COVID-19 has reinforced the need to revisit the integration of health within disaster risk reduction (DRR) strategies for biological hazards in a system-wide approach. In November 2020, DRR experts attended the Asia-Pacific Partnership for Disaster Risk Reduction (APP-DRR) Forum to share progress and learnings in the areas of health system resilience, data management, residual risk management, risk communication, digital literacy, and knowledge product marketing. Advancements for health in DRR included the importance of multi-sectoral, multi-hazard action plans; adaptation to technological... read more

Background: Given the regular winter recurrence of influenza epidemics and the biologically plausible association between seasonal influenza and cardiovascular events, researchers assumed a valid and reliable influenza forecast could envision the timing and burden of winter surge in cardiovascular (CVD) hospitalizations. This, however, is well justified only in temperate regions. In this study, we aim to investigate the temporal association between ambient temperature, seasonal influenza and risk of cardiovascular events in a subtropical city.

(1) Background: The adverse health effect associated with extreme temperature has been extensively reported in the current literature. Some also found that temperature effect may vary among the population with different socioeconomic status (SES), but found inconsistent results. Previous studies on the socioeconomic vulnerability of temperature effect were mainly achieved by multi-city or country analysis, but the large heterogeneity between cities may introduce additional bias to the estimation. The linkage between death registry and census in Hong Kong allows us to perform a city-wide... read more

Background: In response to population aging, there is a need for health systems to focus on care for chronic disease, specifically palliative care, while focusing on people-centered care. The objective of this study is to explore the healthcare system enablers and barriers to the provision of quality palliative and end-of-life care from the perspective of healthcare professionals. Materials and Methods: Using purposive sampling, fifteen focus group interviews and nine individual interviews involving 72 healthcare providers were conducted. Primary qualitative data were collected between May... read more

Background: Maintaining health of healthcare workers with vaccination is a major component of pandemic preparedness and acceptance of vaccinations is essential to its success. This study aimed to examine impact of the coronavirus disease 2019 (COVID-19) pandemic on change of influenza vaccination acceptance and identify factors associated with acceptance of potential COVID-19 vaccination.

The novel coronavirus disease 2019 (COVID-19) pandemic brought about several features that increased the sense of fear and confusion, such as quarantine and financial losses among other stressors, which may have led to adverse psychosocial outcomes. The influence of such stressors took place within a broader sociocultural context that needs to be considered. The objective was to examine how the psychological response to the pandemic varied across countries and identify which risk/protective factors contributed to this response. An online survey was conducted from 29 May 2020–12 June 2020,... read more

This article summarizes the proceedings of the four-session meeting (webinar) conducted by the Alliance of International Science Organizations on Disaster Risk Reduction (ANSO-DRR) on 18 May 2020. ANSO-DRR is an international, nonprofit and nongovernmental scientific alliance bringing together academies of science, research organizations and universities which share a strong interest in disaster risk reduction in the regions along the land-based and maritime routes of the Belt and Road Initiative. ANSO-DRR convenes an annual meeting to review its work progress and discuss its scientific... read more

Climate change is expanding the global at-risk population for vector-borne diseases (VBDs). The World Health Organization (WHO) health emergency and disaster risk management (health-EDRM) framework emphasises the importance of primary prevention of biological hazards and its value in protecting against VBDs. The framework encourages stakeholder coordination and information sharing, though there is still a need to reinforce prevention and recovery within disaster management. This keyword-search based narrative literature review searched databases PubMed, Google Scholar, Embase and Medline... read more

An Ebola virus outbreak taking place in the complex political and social context of The Democratic Republic of the Congo has forced the research community to reflect on their approach to community engagement. Katharine Wright and Michael Parker, on behalf of the Nuffield Council on Bioethics Working Group on research in global health emergencies, say that those affected need to influence research choices from the very beginning and that the value of their knowledge must be recognized.

Climate change-related extreme events are increasing in frequency and severity. Understanding household emergency preparedness capacity in Health-Emergency and Disaster Risk Management (Health-EDRM) for at risk urban communities is limited. The main objective of the study is to explore the association among risk perception, household preparedness, and the self-reported short-term impacts of Typhoons for urban residents. A population-based, cross-sectional telephone survey using random digit-dialling was conducted among Hong Kong adults within 2 weeks following 2018 Typhoon Mangkhut, the... read more

The WHO Thematic Platform for Health Emergency and Disaster Risk Management Research Network (TPRN) was established in 2016 in response to the Sendai Framework for Disaster Risk Reduction 2015⁻2030. The TPRN facilitates global collaborative action for improving the scientific evidence base in health emergency and disaster risk management (Health EDRM). In 2018, the WHO convened a meeting to identify key research questions, bringing together leading experts from WHO, TPRN, World Association for Disaster and Emergency Medicine (WADEM), and the Japan International Cooperation Agency, and... read more

Introduction: As a subtropical urbanized city in Southeast Asia, Hong Kong is prone to frequent typhoons. With increasing number of severe typhoons, usual preparedness measures should be explored to assess their adequacy to safeguard health and wellbeing. Typhoon Mangkhut (2018) serves as an example of the successes and limitation of community preparedness for a severe typhoon. Aim: To explore how Hong Kong residents prepared for Typhoon Mangkhut and whether their usual preparedness measures provided enough protection. Method: A population-based randomized telephone survey of Hong Kong... read more

Heated debates over the Fugitive Offenders and Mutual Legal Assistance in Criminal Matters Legislation (Amendment) Bill 2019 introduced by the Hong Kong Special Administrative Region Government have led to numerous public marches and demonstrations since June 9, 2019.

Health-emergency disaster risk management (health-EDRM) aims to reduce the health risks and vulnerability associated with emergencies and disasters, such as natural disasters, infectious disease epidemics, complex emergencies, technology failure, or global population movement. Medical care and health responses in emergency contexts often rely on best-fit interventions rather than best practices to protect communities in suboptimally functioning systems and complex contexts. Unlike health emergency actions that are focused on the response, the health-EDRM approach emphasises emergency... read more

Introduction

Disaster epidemiological studies indicate that Asia has the highest frequency of natural disasters. Rural communities are heavily impacted by natural disasters and have different healthcare needs to urban ones. Referencing Asian countries, this paper’s objective is to provide an overview of health impacts and the current evidence for designing programmes and policies related to rural health emergency and disaster risk management (health-EDRM).

Sources of data

This paper uses published English-only reports and papers retrieved from PubMed, Google Scholar,... read more

Water security is essential for maintaining health and well-being, and for reducing a population’s vulnerability in a disaster. Among resource-poor villagers in China, water-related disasters and climate change may increasingly affect people’s water security. The purpose of this study was to explore the relationship between perceived water security and disaster risk perception in a rural ethnic minority community. A cross-sectional household survey was conducted in 2015 in Xingguang village, Chongqing, China, examining the association between villagers’ perceptions of household water... read more

OBJECTIVE:

The effects of high temperature on existing allergic conditions are unclear. This study explored the prevalence of allergic symptoms and the effects of high temperature on existing allergic symptoms among an adult population. The effects of high temperature on other non-allergic health outcomes were compared between adults with and without a history of allergic symptoms.

METHOD:

A cross-sectional telephone survey study was conducted in Hong Kong two weeks after a heat wave in 2017. Socio-demographic information, history of allergic symptoms, non-allergic... read more

The El Niño Southern Oscillation (ENSO) is a major driver of climatic variability that can have far reaching consequences for public health globally. We explored whether global, regional and country-level rates of people affected by natural disasters (PAD) are linked to ENSO. Annual numbers of PAD between 1964-2017 recorded on the EM-DAT disaster database were combined with UN population data to create PAD rates. Time-series regression was used to assess de-trended associations between PAD and 2 ENSO indices: Oceanic Niño Index (ONI) and multivariate El Niño Index (MEI). Over 95% of PAD... read more

The global travel and tourism industry has been rapidly expanding in the past decades. The traditional focus on border screening, and by airline and cruise industries may be inadequate due to the incubation period of an infectious disease. This case study highlights the potential role of the hotel industry in epidemic preparedness and response.

Background: Web-based public health courses are becoming increasingly popular. “Public Health Principles in Disaster and Medical Humanitarian Response” is a unique Web-based course in Hong Kong. This course aimed to fill a public health training gap by reaching out to postgraduates who are unable to access face-to-face learning.

Objective: The aim of this paper was to use a structured framework to objectively evaluate the effectiveness of a Web-based course according to Greenhalgh et al’s quality framework and the Donabedian model to make... read more

Background: Mental disorders have been found to be positively associated with temperature in cool to cold climatic regions but the association in warmer regions is unclear. This study presented the short-term association between temperatures and mental disorder hospitalizations in a subtropical city with a mean annual temperature over 21 °C. Methods: Using Poisson-generalized additive models and distributed-lagged nonlinear models, daily mental disorder hospitalizations between 2002 and 2011 in Hong Kong were regressed on daily mean temperature, relative humidity, and air... read more

BACKGROUND:

Acute myocardial infarction (AMI) is the leading cause of death among people with diabetes mellitus (DM) and has been found to occur more frequently with extreme temperatures. With the increasing prevalence of DM and the rising global mean temperature, the number of heat-related AMI cases among DM patients may increase. This study compares excess risk of AMI during periods of extreme temperatures between patients with DM and without DM.

METHODS:

Disaster awareness and household preparedness are crucial for reducing the negative effects of a disaster. This study aims to examine the citizens’ preparedness level in the event of a general disaster or outbreak of infectious disease and to identify suitable channels for community disease surveillance and risk communication. We used a stratified random design to conduct a digit-dialed telephone survey in Hong Kong during February 2014. Level of disaster preparedness was examined according to the possession of disaster kit items. Associations between socio-demographic factors and good... read more

Myanmar is a country in political and economic transition. Facing a wide-variety of natural hazards and ongoing conflict, the country’s under-developed infrastructure has resulted in high disaster risk. Following the devastation of Cyclone Nargis in 2008 and increased global focus on disaster management and risk reduction, Myanmar has begun development of national disaster policies. Myanmar’s Action Plan for Disaster Risk Reduction addressed multiple stages of disaster development and has made progress towards national projects, however, has struggled to implement community-based... read more

Pneumonia and chronic obstructive pulmonary diseases (COPD) are the commonest causes of respiratory hospitalization among older adults. Both diseases have been reported to be associated with ambient temperature, but the associations have not been compared between the diseases. Their associations with other meteorological variables have also not been well studied. This study aimed to evaluate the associations between meteorological variables, pneumonia, and COPD hospitalization among adults over 60 and to compare these associations between the diseases. Daily cause-specific hospitalization... read more

Fire is one of the major disasters in rural communities but evidence of the effectiveness of education interventions against fire risks is limited. This was a 2-year study assessed the effectiveness of face-to-face Health Emergency and Disaster Risk Management (Health-EDRM) education interventions for raising fire risk reduction knowledge in a fire-prone rural ethnic minority community. The study was conducted in various pre-set time points of an intervention-based project in a Dong-based community in Nanjiang Village, Guizhou Province in 2015 and 2016 to increase knowledge among the... read more

OBJECTIVE:

Restrictive food avoidance behavior among Chinese cancer patients is common. Yet, to the authors' knowledge, no study has investigated factors associated with such behavior. This study attempted to validate a new measurement tool, the Cancer Patients Food Avoidance Behaviors Scale (CPFAB), that assessed cancer patients' belief regarding 5 perceived benefits of practicing food avoidance, and to test its applicability.

DESIGN:

Cross-sectional face-to-face interviews.

SETTING:

Two outpatient oncology clinics in 2 different districts of Hong Kong... read more

Ma’an Qiao Village, a Dai and Yi ethnic minority-based community in Sichuan Province, China sustained complete infrastructure devastation during the 2008 Panzhihua earthquake. Health emergency and disaster risk management (Health-EDRM) education intervention programs were implemented in 2010 and 2011. This serial cross-sectional survey study aimed to examine the immediate and long-term impacts of the Health-EDRM interventions in this remote rural community. The findings demonstrate knowledge improvement in areas of water and sanitation, food and nutrition, and disaster preparedness... read more

Objectives: Accidental risks perception, knowledge and willingness to learn about emergency responses are critical elements in disaster risk reduction. Literature on the relevant topics for public transport safety is limited. The three main study objectives include exploring i) relationship between socio-demographic characteristics with risk perception and anxiety of users of urban public transport system, ii) if a major emergency incident affected confidence and increase anxiety of public transport utilization and iii) how previous first aid training might be associated with response... read more

Background: The Rana Plaza collapse was the global garment industry’s deadliest disaster: killing 1,134 and injuring over 2,500, the incident overwhelmed local capacity and caused great damage, destruction and human suffering. The rescue operation took three weeks, relying on a large portion of untrained and inexperienced volunteers. This incident had numerous long-term physical and mental health consequences for victims. This case study sought to understand how disaster preparedness levels of responders impacted health outcomes. Methods: A comprehensive literature review (including grey... read more

Objective To investigate the prevalence of cold related symptoms and its association with socio-economic factors Background: The impact of the temperature on human health has long been reported. Multi-city studies indicated that population in cities in lower latitude and with mild winter are more valuable to cold-weather. Previous studies were mainly focused on mortality and morbidity due to the availability of the data, while cold-related symptoms are however not well studied. It is important to enhance the understanding of prevalence of cold related symptoms and how it associates with... read more

Objectives: The study aims to identify important predictors on the adoption of various protective behaviors under cold spell in Hong Kong. Methods: This is a randomized population-based cross-sectional telephone survey study. The study was conducted three days after the coldest winter in the past 58 years in January 2016. Eligible participants are Cantonese speakers who are Hong Kong residents aged above 15. Basic demographic data, social-economic status (SES) and questions related to protective measures against cold spell were solicited. Descriptive analysis and stepwise multi-logistic... read more

Study/Objective: To review research trends and evidence in the field of health emergency and disaster risk management ﴾HEDRM﴿, and to provide recommendations for the field moving forward. Background: Health is recognised as an outcome and a goal of disaster risk reduction activities, acknowledged in international agreements such as the International Health Regulations ﴾2005﴿ and Sendai Framework for Disaster Risk Reduction ﴾2015﴿. H‐EDRM has emerged as an umbrella field which encompasses emergency and disaster medicine, disaster risk reduction ﴾DRR﴿, humanitarian response and health... read more

Study/Objective: This study primarily aimed to investigate the relationship among different types of household injuries with sociodemographic attributes in Hong Kong, an urban Chinese setting. Background: Injury is a major global disease burden for the 21th century. However, there is little research about unintentional household injury, especially in Asian urban area. Methods: A cross‐sectional retrospective recall study was conducted in 2009 using a random telephone survey with a modified Chinese version of the World Health Organization Injury and Violence instrument. Ethics approval and... read more

Background: Previous research has shown winter peaks for both hospitalizations and mortality from HF, but few studies have examined the association between meteorological parameters and HF.
Methods: Daily HF admissions to Hong Kong public hospitals, which cover about 83% of total admissions, and daily HF deaths, were obtained for 2002–2011. Generalized additive (Poisson) regression models were used with daily HF admissions/mortality as outcomes and dailymean temperature, humidity, and wind speed as predictors, while controlling for pollutant levels, time trend, season, day of theweek... read more

Disasters occur almost daily in the world. Because emergencies frequently have no precedent, are highly uncertain, and can be very destructive, improving a country's resilience is an efficient way to reduce risk. In this article, we collected more than 20,000 historical data points from disasters from 207 countries to enable us to calculate the severity of disasters and the danger they pose to countries. In addition, 6 primary indices (disaster, personal attribute, infrastructure, economics, education, and occupation) including 38 secondary influencing factors are considered in analyzing... read more

Remote, rural ethnic-minority communities face greater disaster-related public health risks due to their lack of resources and limited access to health care. The Ethnic Minority Health Project (EMHP) was initiated in 2009 to work with remote, disaster-prone ethnic-minority villages that live in extreme poverty. One of the project’s aims is to develop and evaluate bottom-up health risk reduction efforts in emergency and disaster risk management (Health-EDRM). This article shares project updates and describes field intervention results from the Yi ethnic community of Hongyan village in China... read more

Health and disaster risk reduction are important and necessary components in building a smart city, especially when climate change may increase the frequency of extreme temperatures and the health risks of urban dwellers. However, limited knowledge is available about the best way to disseminate weather warnings and health protection information. This study explores the weather information acquisition patterns of the Hong Kong public and examines the sociodemographic predictors of these patterns to establish the potential public health implications of smart city development. A population-... read more

Objectives: Some carbon-reducing behaviours are environmental-friendly and good for health. Such co-benefits are promoted since the millennium in Hong Kong (HK). This study aims to found out how the practice of these behaviours may have changed during the past decade in HK. Methods: This 2-stage sequential randomized cross-sectional and population-based telephone survey collected data in 2008 and 2016. Six kinds of behaviours (less electricity, less unnecessary package, less A/C, less meat, more walk/cycling, and more organic food) were investigated. The respondents self-reported their... read more

Increasingly practitioners and policy makers working across the globe are recognising the importance of bringing together disaster risk reduction and climate change adaptation. From studies across 15 Pacific island nations, a key barrier to improving national resilience to disaster risks and climate change impacts has been identified as a lack of capacity and expertise resulting from the absence of sustainable accredited and quality assured formal training programmes in the disaster risk reduction and climate change adaptation sectors.

Background: Climate change has increased extreme temperature events. The study aims to examine the community risk awareness and perceptions of temperature warning system in subtropical city in Asia which is rarely studied. Design and data collection: A cross-sectional, self-administrated questionnaire survey on all incoming students of the Faculty of Medicine (both clinical and non-clinical) in the University was conducted in September 2015. Personal backgrounds, knowledge, attitudes and practices towards current extreme temperature warning systems were collected. Ethics approval and... read more

A better understanding of knowledge gaps and global civil societal learning patterns will support the building of “bottom up” disaster resilience through online global accessible education platforms. Through collaborative efforts between Chinese University of Hong Kong and University of Oxford, a free-of-charge 18-hours online course titled Public Health Principles in Disaster and Medical Humanitarian Response" was developed by CCOUC. Enrolled students may access all learning materials and activities online within each of the four time-study cohorts.

BACKGROUND: Hand, foot and mouth disease (HFMD) is an emerging enterovirus-induced infectious disease for which the environmental risk factors promoting disease circulation remain inconclusive. This study aims to quantify the association of daily weather variation with hospitalizations for HFMD in Hong Kong, a subtropical city in China. METHODS: A time series of daily counts of HFMD public hospital admissions from 2008 through 2011 in Hong Kong was regressed on daily mean temperature, relative humidity, wind speed, solar radiation and total rainfall, using a combination of negative... read more

Objectives: The study aims to investigate the effectiveness of Cold Weather Warning in Hong Kong via evaluation whether such can enhance the adoption of protective measures against cold spell in the community. Methods: This is a randomized population-based cross-sectional telephone survey study. The study was conducted three days after the coldest winter in the past 58 years in January 2016. Eligible participants are Cantonese speakers who are Hong Kong residents aged above 15. Basic demographic data, social-economic status (SES) and questions related to protective measures against cold... read more

Objectives Globally, the effects of climate change pose significant threats to human health. Individual environmental actions are advocated to not only leave a lower carbon footprint, but also to improve health and even reduce daily life expenses. The objective of this study is to assess the community patterns of economical, health and environmental co-benefit behaviours among the Hong Kong public. Methods A randomised cross-sectional population-based telephone survey was conducted between January and February 2016, surveying Cantonese-speaking Hong Kong residents over age 15. Ethics... read more

Study/Objective 1. To understand factors that associated with better online learning outcome. 2. To discuss lessons learnt for future MOOC development for improving community disaster literacy and resilience. Background Resilience is the ability that to anticipate, withstand, respond and recovery from adverse situation. Improved public awareness and knowledge is a preventive measure to reduce adverse health impact of disaster and enhance community resilience. Collaboration Centre of CUHK and Oxford University for Disaster and Humanitarian Response (CCOUC) has been developed and launched an... read more

Study/Objective The project aims to explore community disaster risk perception and to evaluate the impact of disaster preparedness health intervention in Yiminority community in China. Background LiangShan Yi Autonomous Prefecture is one of the disasterprone area in Sichuan province, China. Majority of people belongs to Yiminority and live in rural mountainous area with highly susceptible to multiple natural disasters. A major flood occurred on August 31st 2012 at Hongyan Village, LiangShan Prefecture and had affected 218,000 local residents with 13,300 households collapsed. A postflooding... read more

Introduction: In 2011, north-eastern Japan was struck by ‘a triple disaster’ with a magnitude 9.0 earthquake, tsunamis and nuclear plants meltdown that caused nearly 20,000 deaths. Despite of the pre-event community disaster preparedness and drills, mortalities vary among disaster affected schools. This qualitative case study aims to identify factors that were associated with positive health outcomes.

Study/Objective To explore the capacity building strategy for disaster preparedness through building healthliterate village in rural China. Background Health risk literacy is an important asset for capacity building and a key attribute of the development of a healthy village, a similar project as the Healthy City programme initiated by the World Health Organization (WHO) in 1989. However, not much research has been conducted since then for developing health literate villages in rural settings in China. As such, a rural Chinese village is selected to explore the development of a health... read more

Asthma is one of the most common chronic conditions affecting both children and adults. Examining the health effects of environmental triggers such as temperature variation may have implications for maintenance of asthma control and prevention. We hypothesized that large diurnal temperature range (DTR) might be a source of additional environmental stress and therefore a risk factor for asthma exacerbation. Daily meteorological data, air pollution concentrations and emergency hospital admissions for asthma from 2004 to 2011 in Hong Kong were collected. Poisson regression models were used to... read more

We conducted a population telephone survey in Hong Kong during the second wave of influenza A/H7N9 outbreak in 2014. Among the respondents, 50.5% of the respondents would like to accept A/H7N9 vaccination in future. Respondents had poor knowledge of A/H7N9 influenza and vaccines. More than 60% of respondents mixed up seasonal influenza this year and A/H7N9 influenza. Results show that socio-demographic factors were all independent of the vaccine uptake willingness while anxiety level and vaccine history were the main affecting factors. Vaccine promotion strategies may focus on influenza... read more

Short-term associations between both hot and cold ambient temperatures and higher mortality have been found worldwide. Few studies have examined these associations on longer time scales. Age-standardized mortality rates (ASMRs) were calculated for 1976-2012 for Hong Kong SAR, People's Republic of China, defining "annual" time periods in 2 ways: from May through April of the following year and from November through October. Annual frequency and severity of extreme temperatures were summarized by using a degree-days approach with extreme heat expressed as annual degree-days >29.3°C and... read more

This study aims to quantitatively summarize the association between night shift work and the risk of metabolic syndrome (MetS), with special reference to the dose–response relationship with years of night shift work. We systematically searched all observational studies published in English on PubMed and Embase from 1971 to 2013. We extracted effect measures (relative risk, RR; or odd ratio, OR) with 95% confidence interval (CI) from individual studies to generate pooled results using meta-analysis approach. Pooled RR was calculated using random- or fixed-effect model. Downs and Black scale... read more

BACKGROUND: The prevalence of childhood obesity among adolescents has been rapidly rising in Mainland China in recent decades, especially in urban and rich areas. There is an urgent need to develop effective interventions to prevent childhood obesity. Limited data regarding adolescent overweight prevention in China are available. Thus, we developed a school-based intervention with the aim of reducing excess body weight in children. This report described the study design. METHODS/DESIGN: We designed a cluster randomized controlled trial in 8 randomly selected urban primary schools between... read more

Objectives: There is limited evidence on perceptions of disaster risk and household level preparedness among urban Asian communities. Hong Kong is characterized by high population density, and is susceptible to large-scale natural disasters and health crises such as typhoons, fires and infectious disease outbreaks. This research paper investigates the rates and predictors of urban community disaster risk perception, awareness and preparedness at individual and household levels. Methods: A randomized cross-sectional, population-based telephone survey study was conducted among the Cantonese-... read more

BACKGROUND The chronic health effects from exposure to ambient air pollution are still unclear. This study primarily aims to examine the relationship between long-term exposure to ambient air pollution and respiratory morbidities in Chinese children. METHODS A cross-sectional study was conducted among 2,203 school children aged 8-10 in three districts with different air pollution levels in Hong Kong. Annual means for ambient PM10, SO2, NO2 and O3 in each district were used to estimate participants' individual exposure. Two questionnaires were used to collect children's respiratory... read more

Little is known about the health impact of air pollution on children's cardiovascular health. A cross-sectional study was conducted and data was analysed in 2048 Chinese schoolchildren (aged 8–10 years) in three districts of Hong Kong to examine the association between exposure to outdoor air pollution and cardiorespiratory fitness. Annual means of ambient PM10, SO2, NO2 and O3 from 1996 to 2003 were used to estimate individual exposure of the subjects. Cardiorespiratory fitness was measured for maximal oxygen uptake (VO2max), predicted by the multistage fitness test (MFT). Height and... read more

BACKGROUND: In-flight medical emergencies are difficult to manage and medical volunteers can be valuable when these events occur. The study objective was to examine the role of medical volunteers in medical emergencies which resulted in medical flight diversions. METHODS: This was a retrospective cohort study of medical diversions in a large Hong Kong commercial airline from December 2003 to November 2008. This study is derived from a database of in-flight medical events which has been previously reported. The presence of medical volunteers, the need for diversion, and the outcome for all... read more

The recent Super Typhoon Haiyan, the third category 5 typhoon to strike the Philippines since 2010, tore through Tacloban in the province of Leyte and affected about 13 million people; only 4 weeks after Super Typhoon Usagi affected more than 2.7 million people in southern China. With increasing numbers of disasters related to climate change (from 99 in 1980 to 269 in 2011), Asia is likely to be hit by more typhoons with stronger intensity in the coming decades......

BACKGROUND: Several previous studies examined the association between acute myocardial infarction (AMI) incidence and temperature and/or air pollution. Results of these studies have been inconsistent and few studies have been done in cities with sub-tropical or tropical climates. METHODS: Daily data on AMI hospitalizations, mean temperature and humidity, and pollutants, were collected for 2000-2009 for three warm-climate Asian cities. Poisson Generalized Additive Models were used to regress daily AMI counts on temperature, humidity, and pollutants while controlling for day of the week,... read more

研究证实受灾地区的当地居民是发生灾害时能够最早做出反应的潜在救援力量，可以在黄金时间内施以救助，从而有效地降低灾害招致的人员伤亡。因次，在易受灾灾区对当地居民进行普及教育，提供与灾害救援有关的基本知识和技能，可以最大的发挥这一潜力。Angus在1993年提出“八项急救的基本步骤”的建议，以期达到在社区居民中有效普及灾难教育的目的。以Angus的建议为框架，以5•12汶川大地震为例，本文总结了汶川大地震的经验和教训，探讨了社区健康工作者在灾害发生时应当扮演的角色，从而尽可能地降低灾害对人类生命和健康的影响。

A deeper understanding of extreme hot weather are needed in cities sensitive to heat effects, an investigation was done in the tropical town of Kaohsiung in Taiwan. Its 11 districts were divided into three climatic classes varying from high urban heat, low levels of green space and lack of proximity to water bodies to low urban heat, adequate green space and proximity to water bodies. Daily data on natural mortality, meteorological variables, and pollutants from May-October 1999-2008 were analysed using generalised additive models for the time-series data.

We read with interest the recent Editorial on improving the health response to humanitarian crises (June 1, p 1878). Communities worldwide face increasing threats from a myriad of hazards, so evidence-based advancements in humanitarian assistance are welcomed......

Introduction: Heatwaves have a clear impact on society, including a rise in mortality and morbidity. The aim of fans in a heatwave is to increase heat loss by increasing efficiency of all normal methods of heat loss – but particularly by evaporation and convection methods. There has been little comparative, intervention research on the physiological effects of electric fans. A Cochrane systematic review was undertaken to determine whether the use of electric fans contributes or impedes heat loss at high ambient temperatures. Results would have implications for policies such as the Heatwave... read more

Introduction: A major flood occurred in Liangshan Autonomous Prefecture on 31st August 2012. The disaster has caused massive damage to the local community. Liangshan Prefecture has the largest population of Yi minority in China, and ethnic minority groups like Yi generally attain lower educational and economical status than the Han counterparts. Limited is known in regarding its health impact and post disaster response, this paper described and examined the impact and the community preparedness in the recent forgotten disaster. Methodology: A cross sectional household survey was conducted... read more

Gaps in training have been identified from reviews of the experiences of prehospital medical personnel faced with previous disasters like the Sichuan earthquake in 2008. It would be useful to identify and develop standardised training and educational core competencies in pre-hospital disaster training adapted to the local situation and health system in China. This paper identified six areas of training needs for responders to enhance their effectiveness in disaster settings. Two levels of training for frontline first responders and disaster response managers may be the best approach to... read more

Background Flooding is one of the most common natural disasters in China. With climate change, the Chinese communities will further increase their vulnerabilities to extreme weather events. In order to mitigate disaster risk, a better understanding of flood disaster profile and human health impact of floods in China will provide evidence to support the development of interventions to facilitate recovery of affected population in field setting. The study objective is to summarize update knowledge of health impact of floods in China. Flood assessing methodologies and mapping techniques will... read more

Background: Globally, China is the most natural disaster prone country and its remote area population faces the highest natural disaster risk. These communities are often characterized by ethnic minority based, in extreme poverty. In China, non-Han Chinese constitutes to 8.4% of her population and generally fare worse in economic status than the Han majority. Since 2009, the health education team from the School of Public Health has been to rural villages in China to deliver health education. Four key principles of site selection include: 1. geographic remoteness, 2. ethnic minority based... read more

Background: Disaster risk literacy refers to the ability to identify, understand, interpret and communicate disaster risk-related information. Whilst literature review indicates that health literacy is directly associated with health outcomes, there is currently a literature gap on the predictors of disaster health risk literacy and how risk literacy might be associated with the uptake of first aid trainings for better community disaster preparedness.

Remote rural communities are often more vulnerable to health risk and have worse health outcomes than urban population. Whilst World Health Organization's “Healthy Village” initiatives have been implemented in Africa and Eastern Mediterranean region, no experience has been reported in the Western Pacific region or in China. A health need assessment was carried out in March 2009 to identify health needs and for situation analysis at Maan Village of Xinan Township at Hiuli County, Liangshan, Sichuan. Findings indicated the ethnic minority population in the area had poor health outcomes and... read more

Previous studies examining daily temperature and stroke incidence have given conflicting results. We undertook this retrospective study of all stroke admissions in those aged 35 years old and above to Hong Kong public hospitals from 1999 through 2006 in order to better understand the effects of meteorological conditions on stroke risk in a subtropical setting. We used Poisson Generalized Additive Models with daily hemorrhagic (HS) and ischemic stroke (IS) counts separately as outcomes, and daily mean temperature, humidity, solar radiation, rainfall, air pressure, pollutants, flu... read more

BACKGROUND Heatwaves are hot weather events, which breach regional or national thresholds, that last for several days. They are likely to occur with increasing frequency in some parts of the world. The potential consequences were illustrated in Europe in August 2003 when there were an estimated 30,000 excess deaths due to a heatwave. Electric fans might be used with the intention of reducing the adverse health effects of a heatwave. Fans do not cool the ambient air but can be used to draw in cooler air from outside when placed at an open window. The aim of the fans would be to increase... read more

China has one of the countries with highest occurrence of disasters and disasters are disproportionately affecting rural area of China where ethnic minorities are inhibiting. Mixed methods of studies were conducted in rural Sichuan, Yunnan, Gansu and Hainan province of China to understand the mental health impact and coping after natural disasters. Standardized quantitative questionnaires and over 20 focus groups were conducted among ethnic minority groups including Tai, Naxi, Li, Jiang and Hui affected by earthquake, flooding, mudslide, rain storm and snow storm. Validated psychological... read more

Background: Several studies from Europe and the United States have reported sharp drops in the incidence of acute myocardial infarction (AMI) following the introduction of smoking bans for public places in various cities. In addition some studies have reported that daily AMI hospitalization rates are associated with meteorological conditions, particularly temperature. Hong Kong banned smoking in restaurants, workplaces and outdoor public areas in 2007 and in bars and karaokes in mid-2009. In this study we examine whether AMI hospitalization rates dropped following introduction of the... read more

Sleep disturbances are common symptoms during the immediate and long-term aftermath of exposure of traumatic events. While stress affects sleep in all age groups, due to differences in physiological, psychological, and socio-behavorial risk factors, the clinical management of pediatric patients with sleep disturbances post-disaster might be different. This study aims to systematically review scientific literature on the clinical management of pediatric sleep disturbances post-disaster and its clinical implication in developing countries. Methods: A keyword-based, systematic review was... read more

Limited information is available on the health outcomes of the rural older population in developing countries is affected by disasters. In October 2010, Hainan Province experienced severe flooding following heavy rains. Nearly four million people were affected and many had undergone resettlement. This study investigated the impacts of the flooding on people living in the disaster-affected rural communities. The findings were compared with baseline information collected in 2010 about health issues in rural villages in Hainan. Health outcome comparisons also were made between ethnic groups (... read more

Natural disasters cannot be prevented but their human impact can be mitigated. Effective medical and public health mitigation and responses require multidisciplinary efforts and appropriate training. Whilst Asia is currently ranked as the most natural disaster prone area globally, limited disaster medical and public health response training opportunities are available in the region. Our paper reports efforts to identify the training gaps and ways to fill them to prepare frontline practitioners and academic researchers in disaster and medical humanitarian emergency relief efforts in Asia.... read more

Although China has been known for its high frequency and human toll resulting from natural disasters, limited information is available to understand the human impact of its technological disasters (TD). This study provides a time trend analysis of the TD-induced injuries and fatalities since 1979 in mainland China. Through reviewing available academic literature and the examination of two public accessible databases, descriptive analysis of TD epidemiological profile in China was conducted by Emergency Events Database of the Centre for Research on the Epidemiology of Disasters in Brussels... read more

China has one of the countries with highest occurrence of disasters and disasters are disproportionately affecting rural area of China where ethnic minorities are inhibiting. Mixed methods of studies were conducted in rural Sichuan, Yunnan, Gansu and Hainan province of China to understand the mental health impact and coping after natural disasters. Standardized quantitative questionnaires and over 20 focus groups were conducted among ethnic minority groups including Tai, Naxi, Li, Jiang and Hui affected by earthquake, flooding, mudslide, rain storm and snow storm. Validated psychological... read more

Limited research has been conducted to understand the relationship between heat wave warnings with public awareness and behavioral changes in the Asian population. The Hong Kong Observatory introduced the “very hot weather warning” in 2000 to alert the public of heatstroke and sunburn in Hong Kong. However, the population's behavioral responses to these weather alerts is unclear. Moreover, the relationship between perceived health risks and behavioral changes has not been examined. The goal of this study is to examine the health risk perceptions and behavioral changes following public heat... read more

Background: The Sichuan earthquake on 12 May 2008 with a magnitude of 8.0 killed > 87,000 people. The response of the Hong Kong Red Cross (HKRC) included a basic healthcare team to a small rural town called Yanmen three weeks after the earthquake. The objective of this study was to review HKRC’s medical records to identify the disease pattern in the Chinese rural setting post earthquake. Methods: A cross-sectional, record-based study of all patients treated by the HKRC basic healthcare team from 01 June to 19 June 2008. This retrospective study studied the medical records collected... read more

BACKGROUND: Over the last 100 years, China has experienced the world's three most fatal earthquakes. The Sichuan Earthquake in May 2008 once again reminded us of the huge human toll geological disaster can lead to. METHODS: In order to learn lessons about the impact of earthquakes on health in China during the past century, we conducted a bilingual literature search of the publicly available health-related disaster databases published between 1906 and 2007. RESULTS: Our search found that research was limited and there were major gaps in the published literature about the impact on health... read more

Five of the world's most fatal industrial accidents in the past decade (2001–10) occurred in mainland China. Since 1979, there have been at least 25 586 deaths and 24 214 injuries due to technological disasters in China. Mining-related accidents are the main subgroup of such disasters and occur ten times more frequently than in India, which ranks second in the world. The recent Shanxi Wangjialing coal-mine accident, which resulted in 36 deaths and 115 survivors rescued after being trapped underground for 8 days, reminded the international community once again of the struggle between... read more

In-flight medical emergencies are clinically challenging and may result in aircraft diversions, which are costly and inconvenient, or in-flight deaths. We provide an updated description of in-flight medical emergencies and systematically examine predictors of medical flight diversions and in-flight deaths......

Injury is a major global disease burden for the twenty-first century. There are, however, few studies of unintentional household injury in Asian urban settings where living environments are characterized by extremely compact, high-living-density, multistory apartments. This study investigated the association between nonfatal unintentional household injuries with the resident's sociodemographic attributes and household characteristics in Hong Kong, the city with the world's highest population density. A cross-sectional retrospective recall study was conducted in May 2007 using a random... read more

AIMS: Limited published studies have examined patient characteristics and disease patterns served by mobile clinics in remote areas post natural disaster. By comparing users of a remote mountainous stationary clinic and a mobile helicopter outreach clinic in Neelam Valley, 4 months post Pakistan-Kashmir earthquake, this study aims to: (i) compare the demographic and disease profile of health service users, (ii) examine how acute and chronic disease patterns vary with clinical settings, and (iii) discuss the potential implications to mobile emergency clinical service planning acute phase of... read more

目的 探讨高温热浪对沿海城市每日居民死亡情况的影响,为预防与控制热浪对城市居民健康的不良影响提供科学依据.方法 采用半参数广义相加模型对我国某沿海城市中心城区2005-2007年日平均温度与每日居民死亡数之间关系进行研究,同时采用分布滞后模型探索夏季日平均温度对每日居民死亡数的滞后效应.结果 通过平滑2005-2007年某沿海城市中心区日全死因死亡数与日平均温度的关系,得出它们之间的关系近似呈"V"型.夏季日平均温度每升高1 ℃,相对危险度增加0.036(P＜0.01).在建立的半参数广义相加模型中,日平均温度与日死亡数线性关系特别显著(P＜0.001),通过逐步回归对温度迟滞项lag1、lag2、lag3进行筛选,得出lag3代入模型最有意义,线性关系特别显著(P＜0.001).通过分布滞后模型,获得lag0、lag1对全死因死亡率的影响最明显(P＜0.000 1).结论 高温热浪对城镇居民每日居民死亡人数产生不利的影响,为了应对热浪活动在全球范围内日趋频繁的威胁,应该根据沿海城市的地区特点,采取相应的有效预防措施,以减少热浪导致的健康危害作用,确保沿海城市居民的健康.

Natural disasters always cause vast mortality and morbidity......

BACKGROUND: Overweight and obesity pose a challenge to public health in China. According to Chinese definition, 303 million Chinese are overweight (body mass index, BMI >or= 24 kg m(-2)). Among them, 73 million are clinically obese (BMI >or= 28 kg m(-2)). In line with the global trend, the rate of obesity in China continues to increase, with associated morbidity and mortality. This study was to identify interventions, which are effective in Mainland Chinese society. METHODS: All non-drug-controlled interventions (>or=3 months) in Mainland China, which used anthropometric outcome... read more

Child public health is described by Kohler as “ …the organised efforts of society to develop healthy public health policies to promote child and young people’s health, to prevent disease in children and young people and to foster equity for children and young people, within a framework of sustainable development”. China has the second largest population under the age of 5 in the world and faces complex challenges resulting from legislation, such as the one child policy, as well as the problem of increasing inequity, as demonstrated by trends in infant mortality in urban and rural China.... read more

Background: Under the "two countries, one system" policy implemented by China to manage the return of Hong Kong's sovereignty, Hong Kong has maintained a comparatively prosperous economy within the Asian region. This has resulted in an environment which fosters migration from the mainland to Hong Kong, due largely to proximity, higher earning potential, common language, and a relaxing of border control measures. However not all mainland China citizens are equally able to access these new migration schemes and indeed a number of women such as sex workers are either migrating and/or working... read more

Although natural disasters may cause massive loss of human life and destruction of resources, they also present affected populations with a rare opportunity to access external resources. Nevertheless, many post-disaster medical relief intervention programmes only focus on the provision of acute medical services and the control of communicable diseases. Currently, no specific study has examined why chronic medical needs seem to be insufficiently addressed in disaster relief interventions. This paper review current knowledge about how natural disasters affect people with chronic medical... read more