Letters to the Editor
Letters to the Editor will be reviewed and are published as space penmits. By submitting a Letter to the Editor, the authorgives permission foritspublication in the JournaL Letters should not duplicate material being published or submitted elsewhere. Those referring to a recent Joumal article should be received within 3 months of the article's appearance. The Editors reserve the right to edit and abridge and to publish responses. Submit three copies. Both text and references must be typed double-spacedL Text is limited to 400 words. Reprints can be ordered through the author whose address is listed at the end of the letter.
The Red Cross and CDC's Natural-Disaster Surveillance System As a result of natural disasters throughout the world, each year thousands of people are killed or injured and billions of dollars in economic losses occur. The World Health Organization estimates that, worldwide between 1964 and 1983, nearly 2.5 million people were killed and 750 million were injured, left homeless, or otherwise harmed because of natural disasters. Unless action is taken to prevent such tolls, these statistics can only be expected to rise as populations increase and concentrate in vulnerable urban and coastal areas. In 1987, the American Red Cross and Centers for Disease Control developed a natural-disaster morbidity and mortality surveillance system. Although various federal agencies collect data on natural disasters, this system is unique in two respects: it collects information on the circumstances of deaths and injuries for
1690 American Journal of Public Health
disaster-affected populations, and it collects information on injuries and illnesses sustained by American Red Cross disaster field staff. Recording and analyzing such information will eventually lead to the development of strategies to prevent injury and disease during and after natural disasters. The American Red Cross has been collecting information on disaster-affected communities since 1905, when it was designated the national voluntaxy organization to provide relief for victims of disasters. The information collected was used for the sole purpose of human needs assessment. However, in 1986, almost a century after data were first collected, the Centers for Disease Control recognized this database as a unique source of disaster information, one with a great potential for finding new methods of disease and injury prevention. The Centers for Disease Control approached the American Red Cross to develop a natural-disaster surveillance system. A memorandum of understanding was created whereby American Red Cross Disaster Health Services staff agreed to collect data in the field on major natural disasters and Centers for Disease Control epidemiologists agreed to code and enter the data into a computer format for processing and statistical analysis. Currently the database includes statistics on deaths, injuries, and illnesses associated with all major natural disasters that occurred in the United States and associated territories from 1987 to 1991. The Red Cross groups major natural disasters into three classes of severity (Classes III-V) on the basis of the overall funds it commits to relief and rehabilitation: Class III, $50 000-250 000; Class IV, $250 0002 500 000; Class V, $2 500 000 and greater. In addition, data on any deaths or injuries associated with less severe events
(Class I or Class II disasters) that are brought to the attention of the Red Cross will be included in the surveillance system. The American Red Cross and Centers for Disease Control are currently improving the completeness of data collection during the aftermath of natural disasters. To ensure the efficiency and effectiveness of this system, it is critical that Red Cross field staff receive the cooperation of health professionals involved in disaster relief. The combined efforts ofthe many disciplines involved with disaster response will increase the utility of this database for investigators who study the health and medical impact of natural disasters. In the future, it would be useful to compare our surveillance system with databases such as medical examiner and coroner reports, hospital records, and mortality statistics collected by the US Geological Survey and by the National Weather Service. We believe that the careful analysis of data produced by our surveillance system will provide useful lessons for public health and public safety officials in their efforts to develop citizenprotection guidelines that will reduce or prevent future disaster-related morbidity and mortality. a Penelope Patrick, BS Sue Anne Brenner, MD Eric Nofi MD, MPH Judy Lee, RN Penelope Patrick, Sue Anne Brenner, and Eric Noji are with the Division of Environmental Hazards and Health Effects, National Center for Environmental Health and Injury Control, Atlanta, Ga. Judy Lee is with Disaster Services, American Red Cross, Washington, DC. Requests for reprints should be sent to Eric Noji, MD, MPH, Division of Environmental Hazards and Health Effects, National Center for Environmental Health and Injury Control, MS F46, 4770 Buford Hwy, NE, Atlanta, GA 30341-3724.
December 1992, Vol. 82, No. 12
Letters to the Editor will be reviewed and are published as space penmits. By submitting a Letter to the Editor, the authorgives permission foritspublication in the JournaL Letters should not duplicate material being published or submitted elsewhere. Those referring to a recent Joumal article should be received within 3 months of the article's appearance. The Editors reserve the right to edit and abridge and to publish responses. Submit three copies. Both text and references must be typed double-spacedL Text is limited to 400 words. Reprints can be ordered through the author whose address is listed at the end of the letter.
The Red Cross and CDC's Natural-Disaster Surveillance System As a result of natural disasters throughout the world, each year thousands of people are killed or injured and billions of dollars in economic losses occur. The World Health Organization estimates that, worldwide between 1964 and 1983, nearly 2.5 million people were killed and 750 million were injured, left homeless, or otherwise harmed because of natural disasters. Unless action is taken to prevent such tolls, these statistics can only be expected to rise as populations increase and concentrate in vulnerable urban and coastal areas. In 1987, the American Red Cross and Centers for Disease Control developed a natural-disaster morbidity and mortality surveillance system. Although various federal agencies collect data on natural disasters, this system is unique in two respects: it collects information on the circumstances of deaths and injuries for
1690 American Journal of Public Health
disaster-affected populations, and it collects information on injuries and illnesses sustained by American Red Cross disaster field staff. Recording and analyzing such information will eventually lead to the development of strategies to prevent injury and disease during and after natural disasters. The American Red Cross has been collecting information on disaster-affected communities since 1905, when it was designated the national voluntaxy organization to provide relief for victims of disasters. The information collected was used for the sole purpose of human needs assessment. However, in 1986, almost a century after data were first collected, the Centers for Disease Control recognized this database as a unique source of disaster information, one with a great potential for finding new methods of disease and injury prevention. The Centers for Disease Control approached the American Red Cross to develop a natural-disaster surveillance system. A memorandum of understanding was created whereby American Red Cross Disaster Health Services staff agreed to collect data in the field on major natural disasters and Centers for Disease Control epidemiologists agreed to code and enter the data into a computer format for processing and statistical analysis. Currently the database includes statistics on deaths, injuries, and illnesses associated with all major natural disasters that occurred in the United States and associated territories from 1987 to 1991. The Red Cross groups major natural disasters into three classes of severity (Classes III-V) on the basis of the overall funds it commits to relief and rehabilitation: Class III, $50 000-250 000; Class IV, $250 0002 500 000; Class V, $2 500 000 and greater. In addition, data on any deaths or injuries associated with less severe events
(Class I or Class II disasters) that are brought to the attention of the Red Cross will be included in the surveillance system. The American Red Cross and Centers for Disease Control are currently improving the completeness of data collection during the aftermath of natural disasters. To ensure the efficiency and effectiveness of this system, it is critical that Red Cross field staff receive the cooperation of health professionals involved in disaster relief. The combined efforts ofthe many disciplines involved with disaster response will increase the utility of this database for investigators who study the health and medical impact of natural disasters. In the future, it would be useful to compare our surveillance system with databases such as medical examiner and coroner reports, hospital records, and mortality statistics collected by the US Geological Survey and by the National Weather Service. We believe that the careful analysis of data produced by our surveillance system will provide useful lessons for public health and public safety officials in their efforts to develop citizenprotection guidelines that will reduce or prevent future disaster-related morbidity and mortality. a Penelope Patrick, BS Sue Anne Brenner, MD Eric Nofi MD, MPH Judy Lee, RN Penelope Patrick, Sue Anne Brenner, and Eric Noji are with the Division of Environmental Hazards and Health Effects, National Center for Environmental Health and Injury Control, Atlanta, Ga. Judy Lee is with Disaster Services, American Red Cross, Washington, DC. Requests for reprints should be sent to Eric Noji, MD, MPH, Division of Environmental Hazards and Health Effects, National Center for Environmental Health and Injury Control, MS F46, 4770 Buford Hwy, NE, Atlanta, GA 30341-3724.
December 1992, Vol. 82, No. 12
