Skip to main content Accessibility help
×
Home

Lessons Learned and Unsolved Public Health Problems After Large-Scale Disasters

  • Victor S. Koscheyev (a1), Gloria R. Leon (a2) and Ian A. Greaves (a1)

Abstract

Background:

This paper examines the considerable medical and psychological problems that ensue after disasters in which massive populations are affected for extended and sometimes unknown time periods. The organization of disaster response teams after large-scale disasters is based on experiences as a medical specialist at Chernobyl immediately after this catastrophe. Optimal ways of dealing with the immediate medical and logistical demands as well as long-term public health problems are explored with a particular focus on radiation disasters. Other lessons learned from Chernobyl are explained.

Issues:

Current concerns involve the constant threat of a disaster posed by aging nuclear facilities and nuclear and chemical disarmament activities. The strategies that have been used by various groups in responding to a disaster and dealing with medical and psychological health effects at different disaster stages are evaluated. The emergence of specialized centers in the former Soviet Union to study long-term health effects after radiation accidents are described. Worldwide, there has been relatively little attention paid to mid- and long-term health effects, particularly the psychological stress effects. Problems in conducting longitudinal health research are explored.

Recommendations:

The use of a mobile diagnostic and continuously operating prehospital triage system for rapid health screening of large populations at different stages after a large-scale disaster is advisable. The functional systems of the body to be observed at different stages after a radiation disaster are specified. There is a particularly strong need for continued medical and psychosocial evaluation of radiation exposed populations over an extended time and a need for international collaboration among investigators.

Copyright

Corresponding author

Division of Environmental and Occupational Health, School of Public Health, University of Minnesota, Mayo Box 807, Minneapolis, MN 55455 USA

References

Hide All
1. Green, BL, Lindy, JD, Grace, MC et al. : Buffalo Creek survivors in the second decade: Stability of stress symptoms. Amer J Orthopsychiat 1990;60:4354.
2. Bolin, R: Household and Community Recovery After Earthquakes. Program on Environment and Behavior. Monograph No. 56. Institute of Behavioral Science, University of Colorado, 1994.
3. Goenjian, AK, Najarian, LM, Pynoos, RS et al. : Post-traumatic stress disorder in elderly and younger adults after the 1988 earthquake in Armenia. A J Psychiat 1994;151:6:895901.
4. Sidel, V: Cleaning, up: Risk and risk reduction at military sites. Health and Environmental Digest 1993;7:14.
5. Pretto, EA Jr, Safar, P: National medical response to mass disasters in the United States: Are we prepared? JAMA 1991;266:12591262.
6. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR): Ionizing Radiation: Sources and Biological Effects. New York: United Nations Publications, 1988.
7. Mettler, FA, Briggs, JE: A health study of the population around Chernobyl. Impact of Science on Society 1995;163:227237.
8. Guscova, AK: Medical care at radiation accidents. Journal of Disaster Medicine-Russia 1995;l:9297.
9. Bissell, RA, Pretto, E, Angus, DC et al. : Post-preparedness medical disaster response in Costa Rica. Prehospital and Disaster Medicine 1995;10:3642.
10. Martchenke, J, Rusteen, J, Pointer, JE: Prehospital communications during the Loma Prieta earthquake. Prehospital and Disaster Medicine 1994;10:225231.
11. Martchenke, J, Pointer, JE: Hospital disaster operations during the 1989 Loma Prieta earthquake, Prehospital and Disaster Medicine 1995;9:146153
12. Auf der Heide, E: Disaster Response: Principles of Preparation and Coordination. St. Louis: CV Mosby, 1989.
13. Kirsch, TD: Disaster preparedness and response as primary health care. Prehospital and Disaster Medicine 1995;10:223224.
14. Pretto, EA Jr, Ricci, E, Klain, M et al. : Disaster reanimatology potentials: A structured interview study in Armenia. III. Results, conclusions and recommendations. Prehospital and Disaster Medicine 1992;7:327338.
15. Leaning, J: TMI Emergency Planning Project: Key issues in planning the early medical response. In: Golding, D, Kasperson, JX, Kasperson, RE (eds): Preparing for Nuclear Power Plant Accidents. Boulder, CO: Westview Press, 1995, pp 213235.
16. Verluise, P: Armenia In Crisis. The 1988 Earthquake. Detroit: Wayne State University Press, 1995.
17. Klain, M, Ricci, E, Safar, P et al. : Disaster reanimatology potential: A structured interview study in Armenia. I. Methodology and preliminary results. Prehospital and Disaster Medicine 1989;4:135154.
18. International Chernobyl Project Technical Report: Assessment of Radiological Consequences and Evaluation of Protective Measures. Report of the International Advisory Committee for the IAEA. Vienna: International Chernobyl Project, 1991.
19. VanRooyen, MJ, VanRooyen, JB, Sloan, EP et al. : Mobile medical relief and military assistance in Somalia. Prehospital and Disaster Medicine 1995;10:118120.
20. Pynoos, RS, Goenjian, A,Tashjian, M et al. : Post-traumatic stress reactions in children after the 1988 Armenian earthquake. Br J Psychiat 1993;163:239247.
21. Selidovkin, GD: Medical care in first period of radiation accidents. Journal of Disaster Medicine-Russia 1995;1–2:109118.
22. Ginzberg, HM: The psychological consequences of the Chernobyl accident. International Atomic Energy Agency Study, Public Health Reports 1993;184192.
23. Kramer, WM, Bahme, CW: Fire Officer's Guide to Disaster Control. 2nd ed. Saddle Brook, NJ: Fire Engineering Books and Videos.
24. Noji, EK: Hospital disaster preparedness in Osaka, Japan. Prehospital and Disaster Medicine 1994;9:9495.
25. Comfort, LK: Revisiting Kobe. Presentation at National Disaster Medicine System (NDMS) Annual Conference. San Diego, CA, 17 March, 1995.
26. Drabek, TE: The Professional Emergency Manager. Program on Environment and Behavior. Monograph No.44. Institute of Bahavioral Science, University of Colorado, 1987.
27. Baranov, AE, Densov, D, Fliedner, TM: Pre-Computer Preforma for the International Computer Database for Radiation Exposure. Case Histories. Berlin: Springer-Verlag, 1994.
28. Lord, EJ: Minneapolis Veterans Affairs Medical Center, Personal communication, May 1995.
29. Noji, EK, Kelen, GD, Armenian, HK et al. : The 1988 earthquake in Soviet Armenia: A case study. Ann Emerg Med 1990;19:891897.
30. International Nuclear Safety Group: Summary Report on the Post-Accident. Safety Series No. 75-INSAG-1. Vienna: International Nuclear Safety Group, 1986.
31. Silverstein, M: Prediction Parameters for Industrial Disasters: Bhopal, Chernobyl and Hamlet, North Carolina. Rome: World Conference on Health Emergencies in Technological Disasters, May, 1992:pp 2223.
32. Mitchell, JT: When disaster strikes…The critical incident stress debriefings, Journal of Emergency Services 1983;8:3639.
33. Mitchell, JT: Stress: The history, status and future of critical incident stress debriefing process, Journal of Emergency Services 1988;13:4752.
34. Myers, DG: Disaster Response and Recovery: A Handbook for Mental Health Professionals. Rockville, MD: CMHS, DHHS Publication No. SMA 94–3010, 1994.
35. Weaver, JD: Disasters: Mental Health Interventions. Sarasota, FL: Professional Resources Press, 1995.
36. Mozgovaya, AV: Social Consequences of the Chernobyl Catastrophe: Some Results of Sociological Research. Preliminary Paper 198. University of Delaware, Disaster Research Center, 1993.
37. Baum, A, Gatchel, RJ, Schaeffer, MA: Emotional, behavioral and physiological effects of chronic stress at Three Mile Island. J Consult Clin Psychol 1983;51:565572.
38. Davidson, LM, Baum, A: Chronic stress and posttraumatic stress disorders. J Consult and Clin Pyschol 1986;54:303308.
39. Collins, DL, deCarvalho, AB: The 137Cs radiation accident: Psychological, behavioral and neuroendocrine chronic stress indices. J Behav Med 1993;18:149157.
40. Aleksandrovski, J: Psychoneurotic disorders associated with the Chernobyl accident. Medical Aspects of the Chernobyl Accident. IA–292 1989.
41. Rubonis, AV, Bickman, L: Psychological impairment in the wake of disaster: The disaster-psychopathology relationship. Psychol Bull 1991;109:384399.
42. Bolin, R, Bolton, P: Race, Religion and Ethnicity in Disaster Recovery. Program on Environment and Behavior. Monograph No. 42, Institute of Behavioral Science, University of Colorado, 1986.
43. Guscova, AK, Baranov, AE, Baranova, AV et al. : Acute effects of radiation victims from the Chernobyl reactor explosion. Medical Radiology 1987;32:318.
44. Barabanova, AV: The use of dosimetric data for the assessment of the prognosis of the severity and outcome of local radiation injuries. Br J Radiology (Suppl) 1986;19:7374.
45. Leon, GR, Koscheyev, VS, Gourine, AV: Radiation concerns in a non-contaminated village in the Chernobyl area. Unpublished data, 1995.
46. Tysb, AF, Ivanov, VK, Rastopchin, EuM: Radiation and epidemiological system analysis of the registry data on persons involved in the recovery operation. Bulletin of the All-Russia Medical and Domestic State Registry: Radiation and Risk 1992;2:69110.
47. Koscheyev, VS, Martens, VK, Lartzev, MA: Peculiarities of accident consequences: Immediate and late consequences of the Chernobyl NPP accident. Collected Materials of All-Union Symposium, Russia, 1987.
48. Koscheyev, VS, Martens, VK, Kosenkov, AA et al. : Psychological status of Chernobyl nuclear power plant operators after the nuclear disaster. J Trauma Stress 1993;6:123130.
49. Moscovskii Komsomoletz: Newspaper article, Moscovskii Komsomoletz, Moscow, 24 August, 1994.
50. Bergstrom, S, Bochkov, NP, Leaf, A: Effects of Nuclear War on Health and Health Services. 2nd ed. Geneva: World Health Organization, 1987.
51. National Research Council: Health Effects of Exposure to Low Levels of Ionizing Radiation (BEIR V), Committee on the Biological Effects of Ionizing Radiation, Board of Radiation Effects, Effects Research Commission on Life Sciences, Washington DC: National Academy Press, 1990.
52. Shimizu, Y, Kato, H, Schull, WJ et al. : Comparison of Risk Coefficients for Site-Specific Cancer Mortality Based on the DS86 and T65DR Shielded Kerma and Organ Doses. Life Span Study Report 11, Part 1. Technical Report RERF TR 12–87. Washington DC: Hiroshima Radiation Effects Research Foundation, 1987.
53. National Research Council: The Effect on Populations of Exposure to Low Levels of Ionizing Radiation (BEIR III). Committee on the Biological Effects of Ionizing Radiation, Washington, DC: National Academy Press, 1980.
54. Sevc, J, Junz, E, Tomasek, L: Cancer in man after exposure to Rn daughters. Health Physics 1988;54:2746.
55. Koscheyev, VS, Leon, GR: Strategies for test battery selection for Screening large populations exposed to radiation disasters. University of Minnesota, 1994.

Keywords

Lessons Learned and Unsolved Public Health Problems After Large-Scale Disasters

  • Victor S. Koscheyev (a1), Gloria R. Leon (a2) and Ian A. Greaves (a1)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed