Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-23T17:38:20.970Z Has data issue: false hasContentIssue false
  • English
  • Français

Chronic Diseases and Natural Hazards: Impact of Disasters on Diabetic, Renal, and Cardiac Patients

Published online by Cambridge University Press:  28 June 2012

Andrew C. Miller  and
Bonnie Arquilla
Andrew C. Miller*
Affiliation:
Department of Emergency Medicine, The State University of New York Downstate Medical Center, Brooklyn, New York, USA Department of Internal Medicine, The State University of New York Downstate Medical Center, Brooklyn, New York, USA The New York Institute of Hazard Preparedness, Brooklyn, New York, USA
Bonnie Arquilla
Affiliation:
Department of Emergency Medicine, The State University of New York Downstate Medical Center, Brooklyn, New York, USA Director of Disaster Preparedness and the Disaster Medicine Fellowship, The State University of New York Downstate Medical Center, Brooklyn, New York, USA The New York Institute of Hazard Preparedness, Brooklyn, New York, USA
*
Department of Emergency Medicine 450 Clarkson Avenue, Box 1228 Brooklyn, New York 11203 USA E-mail: andrewcmiller@optonline.net
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Inadequately controlled chronic diseases may present a threat to life and well-being during the emergency response phase of disasters. Chronic disease exacerbations (CDE) account for one of the largest patient populations during disasters, and patients are at increased risk for adverse outcomes.

Objective:

The objective of this study was to assess the burden of chronic renal failure, diabetes, and cardiovascular disease during disasters due to natural hazards, identify impediments to care, and propose solutions to improve the disaster preparation and management of CDE.

Methods:

A thorough search of the PubMed, Ovid, and Medline databases was performed. Dr. Miller's personal international experiences treating CDE after disasters due to natural hazards, such as the 2005 Kashmir earthquake, are included.

Discussion:

Chronic disease exacerbations comprise a sizable disease burden during disasters related to natural hazards. Surveys estimate that 25–40% of those living in the regions affected by hurricanes Katrina and Rita lived with at least one chronic disease. Chronic illness accounted for 33% of visits, peaking 10 days after hurricane landfall. The international nephrology community has responded to dialysis needs by forming a well-organized and effective organization called the Renal Disaster Relief Task Force (RDRTF). The response to the needs of diabetic and cardiac patients has been less vigorous.

Patients must be familiar with emergency diet and renal fluid restriction plans, possible modification of dialysis schedules and methods, and rescue treatments such as the administration of kayexalate. Facilities may consider investing in water-independent extracorporeal dialysis techniques as a rescue treatment. In addition to patient databases and medical alert identification, diabetics should maintain an emergency medical kit. Diabetic patients must be taught and practice the carbohydrate counting technique. In addition to improved planning, responding agencies and organizations must bring adequate supplies and medications to care for diabetic, cardiac, and renal patients during relief efforts.

Conclusions:

By recognizing and addressing impediments to the care of chronic disease exacerbations after natural disasters, the quality, delivery, and effectiveness of the care provided to diabetic patients during relief efforts can be improved.

Keywords

cardiacchronic diseasesdiabetesdisastersemergency responseRenal Disaster Relief Task Force
Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 23 , Issue 2 , April 2008 , pp. 185 - 194
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Braine, T: Was 2005 the year of natural disasters? Bull World Health Organ 2006;84(1):4–6.Google ScholarPubMed
2. EM-DAT: The OFDA/CRED International Emergency Disasters Data Base. Université Catholique de Louvain, Brussels, Belgium. Available at http://www.em-dat.net/.Google Scholar
3. Baggett, J: Florida disasters and chronic disease conditions. Prev Chronic Dis 2006;3(2):A66.Google ScholarPubMed
4. Kleinpeter, MA, Norman, LD, Krane, NK: Dialysis services in the hurricaneaffected areas in 2005: Lessons learned. Am J Med Sci 2006;332(5):259–263.CrossRefGoogle ScholarPubMed
5. Vanholder, R, van der Tol, A, De Smet, M, Hoste, E, Koc, M, Hussain, A, Khan, S, Sever, MS: Earthquakes and crush syndrome casualties: Lessons learned from the Kashmir disaster. Kidney Int 2007;71(1):17–23.CrossRefGoogle ScholarPubMed
6. The National Geophysical Data Center of the National Oceanic and Atmospheric Administration. Available at http://www.ngdc.noaa.gov.Google Scholar
7. Miller, AC, Arquilla, B: Chronic renal insufficiency and diabetes mellitus following disasters: A model for reform. Prehospital Disast Med 2007;22(2):s127.Google Scholar
8. Ohl, CA, Taspell, S:Flooding and human health. BMJ 2000;321(7270):1167–1168.CrossRefGoogle ScholarPubMed
9. Ogawa, K, Tsuji, I, Shiono, K, Hisamichi, S: Increased acute myocardial infarction mortality following the 1995 Great Hanshin-Awaji earthquake in Japan. Int J Epidemiol 2000;29(3):449–455.CrossRefGoogle ScholarPubMed
10. Armenian, HK, Melkonian, AK, Hovanesian, AP: Long term mortality and morbidity related to degree of damage following the 1998 earthquake in Armenia. Am J Epidemiol 1998;148(11):1077–1084.CrossRefGoogle ScholarPubMed
11. Matsuoka, T, Yoshioka, T, Oda, J, Tanaka, H, Kuwagata, Y, Sugimoto, H, Sugimoto, T: The impact of a catastrophic earthquake on morbidity rates for various illnesses. Public Health 2000;114(4):249–253.CrossRefGoogle ScholarPubMed
12. The Henry J Kaiser Foundation: Survey of Hurricane Katrina evacuees. Washington, DC. 2005 Sept 16. Available at http://www.kff.org/newsmedia/ upload/74001pdf.Google Scholar
13. Brodie, M, Weltzien, E, Altman, D, Blendon, RJ, Benson, JM: Experiences of hurricane Katrina evacuees in Houston shelters: Implications for future planning. Am J Public Health 2006;96(8):1402–1408.CrossRefGoogle ScholarPubMed
14. Mokdad, AH, Mensah, GA, Posner, SF, Reed, E, Simoes, EJ, Engelgau, MM, Chronic Diseases and Vulnerable Populations in Natural Disasters Working Group: When chronic conditions become acute: Prevention and control of chronic diseases and adverse health outcomes during natural disasters. Prev Chronic Dis 2005 Nov;2 Spec no:A04.Google Scholar
15. Ford, ES, Mokdad, AH, Link, MW, Garvin, WS, McGuire, LC, Jiles, RB, Balluz, LS. Chronic disease in health emergencies: In the eye of the hurricane. Prev Chronic Dis 2006 Apr;3(2):A46.Google ScholarPubMed
16. Centers for Disease Control and Prevention (CDC): Morbidity surveillance after Hurricane Katrina—Arkansas, Louisiana, Mississippi, and Texas, September 2005. MMWR 2006;55(26):727–731.Google Scholar
17. Piccoli, G, Pacitti, A, Mangiarotti, G, Jeantet, A, Mezza, E, Segoloni, GP, Piccoli, GB: Blade Runner, blackout and haemofiltration: Dialysis in times of catastrophe. Nephrol Dial Transplant 2005;20(3):663–664.CrossRefGoogle ScholarPubMed
18. Sever, MS, Erek, E, Vanholder, R, Kalkan, A, Guney, N, Usta, N, Yilmaz, C, Kutanis, C, Turgut, R, Lameire, N. Features of chronic hemodialysis practice after the Marmara earthquake. J Am Soc Nephrol 2004;15(4):1071–1076.CrossRefGoogle ScholarPubMed
19. Hwang, SJ, Shu, KH, Lain, JD, Yang, WC: Renal replacement therapy at the time of the Taiwan Chi-Chi earthquake. Nephrol Dial Transplant 2001;16 Suppl 5:78–82.CrossRefGoogle ScholarPubMed
20. Vanholder, R, Sever, MS, De Smet, M, Erek, E, Lameire, N: Intervention of the Renal Disaster Relief Task Force in the 1999 Marmara, Turkey earthquake. Kidney Int 2001;59(2):783–791.CrossRefGoogle ScholarPubMed
21. Vanholder, R. Intervention of the renal disaster relief task force (RDRTF) in the Kashmir earthquake. Nephrol Dial Transplant 2006;21(1):40.CrossRefGoogle ScholarPubMed
22. Solez, K, Bihari, D, Collins, AJ, Eknoyan, G, Eliahou, H, Fedorov, VD, Kjellstrand, C, Lameire, N, Letteri, J, Nissenson, AR, et al. : International dialysis aid in earthquakes and other disasters. Kidney Int 1993;44(3):479–483.CrossRefGoogle ScholarPubMed
23. Preparing for Emergencies: A Guide for People on Dialysis. The Centers for Medicare and Medicaid Services. The US Department of Health and Human Services.Available at http://www.medicare.gov/Publications/Pubs/pdf/10150.pdf.Google Scholar
24. Sakai, R. The Japanese experience during the Kobe Earthquake: Management of continuous ambulatory peritoneal dialysis patients in a disaster. Ren Fail 1997;19(5):693–699.CrossRefGoogle ScholarPubMed
25. Naito, H: The basic hospital and renal replacement therapy in the Great Hanshin Earthquake. Ren Fail 1997 Sep;19(5):701–710.CrossRefGoogle ScholarPubMed
26. Sever, MS, Erek, E, Vanholder, R, Yurugen, B, Kantarci, G, Yavuz, M, Ergin, H, Bozfakioglu, S, Dalmak, S, Tulbek, MY, Kiper, H, Lameire, N. Renal replacement therapies in the aftermath of the catastrophic Marmara earthquake. Kidney Int 2002 Dec;62(6):2264–71.CrossRefGoogle ScholarPubMed
27. CDC: Safe use of “tanker” water for dialysis. Available at http://www.bt.cdc.gov/disasters/pdf/watertanker.pdf.Google Scholar
28. CDC:Technical considerations when bringing hemodialysis facilities' water systems back on line after a hurricane. Available at http://www.bt.cdc.gov/di sasters/hurricanes/katrina/pdf/watersystems.pdf.Google Scholar
29. Letteri, JM, Adams, MB, Duffy, M, Fedje, L, Jacobs, C, Kaysen, G, Krohn, BA, Norwood, K, O'Connor, P, Schiereth, M, Witten, B. Disaster preparedness for renal facilities and patients. Ren Fail 1997;19(5):673–685.CrossRefGoogle ScholarPubMed
30. Sengul, A, Ozer, E, Salman, S, Salman, F, Saglam, Z, Sargin, M, Hatun, S, Satman, I, Yilmaz, T: Lessons learnt from influences of the Marmara earthquake on glycemic control and quality of life in people with type 1 diabetes. Endocr J 2004;51(4):407–414.Google ScholarPubMed
31. Salman, S, Sengul, AM, Salman, F, Ozer, E, Gursoy, N, Hatun, S, Karsidag, K, Dinccag, N, Satman, I, Yilmaz, MT: Influence of earthquake on the quality of life of patients with type 1 diabetes. Psychiatry Clin Neurosci 2001;55(2):165.CrossRefGoogle ScholarPubMed
32. Cefalu, WT, Smith, SR, Blonde, L, Fonseca, V: The Hurricane Katrina aftermath and its impact on diabetes care: Observations from “ground zero”: Lessons in disaster preparedness of people with diabetes. Diabetes Care 2006;29(1):158–160.CrossRefGoogle ScholarPubMed
33. Alson, R, Alexander, D, Leonard, RB, Stringer, LW: Analysis of medical treatment at a field hospital following Hurricane Andrew, 1992. Ann Emerg Med 1993 Nov;22(11):1721–1728.CrossRefGoogle Scholar
34. Leonard, RB, Spangler, HM, Stringer, LW: Medical outreach after hurricane Marilyn. Prehospital Disast Med 1997;12(3):189–194.CrossRefGoogle ScholarPubMed
35. Kirizuka, K, Nishizaki, H, Kohriyama, K, Nukata, O, Arioka, Y, Motobuchi, M, Yoshiki, K, Tatezumi, K, Kondo, T, Tsuboi, S: Influences of The Great Hanshin-Awaji Earthquake on glycemic control in diabetic patients. Diabetes Res Clin Pract 1997;36(3):193–196.CrossRefGoogle ScholarPubMed
36. Sone, H, Kawakami, Y, Okuda, Y, Yamashita, K: Diabetes care in emergency settings. Diabetes Care 1995 Sep;18(9):1310–1311.CrossRefGoogle ScholarPubMed
37. Hendrickson, LA, Vogt, RL: Mortality of Kauai residents in the 12-month period following Hurricane Iniki. Am J Epidemiol 1996;144(2):188–191.CrossRefGoogle ScholarPubMed
38. Takakura, R, Himeno, S, Kanayama, Y, Sonoda, T, Kiriyama, K, Furubayashi, T, Yabu, M, Yoshida, S, Nagasawa, Y, Inoue, S, Iwao, N: Follow-up after the Hanshin-Awaji earthquake: Diverse influences on pneumonia, bronchial asthma, peptic ulcer and diabetes mellitus. Intern Med 1997;36(2):87–91.CrossRefGoogle ScholarPubMed
39. Kamoi, K, Tanaka, M, Ikarashi, T, Miyakoshi, M: Effect of the 2004 Mid Niigata Prefecture earthquake on glycemic control in type 1 diabetic patients. Diabetes Res Clin Pract 2006;74(2):141–147.CrossRefGoogle ScholarPubMed
40. Kaufman, FR, Devgan, S: An increase in newly onset IDDM admissions following the Los Angeles earthquake. Diabetes Care 1995;18(3):422.CrossRefGoogle ScholarPubMed
41. Baba, S, Taniguchi, H, Nambu, S, Tsuboi, S, Ishihara, K, Osato, S: The Great Hanshin earthquake. Lancet 1996;347(8997):307–309.CrossRefGoogle ScholarPubMed
42. Stallwood, LG: Assessing emergency preparedness of families caring for young children with diabetes and other chronic illnesses. J Spec Pediatr Nurs 2006;11(4):227–233.CrossRefGoogle ScholarPubMed
43. Miller, AC, Arquilla, B: Disasters, women's health, and conservative society: Working in Pakistan with the Turkish Red Crescent following the south Asian earthquake. Prehospital Disast Med 2007;22(4):269–273.CrossRefGoogle ScholarPubMed
44. Minami, J, Kawano, Y, Ishimitsu, T, Yoshimi, H, Takishita, S: Effect of the Hanshin-Awaji earthquake on home blood pressure in patients with essential hypertension. Am J Hypertens 1997;10(2):222–225.CrossRefGoogle ScholarPubMed
45. Kario, K, Matsuo, T, Kobayashi, H, Yamamoto, K, Shimada, K: Earthquakeinduced potentiation of acute risk factors in hypertensive elderly patients: Possible triggering of cardiovascular events after a major earthquake. J Am Coll Cardiol 1997;29(5):926–933.CrossRefGoogle ScholarPubMed
46. Kario, K, Matsuo, T, Shimada, K, Pickering, TG: Factors associated with the occurrence and magnitude of earthquake-induced increases in blood pressure. Am J Med 2001;111(5):379–384.CrossRefGoogle ScholarPubMed
47. Katsouyanni, K, Kogevinas, M, Trichopoulos, D: Earthquake-related stress and cardiac mortality. Int J Epidemiol 1986;15(3):326–330.CrossRefGoogle ScholarPubMed
48. Suzuki, S, Sakamoto, S, Miki, T, Matsuo, T: Hanshin-Awaji earthquake and acute myocardial infarction. Lancet 1995;345(8955):981.CrossRefGoogle ScholarPubMed
49. Suzuki, S, Sakamoto, S, Koide, M, Fujita, H, Sakuramoto, H, Kuroda, T, Kintaka, T, Matsuo, T: Hanshin-Awaji earthquake as a trigger for acute myocardial infarction. Am Heart J 1997;134(5 Pt 1):974–977.CrossRefGoogle ScholarPubMed
50. Faich, G, Rose, R: Blizzard morbidity and mortality: Rhode Island, 1978. Am J Public Health 1979;69(10):1050–1052.CrossRefGoogle ScholarPubMed
51. CDC: Community needs assessment and morbidity surveillance following an ice storm—Maine, January 1998. MMWR 1998;47(17):351–354.Google Scholar
52. Brown, DL: Disparate effects of the 1989 Loma Prieta and 1994 Northridge earthquakes on hospital admissions for acute myocardial infarction: importance of superimposition of triggers. Am Heart J 1999;137(5):830–836.CrossRefGoogle ScholarPubMed
53. Leor, J, Kloner, RA: The Northridge earthquake as a trigger for acute myocardial infarction. Am J Cardiol 1996;77(14):1230–1232.CrossRefGoogle ScholarPubMed
54. Muller, JE, Tofler, GH: Triggering and hourly variation of onset of arterial thrombosis. Ann Epidemiol 1992;2(4):393–405.CrossRefGoogle ScholarPubMed
55. Muller, JE, Abela, GS, Nesto, RW, Tofler, GH:Triggers, acute risk factors and vulnerable plaques: the lexicon of a new frontier. J Am Coll Cardiol; 23(3):809–813.CrossRefGoogle Scholar
56. Boltwood, MD, Taylor, CB, Burke, MB, Grogin, H, Giacomini, J: Anger report predicts coronary artery vasomotor response to mental stress in atherosclerotic segments. Am J Cardiol 1993;72(18):1361–1365.CrossRefGoogle ScholarPubMed
57. Elliott, TG, Cockcroft, JR, Groop, PH, Viberti, GC, Ritter, JM: Inhibition of nitric oxide synthesis in forearm vasculature of insulin-dependent diabetic patients: blunted vasoconstriction in patients with microalbuminuria. Clin Sci (Lond) 1993;85(6):687–693.CrossRefGoogle ScholarPubMed
58. Bodmer, CW, Patrick, AW, How, TV, Williams, G: Exaggerated sensitivity to NE-induced vasoconstriction in IDDM patients with microalbuminuria. Possible etiology and diagnostic implications. Diabetes 1992;41(2):209–214.Google ScholarPubMed