Global Health Impacts of Floods: Epidemiologic Evidence

Extract

INTRODUCTION

Floods are the most common natural disaster in both developed and developing countries, and they are occasionally of devastating impact, as the floods in China in 1959 and Bangladesh in 1974 and the tsunami in Southeast Asia in December 2004 show (1). Their impacts on health vary between populations for reasons relating to population vulnerability and type of flood event (2–5). Under future climate change, altered patterns of precipitation and sea level rise are expected to increase the frequency and intensity of floods in many regions of the world (6). In this paper, we review the epidemiologic evidence of flood-related health impacts. The specific objectives were as follows:

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MATERIALS AND METHODS

We developed a search algorithm to identify the published literature concerning the health impacts of flood events. A search was made of the BIDS (Bath Information and Data Services, Bath, United Kingdom), CAB Abstracts (Commonwealth Agricultural Bureau International, Wallingford, Oxfordshire, United Kingdom), PsychInfo (American Psychological Association, Washington, DC), Embase (Elsevier B. V., Amsterdam, the Netherlands), and Medline/PubMed (National Library of Medicine, Bethesda, Maryland) reference databases using combinations of terms for flooding and selected health outcomes as terms in the title, keywords, or abstract (figure 1). Terms from Medical Subject Headings (MeSH; National Library of Medicine) were used where relevant. We excluded papers that addressed only population displacement, economic losses, and disruption of food supplies. The search found 3,833 references, of which 212 were identified as epidemiologic studies from review of the abstract and/or title. The scientific quality of these papers was assessed on a case-by-case basis. In drawing inferences, we made no exclusions from these 212, but we gave greatest weight to studies based on epidemiologic designs with controlled comparisons. We report and reference the main findings in this review.