The impact of the 2011 Great East Japan Earthquake on hospitalisation for respiratory disease in a rapidly aging society: a retrospective descriptive and cross-sectional study at the disaster base hospital in Ishinomaki

Abstract

ObjectiveTo investigate the impact in an aging society of the 2011 Great East Japan earthquake on hospitalisation for respiratory disease at the disaster base hospital.DesignDescriptive and cross-sectional study.SettingEmergency care in Japanese Red Cross Ishinomaki Hospital, a regional disaster base hospital in Miyagi, Japan.Participants322 emergency patients who were hospitalised for respiratory disease from 11 March to 9 May 2011, and 99 and 105 emergency patients who were hospitalised in the corresponding periods in 2009 and 2010, respectively.Main outcome measuresDescription and comparison of patient characteristics and disease distribution in terms of age, time after the disaster and activities of daily living (ADL).Results1769 patients were admitted to our hospital during the study period (compared to 850 in 2009 and 1030 in 2010), among whom 322 were hospitalised for respiratory disease (compared to 99 in 2009 and 105 in 2010). Pneumonia (n=190, 59.0%) was the most frequent cause of admission for pulmonary disease, followed by acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) (n=53, 16.5%), asthma attacks (n=27, 8.4%) and progression of lung cancer (n=22, 6.8%). Compared with the corresponding periods in 2009 and 2010, the increase in the absolute numbers of admissions was highest for pneumonia, followed by AE-COPD and asthma attacks. At hospitalisation, 195 patients were ‘dependent’ and 54 patients were ‘partially dependent’. Respiratory admissions accompanied by deterioration of ADL after the disaster were more frequent in elderly and female patients.ConclusionsAfter the Great East Japan Earthquake, admissions for pneumonia and exacerbation of chronic respiratory disease in the elderly increased at the disaster base hospital.

Increase in avoidable hospital admissions after the Great East Japan Earthquake

“…These conditions may have increased just after the disaster, and immediately decreased thereafter. In fact, several studies reported that the increase in such conditions was temporary and that they started to decrease several weeks after the earthquake and tsunami disaster 9 10 12 14–16…”

The Great East-Japan Earthquake and Devastating Tsunami: An Update and Lessons from the Past Great Earthquakes in Japan since 1923

“…In addition, many of those people are elderly (aged 65 years or over) and have large amounts of financial burden as well as psychological stress. In fact, after the Great East-Japan Earthquake, there have been reports showing the increased prevalence or worsening of various diseases, including influenza infection (Hatta et al 2012;Tohma et al 2012), chronic obstructive pulmonary disease (Yamanda et al 2013), pneumonia (Suzuki et al 2011;Aoyagi et al 2012;Takahashi et al 2012;Daito et al 2013), near drowningassociated fungal infection (Nakamura et al 2011;Igusa et al 2012;Kawakami et al 2012), diabetes mellitus (Fujihara et al 2012), hypertension (Ogawa et al 2012, cardiovascular diseases (Aoki et al 2012), heart failure (Nakano et al 2012), deep vein thrombosis (Ueda et al 2012;Shibata et al 2013), peptic ulcers (Kanno et al 2012), dementia (Furukawa et al 2012), and seizure (Shibahara et al 2013). The increased onset or worsening of these diseases may be related to life-threatening stress, depressive situations without future prospects, or unhealthy conditions in the evacuation centers and/or subsequent temporary housing.…”

“…Many papers have reported increases in respiratory diseases, which may be related to the high population of elderly people in the tsunami-stricken areas (Suzuki et al 2011;Daito et al 2013;Yamanda et al 2013). It is of particular importance to take care of elderly evacuees, because they may not complain of problems, as observed in the 1995 Great Hanshin-Awaji Earthquake (Morimoto et al 2011).…”

Update of occupational lung disease

“…On the other hand, the sludge changed into environmental dust, which is possibly harmful after drying to respiratory health. In the Ishinomaki region, the number of patients with pneumonia transiently increased after the disaster, a development which was possibly linked to Tsunami sludge dust.…”