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The Public Health Consequences of Disasters

  • Eric K. Noji (a1)


Although disasters have exacted a heavy toll of death and suffering, the future seems more frightening. Good disaster management must link data collection and analysis to the decision-making process. The overall objectives of disaster management from the viewpoint of public health are: 1) needs assessments; 2) matching available resources with defined needs; 3) prevention of further adverse health effects; 4) implementation of disease-control strategies; 5) evaluation of the effectiveness of the application of these strategies; and 6) improvement in contingency planning for future disasters.

The effects of sudden-onset, natural disasters on humans are quantifiable. Knowledge of the epidemiology of deaths, injuries, and illnesses is essential to determine effective responses; provide public education; establish priorities, planning, and training. In addition, the temporal patterns for the medical care required must be established so that the needs in future disasters can be anticipated.

This article discusses: 1) the nature of disasters due to sudden-onset, natural events; 2) the medical and health needs associated with such events and disasters; 3) practical issues of disaster responses; and 4) the advance organization and management of disasters. The discussion also includes: 1) discussions of past problems in disaster management including non-congruence between available supplies and the actual needs of the affected population; 2) information management; 3) needs assessments; 4) public health surveillance; and 5) linking information with decision-making. This discussion is followed by an analysis of what currently is known about the health-care needs during some specific types of sudden-onset, natural disasters: 1) floods; 2) tropical cyclones; 3) tornadoes; 4) volcanic eruptions; and 5) earthquakes. The article concludes with descriptions of some specific public-health problems associated with disasters including epidemics and disposition of corpses.

All natural disasters are unique in that the regions affected have different social, economic, and health backgrounds. But, many similarities exist, and knowledge about these can ensure that the health and emergency medical relief and limited resources are well-managed.

A pesar que los desastres han exigido una pesada carga de sufrimiento y muerte, el future parece ser mas atemorizador. El buen manejo de los dasastres debe unir la recolección y análisis de datos alproceso de toma de decisiones. Los objetivos generales del manejo de los desastres, desde el punto de vista de la salud .pública son 1) evaluación de necesidades, 2) aparear los recursos disponibles con las necesidades definidas, 3) prevenir efectos adversos adicionales sobre is salud, 4) implementar estrategias de control de enfermedades, 5) evaluar la effectividad de la aplicación de estas estrategias y 6) mejorar elplaneamiento de contingencia para desastres futuros.

Los efectos de los desastres naturales de aparición súbita sobre los humanos son cuantificables. El conocimiento de la epidemiologia de las muertes, lesiones, y enfermiedades es esencial para determinar respuestas efectivas, proveer educación pública, establecer prioridades, planificación y capacitación. Además. Se deben establecer los patrones temporales de atención médica requerida de modo que se puedan anticipar las necesidades en desastres futuros.

Este articulo discate 1) la naturaleza de los desastres debidos a eventos naturales de aparicón súbita, 2) las necesidades médicasy de salud asociadas con tales eventos y desastres, 3) aspectos prácticos de respuesta ante desastres, 4) la avanzada organización y manejo de desastres. La .discusión también incluye 1) discusiones de pasados problemas en el manejo de desastres, que incluyen la incongruencia entre los suministros disponibles y las necesidades reales de la pobiación afectada, 2) el manejo de la información, 3) la evaluación de necesidades, 4) la vigilancia de la salud pública, 5) el enlazar la información can la toma de decisiones. Esta discusión es seguida por un análisis de lo que actualinente se conoce sobre las necesidades de atención médica durante algunos tipos específicos do desastres naturales de inicio súbito 1) inundaciones, 2) ciclones tropicales, 3) tornados, 4) erupciones volcánicas y 5) terremotos. El artículo concluye con descripciones de algunos problemas de salud especificos asociados con los desastres incluyendo epidemias y disposición de cadáveres.

Todos los desastres naturales son úinicos en que las regiones afectadas tienen diferentes antecedentes sociales, económicos y de salud. Pero, exiisten muchas similitudes y el conocimiento de éstas puede asegurar que la salud y le ayuda médka y los limitados recursos sean bis manejados.


Corresponding author

*National Center for Infectious Diseases, Centers for Disease Control & Prevention (CDC), Mail Stop C-18, 1600 Clifton Road, Atlanta, GA 30333, E-mail:


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1.Guha-Sapir, D, Lechat, MF: Reducing the impact of natural disasters: Why aren't we better prepared? Health Policy and Planning 1986;1:118126.
2.National Research Council: Confronting Natural Disasters: An International Decade for Natural Disaster Reduction. Washington, DC: National Academy Press. 1987.
3.Office of US Foreign Disaster Assistance: Disaster History: Significant Data of Major Disasters Worldwide, 1900-Present. Washington, DC: Agency for International Development. 1999.
4.IDNDR Secretariat: The International Decade for Natural Disaster Reduction: Action Plan for 1998–1999. Geneva: UN Office for the Coordination of Humanitarian Assistance. 1998: pp 12.
5.Tatemachi, K: Acute diseases during and after the Great Hanshin-Awaji earthquake. In: Proceedings of the WHO Symposium Earthquakes and People's Health, 27–30 January 1997. Kobe Japan: WHO Center for Health Development. 1997. pp 4852.
6.Kunii, O, Akagi, M, Kata, E: Health consequences and medical and public health response to the Great Hanshin-Awaji Earthquake in Japan: A Case Study in Disaster Planning. Medicine and Global Survival 1995;2:3245.
7.Tanaka, K: The Kobe earthquake: The system response. A disaster report from Japan. Eur J Emerg Med 1996;3:263269.
8.Oda, Y, Shindoh, M, Yukioka, H, et al: Crush syndrome sustained in the 1995 Kobe, Japan earthquake: Treatment and outcome. Ann Emerg Med 1997;30:507512.
9.Centers for Disease Control and Prevention: Morbidity surveillance following the Midwest flood — Missouri, 1993. MMWR 1993;42: 797798.
10.Centers for Disease Control and Prevention. Public health consequences of a flood disaster - Iowa, 1993. MMWR 1993;42:653656.
11.Centers for Disease Control and Prevention: Flood-related mortality — Missouri, 1993. MMWR. 1993;42:836838.
12.Chartoff, SE, Gren, JM: Survey of Iowa emergency medical services on the effects of the 1993 floods. Prehosp Disast Med 1997;12:210214.
13.Hagman, G: Prevention Better than Cure. Stockholm: Swedish Red Cross. 1984.
14.Wijkman, A, Timberlake, L: Natural Disasters: Acts of God or Acts of Man. New York: Earthscan. 1984.
15.UN General Assembly: International Decade for Natural Disaster Reduction: Report of the Secretary-General. 43rd Session, Agenda Item 86. A/43/723. 18 October 1988. New York: United Nations. 1988.
16.Binder, S, Sanderson, LM: The role of the epidemiologist in natural disasters, Ann Emerg Med 1987;16:10811084.
17.Foege, WH: Public health aspects of disaster management. In: Last, JM (ed): Public Health and Preventive Medicine, Norwalk, Conn: Appleton-Century-Crofts. 1986.
18.Western, K: The Epidemiology of Natural and Man-Made Disasters: The Present State of the Art. Dissertation for the Academic Diploma in Tropical Public Health, London School of Hygiene and Tropical Medicine, London: University of London. 1972.
19.Armenian, HK: Methodologie issues in the epidemiologie studies of disasters. In: Proceedings of the International Workshop on Earthquake Injury Epidemiology: Implications for Mitigation and Response, Baltimore: Johns Hopkins University, 1989. pp 95106.
20.Guha-Sapir, D, Lechat, MF: Information systems and needs assessment in natural disasters: An approach for better disaster relief management, Disasters 1986;10:232237.
21.Glass, RI, Noji, EK: Epidemiologie surveillance following disasters. In: Halperin, WE, Baker, EL, Monson, RR (ed): Public Health Surveillance, New York: Van Nostrand Reinhold. 1992.
22.Noji, EK, Sivertson, KT: Injury prevention in natural disasters: A theoretical framework. Disasters 1987;11:290296.
23.Contzen, H: Preparations in hospital for the treatment of mass casualties, Prehosp Disast Med 1985;1:118–73.
24.Katz, LB, Pascarelli, EF: Planning and developing a community hospital disaster program. Emergency Medical Services, Sept/Oct 1978:70.
25.Seaman, J: Disaster epidemiology: Or why most international disaster relief is ineffective. Injury 1990;21:58.
26.Pan-American Health Organization: Emergency Health Management after Natural Disaster. Scientific publication no. 407, Washington, DC: PAHO Office of Emergency Preparedness and Disaster Relief Coordination. 1981.
27.World Health Organization: Emergency care in natural disasters: Views of an international seminar. WHO Chron 1980;34:96100.
28.Jenkins, AL, van de Leuv, JH: Disaster Planning in Emergency Department Organization and Management, 2 ed.St Louis: Mosby. 1978.
29.Foege, WH: Public health aspects of disaster management. In: Last, JM (ed), Public Health and Preventive Medicine, 11 ed, New York: Appleton-Century-Crofts. 1980. Ville de Goyet, C, Jeannee, E: Epidemiological data on morbidity and mortality following the Guatemala earthquake. IRCS Med Sci Soc Med 1976;4:212. Ville de Goyet, C, del Cid, E, Romero, A, et al: Earthquake in Guatemala: Epidemiological evaluation of the relief effort. Pan Am Health Organ Bull 1976;10:95109.
32.Autier, P, Ferir, M, Hairapetian, A, et al: Drug supply in the aftermath of the 1988 Armenian earthquake. Lancet 1990;335:13881390.
33.Lechat, MF: Updates: The epidemiology of health effects of disasters, Epidemiol Rev 1990;12:192197.
34.Noji, EK, Toole, MJ: Public health and disasters: The historical development of public health responses to disasters. Disasters. 1997;21:369379.
35.Toole, MJ, Tailhades, M: Disasters: What are the needs? How can they be assessed? Trop Doet 1991;219(suppl):1823.
36.World Health Organization: Rapid Health Assessment Protocols. Geneva: WHO. 1999.
37.Smith, GS: Development of rapid epidemiologic assessment methods to evaluate health status and delivery of health services. Int J Epidemiol 1989;18(suppl):S2.
38.Guha-Sapir, D: Rapid needs assessment in mass emergencies: Review of current concepts and methods. World Health Stat Q 1991;44:171181.
39.Centers for Disease Control: Rapid health needs assessment following Hurricane Andrew in Florida and Louisiana, MMWR 1992;41:685688.
40.Surmieda, MRS, Abad-Viola, G, Abellanosa, IP, et al: Surveillance in evacuation camps after the eruption of Mt. Pinatubo. MMWR Surveilance Summaries 1992;41(No. Ss-4):912.
41.Orlowski, J: Floods, hurricanes, and tsunamis. In: Baskett, P, Weller, R (ed), Medicine for Disasters, London: Wright. 1988.
42.French, JG, Ing, R, Von allmen, S, et al: Mortality from flash flood: A review of National Weather Service Reports. Public Health Rep 1983;98:584588.
43.Beinin, L: Medical Consequences of Natural Disasters, Berlin: Springer-Verlag. 1985.
44.Seaman, J: Epidemiology of natural disasters. Contrib Epidemiol Biostat 1984;5:1177.
45.Sommer, A, Mosley, WH: East Bengal cyclone of November. Lancet 1970;1:10291036.
46.Ussher, JH: Philippine flood disaster, J Res Naval Med Serv 1973;59:81.
47.Dietz, VJ, Rigau-Perez, JG, Sanderson, L, et al: Health assessment of the 1985 Flood disaster in Puerto Rico, Disasters 1990;14:164170.
48.Pan-American Health Organization: Assessing Needs in the Health Sector after Floods and Hurricanes, Technical paper no. 11. Washington, DC: The Organization. 1987. Ville de Goyet, C, Zeballos, JL: Communicable diseases and epidemiological surveillance after sudden natural disasters. In: Baskett, P, Weller, R (ed): Medicine for Disasters, London: Wright. 1988.
50.Malilay, J: Floods. In: Noji, EK (ed), The Public Health Consequences of Disasters, New York: Oxford University Press. 1997.
51.Federal Emergency Management Agency: Principal Threats Facing Communities and Local Emergency Management Coordinators: A Report to the US Senate Committee on Appropriations. Washington, DC: FEMA Office of Emergency Management. 1992.
52.Philen, RM, Combs, DL, Miller, L, et al: Hurricane Hugo related deaths: South Carolinea and Puerto Rico, 1989. Disasters. 1992;16:5359.
53.Gross, EM: The hurricane dilemma in the United States, Episodes: International Geoscience Newsmagazine 1991;14:36.
54.Sheets, RC: The United States Hurricane Problem: An Assessment for the 1990's. Miami: National Hurricane Center. 1994:145.
55.Glass, RI, Bern, C, Sniezek, J, et al: Health Effects of the 1991 Bangladesh Cyclone: Report of a UNICEF Evaluation Team. New York: UNICEF. 1992:153165.
56.Frazier, K: The Violent Face of Nature: Severe Phenomena and Natural Disasters, New York: William Morrow. 1979.
57.French, JG: Hurricanes. In: Gregg, MB (ed), The Public Health Consequences of Disasters, Atlanta: Centers for Disease Control. 1989.
58.Pan-American Health Organization: Report on Disasters and Emergency Preparedness for Jamaica, St. Vincent and Dominica, Disaster report no. 2. Washington, DC: The Organization. 1980.
59.Centers for Disease Control: Medical examiner reports of deaths associated with Hurricane Andrew in Florida: Preliminary report. MMWR 1992;41:641644.
60.Gurd, CH, Bromwich, A, Quinn, JV: The health management of Cyclone Tracy, Med J Aust 1975;1:641.
61.Centers for Disease Control: Medical examiner/coroner reports of deaths associated with Hurricane Hugo, South Carolina. MMWR 1989;38:754762.
62.Centers for Disease Control: Update: Work-related electrocutions associated with Hurricane Hugo. MMWR 1989;38:718.
63.Henderson, AK, Lillibridge, SR, Salinas, C, Graves, RW, Roth, PB, Noji, EK: Disaster medical assistance teams: Providing health care to a community struck by Hurricane Iniki. Ann Emerg Med 23:726730, 1994.
64.Roth, PB: The St. Croix disaster and the National Disaster Medical System. Ann Emerg Med 1991;20:391395.
65.Noji, EK: Analysis of medical needs in disasters caused by tropical cyclones: The need for a uniform injury reporting scheme. J Trop Med &Hyg 1993;96:370376.
66.Cohen, SP, Raghavulu, CV: The Andora Pradesh Cyclone of 1977. New Delhi, India: Vikas. 1979.
67.Centers for Disease Control and Prevention: Deaths associated with Hurricanes Marilyn and Opal — United States, September-October 1995. MMWR. 1996;45:3238.
68.Longmire, AW, Burch, J, Broom, LA: Morbidity of Hurricane Elena, South Med J 1988;81:13431345.
69.Longmire, AW, Ten Eyck RP: Morbidity of Hurricane Frederic, Ann Emerg Med 1984;13:334335.
70.Pan American Health Organization: The Effects of Hurricane David, 1979, on the Population of Dominica, Disaster Report No. 1, Washington, DC: The Organization. 1979.
71.Pan-American Health Organization: Hurricane Gilbert in Jamaica, September, 1988, Disaster Report No. 5, Washington, DC: The Organization. 1989.
72.Centers for Disease Control: Surveillance of shelters after Hurricane Hugo in Puerto Rico. MMWR 1990;39:41.
73.US Public Health Service: Hurricane Mitch. Situation Report No. 3. Rockville, Md: US Public Health Service. 1998.
74.Noji, EK: The Public Health Consequences of Disasters. New York and Oxford, Oxford University Press, 1997.
75.Bissell, R: Delayed-impact infectious disease after a natural disaster, J Emerg Med 1983;1:5967.
76.Lillibridge, DR: Tornadoes. In: Noji, EK (ed): The Public Health Consequences of Disasters. New York: Oxford University Press. 1997.
77.Galway, G: Relationship of tornado deaths to severe weather watch areas, Monogr Weather Rev 1975;103:737755.
78.National Oceanic and Atmospheric Administration, US Department of Commerce: Tornado. Washington, DC: US Government Printing Office. 1973.
79.Kindel, S: Penny-wise, pound-foolish, Forbes 1985;17:170.
80.Brenner, SA, Noji, EK: Risk factors for death and injury in tornadoes: An epidemiologie approach. In: Church, C, Burgess, D, Doswell, C, et al (eds): The Tornado: Its Structure, Dynamics, Prediction, and Hazards, Washington, DC: American Geophysical Union. 1993.
81.Glass, RI, Craven, RB, Bregman, DJ: Injuries from the Wichita Falls tornado: Implications for prevention, Science 1980;207:734738.
82.Gordon, PD: Special Statistical Summary of Deaths, Injuries and Property Loss by Type of Disaster, 1970–1980, Washington, DC: Federal Emergency Management Agency. 1982.
83.Brenner, SA, Noji, EK: Head injuries and mortality in tornado disasters. Am J Public Health 1992;82:1296. Letter.
84.Mandelbaum, I, Nahrwold, D, Boyer, DW: Management of tornado casualties. J Trauma 1966;6:353357.
85.Bakst, HJ: The Worcester County Tornado: Medical Study of the Disaster, Washington, DC: National Research Council, Committee on Disaster Studies. 1954.
86.Brenner, SA, Noji, EK: Wound infections after tornadoes. J Trauma 1992;33:643. Letter.
87.Hight, D: Medical aspects of the Worcester tornado disaster. N Engl J Med 1956;254:267271.
88.Gilbert, DN, Sanford, JP, Kutscher, , et al: Microbiologie study of wound infections in tornado casualties. Arch Environ Health 1973;26:125130.
89.Ivy, JH: Infections encountered in tornado and automobile accident victims. J Ind Med Assoc 1968;61:16571660.
90.Blong, RJ: Volcanic Hazards: A Sourcebook on the Effects of Eruptions. North Ryde, Australia: Academic Press. 1984.
91.Bailey, RA: The Volcano Hazards Program: Objectives and long-range plans. US Geological Survey Open-File Report 83–400. 1983.
92.Bernstein, RS, Baxter, PJ, Buist, AS: Introduction to the epidemiological aspects of explosive volcanism. Am J Public Health 1986;76 (suppl):39.
93.Cuny, F: Disasters and Development, Oxford, Eng: Oxford University Press. 1983.
94.Baxter, PJ, Bernstein, RS, Falk, , et al: Medical aspects of volcanic disasters: An outline of the hazards and emergency response measures. Disasters 1982;6:268276.
95.Baxter, PJ: Volcanoes. In: Noji, EK (ed): The Public Health Consequences of Disasters, New York Oxford University Press. 1997.
96.Walker, GPL: Volcanic hazards. Interdisc Sci Rev 1982;7:148153.
97.Kerr, RA: Volcanoes to keep an eye on. Science 1983;221:634637.
98.Sigurdsson, H, Carey, S: Volcanic disasters in Latin America and the 13th November 1985 eruption of Nevado del Ruiz volcano in Colombia. Disasters 1986;10:205210.
99.Othman-Chande, M: The Cameroon volcanic gas disaster: An analysis of a makeshift response, Disasters 1987;2:96102.
100.Sigurdsson, H: Gas bursts from Cameroon crater lakes: A new natural hazard. Disasters 1988;12:131134.
101.Bernstein, RS, Baxter, PJ, Falk, H, et al: Immediate public health concerns and actions in volcanic eruptions: Lessons from the Mt. St. Helens eruptions, May 18-October 18, 1980. Am J Public Health 1986:76(suppl):2537.
102.Nania, J, Bruya, TE: In the wake of Mount St. Helens. Ann Emerg Med 1982;11:184187.
103.Rubin, CH, Noji, EK: Impact of the eruption of Mt. Hudson on livestock in Argentina. Bull Global Volcanism Network 1991;16:56.
104.Manni, C, Magalini, S, Proietti, R: Volcanoes. In: Baskett, P, Weller, R (ed): Medicine for Disasters, London: Wright. 1988.
105.Malilay, J: Volcanic Eruption of Cerro Negro, Nicaruagua, April, 1992. Report to the Pan American Health Organization (PAHO). Washington, DC: PAHO Emergency Preparedness and Disaster Relief Coordination Unit. 1992.
106.Eisele, JW: Death during the May 18, 1980, eruption of Mount St. Helens. N Engl J Med 1981;305:931936.
107.Baxter, PJ, Bernstein, RS, Buist, AS: Preventive health measures in volcanic eruptions. Am J Public Health 1986;76(suppl):8490.
108.Falk, H, Baxter, PJ, Ing, R: Mount St. Helens Volcano Health Report No 18, Atlanta: Centers for Disease Control. 1980.
109.Falk, H, Baxter, PJ, Ing, R: Mount St. Helens Volcano Health Report No 19, Atlanta: Centers for Disease Control. 1980.
110.Oxtoby, MJ, Broome, CV, Pinzon, MR: Late mortality in Nevado del Ruiz victims. In: Disaster Chronicles No. 4, The Volcanic Eruption in Colombia, November 13, 1985. Washington, DC: Pan-American Health Organization. 1986.
111.Malilay, J: Medical and healthcare aspects of the 1992 earthquake in Egypt. In: Report of the Earthquake Engineering Research Institute Reconnaissance Team, Oakland: Earthquake Engineering Research Institute. 1992.
112.Shoaf, KI, Nguyen, LH, Sareen, HR, Bourque, LB: Injuries as a result of California earthquakes in the past decade. Disasters 1998;22:218235.
113.Arnold, C, Durkin, M: Hospitals and the San Fernando Earthquake of 1971: The Operational Experience. San Mateo, Calif: Building Systems Development, Inc, 1983. p 1.
114.Noji, EK, Jones, NP: Hospital preparedness for earthquakes. In: Tomasik, KM (ed) Emergency Preparedness: When Disaster Strikes. Plant, Technology & Safety Management Series, Oakbrook Terrace, Ill: Joint Commission on the Accreditation of Healthcare Organizations. 1994.
115.Reitherman, R: How to prepare a hospital for an earthquake, J Emerg Med 1986;4:119131.
116.Glass, RI, Urrutia, JJ, Sibony, S: Earthquake injuries related to housing in a Guatemalan village. Science 1977;197:638643.
117.Noji, EK, Kelen, GD, Armenian, HK, et al: The 1988 earthquake in Soviet Armenia: A case study, Ann Emerg Med 1990;19:891.
118.Pointer, JE: The 1989 Loma Prieta earthquake: Impact on hospital care, Ann Emerg Med 1992;21: 12281233.
119.Coburn, AW, Hughes, RE: Fatalities, injury and rescue in earthquakes. In: 2nd Conference of the Development Studies Association, Manchester, Eng: University of Manchester. 1987.
120.Coburn, AW, Murakami, HO, Ohta, Y: Factors affecting fatalities and injury. In: Earthquakes: Engineering Seismology and Earthquake. Disaster Prevention Planning Internal Report. Hokkaido University, Hokkaido, Japan, 1987.
121.Better, OS, Stein, JH: Early management of shock and prophylaxis of acute renal failure in traumatic rhabdomyolysis, N Engl J Med 1990:322:825829.
122.Safar, P, Pretto, EA, Bircher, NG: Resuscitation medicine including the management of severe trauma. In Baskett, P, Weiler, R (ed), Medicine for Disasters, London: Wright. 1988.
123.Noji, EK: Earthquakes. In: Noji, EK (ed): The Public Health Consequences of Disasters, New York: Oxford University Press. 1997.
124.Memarzadeh, P: The earthquake of August 31, 1968, in the South of Khorasan, Iran. In: Proceedings of the Joint IHF/IUA/UNDRO/WHO Seminar. Manila: World Health Organization Regional Office. 1978.
125.Noji, EK, Armenian, HK, Oganessian, A: Issues of rescue and medical care following the 1988 Armenian earthquake. Int J Epidemiol. 1993;22:10701076.
126.Thiel, CC: 911 EMS process in the Loma Prieta earthquake, Prehosp Disast Med 1992;7:348358.
127.Noji, EK: Acute renal failure in natural disasters. Renal Failure 1992;14:245246.
128.Noji, EK: Prophylaxis of acute renal failure in traumatic rhabdomyoly-sis. N Engl J Med 1990;323:550. Letter.
129.Hingston, RA, Hingston, L: Respiratory injuries in earthquakes in Latin America in the 1970s: a personal experience in Peru (1970); Nicaragua (1972–3); and Guatemala (1976). Disaster Med 1983;1:425426.
130.Noji, EK: Medical consequences of earthquakes: Coordinating medical and rescue response. Disaster Management 1991;4:3240. Bruycker, M, Greco, D, Lechat, MF: The 1980 earthquake in southern Italy: Morbidity and mortality. Int J Epidemiol 1985;14:113117.
132de Bruycker, M, Greco, D, Annino, I, et al: The 1980 earthquake in southern Italy: Rescue of trapped victims and mortality. Bull WHO 1983;61:10211025.
133.Safar, P: Resuscitation potentials in mass disasters, Prehosp Disast Med 1986;2:34.
134.Schultz, CH, Koenig, KL, Noji, EK. A medical disaster response to reduce immediate mortality after an earthquake. N Eng J Med 1996;334:438444.
135.Yong, S: Medical support in the Tangshan earthquake: A review of the management of mass casualties and certain major injuries. J Trauma 1987;27:11301135.
136.Katsouyanni, K, Kogevinas, M, Trichopoulos, D: Earthquake-related stress and cardiac mortality. Int J Epidemiol 1986;15:326330.
137.Trichopoulos, D, Katsouyanni, K, Zavitsanos, X: Psychological stress and fatal heart attack: The Athens 1981 earthquake natural experiment. Lancet 1983;1:441443.
138.Toole, MJ: Communicable disease epidemiology following disasters. Ann Emerg Med 1992;21:418420.
139.Aghababian, RV, Teuscher, J: Infectious diseases following major disasters. Ann Emerg Med 1992;21:362367.
140.Centers for Disease Control: Outbreak of diarrheal illness associated with a natural disaster in Utah. MMWR 1986;35:662664.
141.Centers for Disease Control: Health assessment of the population affected by flood conditions in Khartoum, Sudan. MMWR 1989;38:785788.
142.Gregg, M: Management of Surveillance Operations following a Disaster. Atlanta: Centers for Disease Control. 1979.
143.Woodruff, B, Toole, JM, Rodriguez, DC, et al: Disease surveillance and control after a flood in Khartoum, Sudan, 1988, Disasters 1990; 14:151163.
144.Centers for Disease Control: Current trends in flood disasters and immunization in California. MMWR 1983;32:171172.
145.Hooft, PJ, Noji, EK, Van de Voorde, HP: Fatality management in mass-casualty incidents. Forensic Sei Int 1989;40:314.
146.Noji, EK: Progress in disaster management. Lancet 1994;343: 12391240.
147.Editorial: Disaster epidemiology. Lancet 1990;336:845846.
148.Chen, Y, Tsoi, KL, Chen, F, et al: The Great Tangshan Earthquake of 1976: An anatomy of disaster. Oxford (UK)Pergamon Press, 1988



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