Respiratory Emergencies in Disasters: A Narrative Review

Our plain-English summary of Respiratory Emergencies in Disasters: A Narrative Review, by A.E. Karabulut, B. Özen Karabulut (Thoracic Research and Practice, 2026).

The study

• Authors: A.E. Karabulut, B. Özen Karabulut
• Journal: Thoracic Research and Practice
• Published: 2026;27(5):324-334
• Read it: PubMed · Publisher · Free full text

Abstract

Disasters cause a wide spectrum of respiratory injuries and affect hundreds of millions of people each year. Because the respiratory system is in continuous contact with the external environment, it is among the most vulnerable systems in disaster settings. Silica-and asbestos-containing dust released from earthquake debris, fine particulate matter from wildfire smoke, mold spores in flood-damaged interiors, ash and acidic gases from volcanic eruptions, toxic industrial chemicals released during chemical incidents, barotrauma from explosions, and biological or pandemic threats each trigger acute and chronic respiratory diseases through distinct mechanisms. This narrative review addresses respiratory emergencies associated with natural and human-made disasters, the underlying pathophysiological mechanisms, diagnostic and management approaches, vulnerable populations, and the influence of climate change on the rising burden of disaster-related respiratory disease. Evidence was synthesized from PubMed/MEDLINE, Web of Science, and Scopus, supplemented by official reports from the Emergency Events Database, the World Health Organization, and the United Nations Office for Disaster Risk Reduction. Available data indicate that acute respiratory infections are major causes of morbidity and mortality in disaster settings across all age groups. Furthermore, patients with chronic respiratory diseases face an increased risk of exacerbations, while the management of acute respiratory distress syndrome remains a significant challenge, particularly in resource-limited environments. Disaster preparedness planning must prioritize respiratory emergencies and strengthen response protocols for vulnerable groups.

Copyright© 2026 The Author(s). Published by Galenos Publishing House on behalf of Turkish Thoracic Society.

In plain English

This article was a narrative review, not an original study. The authors searched PubMed/MEDLINE, Web of Science and Scopus, focusing on 2015 to 2026 publications, to describe respiratory emergencies from earthquakes, wildfires, floods, volcanic eruptions, chemical incidents, explosions and pandemics. On asbestos, the review cited dust measurements taken in Hatay, Türkiye, during demolition after the February 2023 Kahramanmaraş earthquakes. Mean respirable and total dust concentrations were 30.84 mg/m3 and 33.66 mg/m3. These were peak rather than time-weighted average values. Electron microscopy of debris found fibrous particles consistent with the shape of asbestos, but the review noted that confirming asbestos requires further testing. No asbestos fiber type was named. Citing Türkiye's existing asbestos burden, the authors wrote that these findings warrant attention to the long-term risk of mesothelioma and lung cancer among survivors and rescue workers. One cited retrospective study of 1,122 patients after the earthquake found significant increases in hospitalization for pneumonia and COPD exacerbations. The authors concluded that respiratory emergencies are a threat across disaster types and that vulnerable groups bear a disproportionate share of the risk.

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 and official disaster reports
• Who was studied: No people were studied directly. The review covered published studies, focusing on 2015 to 2026, plus reports from EM-DAT, the World Health Organization and the UN Office for Disaster Risk Reduction, on respiratory effects of natural and human-made disasters.
• Exposure: Disaster-related respiratory exposures. These included silica- and asbestos-containing dust from collapsed buildings after earthquakes (no asbestos fiber type named), wildfire PM2.5 smoke, mold after floods, volcanic ash and gases, toxic industrial chemicals, blast pressure waves and pathogens.
• Main results:
  • A cited study measured dust in Hatay after the February 6, 2023 Kahramanmaraş earthquakes, during active demolition. It recorded mean respirable dust of 30.84 mg/m3 and mean total dust of 33.66 mg/m3, described as far exceeding international occupational exposure limits.
  • In the same cited study, scanning electron microscopy of debris samples found fibrous particles consistent with the shape of asbestos. Definitive mineral confirmation was not obtained.
  • Citing Türkiye's existing environmental and occupational asbestos burden, the authors wrote that the dust findings warrant attention to the long-term risk of mesothelioma and lung cancer in survivors and rescue workers.
  • One cited retrospective study of 1,122 patients after the Kahramanmaraş earthquake found significant increases in hospitalization for pneumonia and COPD exacerbations.
  • A cited systematic review of 47 studies on earthquake-induced tsunamis found that acute respiratory infections were the most frequently reported post-disaster illness group.
  • The review stated that N95/FFP2 filtering facepiece respirators are recommended for earthquake and structural-collapse scenarios and provide protection against dust, silica and asbestos.
• The authors' conclusion: The authors concluded that respiratory emergencies are a threat across all disaster types, that vulnerable populations bear a disproportionate share of the risk, and that climate change is increasing the disaster-related respiratory burden.
• Limitations the authors state:
  • The cited Hatay dust measurements were taken during active demolition and represent peak exposures, not time-weighted averages.
  • The asbestos-like fibers seen by electron microscopy were not definitively confirmed as asbestos.
  • The authors identified research gaps: long-term respiratory follow-up of disaster survivors, disaster-specific clinical protocols, and underrepresented geographic regions in the evidence base.

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