The COVID-19 pandemic has placed pressure on many national health-care systems worldwide. Due to the rapid surge in caseloads and resource constraints in health systems, in many high-income settings, the focus has been on disease screening, with those who have severe disease prioritised for hospitalisation. But the COVID-19 pandemic has also led to an unprecedented reliance on home care as one pillar of the health-care system to support people with confirmed or suspected COVID-19. Meanwhile, informal home care provision and challenges faced by care providers, excluding those who are formal... read more

Although much of the health emergency and disaster risk management (Health-EDRM) literature evaluates methods to protect health assets and mitigate health risks from disasters, there is a lack of research into those who have taken high-risk behaviour during extreme events. The study’s main objective is to examine the association between engaging in high-risk behaviour and factors including sociodemographic characteristics, disaster risk perception and household preparedness during a super typhoon. A computerized randomized digit dialling cross-sectional household survey was conducted in... read more

Background: Despite larger health burdens attributed to cold than heat, few studies have examined personal cold protection behaviours (PCPB). This study examined PCPB during cold waves and identified the associated factors in a subtropical city for those without central heating system. Methods: A cohort telephone survey was conducted in Hong Kong during a colder cold wave (2016) and a warmer cold wave (2017) among adults (≥15). Socio-demographic information, risk perception, self-reported adverse health effects and patterns of PCPB during cold waves were collected.... 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.

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

Food safety and unhealthy dietary pattern are important global health problems. Understanding food-related health needs and providing corresponding support are important to health risk reduction. A needs assessment, education intervention for food labelling, and another intervention for salt-intake reduction were conducted in a rural Kunge community in Yunnan, China in 2014, 2015 and 2016, respectively. Not checking the expiry date of packaged food (37.1%) and a high salt diet (53.9%) were the most common problems in the community. Both topics were selected for education intervention. Pre... 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

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.

Background: Literature on health emergency disaster risk management (Health-EDRM) for urban public transport safety is limited. This study explored: (i) the confidence in public transport safety, (ii) the relationship between socio-demographic characteristics and risk perception of transport safety and (iii) the association between previous first-aid training and response knowledge. Method: This is a population-based cross-sectional telephone survey conducted in March 2017, one month after a major subway incident in Hong Kong. Respondents were randomly selected with the... read more

Despite the importance of health vulnerability in disaster risk assessment, most of the existing disaster vulnerability indicators only emphasize economic and social vulnerability. Important underlying health risks such as non-communicable disease are not included in vulnerability measures. A three-phase methodology approach was used to construct a disaster risk model that includes a number of key health indicators which might be missing in global disaster risk analysis. This study describes the development of an integrated health vulnerability index and explains how the proposed... read more

OBJECTIVES:

Asthma can be triggered by various factors due to different etiologies. Environmental factors remain a common trigger of asthma, especially amongst children, and such ambient exposures can be harder to avoid compared to behavioral triggers. As such, the contribution of environmental factors may be enhanced when considering repeat asthma cases compared to initial presentations. To test this hypothesis, we assessed associations between ambient temperature and hospital admissions for asthma in Hong Kong and stratified admission records into first and repeat asthma... read more

Rural populations living in poverty are the most vulnerable to disaster. Despite this increased risk of recurrent disaster, previous disaster experience is not a good predictor for disaster preparedness in these populations. This was evidenced on 31 August 2012, when a major flood occurred in Sichuan, China. A health needs assessment carried out in December 2012 showed that residents of Hongyan village, a Yi-minority community in Sichuan lacked disaster preparedness. This indicated that measures were necessary to improve Health Emergency Disaster Risk Management (Health-EDRM) in the... read more

Background

This review examines the human health impact of climate change in China. Through reviewing available research findings under four major climate change phenomena, namely extreme temperature, altered rainfall pattern, rise of sea level and extreme weather events, relevant implications for other middle-income population with similar contexts will be synthesized.

Sources of data

Sources of data included bilingual peer-reviewed articles published between 2000 and 2018 in PubMed, Google Scholar and China Academic Journals Full-text Database.

Areas of... 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

Introduction: Menstrual health is a sensitive topic that causes gender discrimination and segregation. A focus group conducted in Sindupalchok, Nepal (April 2017) found some women had major knowledge gaps and misconceptions regarding menstrual hygiene practices. Objective: To assess programme effectiveness for addressing menstrual health knowledge gap, promote menstrual hygiene practice, and pain relief. Method: A 3 day health education intervention was conducted in January 2018. Knowledge about the menstruation cycle and period, menstruation-related hygiene practices, and pain alleviation... read more

BACKGROUND:

Rotavirus and norovirus are infectious pathogens primarily affecting children under 5 years old. The impact of rainfall on diarrheal diseases remains inconclusive. This study aimed to evaluate the association between short-term variation in rainfall, temperature and humidity, and rotavirus and norovirus hospitalizations among young children in Hong Kong.

METHODS:

Generalized additive negative binomial regression models with distributed lag non-linear terms, were fit with daily counts of hospital admissions due to rotavirus and norovirus infection... read more

Background

Tuberculosis (TB) in the elderly remains a challenge in intermediate disease burden areas like Hong Kong. Given a higher TB burden in the elderly and limited impact of current case-finding strategy by patient-initiated pathway, proactive screening approaches for the high-risk group could be optimal and increasingly need targeted economic evaluations. In this study, we examined whether and under what circumstance the screening strategies are cost-effective compared with no screening strategy for the elderly at admission to residential care homes.

Methods

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

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

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: To reveal the spatial and temporal pattern of student enrolment in the Public Health Principles in Disaster and Medical Humanitarian Response ﴾PHPID﴿ massive open online course ﴾MOOC﴿ and to examine the degree to which socio‐demographic variables can predict the course achievement. Background: The first cohort of PHPID online course was launched by Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response in June 2014. This online course aims to enable students to gain insight and theoretical understanding of the public health... read more

The wars in the Middle East have led to unprecedented threats and attacks on patients, healthcare workers, and purposeful targeting of hospitals and medical facilities. It is crucial that every healthcare provider, both civilian and military, on either side of the conflict become aware of the unique and inherent protections afforded to them under International Humanitarian Law. However, these protections come with obligations. Whereas Governments must guarantee these protections, when violated, medical providers have equal duty and obligations under the Law to ensure that they will neither... read more

The intersection of health and disaster risk reduction (DRR) has emerged in recent years as a field of critical inquiry. Health is recognized as an outcome and a goal of DRR, and the integration of both fields is essential to ensure the implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030. Health Emergency and Disaster Risk Management (Health-EDRM) has emerged as an umbrella field that encompasses emergency and disaster medicine, DRR, humanitarian response, community health resilience, and health systems resilience. In September 2016, an international group of... read more

Background A sound understanding of malaria transmission patterns in the People’s Republic of China (P.R. China) is crucial for designing effective surveillance-response strategies that can guide the national malaria elimination programme (NMEP). Using an established biology-driven model, it is expected that one may design and refine appropriate surveillance-response strategies for different transmission zones, which, in turn, assist the NMEP in the ongoing implementation period (2010–2020) and, potentially, in the post-elimination stage (2020–2050). Methods Environmental data obtained... 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: 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

Objectives: There is limited evidence on urban Asian communities’ disaster risk perceptions and household level preparedness. 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: 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

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

Accidental industrial disasters are often associated with illegal and unethical industrial and commercial practices. A warehouse explosion on Aug 12, 2015, in Tianjin, a major port city in China, caused 158 deaths and 698 hospital admissions. Post-disaster investigations at the explosion site reported illegal storage of dangerous chemical substances comprising 1300 tonnes of oxide and nitrate compounds (mainly potassium nitrate and ammonium nitrate), 500 tonnes of flammable materials (consisting of metallic sodium and magnesium), and 700 tonnes of highly toxic substances (mainly sodium... read more

Study Objectives To assess the effectiveness of using train-the-trainer approach, framed with social-cognitive perspective, to enhance participants’ self-efficacy in planning disaster-related projects in Chinese rural communities.

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

Study/Objective To enhance boarding school teachers' health literacy in disaster risks in disasterprone area in China. Background Yushu in Qinghai Province of China has suffered from a massive earthquake in 2010 and disaster preparedness has yet been emphasised in schools since then. As such, school children will be destined to severely suffer when the next disaster comes. Given a high altitude on high mountains, students usually live in dormitories. Teachers are the most important health promoters in this boarding school setting. However, teachers are equipped with respect to disaster... 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

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

Background Physical activity (PA) and hypertension (HTN) are important influences on the development of type 2 diabetes (T2D). However, the joint impact of PA and HTN on T2D development is unknown. Methods Two community-based prospective cohort studies, with the same protocols, instruments and questionnaires, were conducted among adults in urban areas of Nanjing, China, during 2004–2007 and 2007–2010. T2D was defined using World Health Organization criteria based on physicians' diagnosis and fasting blood glucose concentration. PA level (sufficient/insufficient) and blood pressure status (... 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

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

The 2008 Wenchuan earthquake highlights some of the successes of government-led schemes to mitigate the impact of natural disasters. A stronger focus on individuals and local communities could reduce losses even further in the future.

OBJECTIVES: To examine the association between long-term exposure to air pollution and lung function among Chinese schoolchildren in Southern China (Hong Kong). METHODS: We conducted a cross-sectional study among 3168 schoolchildren (aged 8-10 years) in 3 districts in Hong Kong. Annual means of ambient PM10 (particulate matter <10 µm), SO2, NO2 and O3 from 1996 to 2003 were used to estimate the individual exposure of the subjects. Children's lung function was measured for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), forced expiratory flow between 25% and 75% of... 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......

Objectives Millions of children and adolescents in rural China are left behind as their parents move away for work. Little is known about the impact of parental migration on their smoking and self-efficacy. This study explores the associations among parental migration, self-efficacy and smoking. Methods A cross-sectional study was conducted among middle school students in Liangying Township, Guangdong, China. Socio-demographic and parental migration characteristics, as well as adolescent past 30-day smoking and self-efficacy level were collected using a self-administered questionnaire.... 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。

Background: Numerous studies have found associations between extreme temperatures and human mortality but relatively few studies have been done in sub-tropical and tropical cities, especially in Asia. In this study we examine the impact of cold temperatures, cold waves and other meteorological and environmental variables on cool season mortality in 2 subtropical Asian cities.

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.

This study aimed to conduct a systematic review to sum up evidence of the associations between different aspects of night shift work and female breast cancer using a dose-response meta-analysis approach. We systematicly searched all cohort and case-control studies published in English on MEDLINE, Embase, PSYCInfo, APC Journal Club and Global Health, from January 1971 to May 2013. We extracted effect measures (relative risk, RR; odd ratio, OR; or hazard ratio, HR) from individual studies to generate pooled results using meta-analysis approaches. A log-linear dose-response regression model... read more

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

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 Current measures for breast cancer prevention and options for treatment adopted in Hong Kong are mainly based on research data and clinical evidence from overseas. It is essential to establish a cancer-specific registry to monitor the status of breast cancer in Hong Kong. Objectives We summarized the current status of breast cancer in Hong Kong based on the data collected from Hong Kong Breast Cancer Registry (HKBCR). Methods Prevalent and newly diagnosed breast cancers (including in situ and invasive breast cancers) were registered in the HKBCR. Information on patient... 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: Whilst Asia is ranked as the most disaster prone region of the world in both natural and man-made disasters, research in the Asia-Pacific region is limited. This study is part of a 24 months, multi-country, multidisciplinary partner based project that aims to develop a series of disaster medical and public health case study in the Asia pacific region. Using an internationally standardized disaster incident reporting template developed of WADEM (2010), this specific project aims to delineate and to critically evaluate the health implications of a fire disaster in Bhutan that... 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.

BACKGROUND: Hong Kong, a major city in China, has one of the world's highest income inequalities and one of the world's highest average increases in urban ambient temperatures. Heat-related mortality in urban areas may vary with acclimatisation and population characteristics. This study examines how the effect of temperature on mortality is associated with sociodemographic characteristics at an intracity level in Hong Kong, China, during the warm season. METHODS: Data from the Hong Kong Observatory, Census and Statistics Department, Environmental Protection Department and government... 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

Psychological First Aid (PFA) has become the choice of mental health intervention and integration with the current disaster relief protocols during emergencies by the Institute of Medicine, NIMH and the WHO. It can be used during or immediately after disaster. People without mental health specialized training, including public health practitioners and emergency responders can learn and apply to everyone in need. Whilst being used extensively, few studies have evaluated the effectiveness of PFA and its field applicability. A prospective randomized controlled study. 800 emergency medical... 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

Disaster could greatly affect physical, psychological and social health of people affected. However, current crisis intervention protocols after natural or man-made disasters often overlook the psychosocial impact of crisis on victims. In its executive board meeting in 2005, WHO has called for action in implementing programs that can repair the psychological damage of war, conflict and natural disasters.

OBJECTIVES: No published study, to date, has examined the characteristics and health outcomes of natural disaster-affected populations in unofficial rural self-settled internally displaced camps. By examining resident profiles in various unofficial rural displaced settlements after the 2005 Kashmir, Pakistan earthquake, this study aims to (i) describe the demographic and epidemiological characteristics of residents, (ii) compare their health outcomes with those of residents in official displaced camps, and (iii) highlight health needs and discuss implications for future disaster health... 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

Although older people may be recognized as a vulnerable group post-natural disasters, their particular needs are rarely met by the providers of emergency services. Studies about older people's health needs post disasters in the South East Asia Tsunami, Kashmir, Pakistan, China, and United States has revealed the lack of concern for older people's health needs. Recent study of older people's health needs post the Kashmir Pakistan earthquake (2005) found older peoples' health needs were masked within the general population. This survey study examines the providers' perceptions of older... read more

Introduction: On 08 October 2005, an earthquake measuring 7.6 on the Richter scale, struck Pakistan's autonomous state of Kashmir and part of Indian-administrated Kashmir. The official death toll in Pakistan was 79,000, and nearly 1,400 in Kashmir. This study reports the findings of a three-week health needs assessment to understand the needs of rural, older people postearthquake. This study was conducted in February 2006 in the Neelum Valley of Kashmir, Pakistan, four months after the earthquake. Hypothesis: During emergency relief, the vulnerability and health needs of older people in... read more

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

This study investigates the epidemiological characteristics of non-fatal unintentional household injuries in Hong Kong, the city with the world's highest population density. A population-based, cross-sectional, random telephone survey was conducted with a modified Chinese WHO injury and violence survey questionnarie in May 2007. Descriptive and univariate analysis was conducted to highlight the associated factors. The prevalence of all non-fatal unintentional home injuries in the preceding year was 40.2%. Contusion/crushing injuries, open wounds and burn-related scalds were the most... read more

Emily Y Y Chan took part in the relief effort after the Sichuan earthquake in May. She reports on the short-term needs of those affected and the medical and public-health challenges that will be faced by the Chinese population as rehabilitation and reconstruction continues......

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

News stories about the contamination of milk with melamine in China first emerged on Sept 11, 2008, and the situation has since become an international health scare. Melamine (also known as tripolycyanamide) is an industrial chemical in the production of melamine resins, which are used in laminates, glues, adhesives, and plastics. When added to milk, melamine increases the nitrogen concentration, which suggests a false increase in protein concentration. Melamine has low oral acute toxicity but excessive exposure in animals causes renal stones. When consumed by human beings, babies and... 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