Table 1.
Description of Included Studies
| Author (year) | Purpose | Study design | Disease state studied | Type of disaster | Sample size and description | Findings specific to outcomes of interesta |
|---|---|---|---|---|---|---|
| Kirizuka et al. (1997) | Examine whether an earthquake disturbs glycemic control in diabetic patients | Cohort analysis | Diabetes | Earthquake | Diabetic patients in Japan (n = 177) | HbA1c levels for patients increased from 7.74% (± 1.82) before the earthquake to 8.34% (± 2.07), p < .01 ~2 mo after earthquake. |
| Nishikawa et al. (2015) | Assess the effect of an earthquake on diabetes outpatient care | Cohort analysis | Diabetes (type 2) | Earthquake | Diabetic patients in Japan (n = 575) | No significant differences in mean HbA1c levels were observed among disaster-affected patients with type 2 diabetes. |
| Ohkouchi et al. (2013) | Examine long-term health effects and exacerbations of existing conditions associated with the East Japan Earthquake | Cohort analysis | COPD | Earthquake | Patients admitted to respiratory units Hospital in Japan from March 11 to April 10, 2010 (n = 447) and also from March 11 to April 10, 2011 (n = 1,223) | COPD exacerbations were 2.5 times higher from March to April in the earthquake year (2011) than the year before. |
| Sugisawa et al. (2017) | Explore factors related to earthquake preparedness in Japanese hemodialysis patients | Cross-sectional | ESRD | Earthquake | Chronic kidney disease patients in Japan (n = 1,841) | Patients with higher social support from family (OR 1.080 [95% CI 1.029, 1.132], p = .002) and friends (OR 1.078 [95% CI 1.042, 1.115], p = .001) scored higher on earthquake preparedness measure. |
| Anderson et al. (2009) | Examine the extent of missed dialysis sessions after Hurricane Katrina and the factors that contributed missed sessions | Cross-sectional | ESRD | Hurricane | Hemodialysis patients near New Orleans, LA (n = 386) | Adults aged 65 or over were less likely to miss 1–2 dialysis sessions after disaster than participants younger than 50 (OR 2.44 [95% CI 1.21, 4.95]). |
| Gotanda et al. (2015) | Evaluate older adults’ emergency department and hospital use in lower Manhattan after Hurricane Sandy | Cohort analysis | Overall ED usage | Hurricane | ED visits (n = 3513) and hospitalizations (n = 940) to Beth Israel Medical Center (New York, NY) between May 7, 2012 and April 28, 2013. (Sample size given for pre-Sandy and immediately post-Sandy time periods.) | ED visits and hospital admissions for dialysis-related concerns increased across all age groups studied (18–64, 65–79, and 80+), p < .05 |
| Hyre et al. (2007) | Assess PTSD symptoms and dialysis-related factors (among others) after Hurricane Katrina landfall | Cross-sectional | ESRD | Hurricane | Hemodialysis patients near New Orleans, LA (n = 391) | 24% of patients experienced PTSD, with no significant differences observed for adults aged 50–64 (adj. prevalence ratio 1.24 [95% CI 0.87, 1.77]) or 65+ (adj. prevalence ratio 1.00 [95% CI 0.65, 1.54]) with respect to adults younger than 50. |
| Lee et al. (2016) | Assess geographic distribution and postdisaster medical needs of different Hurricane Sandy evacuation zones | Cohort analysis | Diabetes | Hurricane | ED visits in New York City in 2012 (n = 50,996 records pre-hurricane, n = 46,131 post-hurricane) | Following Hurricane Sandy landfall, the proportion of adults aged 65+ that visited the ED with a secondary diagnosis of diabetes increased from 50% to 60% (p < .01). |
| Lurie et al. (2015) | Evaluate outcomes for ESRD patients who received early dialysis before Hurricane Sandy | Cohort analysis | ESRD | Hurricane | Hemodialysis patients in New York City and New Jersey (n = 13,836) | Patients undergoing early dialysis before the hurricane were less likely to visit the ED (OR 0.75 [95% CI 0.63, 0.89]) or be hospitalized (OR 0.77 [95% CI 0.65, 0.92]) during the week of the hurricane than patients who did not undergo early dialysis. |
| Malik et al. (2018) | Evaluate the acute impact of disasters on diabetic patients using the ED | Cohort analysis | ED visits | Hurricane | ED visits in 2012 before and after Hurricane Sandy (sample size not reported) | Medicare patients presenting to an ED with a primary diagnosis of diabetes increased proportionately (from 41% to 55%, p = .04). |
| Sharma et al. (2008) | Characterize ED visits for chronic disease conditions at emergency departments after Hurricane Katrina | Cross-sectional | ESRD/diabetes | Hurricane | ED visits in hospitals near New Orleans, LA, from September 8 to October 22, 2005 (n = 21673 ED visits) | After Hurricane Katrina, (i) renal failure accounted for 2.5% of ED visits among all patients; (ii) renal failure accounted for 14% of ED visits by adults aged 80 or older; and (iii) diabetic concerns accounted for 7% of ED visits by adults aged 80 or older. |
| Delfino et al. (2009) | To evaluate the relationship of cardiorespiratory outcomes to wildfire-related particulate matter (PM2.5) during California wildfires in October 2003 | Cohort analysis | COPD/CHF | Wildfire | Hospital admissions in southern California, from October 1 to November 15, 2003 (n = 40,856 visits) | COPD-related hospital admissions were smaller for adults aged 65 and older (3%, no CI reported) compared with adults aged 20–64 (7% [95% CI 0.9, 13.1]). |
| Mott et al. (2005) | To determine the effects of wildfires on cardiorespiratory hospitalizations and re-admissions, and to examine longer-term health effects | Cohort analysis | COPD/CHF | Wildfire | Hospitalization records in the Kuching region of Malaysia from January 1, 1995 to December 31, 1998 (n = 190,016). | Wildfire was associated with a smaller increase in COPD-related ED visits for those aged 65+ (42%) versus 50% for patients aged 40–64. |
| Parthum et al. (2017) | Geospatially analyze public health outcomes related to wildfire smoke | Cohort analysis | COPD/CHF | Wildfire | ED visits in the Tidewater region of Virginia from June 9 to October 13, 2008 (n = 548) | Wildfire was associated with increased likelihood of COPD-related (cRR 1.73 [95% CI 1.06, 2.83] for adults 18+ [65+ not specifically reported]) and CHF-related (cRR 1.37 [95% CI 1.01, 1.85] for adults 65+, 18–64 not studied) ED visits in exposed counties during the wildfire. |
| Rappold et al. (2011) | Investigate health effects associated with air pollution from wildfires | Cohort analysis | COPD/CHF | Wildfire | ED visits in North Carolina, USA between June 1 and July 14, 2008 | COPD results for adults aged 65+ (cRR 1.48 [95% CI 0.74, 2.97]) and CHF results for both age groups (cRR 1.34 [95% CI 0.78, 2.32] and 1.29 [95% CI 0.89, 1.87], respectively) were not significant. Adults younger than 65 had increased COPD outcomes (cRR 2.02 [95% CI 1, 4.05]) in wildfire-exposed counties compared with referent counties. |
| Reid et al. (2016) | Examine the effects of long wildfire exposure on cardiorespiratory outcomes interpreted across geography and time | Cohort analysis | COPD/CHF | Wildfire | 102,311 hospitalizations and ED visits in northern California from May 6 to September 15, 2008 | A 5 µg/m3 increase in PM2.5 emissions from wildfire was associated with an overall increase in COPD-related ED visits (RR 1.022 [95% CI 1.006, 1.039]), significant for adults aged 20–64 (RR 1.062 [95% CI 1.033, 1.092]), but not for adults 65+ (RR 1.002 [95% CI 0.979, 1.026]). |
| Tinling et al. (2016) | Examine the relationship between cardiorespiratory outcomes and wildfire smoke exposure in an attempt to replicate a previous study on a similar fire | Cohort analysis | COPD/CHF | Wildfire | ED visits in 28 North Carolina counties between May 5 and June 19, 2011 (57,650 records) | No significant association was observed in older adults between COPD and PM2.5 [cRR 0.92 (95% CI 0.83, 1.02)] or between CHF and PM2.5 (cRR 0.92 [95% CI 0.84, 1.01]). |
Notes: CI = confidence interval; cRR = cumulative relative risk; ED = emergency department; OR = odds ratio; PM2.5 = particulate matter ≤ 2.5 µm in diameter. aEffect size reported when available.