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Meta-Analysis on the Health Effects Resulting from Evacuation or Relocation

Published online by Cambridge University Press:  23 November 2023

Grace G. Adams Open the ORCID record for Grace G. Adams [Opens in a new window] ,
Laurel MacMillan ,
Todd Smith ,
Amy Sharp  and
Rocco Casagrande
Grace G. Adams*
Affiliation:
Gryphon Scientific LLC, Takoma Park, Maryland, USA
Laurel MacMillan
Affiliation:
Gryphon Scientific LLC, Takoma Park, Maryland, USA
Todd Smith
Affiliation:
US Nuclear Regulatory Commission, Washington, DC, USA
Amy Sharp
Affiliation:
US Nuclear Regulatory Commission, Washington, DC, USA
Rocco Casagrande
Affiliation:
Gryphon Scientific LLC, Takoma Park, Maryland, USA
*
Corresponding author: Grace G. Adams; Email: gadams@gryphonscientific.com.
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Abstract

Objective:

Evacuation and relocation are key actions used to protect the public in response to natural or technological disasters, but there are inherent risks to both. Unfortunately, these risks have not been fully quantified, which limits the ability of emergency managers and the public to effectively balance the risks and benefits of evacuation or relocation. This work provides quantitative data on the risks of health effects from displacement following evacuation or relocation.

Methods:

Researchers performed a literature review and meta-analysis of published studies and quantified risks of 14 different health effects, including both physical and socio-behavioral outcomes, from studies of 9 different disaster types.

Results:

The findings show statistically significant increases in 9 of the 14 health effects in displaced populations, indicating an increased likelihood of experiencing detrimental health effects compared with nondisplaced populations. A pooled analysis of all negative health effects found an odds ratio of 1.49 (95% confidence interval: 1.24-1.79), which shows a significant relationship between displacement and negative health outcomes.

Conclusions:

These findings demonstrate that evacuated or relocated populations have an increased risk of experiencing negative health effects associated with displacement. The broad number of disaster types included mean that findings are applicable to any emergency evacuation or relocation.

Keywords

emergency managementevacuationrelocationhealth effects
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e538
Copyright
© NRC/US Government and the Author(s), 2023. To the extent this is a work of the US Government, it is not subject to copyright protection within the United States. Published by Cambridge University Press on behalf of the Society for Disaster Medicine and Public Health

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References

US Environmental Protection Agency. PAG Manual: Protective Action Guides and Planning Guidance for Radiological Incidents (2017). Accessed April 24, 2023. https://www.epa.gov/sites/default/files/2017-01/documents/epa_pag_manual_final_revisions_01-11-2017_cover_disclaimer_8.pdf Google Scholar
Baker, K. Reflection on lessons learned: an analysis of the adverse outcomes observed during the Hurricane Rita evacuation. Disaster Med Public Health Prep. 2018;12(1):115-120. doi: 10.1017/dmp.2017.27 CrossRefGoogle ScholarPubMed
Saji, G. A Post accident safety analysis report of the Fukushima Accident — future direction of evacuation: lessons learned. 2013. Accessed April 8, 2023. https://www.researchgate.net/publication/267581914_A_Post_Accident_Safety_Analysis_Report_of_the_Fukushima_Accident_-_Future_Direction_of_Evacuation_Lessons_Learned CrossRefGoogle Scholar
Tanaka, R. Prolonged living as a refugee from the area around a stricken nuclear power plant increases the risk of death. Prehosp Disaster Med. 2015;30(4):425-430. doi: 10.1017/S1049023X15004926 CrossRefGoogle ScholarPubMed
Hayashi, Y, Nagai, M, Ohira, T, et al. The impact of evacuation on the incidence of chronic kidney disease after the Great East Japan Earthquake: The Fukushima Health Management Survey. Clin Exp Nephrol. 2017;21(6):995-1002. doi: 10.1007/s10157-017-1395-8 CrossRefGoogle ScholarPubMed
Horikoshi, N, Iwasa, H, Kawakami, N, et al. Residence-related factors and psychological distress among evacuees after the Fukushima Daiichi nuclear power plant accident: a cross-sectional study. BMC Psychiatry. 2016;16(1):420. doi: 10.1186/s12888-016-1134-9 CrossRefGoogle ScholarPubMed
Satoh, H, Ohira, T, Nagai, M, et al. Prevalence of renal dysfunction among evacuees and non-evacuees after the Great East Earthquake: results from the Fukushima Health Management Survey. Intern Med. 2016;55(18):2563-2569. doi: 10.2169/internalmedicine.55.7023 CrossRefGoogle ScholarPubMed
Parker, G. Cyclone Tracy and Darwin evacuees: on the restoration of the species. Br J Psychiatry. 1977;130:548-555. doi: 10.1192/bjp.130.6.548 CrossRefGoogle ScholarPubMed
Milne, G. Cyclone Tracy: I. Some consequences of the evacuation for adult victims. Australian Psychologist. 1977;12(1):39-54. doi: 10.1080/00050067708255859 CrossRefGoogle Scholar
Wells, GA, Shea, B, O’Connell, D. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Health Research Institute Web Site. Accessed April 8, 2023. https://www.ohri.ca/programs/clinical_epidemiology/oxford.asp Google Scholar
Caramanica, K, Brackbill, RM, Stellman, SD, et al. Posttraumatic stress disorder after hurricane sandy among persons exposed to the 9/11 disaster. Int J Emerg Ment Health. 2015;17(1):356-362. doi: 10.4172/1522-4821.1000173 CrossRefGoogle Scholar
Chen, Y-L, Lai, C-S, Chen, W-T, et al. Risk factors for PTSD after Typhoon Morakot among elderly people in Taiwanese aboriginal communities. Int Psychogeriatr. 2011;23(10):1686-1691. doi: 10.1017/S1041610211000986 CrossRefGoogle ScholarPubMed
Dirkzwager, AJE, Grievink, L, van der Velden, PG, et al. Risk factors for psychological and physical health problems after a man-made disaster. Prospective study. Br J Psychiatry. 2006;189:144-149. doi: 10.1192/bjp.bp.105.017855 CrossRefGoogle ScholarPubMed
Ebner, DK, Ohsawa, M, Igari, K, et al. Lifestyle-related diseases following the evacuation after the Fukushima Daiichi nuclear power plant accident: a retrospective study of Kawauchi Village with long-term follow-up. BMJ Open. 2016;6(7):e011641. doi: 10.1136/bmjopen-2016-011641 CrossRefGoogle ScholarPubMed
Hashimoto, S, Nagai, M, Fukuma, S, et al. Influence of post-disaster evacuation on incidence of metabolic syndrome. J Atheroscler Thromb. 2017;24(3):327-337. doi: 10.5551/jat.35824 CrossRefGoogle ScholarPubMed
Lawrence, WR, Lin, Z, Lipton, EA, et al. After the storm: short-term and long-term health effects following Superstorm Sandy among the elderly. Disaster Med Public Health Prep. 2019;13(1):28-32. doi: 10.1017/dmp.2018.152 CrossRefGoogle ScholarPubMed
Ohira, T, Nakano, H, Nagai, M, et al. Changes in cardiovascular risk factors after the Great East Japan Earthquake. Asia Pac J Public Health. 2017;29(2_Suppl):47S-55S. doi: 10.1177/1010539517695436 CrossRefGoogle ScholarPubMed
Satoh, H, Ohira, T, Nagai, M, et al. Hypo-high-density lipoprotein cholesterolemia caused by evacuation after the Fukushima Daiichi Nuclear Power Plant accident: results from the Fukushima Health Management Survey. Intern Med. 2016;55(15):1967-1976. doi: 10.2169/internalmedicine.55.6030 CrossRefGoogle ScholarPubMed
Takahashi, S, Nakamura, M, Yonekura, Y, et al. Association between relocation and changes in cardiometabolic risk factors: a longitudinal study in tsunami survivors of the 2011 Great East Japan Earthquake. BMJ Open. 2016;6(5):e011291. doi: 10.1136/bmjopen-2016-011291 CrossRefGoogle ScholarPubMed
Tomio, J, Sato, H, Mizumura, H. Interruption of medication among outpatients with chronic conditions after a flood. Prehosp Disaster Med. 2010;25(1):42-50. doi: 10.1017/s1049023x00007652 CrossRefGoogle ScholarPubMed
Yzermans, CJ, Donker, GA, Kerssens, JJ, et al. Health problems of victims before and after disaster: a longitudinal study in general practice. Int J Epidemiol. 2005;34(4):820-826. doi: 10.1093/ije/dyi096 CrossRefGoogle ScholarPubMed
Borenstein, M. Introduction to Meta-Analysis. John Wiley & Sons; 2009:xxviii, 421 p.CrossRefGoogle Scholar