Rex P.K. Lam, Ronald T.M. Wong, Eric H.Y. Lau, K.W. Wong, Arthur C.K. Cheung, V.K. Chaang, L. Chen, T.C. Tsang, T.K. Chan, Peter P.Y. Chee, Frank H.F. Ko, C.S. Leung, S.M. Yang
Objective Mass Casualty Incidents (MCIs) involving high-speed passenger ferries (HSPFs) may result in the dual-wave phenomenon, in which the emergency department (ED) is overwhelmed by an initial wave of minor injuries, followed by a second wave of more seriously injured victims. This study aimed to characterize the time pattern of ED presentation of victims in such accidents in Hong Kong. Methods All HSPF MCIs from 2005 to 2015 were reviewed retrospectively, with the time interval from accident to ED registration determined for each victim. Multivariable linear regression was used to identify independent factors associated with the time of ED presentation after the accidents. Results Eight MCIs involving 492 victims were identified. Victims with an Injury Severity Score (ISS) ≥ 9 had a significantly shorter median time interval compared to those with minor injuries. An ISS ≥ 9 and evacuation by emergency service vessels were associated with a shorter delay in ED arrival, whereas ship sinking, accident at nighttime, and a longer linear distance between the accident and receiving ED were associated with a longer delay. Conclusion The dual-wave phenomenon was not present in HSPF MCIs. Early communication is the key to ensure early resource mobilisation and a well-timed response.
{"title":"Time Pattern of Presentation of Victims of High-Speed Passenger Ferry Mass Casualty Incidents to the Emergency Department","authors":"Rex P.K. Lam, Ronald T.M. Wong, Eric H.Y. Lau, K.W. Wong, Arthur C.K. Cheung, V.K. Chaang, L. Chen, T.C. Tsang, T.K. Chan, Peter P.Y. Chee, Frank H.F. Ko, C.S. Leung, S.M. Yang","doi":"10.1017/dmp.2024.90","DOIUrl":"https://doi.org/10.1017/dmp.2024.90","url":null,"abstract":"Objective Mass Casualty Incidents (MCIs) involving high-speed passenger ferries (HSPFs) may result in the dual-wave phenomenon, in which the emergency department (ED) is overwhelmed by an initial wave of minor injuries, followed by a second wave of more seriously injured victims. This study aimed to characterize the time pattern of ED presentation of victims in such accidents in Hong Kong. Methods All HSPF MCIs from 2005 to 2015 were reviewed retrospectively, with the time interval from accident to ED registration determined for each victim. Multivariable linear regression was used to identify independent factors associated with the time of ED presentation after the accidents. Results Eight MCIs involving 492 victims were identified. Victims with an Injury Severity Score (ISS) ≥ 9 had a significantly shorter median time interval compared to those with minor injuries. An ISS ≥ 9 and evacuation by emergency service vessels were associated with a shorter delay in ED arrival, whereas ship sinking, accident at nighttime, and a longer linear distance between the accident and receiving ED were associated with a longer delay. Conclusion The dual-wave phenomenon was not present in HSPF MCIs. Early communication is the key to ensure early resource mobilisation and a well-timed response.","PeriodicalId":54390,"journal":{"name":"Disaster Medicine and Public Health Preparedness","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The appropriate response to mass causality biological events requires well-established preparedness and providing a surge capacity. In such a situation, a practical solution is to convert large public venues into shelter hospitals. Due to the lack of a guideline for the transformation of a large public center into a hospital, the present study collected the design criteria for the transformation of public buildings into shelter hospitals in response to biological events such as epidemics or mass causality biological accidents. Methods The keywords were searched in Scopus, Web of Science, and PubMed databases until November 2021. This systematic review was conducted using terms related to mass causality biological accidents, shelter hospitals, and design criteria. Results Of 1802 extracted articles, duplicates (n = 280) and unrelated publications (n = 1342) were left out in the initial evaluation. Among 180 remained papers, 29 records satisfied our criteria after reviewing abstracts and full texts. Most of the included studies were related to the transformation of public venues into hospitals in response to the coronavirus disease 2019 (COVID-19) pandemic. The investigated themes included site selection, layout and structure, waste and wastewater management, ventilation, communication, food and medicine delivery, humanitarians and social supports, post-treatment care, and Management measures. Conclusions In summary, large public venues are highly recommended alternatives for surge capacity in response to mass causality biological accidents. However, the main challenges for using these centers are the provision of basic requirements such as water and electricity, ventilation, and available space.
{"title":"Design Criteria of Shelter Hospitals in Response to Biological Accidents: A Systematic Review","authors":"Maryam Moradi, Simintaj Sharififar, Armin Zareiyan, Seyyed-Javad Hoseyni Shokuh, Ali Nasiri","doi":"10.1017/dmp.2024.82","DOIUrl":"https://doi.org/10.1017/dmp.2024.82","url":null,"abstract":"Background The appropriate response to mass causality biological events requires well-established preparedness and providing a surge capacity. In such a situation, a practical solution is to convert large public venues into shelter hospitals. Due to the lack of a guideline for the transformation of a large public center into a hospital, the present study collected the design criteria for the transformation of public buildings into shelter hospitals in response to biological events such as epidemics or mass causality biological accidents. Methods The keywords were searched in Scopus, Web of Science, and PubMed databases until November 2021. This systematic review was conducted using terms related to mass causality biological accidents, shelter hospitals, and design criteria. Results Of 1802 extracted articles, duplicates (<jats:italic>n</jats:italic> = 280) and unrelated publications (<jats:italic>n</jats:italic> = 1342) were left out in the initial evaluation. Among 180 remained papers, 29 records satisfied our criteria after reviewing abstracts and full texts. Most of the included studies were related to the transformation of public venues into hospitals in response to the coronavirus disease 2019 (COVID-19) pandemic. The investigated themes included site selection, layout and structure, waste and wastewater management, ventilation, communication, food and medicine delivery, humanitarians and social supports, post-treatment care, and Management measures. Conclusions In summary, large public venues are highly recommended alternatives for surge capacity in response to mass causality biological accidents. However, the main challenges for using these centers are the provision of basic requirements such as water and electricity, ventilation, and available space.","PeriodicalId":54390,"journal":{"name":"Disaster Medicine and Public Health Preparedness","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatima El-Mousawi, Ariel Mundo Ortiz, Rawda Berkat, Bouchra Nasri
Background The frequency and severity of floods has increased in different regions of the world due to climate change. It is important to examine how adaptation measures impact the mental health of individuals affected by these disasters. Objective The goal of this scoping review was to document the existing studies on the impact of flood adaptation measures in affected populations to identify the best preventive strategies and limitations that deserve further exploration. Methods This study followed the PRISMA-ScR guidelines. Inclusion criteria focused on studies in English or French available in MEDLINE and Web of Science that examined the impact of adaptation measures on the mental health of flood victims. Literature reviews or non-study records were excluded from the analysis. Results A total of 857 records were obtained from the examined databases. After 2 rounds of screening, 9 studies were included for full-text analysis. Six studies sought to identify the factors that drive resilience in flood victims, whereas 3 studies analyzed the impact of external interventions on their mental health. Conclusions The limited number of studies demonstrates the need for public health policies to develop flood adaptation measures that can be used to support the mental health of flood victims.
{"title":"The Impact of “Soft” and “Hard” Flood Adaptation Measures on Affected Population’s Mental Health: A Mixed Method Scoping Review","authors":"Fatima El-Mousawi, Ariel Mundo Ortiz, Rawda Berkat, Bouchra Nasri","doi":"10.1017/dmp.2024.128","DOIUrl":"https://doi.org/10.1017/dmp.2024.128","url":null,"abstract":"Background The frequency and severity of floods has increased in different regions of the world due to climate change. It is important to examine how adaptation measures impact the mental health of individuals affected by these disasters. Objective The goal of this scoping review was to document the existing studies on the impact of flood adaptation measures in affected populations to identify the best preventive strategies and limitations that deserve further exploration. Methods This study followed the PRISMA-ScR guidelines. Inclusion criteria focused on studies in English or French available in MEDLINE and Web of Science that examined the impact of adaptation measures on the mental health of flood victims. Literature reviews or non-study records were excluded from the analysis. Results A total of 857 records were obtained from the examined databases. After 2 rounds of screening, 9 studies were included for full-text analysis. Six studies sought to identify the factors that drive resilience in flood victims, whereas 3 studies analyzed the impact of external interventions on their mental health. Conclusions The limited number of studies demonstrates the need for public health policies to develop flood adaptation measures that can be used to support the mental health of flood victims.","PeriodicalId":54390,"journal":{"name":"Disaster Medicine and Public Health Preparedness","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective This cross-sectional study investigates the immediate psychological effects of disaster relief operations on team members following 2 consecutive major earthquakes in Turkey. Methods A total of 170 participants, including professional firefighters, search and rescue (SAR) workers, and volunteers, were surveyed approximately 1 month after the conclusion of active SAR operations. The study utilizes the DSM-V criteria and the Posttraumatic Stress Disorder Checklist (PCL-5) to assess symptoms of post-traumatic stress disorder (PTSD) among participants. Results The findings reveal a point prevalence of 35.3% for probable PTSD, highlighting the substantial psychological impact on disaster relief teams. Factors such as age, residency in affected areas, and active SAR involvement significantly influenced probable PTSD rates. Interestingly, actively engaged SAR members had lower probable PTSD rates, possibly due to their training. Those who directly witnessed the earthquakes had higher scores, highlighting the impact of firsthand exposure. Additionally, individuals aged 50 and above displayed a higher mean total severity score compared to younger participants. Conclusions This research contributes to understanding the mental well-being of disaster relief professionals. The study’s findings underscore the importance of timely mental health support and training for these responders, emphasizing the need for preparedness in disaster relief teams.
{"title":"Psychological Impact of Disaster Relief Operations: A Study Following Consecutive Earthquakes in Turkey","authors":"Ali Iseri, Recep Baltaci","doi":"10.1017/dmp.2024.134","DOIUrl":"https://doi.org/10.1017/dmp.2024.134","url":null,"abstract":"Objective This cross-sectional study investigates the immediate psychological effects of disaster relief operations on team members following 2 consecutive major earthquakes in Turkey. Methods A total of 170 participants, including professional firefighters, search and rescue (SAR) workers, and volunteers, were surveyed approximately 1 month after the conclusion of active SAR operations. The study utilizes the DSM-V criteria and the Posttraumatic Stress Disorder Checklist (PCL-5) to assess symptoms of post-traumatic stress disorder (PTSD) among participants. Results The findings reveal a point prevalence of 35.3% for probable PTSD, highlighting the substantial psychological impact on disaster relief teams. Factors such as age, residency in affected areas, and active SAR involvement significantly influenced probable PTSD rates. Interestingly, actively engaged SAR members had lower probable PTSD rates, possibly due to their training. Those who directly witnessed the earthquakes had higher scores, highlighting the impact of firsthand exposure. Additionally, individuals aged 50 and above displayed a higher mean total severity score compared to younger participants. Conclusions This research contributes to understanding the mental well-being of disaster relief professionals. The study’s findings underscore the importance of timely mental health support and training for these responders, emphasizing the need for preparedness in disaster relief teams.","PeriodicalId":54390,"journal":{"name":"Disaster Medicine and Public Health Preparedness","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pharmacist Services in the Aftermath of the February 6, 2023, Earthquake in Turkey: Lessons Learned.","authors":"Halime Yılmaz,Edanur Yusuf,Muhammed Yunus Bektay","doi":"10.1017/dmp.2024.91","DOIUrl":"https://doi.org/10.1017/dmp.2024.91","url":null,"abstract":"","PeriodicalId":54390,"journal":{"name":"Disaster Medicine and Public Health Preparedness","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective The aim of this review is to identify, evaluate, and graphically display gaps in the literature related to scarce health resource allocation in humanitarian aid settings. Methods A systematic search strategy was utilized in MEDLINE (via Ovid), Scopus, EMBASE, CINAHL Complete, and ProQuest Central. Articles were reviewed by 2 reviewers with a third reviewer remedying any screening conflicts. Articles meeting inclusion criteria underwent data extraction to facilitate evaluation of the scope, nature, and quality of experience-based evidence for health resource allocation in humanitarian settings. Finally, articles were mapped on a matrix to display evidence graphically. Results The search strategy identified 6093 individual sources, leaving 4000 for screening after removal of duplicates. Following full-text screening, 12 sources were included. Mapping extracted data according to surge capacity domains demonstrated that all 4 domains were reflected most of all the staff domain. Much of the identified data was presented without adhering to a clear structure or nomenclature. Finally, the mapping suggested potential incompleteness of surge capacity constructs in humanitarian response settings. Conclusions Through this review, we identified a gap in evidence available to address challenges associated with scarce resource allocation in humanitarian settings. In addition to presenting the distribution of existing literature, the review demonstrated the relevance of surge capacity and resource allocation principles underpinning the developed framework.
{"title":"An Evidence Gap Map of Experience-based Evidence of Health Resource Allocation in Disaster and Humanitarian Settings","authors":"Zachary B Horn, Jamie Ranse, Andrea P Marshall","doi":"10.1017/dmp.2024.103","DOIUrl":"https://doi.org/10.1017/dmp.2024.103","url":null,"abstract":"Objective The aim of this review is to identify, evaluate, and graphically display gaps in the literature related to scarce health resource allocation in humanitarian aid settings. Methods A systematic search strategy was utilized in MEDLINE (via Ovid), Scopus, EMBASE, CINAHL Complete, and ProQuest Central. Articles were reviewed by 2 reviewers with a third reviewer remedying any screening conflicts. Articles meeting inclusion criteria underwent data extraction to facilitate evaluation of the scope, nature, and quality of experience-based evidence for health resource allocation in humanitarian settings. Finally, articles were mapped on a matrix to display evidence graphically. Results The search strategy identified 6093 individual sources, leaving 4000 for screening after removal of duplicates. Following full-text screening, 12 sources were included. Mapping extracted data according to surge capacity domains demonstrated that all 4 domains were reflected most of all the staff domain. Much of the identified data was presented without adhering to a clear structure or nomenclature. Finally, the mapping suggested potential incompleteness of surge capacity constructs in humanitarian response settings. Conclusions Through this review, we identified a gap in evidence available to address challenges associated with scarce resource allocation in humanitarian settings. In addition to presenting the distribution of existing literature, the review demonstrated the relevance of surge capacity and resource allocation principles underpinning the developed framework.","PeriodicalId":54390,"journal":{"name":"Disaster Medicine and Public Health Preparedness","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jenny Pettersson, Erik Prytz, Marc Friberg, Anton Björnqvist, Peter Berggren, Jessica Frisk, Carl-Oscar Jonson
Objective To achieve resilience in the response of a major incident, it is essential to coordinate major processes and resources with the aim to manage expected and unexpected changes. The coordination is partly done through timely, adequate, and resilience-oriented decisions. Accordingly, the aim of the present paper is to describe factors that affected decision-making in a medical command and control team during the early COVID-19 pandemic. Methods This study used a qualitative method in which 13 individuals from a regional public healthcare system involved in COVID-19 related command and control were interviewed. Data was collected through semi-structured interviews and analyzed using qualitative content analysis. Results The factors affecting decision-making in medical command and control during early COVID-19 pandemic were grouped into 5 themes: organization, adaptation, making decisions, and analysis, as well as common operational picture. Conclusions The present study indicated that decision-making in medical command and control faces many challenges in the response to pandemics. The results may provide knowledge about disaster resilience and can be utilized in educational and training settings for medical command and control.
{"title":"Decision Making in a Strategic Medical Command and Control Team During the Covid-19 Pandemic: A Case Study","authors":"Jenny Pettersson, Erik Prytz, Marc Friberg, Anton Björnqvist, Peter Berggren, Jessica Frisk, Carl-Oscar Jonson","doi":"10.1017/dmp.2024.95","DOIUrl":"https://doi.org/10.1017/dmp.2024.95","url":null,"abstract":"Objective To achieve resilience in the response of a major incident, it is essential to coordinate major processes and resources with the aim to manage expected and unexpected changes. The coordination is partly done through timely, adequate, and resilience-oriented decisions. Accordingly, the aim of the present paper is to describe factors that affected decision-making in a medical command and control team during the early COVID-19 pandemic. Methods This study used a qualitative method in which 13 individuals from a regional public healthcare system involved in COVID-19 related command and control were interviewed. Data was collected through semi-structured interviews and analyzed using qualitative content analysis. Results The factors affecting decision-making in medical command and control during early COVID-19 pandemic were grouped into 5 themes: organization, adaptation, making decisions, and analysis, as well as common operational picture. Conclusions The present study indicated that decision-making in medical command and control faces many challenges in the response to pandemics. The results may provide knowledge about disaster resilience and can be utilized in educational and training settings for medical command and control.","PeriodicalId":54390,"journal":{"name":"Disaster Medicine and Public Health Preparedness","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lilia P. Christner, Erin F. Carlton, Stephen Gorga, Taylor Whittington, Folafoluwa O. Odetola
Objective A surge of pediatric respiratory illnesses beset the United States in late 2022 and early 2023. This study evaluated within-surge hospital acute and critical care resource availability and utilization. The study aimed to determine pediatric hospital acute and critical care resource use during a respiratory illness surge. Methods Between January and February 2023, an online survey was sent to the sections of hospital medicine and critical care of the American Academy of Pediatrics, community discussion forums of the Children’s Hospital Association, and PedSCCM—a pediatric critical care website. Data were summarized with median values and interquartile range. Results Across 35 hospitals with pediatric intensive care units (PICU), increase in critical care resource use was significant. In the month preceding the survey, 26 (74%) hospitals diverted patients away from their emergency department (ED) to other hospitals, with 46% diverting 1-5 patients, 23% diverting 6-10 patients, and 31% diverting more than 10 patients. One in 5 hospitals reported moving patients on mechanical ventilation from the PICU to other settings, including the ED (n = 2), intermediate care unit (n = 2), cardiac ICU (n = 1), ward converted to an ICU (n = 1), and a ward (n = 1). Utilization of human critical care resources was high, with PICU faculty, nurses, and respiratory therapists working at 100% capacity. Conclusions The respiratory illness surge triggered significant hospital resource use and diversion of patients away from hospitals. Pediatric public health emergency-preparedness should innovate around resource capacity.
{"title":"The 2022–2023 Pediatric Respiratory Illness Surge: Survey of Acute and Critical Care Resource Use","authors":"Lilia P. Christner, Erin F. Carlton, Stephen Gorga, Taylor Whittington, Folafoluwa O. Odetola","doi":"10.1017/dmp.2024.104","DOIUrl":"https://doi.org/10.1017/dmp.2024.104","url":null,"abstract":"Objective A surge of pediatric respiratory illnesses beset the United States in late 2022 and early 2023. This study evaluated within-surge hospital acute and critical care resource availability and utilization. The study aimed to determine pediatric hospital acute and critical care resource use during a respiratory illness surge. Methods Between January and February 2023, an online survey was sent to the sections of hospital medicine and critical care of the American Academy of Pediatrics, community discussion forums of the Children’s Hospital Association, and PedSCCM—a pediatric critical care website. Data were summarized with median values and interquartile range. Results Across 35 hospitals with pediatric intensive care units (PICU), increase in critical care resource use was significant. In the month preceding the survey, 26 (74%) hospitals diverted patients away from their emergency department (ED) to other hospitals, with 46% diverting 1-5 patients, 23% diverting 6-10 patients, and 31% diverting more than 10 patients. One in 5 hospitals reported moving patients on mechanical ventilation from the PICU to other settings, including the ED (n = 2), intermediate care unit (n = 2), cardiac ICU (n = 1), ward converted to an ICU (n = 1), and a ward (n = 1). Utilization of human critical care resources was high, with PICU faculty, nurses, and respiratory therapists working at 100% capacity. Conclusions The respiratory illness surge triggered significant hospital resource use and diversion of patients away from hospitals. Pediatric public health emergency-preparedness should innovate around resource capacity.","PeriodicalId":54390,"journal":{"name":"Disaster Medicine and Public Health Preparedness","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mustafa Sabak, Muge Gulen, Salim Satar, Cuma Yildirim, Ahmet Faruk Yildiz, Suat Zengin
Objective Weather conditions such as low air temperatures, low barometric pressure, and low wind speed have been linked to more cases of carbon monoxide (CO) poisoning. However, limited literature exists regarding the impact of air pollution. This study aims to investigate the relationship between outdoor air pollution and CO poisoning in 2 distinct cities in Turkey. Methods A prospective study was conducted at 2 tertiary hospitals, recording demographic data, presenting complaints, vital signs, blood gas and laboratory parameters, carboxyhemoglobin (COHb) levels, meteorological parameters, and pollutant parameters. Complications and outcomes were also documented. Results The study included 83 patients (Group 1 = 44, Group 2 = 39). The air quality index (AQI) in Group 2 (61.7 ± 27.7) (moderate AQI) was statistically significantly higher (dirtier AQI) than that in Group 1 (47.3 ± 26.4) (good AQI) (P = 0.018). The AQI was identified as an independent predictor for forecasting the need for hospitalization (OR = 1.192, 95% CI: 1.036 - 1.372, P = 0.014) and predicting the risk of developing cardiac complications (OR: 1.060, 95% CI: 1.017 - 1.104, P = 0.005). Conclusions The AQI, derived from the calculation of 6 primary air pollutants, can effectively predict the likelihood of hospitalization and cardiac involvement in patients presenting to the emergency department with CO poisoning.
{"title":"The Prognostic Effect of Air Pollution in Patients Presenting to the Emergency Department with Carbon Monoxide Poisoning","authors":"Mustafa Sabak, Muge Gulen, Salim Satar, Cuma Yildirim, Ahmet Faruk Yildiz, Suat Zengin","doi":"10.1017/dmp.2024.135","DOIUrl":"https://doi.org/10.1017/dmp.2024.135","url":null,"abstract":"Objective Weather conditions such as low air temperatures, low barometric pressure, and low wind speed have been linked to more cases of carbon monoxide (CO) poisoning. However, limited literature exists regarding the impact of air pollution. This study aims to investigate the relationship between outdoor air pollution and CO poisoning in 2 distinct cities in Turkey. Methods A prospective study was conducted at 2 tertiary hospitals, recording demographic data, presenting complaints, vital signs, blood gas and laboratory parameters, carboxyhemoglobin (COHb) levels, meteorological parameters, and pollutant parameters. Complications and outcomes were also documented. Results The study included 83 patients (Group 1 = 44, Group 2 = 39). The air quality index (AQI) in Group 2 (61.7 ± 27.7) (moderate AQI) was statistically significantly higher (dirtier AQI) than that in Group 1 (47.3 ± 26.4) (good AQI) (<jats:italic>P</jats:italic> = 0.018). The AQI was identified as an independent predictor for forecasting the need for hospitalization (OR = 1.192, 95% CI: 1.036 - 1.372, <jats:italic>P</jats:italic> = 0.014) and predicting the risk of developing cardiac complications (OR: 1.060, 95% CI: 1.017 - 1.104, <jats:italic>P</jats:italic> = 0.005). Conclusions The AQI, derived from the calculation of 6 primary air pollutants, can effectively predict the likelihood of hospitalization and cardiac involvement in patients presenting to the emergency department with CO poisoning.","PeriodicalId":54390,"journal":{"name":"Disaster Medicine and Public Health Preparedness","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Siddhartha Roy, Marc A. Edwards, Keith J. Petrie, Greg D. Gamble, Ellie Jacques
Objective Special education enrollment increased in Flint following the 2014–2015 Flint Water Crisis, but lead exposure is not plausibly responsible. Labeling Flint children as lead poisoned and/or brain damaged may have contributed to rising special education needs (ie, nocebo effect). To better document this possibility, we surveyed schoolteachers and reviewed neuropsychological assessments of children for indications of negative labeling. Methods A survey of Flint and Detroit (control) public schoolteachers using a modified Illness Perception Questionnaire was conducted 5 years post-crisis. We also examined neuropsychological assessments from a recently settled class lawsuit. Results Relative to Detroit (n = 24), Flint teachers (n = 11) believed that a higher proportion of their students had harmful lead exposure (91.8% Flint vs 46% Detroit; P = 0.00034), were lead poisoned (51.3% vs 24.3%; P = 0.018), or brain damaged (28.8% vs 12.9%; P = 0.1), even though blood lead of Flint children was always less than half of that of Detroit children. Neuropsychological assessments diagnosed lead poisoning and/or brain damage from water lead exposure in all tested children (n = 8), even though none had evidence of elevated blood lead and a majority had prior learning disability diagnoses. Conclusion Teachers’ responses and neuropsychological assessments suggest Flint children were harmed by a nocebo effect.
{"title":"A Possible Nocebo Effect in Children Following the Flint Water Crisis: Evidence From Schoolteacher Perceptions and Neuropsychological Evaluations","authors":"Siddhartha Roy, Marc A. Edwards, Keith J. Petrie, Greg D. Gamble, Ellie Jacques","doi":"10.1017/dmp.2024.106","DOIUrl":"https://doi.org/10.1017/dmp.2024.106","url":null,"abstract":"Objective Special education enrollment increased in Flint following the 2014–2015 Flint Water Crisis, but lead exposure is not plausibly responsible. Labeling Flint children as lead poisoned and/or brain damaged may have contributed to rising special education needs (ie, nocebo effect). To better document this possibility, we surveyed schoolteachers and reviewed neuropsychological assessments of children for indications of negative labeling. Methods A survey of Flint and Detroit (control) public schoolteachers using a modified Illness Perception Questionnaire was conducted 5 years post-crisis. We also examined neuropsychological assessments from a recently settled class lawsuit. Results Relative to Detroit (n = 24), Flint teachers (n = 11) believed that a higher proportion of their students had harmful lead exposure (91.8% Flint vs 46% Detroit; <jats:italic>P</jats:italic> = 0.00034), were lead poisoned (51.3% vs 24.3%; <jats:italic>P</jats:italic> = 0.018), or brain damaged (28.8% vs 12.9%; <jats:italic>P</jats:italic> = 0.1), even though blood lead of Flint children was always less than half of that of Detroit children. Neuropsychological assessments diagnosed lead poisoning and/or brain damage from water lead exposure in all tested children (n = 8), even though none had evidence of elevated blood lead and a majority had prior learning disability diagnoses. Conclusion Teachers’ responses and neuropsychological assessments suggest Flint children were harmed by a nocebo effect.","PeriodicalId":54390,"journal":{"name":"Disaster Medicine and Public Health Preparedness","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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