Injury Patterns After the Landslide Disaster in Oshima, Tokyo, Japan on October 16, 2013

Human Vulnerability to Landslides

Landslides pose a devastating threat to human health, killing thousands of people annually. Human vulnerability is a crucial element of landslide risk reduction, yet up until now, all methods for estimating the human consequences of landslides rely on subjective, expert judgment. Furthermore, these methods do not explore the underlying causes of mortality or inform strategies to reduce landslide risk. In light of these issues, we develop a data-driven tool to estimate an individual's probability of death based on landslide intensity, which can be used directly in landslide risk assessment. We find that between inundation depths of approximately 1-6 m, human behavior is the primary driver of mortality. Landslide vulnerability is strongly correlated with the economic development of a region, but landslide losses are not stratified by gender and age to the degree of other natural hazards. We observe that relatively simple actions, such as moving to an upper floor or a prepared refuge space, increase the odds of survival by up to a factor of 12. Additionally, community-scale hazard awareness programs and training for citizen first responders offer a potent means to maximize survival rates in landslides.

Physical rehabilitation in the context of a landslide that occurred in Brazil

Backgrounds

The efforts to develop research and training on physical rehabilitation in regards to disasters is considered recent worldwide. In the late evening of the 11th up until the 12th of January of 2011, the most massive natural disaster occurred in Brazil with extremely heavy downpour, abrupt flood, as well as landslides on multiple areas of the Mountain Region of Rio de Janeiro. The objective of this research was to investigate the challenges in terms of physical rehabilitation provided by this event

Methods

The cross-sectional mixed method’s study, which was conducted in the city of Nova Friburgo, used two different data sources: hospital records on traumatic injuries pre and post disaster, and interviews with key informants - victims who suffered injuries related to the disaster, professionals from rehabilitation services in the municipality, and also the city’s health service management. Pearson’s chi-squared test was performed to evaluate statistical significance between the week of a given incident and the type of injury. Interviews were transcribed and analysed through content analysis.

Results

A total of 2326 hospital records and 27 interviews were analysed. The proportion of traumatic injury in the municipal emergency service increased from 16% in the prior week, to 40% in the week post-disaster (p <  0.0001). Different injuries were identified: multiple fractures, crushing, amputation, perforation of soft tissues, inhalation of dust and establishment of chronic conditions through stress. Despite this scenario, out of the 16 health professionals interviewed, twelve did not observe an increase in the demand for outpatient rehabilitation services after the disaster. Interviews with the victims revealed that the pathways for care ran into different barriers. From 11 victims interviewed, only one received complete physiotherapy care through the public health services in the city, while all others hired additional assistance, received volunteer services, had assistance in other cities or remained without rehabilitation.

Conclusions

The needs for rehabilitation increased after the disaster; however, the demand was repressed due to different barriers such as competing needs and possible lack of medical referral. Recommendations were made, including the action of performing a search of victims with rehabilitation needs.

Debris Flow Syndrome: Injuries and Outcomes after the Montecito Debris Flow

On January 9, 2018, a catastrophic debris flow devastated Montecito, California. A 30-foot wall of boulders, mud, and debris ran down the hillsides at 15 miles per hour injuring dozens and causing 21 prehospital deaths. A retrospective review was conducted of the victims from the debris flow presenting to Cottage Health. Injury patterns, procedures performed, complications, length of stay, and outcomes were analyzed. Twenty-four patients were evaluated; 15 were admitted. Of the patients admitted, the most common presenting symptoms were soft tissue injuries (100%), hypothermia (67%), craniofacial injuries (67%), corneal abrasions (53%), and orthopedic injuries (47%), as well as loss of an immediate family member during the incident (73%). Procedures included skin irrigation (93%), operative soft tissue debridement (47%), body orifice irrigation due to mud impaction (40%), and orthopedic repair of fractures and ligaments (40%). All survived to discharge. “Debris flow syndrome” can be defined as a pattern of injuries, including soft tissue injuries, hypothermia, craniofacial trauma, corneal abrasions, orthopedic injuries, and mud impaction. Managing the debris flow syndrome requires co-ordinated and specialized care.

Natural Disasters and Injuries: What Does a Surgeon Need to Know?

PURPOSE OF REVIEW

Natural disasters have injured more than 2 million people in the last 10 years and led to significant international medical relief deployment. Knowledge of expected injury patterns following these disasters is an important part of planning for type and size of outside surgical assistance. This review aims to summarize what is known about injury patterns following natural sudden-onset disasters (SODs).

RECENT FINDINGS

Several systematic reviews have concluded that data on injury patterns and surgical needs following natural SODs is scarce. Studies on earthquakes indicate that earthquakes generate large numbers of injured, out of which limb injuries are most common. Tsunamis, floods, storms, and wildfires do not generate a significant burden of injuries in relation to numbers affected.

SUMMARY

Earthquake may require surgical assistance, especially for limb injuries; therefore, mainly orthopedic and plastic surgeries are priority specialist areas. Major injuries seem to be few in other natural disasters. However, more detailed data is needed on specific injury patterns to determine if additional surgical assistance is needed and to what extent it is needed to cater for normal surgical conditions if existing health care has seized to function.