Destruction of Health Care Infrastructure Sendai sewage treatment - - PowerPoint PPT Presentation

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Destruction of Health Care Infrastructure Sendai sewage treatment - - PowerPoint PPT Presentation

Jul 19, 2023 236 likes •634 views

FLOODING & P UBLIC H EALTH IMPACT Paul R Hunter The Norwich Medical School University of East Anglia D IRECT IMPACTS ON HEALTH Pre-onset phase Injuries Onset phase Death by drowning Injuries Post-onset phase

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FLOODING &

PUBLIC HEALTH

IMPACT

Paul R Hunter The Norwich Medical School University of East Anglia

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DIRECT IMPACTS ON HEALTH

▪ Pre-onset phase

▪ Injuries

▪ Onset phase

▪ Death by drowning ▪ Injuries

▪ Post-onset phase

▪ Faecal oral disease ▪ Vector and rodent-borne disease ▪ Respiratory infections ▪ Skin infections ▪ Mental health

Few et al 2004

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INDIRECT IMPACTS ON HEALTH

▪ Damage to health care infrastructure ▪ Chemical contamination of food and water stocks ▪ Damage to water and sanitation infrastructure ▪ Damage to crops and/or disruption of food supplies ▪ Damage/destruction of property (e.g. lack of shelter may lead to increased

exposure to vectors)

▪ Population displacement

Few et al 2004

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Destruction of Health Care Infrastructure

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Sendai sewage treatment plant

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Onagawa

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DEATHS

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ANNUAL REPORTS OF FLOODING EVENTS GLOBALLY

50 100 150 200 250 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015

Data taken from EM-DAT http://www.emdat.be/

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ANNUAL REPORTS OF DEATHS FROM FLOODING

5000 10000 15000 20000 25000 30000 35000 40000 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015

Data taken from EMDAT Bangladesh 1974 Venezuela 1999

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ANNUAL REPORTS OF DEATHS FROM FLOODING PER

EVENT

1 10 100 1000 10000 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015

Data taken from EMDAT

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ANNUAL REPORTS OF NUMBERS AFFECTED BY

FLOODING

50.000.000 100.000.000 150.000.000 200.000.000 250.000.000 300.000.000 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015

Data taken from EMDAT

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DEATHS PER 10000 PEOPLE AFFECTED BY FLOODING

0,1 1 10 100 1000 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015

Data taken from EMDAT

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DEATHS PER EVENT BY WHO SUB-REGION 1960-2016

0,1 0,2 0,3 0,4 0,5 0,6 AFR-D AFR-E AMR-A AMR-B AMR-D EMR-B EMR-D EUR-A EUR-B EUR-C SEAR-B SEAR-D WPR-A WPR-B E D C B A

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DEATHS PER EVENT BY WHO REGION TYPE 1960-2016

0,1 0,2 0,3 0,4 0,5 0,6 0,7 ABC DE 60 - 79 80 - 99 2000+

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ACUTE MORBIDITY

High income vs low income countries

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HEALTH IMPACTS POST FLOODING

▪ Infectious dissease ▪ Toxicity ▪ Psychological ▪ Adverse Birth Outcomes

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FLOODING IN UK

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FLOODING IN DEVELOPING NATIONS

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INFECTIOUS DISEASE RISK POST FLOODING

DEVELOPED NATIONS

▪ Common source of anxiety ▪ Outbreaks infrequent

▪ Giardiasis in Utah

▪ Outbreaks of waterborne disease

have been described

▪ Cryptosporidium ▪ E. coli O157 ▪ Acanthamoeba keratitis

DEVELOPING NATIONS

▪ Enteric disease

▪ Diarrhoeal disease ▪ Hepatitis E

▪ Leptospirosis ▪ Vector-borne disease, e.g.:

▪ Malaria

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WATERBORNE

DISEASE & WATER QUALITY

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HURRICANE KATRINA

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THE KATRINA EXPERIENCE

▪ Flood waters contained high levels of faecal indicator bacteria ▪ Surface water indicator bacteria levels returned to pre-event levels within two

months

▪ Bifidobacterium and bacterial diversity analysis suggested that indicator

bacteria were of human origin

▪ Vibrio and Legionella concentrations higher post event ▪ Giardia and Cryptosporidium present in flood water

Sinigalliano et al. 2007

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KATRINA AND GROUND WATER

▪ Many wells submerged under 0.6 to 4.5m of water ▪ Associated plumbing damaged ▪ Chemical evidence of saltwater intrusion into wells ▪ Some evidence of indicator organisms

Van Biersel et al. 2007

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CHOLERA AND DIARRHOEA VISITS TO HOSPITAL POST 1998

FLOOD - BANGLADESH

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REDUCING THE

IMPACT OF FLOODING

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REDUCING THE PUBLIC HEALTH IMPACT OF FLOODING

▪ Mitigation ▪ Warning and preparedness ▪ Needs assessment ▪ Surveillance ▪ Response and recovery ▪ Continuing health education

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KATRINA

▪ Of people who did not evacuate the city prior to the arrival of Hurricane

Katrina

▪ 1/3 did not get the message ▪ 1/3 heard the message but did not understand how to evacuate.

▪ People who did not evacuate were predominantly from the poorest and most

marginalised sections of society.

Brodie et al 2006

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THE 2007 SEVERN FLOODS

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DID PEOPLE COMPLY WITH THE ADVICE?

▪ During the boil water notice

▪ 42% people used unboiled water for food preparation ▪ 38% people used unboiled water for brushing teeth ▪ 29% people used unboiled water for drinking

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SOURCES OF INFORMATION IN A DO NOT DRINK NOTICE

ISSUED DURING SEVERE FLOODING

10 20 30 40 50 60 70 internet Friend/neighbour TV Local newspaper Water company Leaflet Local radio % reporting use of information source

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CONCLUSIONS

▪ Despite the large number of floods reported annually the quality of the

evidence base for public health impacts is still poor.

▪ Not all adverse health effects of flood disasters are unavoidable ▪ By good planning and response many health effects can be eliminated (and

appear to have been) or their impact reduced

▪ In a flood emergency use multiple channels of communication.