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Biomedical subjects

E K Noji

Publications and source records attributed to E K Noji.

At least 19 recordsLinked to original sources
PubMed1997

Deaths and injuries due to the earthquake in Armenia: a cohort approach.

BACKGROUND: This is the first population-based study of earthquake injuries and deaths that uses a cohort approach to identify factors of high risk. As part of a special project that collected data about the population in the aftermath of the earthquake that hit Northern Armenia on 7 December 1988, employees of the Ministry of Health working in the earthquake zone on 7 December 1988, and their families, were studied as a cohort to assess the short and long term impact of the disaster. The current analysis assesses short term outcomes of injuries and deaths as a direct result of the earthquake. METHODS: From an unduplicated list of 9017 employees, it was possible to contact and interview 7016 employees or their families over a period extending from April 1990 to December 1992. The current analysis presents the determinants of 831 deaths and 1454 injuries that resulted directly from the earthquake in our study population of 32,743 people (employees and their families). RESULTS: Geographical location, being inside a building during the earthquake, height of the building, and location within the upper floors of the building were risk factors for injury and death in the univariate analyses. However, multivariate analyses, using different models, revealed that being in the Spitak region (odds ratio [OR] = 80.9, 95% confidence interval [CI]: 55.5-118.1) and in the city of Gumri (OR = 30.7, 95% CI: 21.4-44.2) and inside a building at the moment of the earthquake (OR = 10.1, 95% CI: 6.5-15.9) were the strongest predictors for death. Although of smaller magnitude, the same factors had significant OR for injuries. Building height was more important as a factor in predicting death than the location of the individual on various floors of the building except for being on the ground floor of the building which was protective. CONCLUSIONS: Considering that most of the high rise buildings destroyed in this earthquake were built using standard techniques, the most effective preventive effort for this disaster would have been appropriate structural approaches prior to the earthquake.

Adolescent↗
PubMed1997

The historical development of public health responses to disaster.

The first of a of series state-of-the-art reviews commissioned to mark Disasters' 21st anniversary, this paper considers key publications on public health aspects of natural disasters, refugee emergencies and complex humanitarian disasters over the past twenty-odd years. The literature is reviewed and important signposts highlighted showing how the field has developed. This expanding body of epidemiological research has provided a basis for increasingly effective prevention and intervention strategies.

Disaster Planning↗
PubMed1996

Disaster epidemiology.

Sound epidemiologic knowledge of the morbidity and mortality caused by disasters is essential when determining what relief supplies, equipment, and personnel are needed to respond effectively in emergency situations. All disasters are unique because each affected region of the world has different social, economic, and baseline health conditions. Some similarities exist, however, among the health effects of different types of disasters, that if recognized, can ensure that the limited health and medical resources of the affected community are well managed.

Disasters↗
PubMed1996

The World Trade Center bombing: injury prevention strategies for high-rise building fires.

The WTC disaster provided an opportunity to look for ways to prevent morbidity among occupants of high-rise buildings during fires. This paper first describes the overall morbidity resulting from the explosion and fire, and second, presents the results of a case-control study carried out to identify risk factors for smoke-related morbidity. The main ones include: increased age, presence of a pre-existing cardio-pulmonary condition, entrapment in a lift and prolonged evacuation time. Study results point to the importance of the following safety systems during high-rise building fires: smoke-control systems with separate emergency power sources; lift-cars, lift-car position-monitoring systems, and lift-car communication systems with separate emergency power sources; two-way emergency communication systems on all floors and in stairwells; stairwells with emergency lighting and designed for the rapid egress of crowds; evacuation systems/equipment to assist in the evacuation of vulnerable people (elderly, infirm). Also important are evacuation plans that include regularly scheduled safety training and evacuation drills.

Adolescent↗
PubMed1995

Disaster epidemiology and disease monitoring.

Better epidemiologic knowledge of the mechanisms of death and of the types of injuries and illnesses caused by disasters is clearly essential to determining the appropriate relief medications, supplies, equipment, and personnel needed to effectively respond to such emergencies. The overall objective of disaster epidemiology is to measure scientifically and describe the health effects of disasters and the factors contributing to these effects. The results of such investigations allow disaster epidemiologists to assess the needs of disaster-affected populations, efficiently match resources to needs, prevent further adverse health effects, evaluate relief effectiveness, and plan for future disasters.

Communicable Disease Control↗
PubMed1995

Tornado injuries related to housing in the Plainfield tornado.

BACKGROUND: On 28 August 1990, a tornado in Will County, Illinois, caused 29 deaths and more than US $200 million in damage. Risk factors for impact-related morbidity and mortality were studied. METHODS: A case-control study was conducted of 26 people hospitalized or killed, and 116 injured, randomly selected people who were in houses damaged by the tornado. To obtain information on study subjects, telephone interviews were conducted, and hospital records, coroners' reports, and American Red Cross records were abstracted. Structural details on houses were collected from tax assessor records. RESULTS: Cases were more likely than controls to have been in multistorey houses than in single-storey houses (OR = 3.9; 95% CI: 1.2-13.2). The risk associated with houses built after 1972 (OR = 7.9) and those built from 1962 to 1972 (OR = 2.2) was greater than for those built before 1962 (OR = 1.0; chi 2 for trend = 12.1; P < 0.01). Being in the basement when the tornado hit was protective (OR = 0.1; 95% CI: 0.0-0.4). CONCLUSIONS: One-storey houses were safer than multistorey houses, and basements were safer than other rooms. The association of risk with the construction date of the house is a new finding and should be examined in further studies.

Adult↗
PubMed1995

The rapid implementation of a statewide emergency health information system during the 1993 Iowa flood.

In the face of disastrous flooding, the Iowa Department of Public Health established the statewide Emergency Computer Communications Network to establish rapid electronic reporting of disaster-related health data, provide e-mail communications among all county health departments, monitor the long-range public health effects of the disaster, and institute a general purpose public health information system in Iowa. Based on software (CDC WONDER/PC) provided by the Centers for Disease Control and Prevention and using standard personal computers and modems, this system has resulted in a 10- to 20-fold increase in surveillance efficiency at the health department, not including time saved by county network participants. It provides a critical disaster assessment capability to the health department but also facilitates the general practice of public health.

Computer Communication Networks↗
PubMed1994

Use of a modified cluster sampling method to perform rapid needs assessment after Hurricane Andrew.

STUDY OBJECTIVE: To rapidly obtain population-based estimates of needs in the early aftermath of Hurricane Andrew in South Florida. METHODS: We used a modified cluster-sampling method (the Expanded Programme on Immunization [EPI] method) for three surveys. We selected a systematic sample of 30 quarter-mile square clusters for each survey and, beginning from a random start, interviewed members of seven consecutive occupied households in each cluster. Two surveys were of the most affected area (1990 population, 32,672) at three and ten days after the hurricane struck; one survey was of a less affected area (1990 population, 15,576) seven days after the hurricane struck. MEASUREMENTS AND MAIN RESULTS: Results were available within 24 hours of beginning each survey. Initial findings emphasized the need for restoring utilities and sanitation and helped to focus medical relief on primary care and preventive services. The second survey of the most affected area showed improvement in the availability of food, water, electricity, and sanitation (P < or = .05). There was no evidence of disease outbreaks. CONCLUSION: For the first time, the EPI method provided population-based information to guide and evaluate relief operations after a sudden-impact natural disaster. An improvement over previous approaches, the EPI method warrants further evaluation as a needs assessment tool in acute disasters.

Adult↗
PubMed1994

Disaster medical assistance teams: providing health care to a community struck by Hurricane Iniki.

STUDY OBJECTIVE: To describe the type of medical care that disaster medical assistance teams (DMATs) provided to a community struck by a major hurricane. STUDY DESIGN: A prospective study describing the use of DMAT field clinics by a population affected by a major hurricane. Data regarding the type of medical care provided to disaster victims and the acuity of each patient's medical condition were abstracted from medical charts at each field clinic. SETTING: Three DMAT field clinics that provided medical care to residents of Kauai, Hawaii, after Hurricane Iniki struck the island on September 11, 1992. RESULTS: From September 16 to 19, 1992, three DMATs provided medical care to 614 people. The patients' average age was 34 years, and 60% were male. The largest treatment categories were injury (40.4%), illness (38.6%), and preventive services (9.0%). Most illnesses and injuries were minor, and 99% of the patients were ambulatory. Only 33 patients (5.4%) were referred to another medical provider. Referrals were generally for procedures not available in DMAT field clinics rather than for life-threatening conditions. CONCLUSION: DMATs sent to assist with the medical needs of a US community struck by a major hurricane should be prepared to deliver basic medical services and primary health care. The need for these medical services will continue beyond the impact phase of a hurricane disaster.

Adolescent↗
PubMed1994

Haitian mass migration: Uniformed Service medical support, May 1992.

Beginning in November 1991, the United States Department of Defense established a Joint Task Force (JTF) to deal with the mass migration of Haitians. During the next 9 months, pending a determination of their immigration status, 34,000 Haitians were managed by uniformed service personnel at a temporary camp facility at the U.S. Naval Base in Guantanamo Bay, Cuba. To meet the urgent clinical and public health needs of this population, the JTF developed a camp medical system. This article describes the system of uniformed service medical support for the Haitians at the Guantanamo Bay facility during May 1992, the busiest month of the operation, when 11,400 Haitians (34% of the total) arrived.

Adult↗
PubMed1993

Disaster assessment: the emergency health evaluation of a population affected by a disaster.

In the past decade, interest in the operational and epidemiologic aspects of disaster medicine has grown dramatically. State, local, and federal organizations have created vast emergency response networks capable of responding to disasters, while hospitals have developed extensive disaster plans to address mass casualty situations. Increasingly, the US armed forces have used both their ability to mobilize quickly and their medical expertise to provide humanitarian assistance rapidly during natural and man-made disasters. However, the critical component of any disaster response is the early conduct of a proper assessment to identify urgent needs and to determine relief priorities for an affected population. Unfortunately, because this component of disaster management has not kept pace with other developments in emergency response and technology, relief efforts often are inappropriate, delayed, or ineffective, thus contributing to increased morbidity and mortality. Therefore, improvements in disaster assessment remain the most pressing need in the field of disaster medicine.

Disaster Planning↗
PubMed1993

Issues of rescue and medical care following the 1988 Armenian earthquake.

On-site emergency care and rescue efforts may be critical in preventing disability and other serious consequences of disasters. In this report we compare efforts used in the rescue and emergency medical care of 189 people (case subjects) from Kumairy (Leninakan), Armenia, who were hospitalized with serious injuries following the Armenian earthquake of 7 December 1988, with efforts used in helping 68 people (controls) from Kumairy with mild injuries who were not hospitalized. We used a standardized interview questionnaire to ascertain the circumstances of entrapment, the rescue process used, the injuries the victims sustained, and the medical care they received. Case and control subjects shared similar social and demographic characteristics; however, case subjects waited longer to be rescued and to receive medical care than did control subjects. Of the people who said they were trapped, 66.2% of the case subjects and 41.2% of the control subjects said that they were trapped for > 1 hour (odds ratio [OR] = 2.79, 95% confidence interval [CI]: 1.52-5.13) whilst the OR for > 6 hours of entrapment was 3.88 (95% CI: 1.69-9.10). Of those requiring medical care, 28.6% of people who were hospitalized waited > 1 hour after rescue to receive medical care, compared with only 14.7% of the control subjects (OR = 2.32, 95% CI: 1.05-5.23). In addition to the case-control study, we collected data on general characteristics of the rescue and emergency medical care process. We found that most of the trapped people were rescued by untrained local inhabitants who most often used their hands or simple tools.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Analysis of medical needs during disasters caused by tropical cyclones: anticipated injury patterns.

This paper is a summary of the data for describing the distribution of injuries among people affected by tropical cyclones that have occurred during the past 20 years. The most striking feature of the data gathered from a review of the epidemiologic literature on tropical cyclones is its lack of uniformity. The absence of an international classification and coding scheme for recording injuries sustained in cyclones also makes planning medical assistance difficult following future cyclones and hurricanes. We propose here a simple injury classification scheme comprising three components for categorizing injury data. Such a standardized disaster injury classification scheme, coupled with other types of information about injuries, will greatly aid relief officials in efficiently matching available resources to needs, in effectively managing health relief operations, and in developing strategies to prevent future cyclone-related morbidity and mortality.

Disaster Planning↗