Armenian H K, Melkonian A K, Hovanesian A P
Department of Epidemiology, School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, MD 21205, USA.
Am J Epidemiol. 1998 Dec 1;148(11):1077-84. doi: 10.1093/oxfordjournals.aje.a009585.
To assess the relation of increased mortality and morbidity to personal loss and damage following the 1988 earthquake in Armenia, the authors conducted a prospective study of mortality and a nested case-control analysis of incident morbidity. Employees of the Armenian Ministry of Health and their immediate families (n = 35,043) who survived the disaster formed the study population. Two sets of interviews with the employees, carried out over a period of 4 years of follow-up, were used as the primary source of data for this study. The highest numbers of deaths from all causes and from heart disease were observed within the first 6 months following the earthquake. The nested case-control analysis of 483 cases of newly reported heart disease and 482 matched non-heart-disease controls revealed that people with increasing levels of loss of material possessions and family members had significant increases in heart disease risk (odds ratios for "loss scores" of 1, 2, and 3 were 1.3, 1.8, and 2.6, respectively). The findings were similar with regard to the relation of damage and loss to newly reported hypertension, diabetes mellitus, and arthritis. The findings of this study support the hypothesis that longer term increased rates of heart disease and chronic disease morbidity following an earthquake are related to the intensity of exposure to disaster-related damage and losses. People sustaining such losses should be closely monitored for increased long term morbidity.
为评估1988年亚美尼亚地震后死亡率和发病率上升与个人损失和损害之间的关系，作者进行了一项死亡率前瞻性研究和一项发病情况嵌套病例对照分析。亚美尼亚卫生部的雇员及其直系亲属（n = 35,043）中在灾难中幸存下来的人构成了研究人群。在4年随访期间对这些雇员进行的两组访谈被用作本研究的主要数据来源。地震后的头6个月内观察到所有原因和心脏病导致的死亡人数最多。对483例新报告的心脏病病例和482例匹配的非心脏病对照进行的嵌套病例对照分析显示，物质财产和家庭成员损失程度增加的人患心脏病的风险显著增加（“损失分数”为1、2和3时的比值比分别为1.3、1.8和2.6）。关于损害和损失与新报告的高血压、糖尿病和关节炎之间的关系，研究结果相似。本研究结果支持这样的假设，即地震后心脏病和慢性病发病率的长期上升与遭受灾难相关损害和损失的程度有关。遭受此类损失的人应密切监测其长期发病率的增加情况。
