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.

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

Introduction

Non-pharmaceutical measures to facilitate a response to the COVID-19 pandemic, a disease caused by novel coronavirus SARS-CoV-2, are urgently needed. Using the World Health Organization (WHO) health emergency and disaster risk management (health-EDRM) framework, behavioural measures for droplet-borne communicable diseases and their enabling and limiting factors at various implementation levels were evaluated.

Sources of data

Health-Emergency Disaster Risk Management (Health-EDRM) emerged as the latest knowledge, research and policy paradigm shift from response to preparedness and health risk management in non-emergency times. This approach attempts to enlist and empower communities to invest and emphasize their disaster health risk reduction efforts, thereby strengthening health systems and supporting community health resilience building. This Special Issue has collected 20 scientific papers that attempt to examine the research frontier in Health-EDRM.

Addressing the psychological mechanisms and structural inequalities that underpin mental health issues is critical to recovery following disasters and pandemics. The Asia Pacific Disaster Mental Health Network was established in June 2020 in response to the current disaster climate and to foster advancements in disaster-oriented mental health research, practice and policy across the region. Supported by the World Health Organization (WHO) Thematic Platform for Health Emergency and Disaster Risk Management (Health EDRM), the network brings together leading disaster psychiatry, psychology... read more

Background: Extreme weather events happen more frequently along with global warming and they constitute a challenge for public health preparedness. For example, many investigations showed heavy rainfall was associated with an increased risk of acute gastroenteritis. In this study, we examined the associations between different meteorological factors and paediatric acute gastroenteritis in an affluent setting in China controlling for pollutant effects.

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.

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

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

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

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.

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

Objective: To understand the community‘s response to hot weather in terms of risk perception, awareness of warning signal and personal protective measure taken for heat planning suggestions. Method: A telephone survey was conducted 2 weeks after a heatwave in Hong Kong, August 2017, and 436 respondent (≥15 years) were included. Respondents were the follow-up sample of a previous cold wave study. Sociodemographic characteristics, risk perception, awareness of the issue of Very-Hot-Weather Warning and the uptake of personal protective measure during study during the study period were... read more

Background/Aim: As numerous climate change mitigation measures promote health as well as environmental benefits, it is imperative to assess their uptake in communities. A previous study in Hong Kong showed women and older people practiced health and environmental co-benefit behaviours more frequently. However, the attitude and awareness behind those behaviours have not been explored. This study examines the patterns and predictors among dietary-related co-benefit behaviours. Methods: We conducted a population-based random-digit dialling telephone survey for n=1000 Hong Kong residents in... read more

Background: Extreme temperatures are increasing due to climate change, however research of their impacts on health behaviour are rare. While cold winter temperatures have been identified as a barrier to physical activity, an increase of extremely hot temperatures due to climate change may also potentially affect frequency of physical activity. This study aims to estimate the change of self-reported frequency of outdoor physical activity (PA) during cold and heat waves in a sub-tropical urban population and identify its predictors. Methods: A prospective population-based cohort telephone... read more

Introduction: Dioxin emissions from burning plastic waste are known to contain human carcinogens detrimental to health, yet indoor burning of household waste is a common practice in rural China. As part of the Ethnic Minority Health Project (EMHP), a drama-and -song based health education on household waste management was conducted at Dacao village, to improve individual and community health through primary education at increasing knowledge in the Manchu ethnic minority-based village in China. Methods: A cross-sectional study was conducted in June 2017, in Dacao village in Jilin Province,... read more

Background: With the increasing evidence of climate change, human health impact associated with rising global temperature has received more attention. Studies from higher latitudes, with cooler climates, have reported positive temperature-mental disorders association but the association from lower latitudes with warmer climates is still unclear. This study showed the short- term temperature-mental disorders association in a subtropical city located below the Tropic of Cancer with an annual mean temperature over 21°C.

Background/Aim: Previous studies have found increased fall incidence during winter months. However, most of the studies were conducted among the elderly only. Few studies have directly examined the impact of weather on the occurrence of falls. The findings of these studies are also not consistent. Therefore, this study aimed to explore the influences of temperatures on falls. Methods: Between 1998 and 2011, daily falls-related hospital admission were obtained from Hong Kong Hospital Authority, which were compiled with daily meteorological and air pollutants data obtained from the Hong Kong... 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

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

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:

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

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

Cruise tourism has become more popular. Long-term personal contact, complex population flows, a lack of medical care facilities, and defective infrastructure aboard most cruise ships is likely to result in the ship becoming an incubator for infectious diseases. In this paper, we use a cruise ship as a research scenario. Taking into consideration personal behavior, the nature and transfer route of the virus across different surfaces, virus reproduction, and disinfection, we studied contact infection of infectious disease on a cruise ship. Using gastroenteritis caused by the norovirus as an... read more

“Health” is mentioned 76 times in the Sendai Framework, listed repeatedly alongside economic, social, cultural and environmental components adversely affected by disasters. The Sendai Framework also advocates an inclusive and multi-stakeholder approach; recognising the need to mobilise research and scientific institutions in particular toward reducing disaster risk and building resilience. The Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC) is a Hong Kong-based non-profit academic centre which uses a public health approach to carry... read more

Objectives: The impacts of climate change are known to be human health threats. In recent years, there are increasing advocacy to the promotion of behaviors that might reduce human carbon footprint and can provide benefits for individuals' health outcomes. This study aims to assess the patterns, knowledge and socio-economic predictors of these health and environmental co-behaviors (HEC) in urban Asia metropolis such as Hong Kong. Methods: A cross-sectional, randomized population-based telephone survey study was conducted among Hong Kong Cantonese-speaking population aged over 15 years... 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

BACKGROUND: Previous studies have found associations between meteorological variables and asthma hospitalisations but the nature of these associations has varied and few studies have been done in subtropical areas or evaluated effect modification by age. OBJECTIVES: This study aimed to evaluate associations between asthma hospitalisations and meteorological factors and to assess effect modification of these associations by age and season in Hong Kong. METHODS: Poisson generalised additive models combined with distributed lag nonlinear models and piecewise linear models were used to model... 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.

At the first gathering of its kind on the role of science in implementing the Sendai Framework for Disaster Risk Reduction 2015–2030, over 750 scientists, policymakers, business people, and practitioners met in Geneva from January 27–29, 2016. The UNISDR Science and Technology Conference on the Implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030 featured experts from some of the world’s most disaster-prone countries.

Background: Hong Kong is an urban Asian community connected to mainland China characterized by a very high population density. Since SARS epidemic in 2003, the city had experiences several major epidemic risks but how general community might react to the repeated infectious diseases health risks are not studied. In 2013, imported human H7N9 influenza infected cases from China have been reported. Our study aims to assess the knowledge, attitude and practice (KAP) concerning A/H7N9 among Hong Kong general population during the second wave of the pandemic preparedness Methods: A cross-... 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/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

Study/Objective To equip the villagers living with NCDs (NCD villagers) with adequate health risk literacy for managing their diseases in times of disasters in rural China. Background NCDs are prevalent in China, including rural villages. These villagers may not have adequate health risk literacy for managing their NCDs when disaster comes. As such, packing an easytomake emergency rescue bag, inclusive of adequate medication for disasters, can be an important means for disaster risk management. Particular focus on addressing disease management when the supply of medication is interrupted... 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

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

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

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......

Background: Six of the ten deadliest natural disasters, as measured by death toll, have occurred in China. First-aid knowledge and skills can be useful in treating injuries that commonly result from natural disasters. Yet there have been no studies examining first-aid as a potential means of disaster preparedness and/or emergency response in either Hong Kong or Mainland China. The present study focuses on the relationship between first-aid training and disaster preparedness within the general public community in Hong Kong. Methods: Cross sectional study was performed using a randomized,... 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

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

Background Medical teams might have difficulties preparing for deployment to rural towns due to a lack of prior information. The study objective was to identify the health needs and chronic disease prevalence of rural Chinese following a major earthquake. Methods Hong Kong Red Cross organised a basic healthcare team to Yanmen town, Jiangyou 3 weeks after the 2008 Sichuan earthquake. A cross-sectional records-based study of all patients treated by the Hong Kong Red Cross basic healthcare team from 1 June to 19 June 2008 was conducted. Results Two thousand and thirty-four individual patient... read more

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

Objective To explore the relationship between weather phenomena and pollution levels and daily hospital admissions (as an approximation to morbidity patterns) in Hong Kong Special Administrative Region (SAR), China, in 1998–2009. Methods Generalized additive models and lag models were constructed with data from official sources on hospital admissions and on mean daily temperature, mean daily wind speed, mean relative humidity, daily total global solar radiation, total daily rainfall and daily pollution levels. Findings During the hot season, admissions increased by 4.5% for every increase... read more

目的：评估在少数民族地区进行灾害教育对居民防灾备灾知-信-行的改变。 方法：2011年-2012年3月期间，对甘肃省黄土高原上的大滩村（回族）和四川省金沙江马鞍桥村（傣族）的居民予以灾害教育，干预前、后、及之后10-14个月的随访期间用自制问卷，采用面对面调查方式收集研究参加者干预前后防灾备灾的知-信-行情况，同时收集个人及家庭等有关资料。统计分析使用SPSS 19.0统计软件包，显著性取值0.05，双侧检验。 结果：133个大滩村居民和110个马鞍桥村居民参加了研究，参与率分别为62.4%和43.1%。经过干预后，居民的防灾备灾知识、态度、信心等指标都有显著提高，然而10-14个月之后，除了马鞍桥村居民对灾前准备的重要性的态度、以及两村居民对如何紧急应对灾害知识的提高继续保持外，其他指标都有显著性回弹，但仍然高于干预前的水平。 结论：在容易遭受灾害影响、少数民族聚居的偏远农村推行适合的灾害教育可以有效地提高居民抗灾减灾的知识、态度和水平，从而降低灾害引致的伤亡和损失。为了避免“回弹”，定期的强化教育可能是有效的方法之一。

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 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

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.

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

Speed and accuracy are major considerations in triage in emergency field settings. Traditional physical examination techniques often are limited in detecting the true nature and full extent of internal visceral injuries, for which delayed recognition and treatment may lead to catastrophic results. Ultrasound has a well-established role in the rapid initial assessment of intraabdominal pathologies, including trauma, and contemporary portable ultrasound machines are available for use in the field. This presentation will introduce the basic principles of diagnostic ultrasound and its use in... read more

The negative impact of extreme temperatures on health is well-established. Individual help-seeking behavior, however, may mitigate the extent of morbidity and mortality during elevated temperatures. This study examines individual help-seeking behavior during periods of elevated temperatures among a Chinese population. Help-seeking patterns and factors that influence behavior will be identified so that vulnerable subgroups may be targeted for health protection during heat crises. A retrospective time-series Poisson generalized additive model analysis, using meteorological data of Hong Kong... read more

Knowledge about disasters plays an essential role in managing and responding to disasters and emergencies, especially among a group of health care professionals who are actively or will potentially be involved in disaster and emergency settings. A set of training materials that aims to enhance understanding of disasters and their impact of health has been developed. This project aims to examine the effectiveness of the disaster knowledge training to improve technical knowledge and perceptions of health impact of disasters in health care professionals and responders. “Understanding... read more

In China, water resources are both inadequate and unevenly distributed. Professor Emily Chan and Professor Sian Griffiths from the Chinese University of Hong Kong, discuss the impact of water quantity, quality, cost and development on public health in China......

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

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

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

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

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

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