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A Sex Disparity Among Earthquake Victims

  • Michael Ardagh (a1), Sarah Standring (a2), Joanne M. Deely (a3), David Johnston (a4), Viki Robinson (a5), Pauline Gulliver (a2), Sandra Richardson (a1), Alieke Dierckx (a6) and Martin Than (a5)...



Understanding who is most vulnerable during an earthquake will help health care responders prepare for future disasters. We analyzed the demography of casualties from the Christchurch earthquake in New Zealand.


The demography of the total deceased, injured, and hospitalized casualties of the Christchurch earthquake was compared with that of the greater Christchurch population, the Christchurch central business district working population, and patients who presented to the single acute emergency department on the same month and day over the prior 10 years. Sex data were compared to scene of injury, context of injury, clinical characteristics of injury, and injury severity scores.


Significantly more females than males were injured or killed in the entire population of casualties (P<0.001). Most of the deceased and hospitalized casualties were injured in the central business district (171/182 deceased [94%]; 33/91 hospitalized [36.2%]). Approximately half of both sexes were injured at home (1002/2032 males [49%]; 2390/4627 females [52%]) and >20% were injured at commercial or service localities (444/2032 males [22%]; 1105/4627 females [24%]). Adults aged between 20 and 69 years (1639/2032 males [81%]; 3717/4627 females [80%]) were most frequently injured.


Where people were and what they were doing at the time of the earthquake influenced their risk of injury. (Disaster Med Public Health Preparedness. 2016;10:67-73)


Corresponding author

Correspondence and reprint requests to Professor Michael W Ardagh, Emergency Department, Christchurch Hospital, Christchurch, New Zealand (e-mail:


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1. Ramirez, M, Peek-Asa, C. Epidemiology of traumatic injuries from earthquakes. Epidemiol Rev. 2005;27:47-55.
2. Briggs, SM. Earthquakes. Surg Clin North Am. 2006;86:537-544.
3. Doocy, S, Daniels, A, Aspilcueta, D. Mortality and injury following the 2007 Ica earthquake in Peru. Am J Disaster Med. 2009;4:15-22.
4. Alexander, D. The health effects of earthquakes in the mid-1990s. Disasters. 1996;20:231-247.
5. Osaki, Y, Minowa, M. Factors associated with earthquake deaths in the great Hanshin-Awaji earthquake, 1995. Am J Epidemiol. 2001;153:153-156.
6. Chou, YJ, Huang, N, Lee, CH, et al. Who is at risk of death in an earthquake? Am J Epidemiol. 2004;160:688-695.
7. Tanida, N. What happened to elderly people in the great Hanshin earthquake. BMJ. 1996;313:1133-1135.
8. Phalkey, R, Reinhardt, JD, Marx, M. Injury epidemiology after the 2001 Gujarat earthquake in India: a retrospective analysis of injuries treated at a rural hospital in the Kutch district immediately after the disaster. Glob Health Action. 2011;4:7196.
9. Mohebbi, HA, Mehrvarz, S, Saghafinia, M, et al. Earthquake related injuries: assessment of 854 victims of the 2003 Bam disaster transported to tertiary referral hospitals. Prehosp Disaster Med. 2008;23:510-515.
10. Emami, MJ, Tavakoli, AR, Alemzadeh, H, et al. Strategies in evaluation and management of Bam earthquake victims. Prehosp Disaster Med. 2005;20:327-330.
11. Papadopoulos, IN, Kanakaris, N, Triantafillidis, A, et al. Autopsy findings from 111 deaths in the 1999 Athens earthquake as a basis for auditing the emergency response. Br J Surg. 2004;91:1633-1640.
12. Eberhart-Phillips, JE, Saunders, TM, Robinson, AL, et al. Profile of mortality from the 1989 Loma Prieta earthquake using coroner and medical examiner reports. Disasters. 1994;18:160-170.
13. Ardagh, MW, Richardson, SK, Robinson, V, et al. The initial health-system response to the earthquake in Christchurch, New Zealand, in February, 2011. Lancet. 2012;379:2109-2115.
14. Johnston, D, Standring, S, Ronan, K, et al. The 2010/2011 Canterbury earthquakes: context and cause of injury. Natural Hazards. 2014;73:627-637.
15. Statistics New Zealand. 2006 Census. Accessed January 2012.
16. Statistics New Zealand. Estimating local populations after the 2010/2011 Canterbury earthquakes. Published October 2011. Accessed June 10, 2012.
17. Algorithm to Transform ICD-10 codes to AIS 90 (1998 update). Version 1. Pamplona, Spain: European Centre for Injury Prevention UoN; 2006.
18. Baker, SP, O’Neill, B, Haddon, W, et al. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14:187-196.
19. Kreiss, Y, Merin, O, Peleg, K, et al. Early disaster response in Haiti: the Israeli field hospital experience. Ann Intern Med. 2010;153:45-48.
20. Amundson, D, Dadekian, G, Etienne, M, et al. Practicing internal medicine onboard the USNS COMFORT in the aftermath of the Haitian earthquake. Ann Intern Med. 2010;152(11):733-737.
21. Sami, F, Ali, F, Zaidi, SH, et al. The October 2005 earthquake in Northern Pakistan: patterns of injuries in victims brought to the Emergency Relief Hospital, Doraha, Mansehra. Prehosp Disaster Med. 2009;24:535-539.
22. Bozkurt, M, Ocguder, A, Turktas, U, et al. The evaluation of trauma patients in Turkish Red Crescent Field Hospital following the Pakistan earthquake in 2005. Injury. 2007;38:290-297.
23. Etienne, M, Powell, C, Faux, B. Disaster relief in Haiti: a perspective from the neurologists on the USNS COMFORT. Lancet Neurol. 2010;9:461-463.
24. Mahue-Giangreco, M, Mack, W, Seligson, H, et al. Risk factors associated with moderate and serious injuries attributable to the 1994 Northridge Earthquake, Los Angeles, California. Ann Epidemiol. 2001;11:347-357.
25. Hu, Z, Zeng, X, Fu, P, et al. Predictive factors for acute renal failure in crush injuries in the Sichuan earthquake. Injury. 2012;43:613-618.
26. He, Q, Wang, F, Li, G, et al. Crush syndrome and acute kidney injury in the Wenchuan Earthquake. J Trauma. 2011;70:1213-1217.
27. Rathore, MF, Rashid, P, Butt, AW, et al. Epidemiology of spinal cord injuries in the 2005 Pakistan earthquake. Spinal Cord. 2007;45:658-663.
28. Peek-Asa, C, Kraus, JF, Bourque, LB, et al. Fatal and hospitalized injuries resulting from the 1994 Northridge earthquake. Int J Epidemiol. 1998;27:459-465.
29. Peek-Asa, C, Ramirez, M, Seligson, H, et al. Seismic, structural, and individual factors associated with earthquake related injury. Inj Prev. 2003;9:62-66.
30. Armenian, HK, Melkonian, A, Noji, EK, et al. Deaths and injuries due to the earthquake in Armenia: a cohort approach. Int J Epidemiol. 1997;26:806-813.
31. Tanaka, H, Iwai, A, Oda, J, et al. Overview of evacuation and transport of patients following the 1995 Hanshin-Awaji earthquake. J Emerg Med. 1998;16:439-444.
32. Chan, CC, Lin, YP, Chen, HH, et al. A population-based study on the immediate and prolonged effects of the 1999 Taiwan earthquake on mortality. Ann Epidemiol. 2003;13:502-508.
33. Liang, NJ, Shih, YT, Shih, FY, et al. Disaster epidemiology and medical response in the Chi-Chi earthquake in Taiwan. Ann Emerg Med. 2001;38:549-555.
34. Zhang, L, Li, H, Carlton, JR, et al. The injury profile after the 2008 earthquakes in China. Injury. 2009;40:84-86.
35. Xie, J, Du, L, Xia, T, et al. Analysis of 1856 inpatients and 33 deaths in the West China Hospital of Sichuan University from the Wenchuan earthquake. J Evid Based Med. 2008;1:20-26.
36. Mulvey, JM, Awan, SU, Qadri, AA, et al. Profile of injuries arising from the 2005 Kashmir earthquake: the first 72 h. Injury. 2008;39:554-560.
37. Ellidokuz, H, Ucku, R, Aydin, UY, et al. Risk factors for death and injuries in earthquake: cross-sectional study from Afyon, Turkey. Croat Med J. 2005;46:613-618.
38. Kaiser, A, Holden, C, Beaven, J, et al. The Mw 6.2 Christchurch earthquake of February 2011: preliminary report. N Z J Geology Geophysics. 2012;55:67-90.
39. Doocy, S, Daniels, A, Packer, C, et al. The human impact of earthquakes: a historical review of events 1980-2009 and systematic literature review. PLoS Curr. 2013;5:1-39.
40. Baird, A, Palermo, A, Pampanin, S, et al. Focusing on reducing the earthquake damage to facade systems. Bull N Z Soc Earthquake Engineering. 2001;44:108-120.
41. Falk, P, Campbell, C. The Shopping Experience. London: Sage Publications; 1997.
42. Bennet, B, Dann, J, Johnson, E, et al. Once in a Lifetime: City Building After Disaster in Christchurch. Christchurch, New Zealand: Freerange Press; 2014.
43. The Encyclopaedia of New Zealand. Historic earthquakes: The 1931 Hawke’s Bay earthquake. Accessed April 2015.
44. New Zealand Legislation. Building Act 2004. Parliamentary Counsel Office, January 2015. Accessed April 2015.
45. Fothergill, A. Gender, risk, and disaster. Int J Mass Emerg Disasters. 1996;14:33-56.
46. World Health Organization. Gender and Health in Disasters. Geneva: World Health Organization; 2002. Accessed August 2014.
47. Arnett, JJ. Adolescents’ uses of media for self-socialization. J Youth Adolesc. 1995;24:519-533.
48. Santesso, DL, Segalowitz, SJ. Poor error monitoring response is related to risk-taking and lack of empathy in males. Psychophysiology. 2009;46:143-152.
49. Statistics New Zealand. New Zealand in Profile 2014: An Overview of New Zealand’s People, Economy and Environment. Accessed July 2014.
50. Lu-Ping, Z, Rodriguez-Llanes, JM, Qi, W, et al. Multiple injuries after earthquakes: a retrospective analysis on 1,871 injured patients from the 2008 Wenchuan earthquake. Crit Care. 2012;16:R87.


A Sex Disparity Among Earthquake Victims

  • Michael Ardagh (a1), Sarah Standring (a2), Joanne M. Deely (a3), David Johnston (a4), Viki Robinson (a5), Pauline Gulliver (a2), Sandra Richardson (a1), Alieke Dierckx (a6) and Martin Than (a5)...


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