Survey research in disaster public health.

INTRODUCTION: While much has been learned during the past three decades of research in the disaster field, there still are some major gaps in knowledge. The need for more and better research on the health aspects of disasters is especially noted. Often, research into the health aspects has been anecdotal in nature and suffers from poor documentation of human losses. However, there are valid research methodologies that can be adapted to better document losses, evaluate interventions, and set priorities for investments to reduce the burden on the health of the population caused by disasters. METHODS: A number of data sources are used to demonstrate the potential uses of surveys in disaster health. The majority of the examples reflect data collected by telephone interviews following earthquakes in California. RESULTS: By using comparable instruments, it is possible to track the changes in preparedness levels across time. Similarly, it is possible to compare injury rates or other health impacts across time, place, and disaster type. In addition, risk factors can be identified for health outcomes. For example, in the Northridge earthquake, those over age 60 years were three times more likely to be hospitalized or die as a result of injuries than were those aged 20-59 years. Interventions can be evaluated. Slightly less than half of the respondents of the El Niño study had heard messages about preparing for the on-coming weather and their preparedness levels were not significantly different from those who had not heard about preparing for the weather. CONCLUSION: Surveys are useful tools for identifying and evaluating the health impacts of disasters.

Prevalence of assault and perception of risk of assault in urban public service employment settings.

This study describes the prevalence and correlates of physical assaults, threats of assault, and workers' perceptions of safety in selected urban employment settings. Questionnaires were mailed to a random sample of 1,763 persons working at various jobs and sites throughout Los Angeles County. Workers were asked to describe their work environments, their perceptions of personal safety at work, and physical assaults and threats they had experienced. Three percent of the respondents reported being assaulted within the previous year and 14% reported being threatened within the previous 30 days. Younger workers, more educated workers, and those who worked with clients or patients were more likely to report assaults. Approximately one third of those who reported threats or assaults described the perpetrator(s) as clients, patients, or persons in legal custody, and one third described the perpetrator(s) as co-workers or supervisors. Fifty-two percent of the workers reported being concerned about their safety at work.

Impact of the 1994 Northridge earthquake on the utilization and difficulties associated with prescription medications and health aids.

INTRODUCTION: The medical impacts of disasters have focused on the injuries, illnesses, and deaths related to the disaster. Little has been written about the impact of disasters on persons who use prescription medications or those medications that require refrigeration, or those who require health aids. The objective of this study was an evaluation of the level of utilization of prescription medications and medications that require refrigeration as well as the use of health aids by the population affected by the disaster. METHODS: Following the Northridge earthquake of 1994, a survey of Los Angeles County households was conducted to assess the impact of the earthquake. A total of 1247 households completed the 48 minute telephone interview. As part of the interview, 10 questions assessed the utilization of medications and medical aids by household members and the effects that the earthquake had on those medications and devices. Chi-square, analysis of variance (ANOVA), and logistic regression analysis were applied. RESULTS: Of the 1,212 completed interviews, 21% of the households had a family member taking a prescription medication or a medication requiring refrigeration. Associated factors included gender, race, age, household income, level of education, presence of children, and the intensity of the earthquake (by the Modified Mercalli Index). Only 3% of those that reported medication usage noted problems associated with the use of these medications. Thirty-nine percent of the respondents indicated that someone in the household used a health aid (e.g., eyeglasses, hearing aid, etc.). Usage was related to gender, race, age, household income, level of education, presence of children, and the intensity of the shaking associated with the earthquake. Of these, 6.5% reported difficulty with these aids, usually related to loss or breakage. CONCLUSIONS: Although the proportions of the population requiring prescription or refrigerated medications and/or for those using health aids in Los Angeles seemingly are small, this translates to 630,000 households in which someone requires medications and 1.2 million households with a requirement for health aids. Thus, there are a huge number of persons at risk for serious medical problems related to these medications and devices that could produce profound medical problems during a disaster. However, during and following a moderate earthquake, it does not seem that the consequences will be great.

Injuries as a result of California earthquakes in the past decade.

The devastating effects of earthquakes have been demonstrated repeatedly in the past decade, through moderate and major earthquakes such as the October 1987 Whittier Narrows earthquake (5.9 on the Richter scale), the October 1989 Loma Prieta earthquake (7.1) and the January 1994 Northridge earthquake (6.7). While 'official' tallies of injuries and deaths are reported for each event, the numbers vary from report to report. For Northridge, the number of injuries vary between 8,000 and 12,000; the number of deaths from 33 to 73 (Peek-Asa et al., 1997; Durkin, 1996). While official estimates are commonly reported following disasters, the study of actual numbers, types and causes of casualties has not developed. In this paper, we identify the numbers and risk factors for injuries within community-based samples across three earthquakes in urban California. We first report the numbers and types of injuries in each earthquake and then identify risk factors specifically associated with the Northridge earthquake.

Examining self-perceived first-aid abilities after the Northridge earthquake.

INTRODUCTION: This study examines those factors predictive of self-perceived first-aid abilities among a community-based sample after the 1994 Northridge earthquake. METHODS: A probabilities-proportionate-to-size (pps) sample of residents of Los Angeles Country and 11 pre-selected zip codes from southeastern Ventura County was selected using computer-generated random digit-dialing (rdd) procedures 7-11 months after the earthquake. Data were collected from 506 individuals in 45 minute interviews. A unidimensional scale of self-perceived first-aid ability was created and represents the dependent variable in a causal path model. RESULTS: In a causal path model, standardized path coefficients suggested that while reports of taking first-aid courses were the most influential factors in predicting higher self-perceived first-aid abilities, other factors including being white, younger, speaking English in the home, and lower income also predicted higher self-perceived first-aid abilities that were independent from taking formal first-aid courses. CONCLUSIONS: First-aid training should be directed towards target segments of the population that are not likely to have had instruction in these basic skills. Those individuals who self-report high first-aid proficiency, independent of formal first-aid training, should be evaluated to assess their abilities to perform these skills.