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DISASTER MANAGEMENT

DISASTER MANAGEMENT. Lt.Col.Karesh Prasad M.Sc (N) Principal People’s College of Nursing & Research Centre Bhopal. EFFECTS ON HEALTH OF BHOPAL GAS DISASTER. NIGHT OF TRAGEDY - 2 & 3 DEC 1984

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DISASTER MANAGEMENT

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  1. DISASTER MANAGEMENT Lt.Col.Karesh Prasad M.Sc (N) Principal People’s College of Nursing & Research Centre Bhopal

  2. EFFECTS ON HEALTH OF BHOPAL GASDISASTER NIGHT OF TRAGEDY - 2 & 3 DEC 1984 CULPRIT - UNION CARBIDEFACTORY STAINLESS STEEL TANK NO :610 , HAD 42 TONS OF LIQUID METHYL ISOCYNATE. SUFFERINGS - 2500 DEATHS IN 48 HOURS 85000 AFFECTED 5 Lac EXPOSED PLANTS , ANIMALS INCLUDING FISHES

  3. EFFECTS ON HEALTH- CONTD. Main symptoms : Lacrimation and burning of eyes breathlessness, cough & chest pain Agent -MIC : Colourless liquid ,boils at 39º C stablized with phosphogene polymerisation with metals exothermic reaction with water

  4. EFFECTS ON HEALTH - CONTD. Event : water leaked in tank , increase in temp MIC convertad to vapour/gas foam , Increased pressure , leaked into atmosphere , in cool still air , setteled over nearby areas upto 2-3 km

  5. EFFECTS ON HEALTH- CONT • HAVOC: Over 100000 people visited hospital and equal numbers attended mobile /make shift dispensaries . • Immediate effects and prolonged effects on health of exposed persons , psychological effects.

  6. EFFECTS ON HEALTH CONTD • RESOURCES TO DEAL DISASTER: Negligible/meagre to cope such a large medical emergency, no enough doctors,nurses,paramedicals,equipments like oxygen mask regulators ,drugs besides beds and hospital space even not enough means to dispose deads.

  7. HEALTH EFFECTS 3-4 YRS FOLLOW UP

  8. Continuation

  9. EFFECTS OF HEALTH CONTD. OTHER CHANGES EARLY CASES OF RESP GP-ESTABLISHING INTO Bronchiolitis obliterans Reactive airway dysfunction syndrome like Bronchial asthma ,chronic bronchitis bronciactasis , emphysema & koch’s POSSIBLY LEADING TO COPD , cor pulmonale , chronic bronchitis

  10. EFFECTS OF HEALTH CONTD. ADVERESLY AFFECTED BY/ PRECIPITATION Smoke , dust & fumes of coal , wood & kerosene used for cooking 15.4% children 6-15 years age group at exposure have evidence of obstructive lung disease

  11. EFFECTS OF HEALTH CONTD. EYES : Cases of lacrimation/burning corneal opacities , early age cataract incl fundus changes & poly chromatic lusture MENTAL HEALTH Neurotic depression & anxiety fortunately amenable to treatment ENDOCRINES: No effect on thyroid IMMUNE SYSTEM : Detrimental effect

  12. EFFECTS OF HEALTH CONTD. GENETICAL CHANGES: Increased chromosomal aberrations NO CARCINOGENESIS EVIDENCE YET.

  13. EFFECTS OF HEALTH SYMPTOMS SIGNS OPHTHALMIC : Intense burning in eyes as if chillies puf in Continous profuse lacrimation Difficulty to see clearly Conjunctival hyperaemia Superficial corneal ulceration RESPIRATORY : Breathlessness , gasping , cough with or without expectoration pain chest

  14. EFFECTS OF HEALTH CONTD. LUNGS - Crypts/rails-ronchi++ no cyanosis X-RAY- Patchy opacities , increased broncho vesicular markings , massive opacity of pulmonary odema GI: Nausea , vomiting , pain abo General : Fatigability , weakness MENTAL: Disturbed psychae

  15. EFFECTS OF HEALTH CONTD. TREATMENT oxygen steroids antibiotics sodium thiosulphate

  16. EFFECTS ON HEALTH CONTD. FOLLOW UP - RESEARCH 80021 persons affected area 15931 control unaffected area Six Monthly survey Medical check up , lab investigation Involvement of multiple specialists persons/ agencies , ICMR and almost all pioneer Medical/social institutes.

  17. EFFECTS ON HEALTH CONTD. REMEDIAL NECESSITIES Chemotherapy , environmental sanitation Pollution control , replacing cooking fuel to LPG Abstinence from smoking Social sciences. To prevent ills of easy money coming in AIDS-drugs , alcohol etc Disaster control plans , resourceallocation etc

  18. INVESTIGATION OF EPIDEMIC • PURPOSE • To investigate determinants of disease - Agent, Host, Environment • To meet public service and scientific needs

  19. STEPS • Determine/confirm existence • Verification/confirmation of diagnosis • Define/count cases and distribution • Analyze time, place, person.

  20. Steps continued • Formulate hypothesis • Compare/ test • Plan systematic study • Report • Measures for control and prevention

  21. OBJECTIVE • To define magnitude of epidemic - time,place,person • To determine factors responsible • To identify cause, source of infection and modes of transmission

  22. PREPARATION/TOOLS FOR INVESTIGATION • Notification to people/organization: auth • Identification of material needs • Travel needs :- Questionnaire samples, stationery, calculator, computer, camera, lab sampling container, pocket reference on agent/diseases, internet access code etc

  23. CONFIRMATION OF DIAGNOSIS • Clinical examination of sample cases • Lab investigations • Case definition : • Case finding - Mapping house numbering • Population denomination • Rapid Search - Medical survey

  24. EPIDEMOLOGICAL CASE SHEET • Population/Sample Survey • Name, Age, Sex, Occupation, Social Class, Movements H/O contacts, Time of onsets of Symptoms • Symptoms/Signs, Past History, Any special events Eg. Party, Picnic etc.

  25. ENVIRONMENTAL FACTORS • Sanitation state • Water supply • Fresh supply • Any breakdown in the above mentioned systems

  26. ATMOSPHERIC CONDITIONS • Temperature • Humidity • Pollution • Entomological data etc

  27. POPULATION AT RISK • History of exposure to suspected/potential vehicle • Attacked/spared distribution

  28. DATA ANALYSIS • Time • Place • Person Distribution

  29. HYPOTHESIS • Possible Source • Causative agent • Mode of spread • Environmental Factors • Further study - if required • Report - Format • Measures for control and prevention

  30. REPORT FORMAT • Back ground • Geographical location • Climatic condition • Demographic and Socio-economic situation • Health Services Org & Systems of report • Normal disease prevelance

  31. Methodology Case definition Format for investigation Survey technique Analysis of Data Clinical Frequency Course D/D Sequlae/Death FIRST CASE

  32. EPIDEMIOLOGICAL DATA • Mode • Time • Place • Person Affected

  33. MODE OF TRANSMISSION • Source • Route of Excretion • Factors Affecting Transmission

  34. LAB RESULTS • Identification • Serological • Significance

  35. INTERPRETATION • Comprehensive Picture of Outbreak • Hypothesis • Statistical Analysis

  36. CONTROL MEASURES • Define Strategies • Constraints

  37. RESULT • Evaluation - Significance of Result • Cost Effectiveness • Preventive Measures

  38. THANK YOU

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