Earthquakes’ medical toll: ‘devastating’

Angelenos and others who live in earthquake zones occasionally need reminding that quakes can be pretty darn scary. A new study published Thursday in the Lancet should be eye-opening.

Dr. Susan A. Bartels of the Beth Israel Deaconess Medical Center and Dr. Michael VanRooyen of Brigham and Women’s Hospital, both in Boston, reviewed the medical literature on the health effects of earthquakes -- and described them as “devastating.”

In the past 10 years, they wrote, earthquakes have caused more than 780,000 deaths -- almost 60% of disaster-related morality. More than a million earthquakes occur around the world each year, the equivalent of about 2 temblors per minute. Some of the world’s largest and most populated metropolitan areas -- Tokyo, Mexico City, India’s Mumbai, Shanghai, Los Angeles, even New York City -- are in seismic zones.

Unlike floods and hurricanes, which can cause a lot of deaths (mainly from drowning) but typically aren’t associated with injuries that require ongoing medical or surgical care, earthquakes also inflict assorted traumas. They also wreck roads, hospitals and other infrastructure, derailing emergency services and creating “a large, unmet need for complex surgical and medical care,” the co-authors wrote.

They list a variety of injuries earthquake victims often suffer. People who are trapped under collapsed buildings and other structures get crush injuries, in which pressure on muscles damages tissues and can lead to electrolyte imbalances, kidney failure, sepsis and death.

Earthquake victims often have cuts and broken bones -- many of them, bones fractured into three or more pieces. Gangrene is common.

In some cases, cardiovascular woes spiked after a quake. In the week of the 1994 Northridge earthquake, heart attacks rose 35% over the previous week (though in the 1989 Loma Prieta quake, there was no detectable rise in acute coronary events.) Victims have chest injuries, head injuries and spinal injuries. Infectious diseases proliferate when water and sanitation services are interrupted. Mental health problems such as depression and post-traumatic stress disorder have been reported; earthquakes are also associated with the highest rate of suicide of any type of natural disaster.

Children are often at higher risk of injury and death during earthquakes than adults, the authors added.

An abstract of the review is available at the Lancet’s website.

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