicators with the SDGs and the Sendai Framework for Disaster and Risk Reduction (SFDRR). While the GDRI has a modular indicator library, the most relevant indicators for this research were selected through a delta-specific impact chain designed in consultation with experts, communities and stakeholders in three delta regions: the Red River and Mekong deltas in Vietnam and the Ganges–Brahmaputra–Meghna (GBM) delta in Bangladesh and India. We analyse how effectively the 143 indicators for the GDRI match (or not) the SDG and SFDRR global frameworks. We demonstrate the interconnections of the different drivers of risk to better inform risk management and in turn support delta-level interventions towards improved sustainability and resilience of these Asian mega-deltas.

The paper deals with the development of a general as well as integrative and holistic framework to systematize and assess vulnerability, risk and adaptation. The framework is a thinking tool meant as a heuristic that outlines key factors and different dimensions that need to be addressed when assessing vulnerability in the context of natural hazards and climate change. The approach underlines that the key factors of such a common framework are related to the exposure of a society or system to a hazard or stressor, the susceptibility of the system or community exposed, and its resilience and adaptive capacity. Additionally, it underlines the necessity to consider key factors and multiple thematic dimensions when assessing vulnerability in the context of natural and socio-natural hazards. In this regard, it shows key linkages between the different concepts used within the disaster risk management (DRM) and climate change adaptation (CCA) research. Further, it helps to illustrate the strong relationships between different concepts used in DRM and CCA. The framework is also a tool for communicating complexity and stresses the need for societal change in order to reduce risk and to promote adaptation. With regard to this, the policy relevance of the framework and first results of its application are outlined. Overall, the framework presented enhances the discussion on how to frame and link vulnerability, disaster risk, risk management and adaptation concepts.

Risk assessment is an effective means to alleviate urban flood disasters and has attracted the attention of many studies. However, most previous studies about urban flood risk assessment often focused more on urban inundation area and depth, less on the inter-relationship of the components of risk. In this study, an urban flood risk assessment approach that characterizes the relationship among the three components of risk “hazard-exposure-vulnerability” (H-E-V) is developed. Firstly, eleven flood risk indicators are selected based on the flood simulation results of urban flood model and statistical data to establish the urban flood risk assessment index system. Then, the combination of analytic hierarchy process (AHP) and entropy weight method is employed to determine the weight of each indicator and the comprehensive urban flood risk is assessed. Most importantly, the coupling coordination degree model (CCDM) is used to reveal the relationship among H-E-V. After applying this method to Haikou city, China, the results show that the comprehensive effect and the coupling coordination degrees among H-E-V have a multidimensional impact on urban flood risk. For example, some sub-catchments, although at high risk of flooding, may experience a potential waste of resources. Urban flood assessment can be made more detailed and three-dimensional by comparing hazard, exposure, and vulnerability horizontally. Understanding and grasping the internal relationships among these three risk components can help implement flood prevention measures, optimize the allocation of flood prevention resources, and effectively reduce urban flood risks.

Urban climate-related disaster risks are set to rise, driven by the interaction of two global megatrends: urbanization and climate change. A detailed understanding of whether, where and how cities are growing within or into hazard-prone areas is an urgent prerequisite for assessing future risk trajectories, risk-informed planning, and adaptation decisions. However, this analysis has been mostly neglected to date, as most climate change and disaster risk research has focused on the assessment of future hazard trends but less on the assessment of how socio-economic changes affect future hazard exposure. Urban growth and expansion modeling provide a powerful tool, given that urban growth is a major driver of future disaster risk in cities. The paper reviews the achievements lately made in urban growth and exposure modeling and assesses how they can be applied in the context of future-oriented urban risk assessment and the planning of adaptation measures. It also analyses which methodological challenges persist in urban growth and exposure modeling and how they might be overcome. These points pertain particularly to the need to consider and integrate (1) urban morphology patterns and potential linkages to exposure as well as vulnerability, (2) long-term time horizons to consider long-term developments, (3) feedbacks between urbanization trajectories and hazard trends, (4) the integration of future urban growth drivers and adaptation responses, (5) feedbacks between adaptation and urbanization, and (6) scenarios, which are developed within a commonly defined scenario framework.

Natural hazards can impair socio-economic development. While population exposure to various natural hazards has been quantified, the exposure to hydrogeomorphic hazards – involving water-induced landscape changes – remains unknown. Using high-resolution hydrogeomorphic modelling, combined with population and wealth data, this study provides a national-scale spatial assessment of exposure to hydrogeomorphic hazards across population and wealth groups, taking Bangladesh as a case study. Bangladesh is an exceptionally geo-dynamic country, where multiple hazards coincide with a dense population (1300 people per km 2 ) and a high poverty rate (20%). Here we show that over 22 million people, making up 13% of the population, live within hydrogeomorphically unstable regions. Of the 22 million, 86% are within the lowest wealth groups of the population. Given such a high level of disparity in exposure, hydrogeomorphic hazards must be incorporated into disaster risk management and poverty alleviation efforts in Bangladesh and beyond. In Bangladesh, 22 million people are exposed to hydrogeomorphic hazards, of which 86% have low levels of wealth. This study shows a statistically significant bias of populations with lower wealth levels living in hydrogeomorphically unstable areas.