The Use of Epidemiologic Methods in Disasters

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The Use of Epidemiologic Methods in Disasters

• Eric K. Noji, M.D., M.P.H
• Office of the US Surgeon General
• US Public Health Service August, 2003

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Noji Eric K., M. D., M. P. H. Office of the US
Surgeon General US Public Health Service
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Learning objectives

• Define disaster epidemiology
• Give historical overview of disaster epidemiology
• Discuss applications of epidemiological methods
  to disasters (before, during, and after the
  events)
• Learn about challenges and problems facing
  epidemiologists following a disaster

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Epidemiology and its applications in measuring
the effects of disasters

• Epidemiology -The quantitative study of the
  distribution and determinants of health related
  events in human populations

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Epidemiology and its applications in measuring
the effects of disasters

• Disaster Epidemiology- The use of epidemiology in
  disaster situations. Epidemiologic methods can be
  used to measure and describe the adverse effects
  of natural and human-caused disasters.

September 11, 2001, New York
Earthquake in Armenia 1980s
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(No Transcript)
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Types of Studies in Disaster Epidemiology

• Surveillance
• Public health impact evaluation
• Natural history evaluation
• Analytic studies of risk factors
• Clinical investigation
• Population based study
• Studies of psychological effects of disasters

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Historical Developments of Disaster Epidemiology

• 1950-early review of the role of epidemiology
  during disasters (Saylor and Gordon)

Late 1960s Civil War in Nigeria-practical
application of epidemiology in disaster management
Nigeria Civil War refugees
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Historical Developments of Disaster Epidemiology
(continued)

• Early 1970- Establishment of the Centre for
  Research on the Epidemiology of Disasters
• 1976 Earthquake in Guatemala-important
  epidemiologic studies
• 1980 Eruption of Mt. St. Helens major milestone
  in shaping governments response to disasters

Railroad destroyed by earthquake in Guatemala
Eruption on Mt. St. Helens
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Application of Epidemiologic Methods to Disasters

• Before a Disaster
• Hazard Analyses-collecting and assessing data on
  the nature, causes, frequency, distribution, and
  effects of past events in order to make
  predictions about future events
• Vulnerability Analysis- analysis of a
  populations risk when a hazard of a given
  magnitude occurs

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Application of Epidemiologic Methods to Disasters

• During a Disaster
• Damage assessment
• Information collection
• Public Health surveillance

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Application of Epidemiologic Methods to Disasters

• After a Disaster
• Utilization of cross-sectional survey methods to
  study the frequency of deaths, illnesses,
  injuries and other adverse health effects a
  disaster
• Analytic epi. studies (case-control, cohort)
  toidentify risk factors for death and injury to
  develop evidence-based prevention strategies

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Challenges and Problems Facing Epidemiologists
Following a Disaster

• Political environment
• Changing social conditions and demographics
• Difficulty in applying standard epidemiologic
  techniques in the context of great destruction
• Lack of time for organizing epidemiologic
  investigation
• Absence of well defined population counts
• Lack of active collaboration between scientists
  from different disciplines

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Critical Knowledge Gaps and Research Priorities
in Disaster Epidemiology

• Steps that can make the results of disaster
  epidemiology more precise
• -Development of standardized protocols for
  gathering information
• -Standardization of disaster terminology,
  technologies, methods and procedures
• -Conduction of more extensive evaluation studies
• -Making greater use of existing disaster
  information systems

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Conclusions

• Epidemiology can provide much needed information
  on which a rational, effective, and flexible
  policy for the management of disasters is based.
• In particular, epidemiology provides the tools
  for rapid and effective problem solving during
  public health emergencies such as natural and
  technological disasters

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