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Tsuboi M, Sasaki H, Park H, Usuda Y, Hanashima M, Saito M, Takahashi S, Sakisaka K, Hibiya M, Kiyota K, Hatsugai K, Nishizawa M, Sugawara Y, Tsuji I, Egawa S. Evacuation at Home Delayed the First Medical Intervention in Minamisanriku Town after the 2011 Great East Japan Earthquake. Prehosp Disaster Med 2023:1-10. [PMID: 37184063 DOI: 10.1017/s1049023x2300050x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
INTRODUCTION In Japan, evacuation at home is expected to increase in the future as a post-disaster evacuation type due to the pandemic, aging, and diverse disabilities of the population. However, more disaster-related indirect deaths occurred in homes than in evacuation centers after the 2011 Great East Japan Earthquake (GEJE). The health risks faced by evacuees at home have not been adequately discussed. STUDY OBJECTIVE This study aimed to clarify the gap in disaster health management for evacuees at home compared to the evacuees at the evacuation centers in Minamisanriku Town, which lost all health care facilities after the 2011 GEJE. METHODS This was a retrospective cross-sectional and quasi-experimental study based on the anonymized disaster medical records (DMRs) of patients from March 11 through April 10, 2011, that compared the evacuation-at-home and evacuation-center groups focusing on the day of the first medical intervention after the onset. Multivariable Cox regression analysis and propensity score (PS)-matching analysis were performed to identify the risk factors and causal relationship between the evacuation type and the delay of medical intervention. RESULTS Of the 2,838 eligible patients, 460 and 2,378 were in the evacuation-at-home and evacuation-center groups, respectively. In the month after the onset, the evacuation-at-home group had significantly lower rates of respiratory and mental health diseases than the evacuation-center group. However, the mean time to the first medical intervention was significantly delayed in the evacuation-at-home group (19.3 [SD = 6.1] days) compared to that in the evacuation-center group (14.1 [SD = 6.3] days); P <.001). In the multivariable Cox regression analysis, the hazard ratio (HR) of delayed medical intervention for evacuation-at-home was 2.31 with a 95% confident interval of 2.07-2.59. The PS-matching analysis of the adjusted 459 patients in each group confirmed that evacuation at home was significantly associated with delays in the first medical intervention (P <.001). CONCLUSION This study suggested, for the first time, the causal relationship between evacuation at home and delay in the first medical intervention by PS-matching analysis. Although evacuation at home had several advantages in reducing the frequencies of some diseases, the delay in medical intervention could exacerbate the symptoms and be a cause of indirect death. As more evacuees are likely to remain in their homes in the future, this study recommends earlier surveillance and health care provision to the home evacuees.
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Affiliation(s)
- Motohiro Tsuboi
- International Cooperation for Disaster Medicine Lab., International Research Institute of Disaster Science (IRIDeS), Tohoku University, Miyagi, Japan
- Department of Emergency and Critical Care Medicine, Japanese Red Cross Saitama Hospital, Saitama, Japan
| | - Hiroyuki Sasaki
- International Cooperation for Disaster Medicine Lab., International Research Institute of Disaster Science (IRIDeS), Tohoku University, Miyagi, Japan
| | - Hyejeong Park
- International Cooperation for Disaster Medicine Lab., International Research Institute of Disaster Science (IRIDeS), Tohoku University, Miyagi, Japan
- Disaster Medical Informatics Lab., IRIDeS, Tohoku University, Miyagi, Japan
| | - Yuichiro Usuda
- National Research Institute for Earth Science and Disaster Resilience (NIED), Ibaraki, Japan
| | - Makoto Hanashima
- National Research Institute for Earth Science and Disaster Resilience (NIED), Ibaraki, Japan
| | | | | | - Kayako Sakisaka
- Faculty of International Liberal Arts, Kaichi International University, Chiba, Japan
| | - Manabu Hibiya
- Teikyo Academic Research Center, Teikyo University, Tokyo, Japan
| | - Kazuya Kiyota
- Department of Emergency and Critical Care Medicine, Japanese Red Cross Saitama Hospital, Saitama, Japan
| | | | | | - Yumi Sugawara
- Department of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Ichiro Tsuji
- Department of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Shinichi Egawa
- International Cooperation for Disaster Medicine Lab., International Research Institute of Disaster Science (IRIDeS), Tohoku University, Miyagi, Japan
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Wu C, Xu K, Wang Z, Chen Z, Sun Z, Yu W, Ji N, Huang M, Zhang M. Increased neutrophils and IL-17A in a rare organizing pneumonia secondary to extrapulmonary operation. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:344. [PMID: 31475214 DOI: 10.21037/atm.2019.06.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Organizing pneumonia (OP) is a clinical syndrome caused by various diseases. The most common causes are infection, connective tissue disease, radiation therapy, drug reaction and thoracic operation. Herein, we describe the case of a patient that developed OP after fracture internal fixation. The case was confirmed to be OP by computer tomographic (CT)-guided percutaneous needle lung biopsy, and other causes of OP were excluded. After the initiation of corticosteroid therapy, marked clinical and radiographic improvements occurred. In addition, we discovered increased neutrophils and IL-17A in the lung tissue of the patient. To the best of our knowledge, this is the first case report about OP secondary to extrapulmonary operation.
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Affiliation(s)
- Chaojie Wu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Kun Xu
- Department of Respiratory Medicine, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi 214002, China
| | - Zhengxia Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhongqi Chen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhixiao Sun
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wenqing Yu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.,Department of Infectious Disease, Taizhou People's Hospital, Taizhou 225300, China
| | - Ningfei Ji
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Mao Huang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Mingshun Zhang
- NHC Key Laboratory of Antibody Technique, Nanjing Medical University, Nanjing 211166, China.,Department of Immunology, Nanjing Medical University, Nanjing 211166, China
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Suganuma N, Natori Y, Kurosawa H, Nakano M, Kasai T, Morimoto Y. Update of occupational lung disease. J Occup Health 2019; 61:10-18. [PMID: 30698346 PMCID: PMC6499361 DOI: 10.1002/1348-9585.12031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 09/01/2018] [Accepted: 09/20/2018] [Indexed: 01/06/2023] Open
Abstract
Objective Occupational Lung Disease is an oldest but still a biggest problem in occupational health. Methods Steering Committee members of the Japan Society for Occupational Health (JSOH) Occupational Lung Disease Study Group selected and summarized current topics on occupational lung diseases based on expert opinion, as informed by governmental regulation, public health concerns, and frequently discussed in related academic conferences. Results The topics included in this review are professional education in medical screening skills, 2014 update of Helsinki Criteria, respiratory diseases found in the earthquake and tsunami affected regions, newly recognized occupational lung diseases, and potential respiratory health hazards. Discussions Although occupational lung diseases seem to stay as one of the major concerns in occupational health, screening tools and control measures are standardized for the better prevention of the diseases. As this health problem usually occurs in where the most actively economically developing area is, the patients tend to increase in emerging economic powers with huge population.
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Affiliation(s)
- Narufumi Suganuma
- Japan Society for Occupational Health (JSOH) Occupational Lung Disease Study Group, Tokya, Japan.,Department of Environmental Medicine, Kochi Medical School, Kochi Univeristy, Nankoku, Japan
| | - Yuji Natori
- Japan Society for Occupational Health (JSOH) Occupational Lung Disease Study Group, Tokya, Japan.,Hirano-Kameido Himawari-Clinic, Koto-ku, Japan
| | - Hajime Kurosawa
- Japan Society for Occupational Health (JSOH) Occupational Lung Disease Study Group, Tokya, Japan.,Department of Occupational Health, Tohoku University School of Medicine, Sendai, Japan
| | - Makiko Nakano
- Japan Society for Occupational Health (JSOH) Occupational Lung Disease Study Group, Tokya, Japan.,Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku, Japan
| | - Takahiko Kasai
- Japan Society for Occupational Health (JSOH) Occupational Lung Disease Study Group, Tokya, Japan.,Department of Pathology, Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Yasuo Morimoto
- Japan Society for Occupational Health (JSOH) Occupational Lung Disease Study Group, Tokya, Japan.,University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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The influence of the Great East Japan earthquake on microscopic polyangiitis: A retrospective observational study. PLoS One 2017; 12:e0177482. [PMID: 28498830 PMCID: PMC5428958 DOI: 10.1371/journal.pone.0177482] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 04/27/2017] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Antineutrophil cytoplasmic antibody-associated vasculitis is triggered by environmental factors, including silica dust exposure. Repeated tsunami waves brought a large volume of silica-containing sludge inland after the Great East Japan earthquake in 2011. We aimed to determine if the serious disaster influenced the clinical features of the microscopic polyangiitis. METHODS This is an observational retrospective study conducted in a single institute. A total of 43 patients were included based on the CHCC2012 criteria for microscopic polyangiitis from 2007 to 2015. We used the Poisson regression model to determine the incidence of microscopic polyangiitis within the annual population of the medical district. The participants were selected during a 3-year period from before (N = 13) to after the disaster (N = 20). The differences of parameters and the overall survival between the groups were analyzed. RESULTS The incidence of microscopic polyangiitis increased after the disaster (λ = 17.4/million/year [95%CI: 7.66-39.6] before the disaster and λ = 33.1/million/year [17.7-61.7] after the disaster, P = 0.044). A high Birmingham Activity Score was associated with a high incidence of microscopic polyangiitis after the disaster. The overall survival of the patients with microscopic polyangiitis declined significantly after the disaster. CONCLUSIONS The Great East Japan earthquake influenced the development of the microscopic polyangiitis in our restricted area. The patients who developed after the disaster had severe symptoms and a high mortality rate.
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