Impact of Earthquakes on Lung Health

Our plain-English summary of Impact of Earthquakes on Lung Health, by E. Güleç Balbay, Ö. Kayalar, Ö. Balbay, et al (Thoracic Research and Practice, 2024).

The study

• Authors: E. Güleç Balbay, Ö. Kayalar, Ö. Balbay, Ö. Dikensoy, P. Arbak, H. Bayram
• Journal: Thoracic Research and Practice
• Published: 2024;25(2):89-98
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Earthquakes are catastrophic natural disasters that cause extensive damage to infrastructure and disrupt the lives of millions worldwide. Beyond the immediate physical and psychological damage caused by earthquakes, these events can significantly impact respiratory health. The inhalation of dust, smoke, particulates, toxic gases, and asbestos exposure can lead to various respiratory health pathologies. These include respiratory infections, exacerbations of pre-existing respiratory diseases, chest traumas, and pulmonary and venous thromboembolism. Longitudinal studies are necessary to assess the long-term respiratory health effects in affected populations. By addressing these knowledge gaps, future mitigation strategies and preparedness measures can be developed to minimize the respiratory health impacts of earthquakes and improve the well-being of affected communities. Robust building infrastructure and comprehensive earthquake preparedness are emerging as the most important determinants for not only mitigating building collapse but also significantly reducing the potential health impacts that follow. This comprehensive review aims to provide a systematic overview of the lung health impacts of earthquakes. It highlights the need for further research to identify specific pollutants, air contaminants, and environmental factors contributing to respiratory health issues following earthquakes.

In plain English

This article was a review. Written after the February 6, 2023 earthquakes in Southeastern Turkey and north-western Syria, it drew on earlier published studies to describe how earthquakes can affect the lungs: dust and silica particles, radon and other gases, infections, chest injuries, flare-ups of COPD and asthma, blood clots in the lungs, and asbestos. It did not report new data of its own, and it did not name specific asbestos fiber types. On asbestos, the authors wrote that collapsing buildings are believed to release fibers into the air. They noted that asbestos was banned in Japan in 2006 and in Turkey in 2010, and that 1.2 million tons were reported used in Turkish construction between 1900 and 2003. They cited a study of buildings after a 1989 California earthquake. It found indoor asbestos levels generally did not significantly differ from outdoor levels, with slightly higher levels near debris clean-up and asbestos abatement. The authors concluded that air and debris in the Turkish earthquake zone should be tested for asbestos and that longer-term studies are needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of published literature on earthquakes and lung health; no new data were collected, and no literature-search method is described
• Who was studied: Published studies of earthquake victims, rescue and demolition workers, and residents after earthquakes in Japan, China, Turkey, Italy, the USA, the Philippines and Haiti; written in the context of the 2023 earthquakes in Southeastern Turkey and north-western Syria
• Exposure: Dust, smoke, particulate matter (including silica), toxic gases (radon, carbon dioxide, carbon monoxide), microbes and molds, and asbestos released from damaged buildings; no asbestos fiber types are specified
• Main results:
  • The authors described asbestos as a known cause of asbestosis, lung cancer and mesothelioma, and wrote that building collapse during earthquakes is believed to spread asbestos fibers into the air, exposing rescue workers and victims
  • Asbestos has been banned since 2006 in Japan and since 2010 in Turkey. Before the ban, a reported 1.2 million tons were used as a construction material in Turkey between 1900 and 2003
  • A cited study (Van Orden et al) of air samples from buildings after the 1989 central coastal California earthquake found that, in general, asbestos levels in the sampled buildings did not significantly differ from outdoor levels
  • In the same cited study, samples taken near debris clean-up areas and in buildings undergoing asbestos abatement showed slightly higher concentrations
  • A cited study (Mastrantonio et al) after the 2009 earthquake in central Italy found that workers doing manual demolition were exposed to inhalable dust above the 10 mg/m3 threshold limit value
  • After the 1994 Northridge, California earthquake, the review reports that people physically present in landslide dust clouds were 3 times more likely to be diagnosed with acute coccidioidomycosis than people not exposed
  • A cited study (Bulut et al) of 645 earthquake victims after the 1999 Marmara earthquake found that about 10% of those seen at the hospital had chest trauma
  • A cited study (Ma et al) of 301 COPD patients after the Wenchuan earthquake found a significantly higher incidence of acute COPD exacerbations in patients from the earthquake zone than in patients from a non-earthquake zone at 3 and 12 months
  • A cited study (Watanabe et al) after the Niigata, Japan earthquake found that 6 of 9 patients (67%) with pulmonary embolism had taken refuge in their automobiles before symptoms began
• The authors' conclusion: The authors concluded that air and debris from buildings in earthquake areas should be analyzed for asbestos and that reports on the consequences of such exposure should be compiled. More broadly, they concluded that further research is needed on the specific pollutants behind post-earthquake respiratory problems, and that sound buildings and earthquake preparedness are key to reducing these health effects.
• Limitations the authors state:
  • The authors stated that research on increased dust levels after earthquakes, and on the specific particle types involved, is limited
  • The authors stated that more long-term follow-up studies are needed to assess middle- and long-term effects, including mesothelioma

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure.

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