Journal Article

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

Crane, Michael, Landrigan, Philip J., Luft, Benjamin J., Mori, Koji, Reibman, Joan, Takahashi, Ken, Melius, James, Prezant, David, Basanets, Angela, Holden, William, Acquilla, Sushma, Mocarelli, Paolo, Reissman, Dori B., Harrison, Denise J., Hashim, Dana, Bertazzi, Pier Alberto, Todd, Andrew C., Stazharau, Alexander, Bushmanov, Andrey, Udasin, Iris G., Lucchini, Roberto G., Mazitova, Nailya, Moline, Jacqueline M.

2017

Overview

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.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Analysis / Bhopal Accidental Release / Biostatistics / Civil Defense - history / Civil Defense - methods / Comparative analysis / Complications / Disaster epidemiology / Disaster exposure assessment / Disaster management / Disaster Planning - history / Disaster Planning - methods / Disasters / Disasters - history / Disasters - statistics & numerical data / Emergency management / Emergency preparedness / Environmental Exposure - analysis / Environmental Health / Epidemiological health surveillance / Epidemiology / Evacuations & rescues / Exposure / Health care / Health surveillance / History, 20th Century / History, 21st Century / Humans / Leukemia / Literature reviews / Major accidents / Man made disasters / Medical care / Medicine / Medicine & Public Health / Mental disorders / Mental health / Mental health care / Nuclear accidents / Nuclear accidents & safety / Nuclear power plants / Nuclear reactors / Occupational exposure / Pennsylvania / Population Surveillance - methods / Populations / Public Health / Radiation / Radioactive Hazard Release - history / Research Article / Risk Assessment - methods / September 11 Terrorist Attacks / Seveso Accidental Release / Thyroid cancer / Vaccine / Womens health / Workers