Asthma exacerbations after the East Japan Disaster

Abstract

On March 11, 2011, a 9.0-magnitude earthquake struck east Japan, following tsunami. Many people are forced to live in evacuation shelters without enough life-saving drugs. Asthma control for management of health crisis is required, because asthma exacerbation is a major cause of morbidity, can need acute care and results in death. However, it remains obscure what parameter should be used in primary clinic of evacuation shelters. The objective of this study is to elucidate the practical efficacy of asthma assessment tool in primary clinic for victims of this disaster. Asthma control test (ACT), a brief and patient-based tool to evaluate asthma control, was conducted for 17 patients with asthma in evacuation shelters at Tohoku district. Total sum of ACT scores were significantly decreased after this disaster. Significant decreases were observed for the items; "Asthma keeps you from getting much done at work", "Shortness of breath", "Asthma symptoms wake you up" and "Patient rating of control". ACT, an easy and practicable tool, clearly demonstrated the asthma exacerbation in evacuation shelters without the use of lung function testing. ACT may contribute to the management of health crisis not only for this East Japan disaster but also for the other forthcoming unavoidable disasters.

A comparison of the efficacy of once-daily fluticasone furoate/vilanterole with twice-daily fluticasone propionate/salmeterol in asthma-COPD overlap syndrome

“…The CAT scores of 1-10, 11-20, 21-30, and 31-40 represent categories of mild, moderate, severe, and very severe health status impairment, respectively [23,24]. To evaluate asthma control status during the previous 4 weeks, patients were asked to conduct the ACT, an easy 5-questioned test for asthma, to examine their symptoms [25,26]. The ACT scores 1-5 for each question, with an overall score ranging from 5 to 25, with low scores corresponding to a high level of symptoms and therefore poor asthma control.…”

Eczema and Asthma Symptoms among Schoolchildren in Coastal and Inland Areas after the 2011 Great East Japan Earthquake: The ToMMo Child Health Study

“…In addition, studies after combination disasters involving both an earthquake and a tsunami have also been reported; these include skin problems such as eczema after the 2004 Sumatra earthquake (Lee et al 2006) and control of asthma after the 2011 Great East Japan Earthquake (Yamaoka et al 2011;Fukuhara et al 2012;Minoura et al 2012;Yanagimoto et al 2012;Ishiura et al 2013;Ohkouchi et al 2013). Although those studies were highly valuable, the generalizability of their results was limited as they relied primarily on data from patients; data from individuals who did not visit a clinic or medical institution remained hidden.…”

Disaster preparation: Survey of patients with food allergies in Kobe, Japan

“…likely to worsen due to air pollution or post-traumatic stress disorder. [6][7][8] Therefore, anaphylaxis is likely to occur during disasters. In this survey, almost all patients prescribed adrenaline carried the medication, which was also common in patients investigated in another study.…”