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 editorial on complete protection for healthcare workers (HCW) resonated with Liu and colleagues’ study and re-emphasized the effectiveness of appropriate personal protective equipment (PPE) on protecting frontline healthcare workers during the SARS-CoV-2 epidemic. We applaud the authors’ well-articulated arguments on defining the “appropriateness” of PPE based on evidence rather than irrational fears; yet, as we learned from the local experience in Hong Kong, especially those from the SARS-CoV-1 outbreak, appropriate PPE is only one of the few factors that could help protect HCWs.

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

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

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

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

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

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

Background

The post-disaster mental health crisis intervention (MHCI) system in China remains immature and unsystematic. We aim to report the perceptions of a large sample of MHCI workers and government administrators and provide recommendations for developing a national mental health disaster response management plan in China.

Methods

An in-depth qualitative study was conducted, collecting data from 20 focus-group discussions and 25 key stakeholder interviews. These recruited participants who had been involved in different types of disaster rescue across 7 provinces/... read more

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

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

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

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

Objective How high temperature affects existing allergic conditions are unclear. This study examines the effects of high temperature on Hong Kong adult populations who have existing allergic symptoms. To explore the health outcomes of non-allergic symptoms, comparison was explored between adults with and without a history of allergic symptoms. Method Two week aster a health wave in 2017, a cross-sectional telephone survey study was conducted in Hong Kong. Socio-demographic information, history of allergic symptoms, non-allergic health symptoms, and self-reported changes of allergic... 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

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.

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

In recent years, “health” has been recognized explicitly as both a determinant and an outcome of the human dimension of disaster risk reduction (DRR). Every disaster creates significant public health needs that can exceed local capacity to respond, resulting in excess mortality and morbidity. The European Union report on Science for Disaster Risk Management 2017: Knowing Better and Losing Less recommended that health sciences should be more involved in the community of disaster risk management to advance our understanding of outbreaks and pandemics and the health impacts of all... read more

There is an important opportunity to build coherence across different policy areas with the 2015–16 adoption of four landmark UN agreements—the Sendai Framework for Disaster Risk Reduction 2015–2030, the 2030 Sustainable Development Goals (SDGs), the Paris Agreement, and the New Urban Agenda (Habitat III). Ensuring that health is at the heart of the Sendai Framework is crucial. The 2030 targets of the Sendai Framework call for substantial global reductions in disaster-related mortality, number of affected people, direct economic loss, and damage to critical infrastructure (panel).

Objective
This study aims to examine the patterns and socio-demographic predictors of health and environmental co-benefit behaviours that support climate change mitigation in a densely populated Asian metropolis—Hong Kong.

Methods
A population-based, stratified and cross-sectional random digit dialling telephone survey study was conducted between January and February 2016, among the Cantonese-speaking population aged 15 and above in Hong Kong. Socio-demographic data and the self-reported practice of 10 different co-benefit behaviours... read more

Objectives

To investigate specific challenges to Hong Kong’s capacity for effective disaster response, we assessed perceived barriers to evacuation and citizens’ self-efficacy.

Methods

Global positioning system software was used to determine random sampling locations across Hong Kong, weighted by population density. The resulting sample of 1023 participants (46.5% female, mean age 40.74 years) were invited to complete questionnaires on emergency preparedness, barriers to evacuation and self-efficacy. Latent profile analysis and multinomial logistic regression were used... 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

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

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

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

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

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

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

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

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

We conducted a cross-sectional population-based telephone survey between 15 and 28 February 2014 in Hong Kong during the second wave of influenza A/H7N9 outbreak to delineate the willingness of future A/H7N9 vaccine uptake and factors affecting their choices. We found half of the respondents were willing, which was independent of demographic factors. High anxiety level and a vaccine history were associated with willingness to uptake future A/H7N9 vaccine. Understanding the willingness of A/H7N9 influenza vaccine uptake in the community help policy makers to decide suitable strategies to... 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

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

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

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

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

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

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

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

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.

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。

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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......

BACKGROUND Malaria is a major public health burden in the tropics with the potential to significantly increase in response to climate change. Analyses of data from the recent past can elucidate how short-term variations in weather factors affect malaria transmission. This study explored the impact of climate variability on the transmission of malaria in the tropical rain forest area of Mengla County, south-west China. METHODS Ecological time-series analysis was performed on data collected between 1971 and 1999. Auto-regressive integrated moving average (ARIMA) models were used to evaluate... 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