The Toll On Human Health Is Still Being Counted 10 Years After Attacks On World Trade Center

Main Category: Bio-terrorism / Terrorism
Also Included In: Aid / Disasters;  Heart Disease
Article Date: 14 Dec 2011 - 0:00 PST

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The World Trade Center disaster exposed nearly half a million people to hazardous chemicals, environmental toxins, and traumatic events. According to research published in the December 2011 issue of Elsevier-published journal Preventive Medicine, this has resulted in increased risk of developing physical and mental health conditions after 9/11.

"The New York City Health Department's volunteer and heart disease studies in this issue of Preventive Medicine reinforce the importance of tracking the long-term physical and mental health effects of 9/11 and help inform planning for future 9/11-related health care needs," said New York City Health Commissioner Dr. Thomas Farley.

A study of volunteers who turned out in the thousands to assist the 9/11 rescue operation, shows they, along with others who were directly exposed to the events of the 9/11 disaster, are now suffering from a range of physical and mental illnesses. At particular risk for poorer health outcomes are volunteers not affiliated with groups such as the American Red Cross, whose earlier arrival at the WTC sites and day-to-day work left them less prepared for the horrific events and injuries of 9/11.

Volunteers not affiliated with an organization were more highly exposed to the WTC disaster than volunteers affiliated with recognized organizations and were at greater risk for developing physical and mental health conditions after 9/11, according to the volunteer study. The study showed the need to provide volunteers with long-term screening and treatment for 9/11-related conditions that resulted from hazardous exposures.

A study of adults exposed to 9/11 found that being in the dust cloud, being injured on 9/11, or developing posttraumatic stress disorder increased the risk of developing heart disease years after the disaster.

"This exploratory heart disease study suggests that adults who were directly exposed to the World Trade Center disaster and its aftermath have an increased risk for heart disease," said Dr. Hannah Jordan, first author of the study. "It will be important to confirm and expand upon these findings so that appropriate steps can be taken to prevent heart disease in this population."

Respiratory illness - dubbed 'World Trade Center Cough' - is also more likely to afflict first responders from the Fire Department of New York City than other U.S. males. According to the research in Preventive Medicine, bronchitis is nearly six-fold higher in young-WTC exposed firefighters. The study of 11,000 firefighters demonstrates that the firefighters exposed to the WTC disaster, along with volunteers of all kinds, continue to bear a heavy burden following their remarkable actions ten years ago.

The research appears in the special 'World Trade Center Disaster: 10th Anniversary' issue of Preventive Medicine.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our bio-terrorism / terrorism section for the latest news on this subject. Full article citation
Indira Debchoudhury, Alice E. Welch, Monique A. Fairclough, James E. Cone, Robert M. Brackbill, Steven D. Stellman, Mark R. Farfel, Comparison of health outcomes among affiliated and lay disaster volunteers enrolled in the World Trade Center Health Registry, Preventive Medicine, Volume 53, Issue 6 , 1 December 2011 0091-7435, DOI: 10.1016/j.ypmed.2011.08.034.
Jessica Weakley, Mayris P. Webber, Jackson Gustave, Kerry Kelly, Hillel W. Cohen, Charles B. Hall, David J. Prezant, Trends in respiratory diagnoses and symptoms of firefighters exposed to the World Trade Center disaster: 2005-2010, Preventive Medicine, Volume 53, Issue 6, 1 December 2011, Pages 364-369, 0091-7435, DOI: 10.1016/j.ypmed.2011.09.001.
Hannah T. Jordan, Sara A. Miller-Archie, James E. Cone, Alfredo Morabia, Steven D. Stellman, Heart disease among adults exposed to the September 11, 2001 World Trade Center disaster: Results from the World Trade Center Health Registry, Preventive Medicine, Volume 53, Issue 6, 1 December 2011, Pages 370-376, 0091-7435, DOI: 10.1016/j.ypmed.2011.10.014.
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New Study Shows Evacuation Plans Need To Incorporate Family Perspectives

Main Category: Aid / Disasters
Article Date: 10 Dec 2011 - 0:00 PST

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A study sponsored by the National Science Foundation found that most respondents felt the evacuation of New Orleans residents to the Superdome after Hurricane Katrina was a "failure" and this opinion has shaped their willingness to accept shelter if offered in an emergency evacuation.

This finding, as well as many others, was derived from interviews of residents in the Chicago metropolitan area, with particular focus in two areas where neighborhood evacuations are likely due to large amounts of toxic materials that are transported nearby Logan Square and Blue Island, Ill. Logan Square is a predominantly Latino, low-income community with a high concentration of recent arrivals to this region from Mexico and Puerto Rico. By contrast, Blue Island is a mixed-race, predominantly low to middle income community on Chicago's south side.

Pamela Murray-Tuite, an assistant professor of civil and environmental engineering at Virginia Tech, led this study that she calls the first of its kind. "We took an integrated, interdisciplinary approach to evacuation study. This approach is absolutely critical to the development of transportation evacuation models, but in practice, it was virtually non-existent until our work," she said.

In the past, officials have "made overly optimistic evacuation time predictions that could have potentially devastating consequences," she added.

Murray-Tuite's study was unique because it integrated social science perspectives with transportation engineering. It used in-depth personal interviews to gather household decision-making data and to model household member interactions and decision-making when faced with an immediate, no-notice evacuation. The study also estimated the resulting effects on traffic and evacuation times, and considered the relocation of school children to sites within the communities to facilitate pick up.

Working with Murray Tuite was Lisa Schweitzer of the University of Southern California, an associate professor in its school of policy, planning and development. She has expertise in sustainable transportation and hazardous materials in urban environments. The late Janice Metzger, a senior program manager at the Center for Neighborhood Technology (CNT) in Chicago, also served as a co-principal investigator on the NSF project. Henry Sullivan of this center finished the study.

Schweitzer described one of the influencing factors their team found regarding emergency evacuations was that in the Logan Square area nearly 60 percent of the immigrant mothers were stay-at-home, whereas U.S. Bureau of Labor Statistics has put the average percentage of mothers outside of the paid workforce at a little less than 10 percent. Anecdotal evidence suggested that the U.S. recession was responsible for this much higher than average number.

"Foreign born women who are engaged in traditional care giving roles may be exceptionally vulnerable to events that disrupt their neighborhood. However, native-born women, though far more mobile due to their higher car usage and roles outside the home, also have dimensions upon which they may be more vulnerable," since they retain the primary role for securing their children, the researchers wrote in their report to NSF.

Some 300 households participated in the research project. Approximately 50 questions were posed in each of the interviews. Personal information about such issues as education level and income were answered separately and included in an anonymous sealed envelope.

The interviews covered topics from everyday commuting habits, child-transportation both before and after school, to thoughts about how they might handle short to long-term evacuations.

Murray-Tuite presented some initial findings at the Fourth International Conference on Women's Issues in Transportation. Her doctoral student Sirui Liu of Falls Church, Va., presented the relocation model at the 90th Annual Meeting of the Transportation Research Board.

She and her colleagues are also publishing several technical papers on emergency evacuations that include emphasis on scenarios such as child pick-up from another location, as well as one on how the effect of spouses attempting to find each other impacts a hasty exit from a community.

"We know from our study that everyday travel behavior and neighborhood environments shape what people believe they would do when they envision disaster conditions," Murray-Tuite said. "We now have a series of discrete choice analyses that we are working on to uncover systematic differences in everyday travel behavior in men and women, parents and non-parents, and how those systematic differences in everyday travel behavior affect how individuals view their disaster resources."

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Over 2,400 Cholera Deaths In West And Central Africa

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Main Category: Aid / Disasters
Also Included In: Tropical Diseases;  Infectious Diseases / Bacteria / Viruses
Article Date: 11 Oct 2011 - 23:00 PDT

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UNICEF says it is fighting "one of the worst ever" outbreaks of cholera in West and Central Africa that has made over 85,000 people sick and killed 2,466 people so far this year. The magnitude of the outbreaks mean this part of the world is facing one of the most devastating epidemics in its history, the United Nations agency added.

CFRs (case fatality rates) are alarmingly high, UNICEF warned, ranging from 2.3% to 4.7% in many areas, and possibly up to 22% in some parts of Cameroon.

Young children are especially susceptible to cholera complications because they dehydrate more rapidly than adults - those at most risk are malnourished children.

This year, Cameroon, western Democratic Republic of Congo (DCR), and Chad have had the highest increases in cholera incidence.

UNICEF wrote in a communiqué today:

"In addition there are still challenges with getting access, ensuring staff presence in medical facilities and establishing surveillance systems to monitor cases and numbers in parts of North-East DRC."

Severe dehydration caused by cholera. Note the sunken eyes and wrinkled hands

In West and Central Africa, UNICEF reports three major cross-border cholera epidemics: The Lake Chad Basin - which borders Niger, Nigeria, Cameroon and ChadWest Congo Basin - which borders the Central African Republic, DRC and CondoLake Tanganyika - where Burindi and DRC meet.UNICEF is supplying desperately needed treatment kits, carrying out community education campaigns on hygiene, as well as assisting with epidemiological surveys to try to make sure control efforts are optimally targeted.

Authorities can play a major role in saving lives in this emergency, UNICEF stressed.

Many lives can be saved and the disease controlled if there is effective information exchange between cross-border districts on the number of cases and population movements. Inspections across borders for chlorination and disinfection can also save lives and keep the disease under control.

It is important that the governments in the affected areas coordinate the response and preparation both within their own borders and in collaboration with their neighbors. Multi-level cross-border coordination is crucial, UNICEF emphasized - from national to district levels.

In 2010, UNICEF initiated a cross-border epidemiological study which covered the Lake Basin, where Niger, Nigeria, Chad and Cameroon borders are located. This study is now in its second phase.

UNICEF wrote, regarding this study:

"The study provides critical evidence for informing cholera prevention and response interventions, which have to be coordinated across borders. Cross-border coordination between teams in Kinshasa and Brazzaville has also been initiated for the more recent cholera outbreak in the West Congo Basin."

Vibrio cholerae, the bacterium that causes cholera

According to Medilexicon's medical dictionary:

Cholera "is an acute epidemic infectious disease caused by the bacterium Vibrio cholerae. A soluble toxin elaborated in the intestinal tract by the bacterium activates the adenylate cylase of the mucosa, causing active secretion of an isotonic fluid resulting in profuse watery diarrhea, extreme loss of fluid and electrolytes, and dehydration and collapse, but no gross morphologic change in the intestinal mucosa."

The majority of cholera infections are not, in fact, severe. Approximately 75% of infected individuals show no symptoms.

If signs and symptoms do appear, they will do so within 6 hours to five days of exposure. In severe cases the patient can have explosive watery diarrhea, sometimes referred to as rice water stools because it looks like water that has been used to wash rice. There is also vomiting and leg cramps. Fluid loss can be severe and rapid, with some patients losing up to 20 liters per day - in such cases there is a serious risk of severe dehydration and shock.

Signs of dehydration may include an accelerated heart beat, low blood pressure, rapid weight loss, sunken eyes, and a loss of skin plasticity. Shock occurs when the circulatory system collapses.

The bacterium which causes cholera, Vibrio cholera, is not endemic to humans. Its presence in the human digestive system is not a natural part of its life cycle. Vibrio cholera is typically found, for example, in estuaries, and during its life cycle it shifts between various reservoir species, such as crustaceans, small snails, free-floating planktonic forms, and static forms resident in the silt of the estuary.

The bacterium most commonly enters the human ecosystem through contaminated food or water, such as insufficiently cooked seafood from estuaries, or poorly cleaned vegetables irrigated by tainted water sources.

A single infected human can contaminate all the water for an entire population if sanitation is poor.

Cholera is a disease that affects poor areas where basic sanitation and hygiene are inadequate.

Written by Christian Nordqvist
Copyright: Medical News Today
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Search And Rescue Could Employ High-Tech Spider For Hazardous Missions

Main Category: Aid / Disasters
Also Included In: Public Health;  IT / Internet / E-mail
Article Date: 08 Nov 2011 - 1:00 PST

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Spiders are very agile, and some can even jump. They owe this capability to their hydraulically operated limbs. Researchers have now designed a mobile robot modeled on the same principle that moves spider legs. Created using a 3-D printing process, this lightweight can explore terrain that is beyond human reach.

Enviably agile and purposeful, the mobile robot makes its way through grounds rendered off-limits to humans as the result of a chemical accident. Depressions, ruts and other obstacles are no match for this eight-legged high-tech journeyman. Its mission: with a camera and measurement equipment on board, it will provide emergency responders with an image of the situation on the ground, along with any data about poisonous substances. Not an easy task; after all, it must be prevented from tipping over. But this risk seems a minor one as it confidently and reliably picks its way through the area. As a real spider would, it keeps four legs on the ground at all times while the other four turn and ready themselves for the next step. Even in its appearance, this artificial articulate creature resembles an octopod. And no wonder - the natural specimen provided the model for researchers at the Fraunhofer Institute for Manufacturing Engineering and Automation IPA. This high-tech assistant is still a prototype, but future plans envision its use as an exploratory tool in environments that are too hazardous for humans, or too difficult to get to. After natural catastrophes and industrial or reactor accidents, or in fire department sorties, it can help responders, for instance by broadcasting live images or tracking down hazards or leaking gas.

With its long extremities, the spider has a range of ways to get around. Some models can even jump. This is possible using hydraulically operated bellows drives that serve as joints and keep limbs mobile. With no muscles to stretch their legs, these creatures build up high levels of body pressure that they then use to pump fluid into their limbs. Shooting fluid into the legs extends them. "We took this mobility principle and applied it to our bionic, computer-controlled lightweight robot. Its eight legs and body are also fitted with elastic drive bellows that operate pneumatically to bend and extend its artificial limbs," explains Dipl.-Ing. Ralf Becker, a scientist at IPA. The components required for locomotion, such as the control unit, valves and compressor pump, are located in the robot's body; the body can also carry various measuring devices and sensors, depending on the application at hand. Hinges interoperate with the bellows drives so that the legs can move forward and turn as needed. Diagonally opposed members move simultaneously, too. Bending the front pairs of legs pulls the robotic spider's body along, while stretching the rear extremities pushes it.

The special aspect of this high-tech helper: not only very light, it also combines rigid and elastic shapes in a single component; with just a few production steps, it can also be produced at low cost. To date, designs such as the mobile robot have been generated using conventional mechanical-engineering technologies - a time-consuming and costly undertaking. Researchers at IPA, on the other hand, rely on generative production technologies, and specifically on selective laser sintering (SLS) of plastics, a 3-D printing process. In this process, step by step thin layers of a fine polyamide powder are applied one at a time and melted in place with the aid of a laser beam. This way, complex geometries, inner structures and lightweight components can be produced - with structures optimized much as if produced by Nature herself. The experts at IPA have a great deal of latitude in the design of their mobile robot; the leg modules, for instance, can be designed with infinitely variable load-bearing characteristics.

"We can use SLS to produce one or even several legs in a single operation; this minimizes assembly effort, saves materials and reduces the time it takes to build a robot. With the modular approach, individual parts can be quickly swapped as well. Our robot is so cheap to produce that it can be discarded after being used just once - like a disposable rubber glove," Becker points out. A prototype of the robot can be seen at the EuroMold 2011 trade fair in Frankfurt, at the joint stand of the Fraunhofer-Gemeinschaft (Hall 11, Stand C66), from November 29 through December 2.

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Recent Climate Change Related Events Resulted In Billions In Health Costs And Lost Lives

Main Category: Aid / Disasters
Also Included In: Public Health
Article Date: 11 Nov 2011 - 1:00 PST

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Health costs exceeding $14 billion dollars, 21,000 emergency room visits, nearly 1,700 deaths, and 9,000 hospitalizations are among the staggering impacts of six climate change-related events in the United States during the last decade, according to a first-of-its-kind study published in November 2011 edition of the journal Health Affairs.

"When extreme weather hits, we hear about the property damage and insurance costs. The healthcare costs never end up on the tab, but that doesn't mean they're not there," said lead author Kim Knowlton, DrPH, assistant clinical professor of Environmental Health Sciences at Columbia University's Mailman School of Public Health and Senior Scientist for the Natural Resources Defense Council (NRDC). "Right now, there's a gaping hole in our understanding of the health-related costs of climate change. This report begins the work to fill that void. Only by having a clear sense of health impacts and their costs, can we work to reduce them."

The analysis spotlights cases in six specific categories in the U.S. occurring during 2002 through 2009, including: Florida hurricanes, North Dakota floods, California heat waves and wild fires, nationwide ozone air pollution, and West Nile virus outbreaks in Louisiana (which were tied to warmer weather and changes in precipitation patterns). The study is the first to develop a uniform method of quantifying the associated health costs for extreme weather and disease events that are expected to be exacerbated by climate change.

Researchers found that the six categories of events resulted in an estimated 1,689 premature deaths, 8,992 hospitalizations, 21,113 emergency room visits, and 734,398 outpatient visits, totaling over 760,000 encounters with the health care system. Extreme climate-change related events are projected to increase in severity and frequency as climate change continues to go unchecked.

Only 13 U.S. states currently include public health measures in their climate change adaptation plans. With a better understanding of the economic impacts and health risks, as offered by the study, government agencies and key players can create effective partnerships for climate-health preparedness that aggressively limit and reduce public health damage.

"Investments in climate change mitigation at the local, state and national levels, married with analyses of the climate change health costs to inform this strategic planning, will save billions of dollars in health costs and save lives," notes Dr. Knowlton.

This week Congresswoman Lois Capps (D - CA) proposed the Climate Change Health Protection and Promotion Act. The bill would direct the Secretary of Health and Human Services to develop a national strategic action plan to assist health professionals in preparing for and responding to the public health effects of climate change.

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Saving Firefighter Lives Using Aerial Robot System

Main Category: Aid / Disasters
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Article Date: 11 Nov 2011 - 0:00 PST

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Wildfires kill and, too often, fatalities are caused by a lack of situational awareness, said Kelly Cohen. Timely information can prevent wildfire deaths, especially among first responders, said Cohen, associate professor of aerospace engineering & engineering mechanics at the University of Cincinnati.

Cohen supervises a project known as SIERRA (Surveillance for Intelligent Emergency Response Robotic Aircraft) which integrates small, unmanned aircraft with global positioning systems, environmental data, video and fire-prediction software to give real-time information about where a fire is burning, and where it is moving.

"What we are designing is a complete system," Cohen said. "It is low-cost and low-risk. That is important for this application because, while the technology is ready, firefighters are not quick to adopt new technologies. We can show that this works."

To gain the confidence of working firefighters, the graduate student who serves as SIERRA team leader, Robert Charvat, participated in firefighter training in West Virginia.

The SIERRA team tested the system in Coopers Rock State Forest, West Virginia, with a small, contained fire on Nov. 5, 2011, in collaboration with the West Virginia Division of Forestry. The UC team present at this test included five graduate students and three undergraduates who experienced a valuable day of learning away from the classroom and labs.

"This test was a clear demonstration of the potential for this technology to limit wild land fire damage by saving money, lives and land," Charvat said.

The SIERRA system, Cohen said, is designed to assist firefighters overcome a major handicap during a wildfire - the inability to see the whole fire. Wildfires not only burn through rugged terrain marked by hills and valleys but, even on relatively level ground, obscure their extent by screens of smoke.

"If I am coordinating response efforts," Cohen said, "I require information to determine what resources I need, where I must deploy those resources, and where I must be ready to move. This system uses the information gathered and allocates resources."

The SIERRA system is built around a small, unmanned aerial vehicle from Marcus UAV Inc. The five-pound vehicle has a 54-inch wingspan and the ability to fly faster than 35 miles per hour to altitudes of 10,000 feet on flights lasting approximately an hour. While in the air, the vehicle can transmit video while it navigates using GPS.

"For our purposes, the vehicle flew no higher than 500 feet," Cohen said. "It was a successful demonstration of tactical unmanned aerial system technology for use in wild land fire events."

At the fire command center, the in-flight data is merged with Google Earth images, NOAA weather data and fire-prediction software to make informed and effective decisions by the incident commander.

Although the West Virginia demonstration focused on firefighting, the integrated system Cohen has developed along with Manish Kumar of UC's Cooperative Distributed Systems Lab, has applications beyond wildfire response.

"A similar decision-making need arises in many disasters," Cohen said, "including floods and earthquakes."

The system can even be modified for use for simulation based training for first responders.

"As we execute this work," Cohen said. "We are continually reviewing additional areas in which our unmanned aerial vehicle based systems and algorithms may provide a benefit. One such area is air traffic management while effectively integrating unmanned aerial vehicles into the national airspace."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our aid / disasters section for the latest news on this subject. Support for the SIERRA project was provided by NASA through the Ohio Space Grant Consortium with the University of Cincinnati providing more than 50 percent of the cost share.
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In Wake Of Disasters Mental Health Relief Efforts Often Overlooked

Main Category: Aid / Disasters
Also Included In: Mental Health;  Psychology / Psychiatry
Article Date: 21 Oct 2011 - 1:00 PDT

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Recent events such as the ten-year commemoration of September 11th just weeks ago, Hurricane Irene striking the east coast this past summer, three months of oil spills off of the Gulf Coast a year ago, and the tragic earthquakes that struck Chile and Haiti in early 2010, are constant reminders that tragedy and catastrophe can occur at any moment. But what kind of effects do these devastating disasters have on those involved and what can counselors and psychologists do to help them?

A new issue of The Counseling Psychologist (published by SAGE) titled "Counseling Psychology and Large-Scale Disasters, Catastrophes, and Traumas: Opportunities for Growth," discusses past efforts by mental health professionals in responding to international disasters, current research endeavors, and training and intervention programs that can be implemented at a global level in the future.

"Disasters affect individuals, families, communities, work places, and disaster responders. Thus, they require a multisystem analysis and response, which counseling psychologists can provide," wrote Sue C. Jacobs, Mark M. Leach, and Lawrence H. Gerstein, authors of the introductory article, "Introduction and Overview: Counseling Psychologists' Roles, Training, and Research Contributions to Large-Scale Disasters." "

Following Hurricane Katrina's destructive assault on the Gulf Coast in 2005, a group of psychologists came together to form the Special Task Group (STG) in order to encourage and support students and faculty from counseling psychology programs in their efforts to organize mental health relief efforts for those affected by the disaster. After the effects of the hurricane lessened, members of the STG found that they needed a way to discuss what they learned from the experience as well as what they could do to improve their services when disasters occurred in the future.

Defining disasters as natural disasters, human made disasters, and war and genocide, the November 2011 edition of The Counseling Psychologist reflects this proactive and systematic attempt to organize and prepare psychologists as they help those affected by traumatic events on their long road to recovery.

Jacobs, Leach, and Gerstein wrote, "As we discussed this contribution it became blatantly clear that Hurricane Katrina was just the latest in a series of disasters that had widespread effects. We decided, therefore, to invite other counseling psychologists with appropriate expertise to be part of this major contribution"

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