Maeda H, Nakagawa M, Yokoyama M
First Department of Internal Medicine, Kobe University School of Medicine, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Feb;34(2):164-73.
A questionnaire was sent to 30 hospitals and medical institutes in and around the Hanshin district, where the Great Hanshin Earthquake, occurred on January 17th, 1995. The questions concerned patients who were admitted from the day of the earthquake until 10 weeks later. Answers were obtained from 18 of the 30 facilities and the total number of patients admitted with respiratory diseases was 148. Patients with lobar pneumonia or focal pneumonia, or both, accounted for 58.8% of the total, and those with upper respiratory tract infection made up 19.6%. Patients with acute-on-chronic respiratory failure made up 6.8% of the total, as did those with exacerbation of bronchial asthma. Some patients had underlying respiratory diseases, which included bronchial asthma, sequelae of tuberculosis, and chronic obstructive pulmonary disease, and many patients were more than 65 years old. The week with the highest number of admissions was the second week after the earthquake, and 69.6% of the patients were admitted within the first 3 weeks. At time of admission, most patients had been living in Temporary shelters, or with relatives of friends. Most patients (68.9%) were discharged after their conditions had improved, but 9.5% died. All but one of those who died were more than 65 years old. These data indicate that in most cases admission to the hospital resulted not from the earthquake itself but from secondary factors such as unsatisfactory facilities in temporary shelters, psychological stress, the common cold, influenza, overwork, and the disruption of medical services. These data should be useful in establishing medical and political strategies to reduce admissions of patients with respiratory diseases after natural disasters.
