International Journal of Epidemiology, Vol 26, 806-813, Copyright © 1997 by International Epidemiological Association
HK Armenian, A Melkonian, EK Noji and AP Hovanesian
BACKGROUND: This is the first population-based study of earthquake injuries
and deaths that uses a cohort approach to identify factors of high risk. As
part of a special project that collected data about the population in the
aftermath of the earthquake that hit Northern Armenia on 7 December 1988,
employees of the Ministry of Health working in the earthquake zone on 7
December 1988, and their families, were studied as a cohort to assess the
short and long term impact of the disaster. The current analysis assesses
short term outcomes of injuries and deaths as a direct result of the
earthquake. METHODS: From an unduplicated list of 9017 employees, it was
possible to contact and interview 7016 employees or their families over a
period extending from April 1990 to December 1992. The current analysis
presents the determinants of 831 deaths and 1454 injuries that resulted
directly from the earthquake in our study population of 32,743 people
(employees and their families). RESULTS: Geographical location, being
inside a building during the earthquake, height of the building, and
location within the upper floors of the building were risk factors for
injury and death in the univariate analyses. However, multivariate
analyses, using different models, revealed that being in the Spitak region
(odds ratio [OR] = 80.9, 95% confidence interval [CI]: 55.5-118.1) and in
the city of Gumri (OR = 30.7, 95% CI: 21.4-44.2) and inside a building at
the moment of the earthquake (OR = 10.1, 95% CI: 6.5-15.9) were the
strongest predictors for death. Although of smaller magnitude, the same
factors had significant OR for injuries. Building height was more important
as a factor in predicting death than the location of the individual on
various floors of the building except for being on the ground floor of the
building which was protective. CONCLUSIONS: Considering that most of the
high rise buildings destroyed in this earthquake were built using standard
techniques, the most effective preventive effort for this disaster would
have been appropriate structural approaches prior to the earthquake.
ARTICLES
Deaths and injuries due to the earthquake in Armenia: a cohort approach
Department of Epidemiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
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