Natural Disasters Can Produce Major Lung Problems

A comprehensive new review published in the journal Respirology indicates that lung problems are major causes of morbidity and mortality following natural disasters.

Professor Bruce Robinson of the University of Western Australia and fellow clinicians, all of whom have served in areas of natural disasters such as the Indian Ocean tsunami and earthquakes in Jogjakarta, Padang and Haiti, reviewed the lung effects of natural disasters in the immediate setting and in the post-disaster aftermath.

All survivors of disasters are at increased risk of pulmonary disease. Many lung complications that occur following natural disasters are a direct result of the disaster itself.

Lung injury accounts for the majority of fire-related deaths and the mortality in burn cases increases from 4% to around 30% if inhalation injury is present. Inhalation lung injury occurs in around one fifth of all burn victims, and this number rises to two thirds if central facial burns are present.

In 1997 forest fires in Indonesia led to over 500 environmental haze related deaths in a three month period, with around 300,000 episodes of asthma, 50,000 cases of bronchitis, and 1.5 million respiratory infections reported during this time.

Postmortem studies on victims killed by the 1982 St. Helens volcanic eruption demonstrated that over eighty percent died as a result of asphyxiation due to bronchial obstruction following ash inhalation. Additionally, toxic volcanic gases, including carbon dioxide and sulphur dioxide, can be released during eruptions and during non-eruptive periods and it is estimated they account for up to 4 percent of volcano-related deaths.

Chest trauma is present in around 10% of earthquake casualties who are admitted to the hospital. The spectrum of injuries seen in those with chest trauma includes rib fractures (17-50%); lung collapse (6-52%), and serious bleeding into the chest cavity (11-19%).

“While respiratory (lung) conditions are common post disaster, the treatment required to manage them is often absent,” Robinson concludes. “A necessary part of an effective response to any natural disaster is having the required equipment and pharmaceuticals that are needed to manage and treat the resulting conditions that will predictably occur.”

Full citation: Robinson et al. Natural Disasters and the Lung. Respirology. DOI: 10.1111/j.1440-1843.2011.01923.x