Risk factors of death from flood: Findings of a systematic review

Understanding Natural Disaster or Weather-Related Drowning Deaths Among Children

OBJECTIVES

Drowning is the leading cause of death during flood disasters. Little is known about these deaths. Child death review teams review details of child deaths to understand circumstances and risk factors to inform prevention.

METHODS

Using data entered in 2005 to 2021 for children ages 0 to 17 years from the National Fatality Review-Case Reporting System, we identified 130 drowning deaths directly attributed to natural disaster or weather incidents, and 14 deaths indirectly attributed to these incidents. Frequencies, proportions, and χ2 statistics were used to describe selected measures and compare with other drowning deaths.

RESULTS

Children who drowned as a direct result of a natural disaster- or weather-related incident were more likely to be aged >4 years (81% vs 40%, P < .001) and located in a rural or frontier setting (63% vs 30%, P < .001). They were more likely to be supervised at the time of the incident (61% vs 38%, P < .001), and it was more likely for additional children (35% vs 5%, P < .001) or adults (33% vs 3%, P < .001) to have perished. The indirect deaths were commonly a result of damage to protective barriers.

CONCLUSIONS

The characteristics of natural disaster- or weather-related drowning deaths among children differ from other drowning deaths. Natural disaster- or weather-related drowning may warrant tailored drowning prevention strategies. Improved surveillance of all water-related deaths may be a proactive action leading to the development of these prevention strategies, whereas poststorm remediation of protective barriers can be used as a reactive prevention after a storm has passed.

Global, regional and national trends and impacts of natural floods, 1990-2022

Objective

To assess global, regional and national trends in the impact of floods from 1990 to 2022 and determine factors influencing flood-related deaths.

Methods

We used data on flood disasters from the International Disaster Database for 1990-2022 from 168 countries. We calculated the annual percentage change to estimate trends in the rates of people affected and killed by floods by study period, World Health Organization (WHO) region, country income level and flood type. We used multivariable logistic regression analysis to assess the factors associated with death from floods.

Findings

From 1990 to 2022, 4713 floods were recorded in 168 countries, which affected > 3.2 billion people, caused 218 353 deaths and were responsible for more than 1.3 trillion United States dollars of economic losses. The WHO Western Pacific Region had the most people affected by floods (> 2.0 billion), accounting for 63.19% (2 024 599 380/3 203 944 965) of all affected populations. The South-East Asia Region had the most deaths (71 713, 32.84%). The African and Eastern Mediterranean Regions had the highest number of people affected and killed by floods per 100 000 population in 2022. The odds of floods causing more than 50 deaths were significantly higher in low-income countries (adjusted odds ratio: 14.34; 95% confidence interval: 7.46 to 30.04) compared with high-income countries. Numbers of people affected and mortality due to floods declined over time.

Conclusion

Despite the decreases in populations affected and deaths, floods still have a serious impact on people and economies globally, particularly in lower-income countries. Action is needed to improve disaster risk management and flood mitigation.

Definition and characteristics of climate-adaptive cities: a systematic review

BACKGROUND

Cities, as frontline responders to climate change, necessitate a precise understanding of climate-adaptive features. This systematic review aims to define and outline the characteristics of climate-adaptive cities, contributing vital insights for resilient urban planning.

METHODS

This systematic review, initiated on March 6, 2018, and concluded on August 26, 2021, involved reviewing multiple electronic databases based on the study's objectives. The Critical Appraisal Skills Program (CASP) tool was used for quality assessment and critical evaluation of articles retrieved through a comprehensive and systematic text search. Descriptive and thematic analyses were conducted to extract definitions, features, and characteristics of climate-adaptive cities.

RESULTS

Out of 6104 identified articles, 38 articles met the inclusion criteria. In total, 20 definitions and 55 features for climate-adaptive cities were identified in this review. Codes were categorized into two categories and ten subcategories. The categories included definitions and features or characteristics of climate-adaptive cities.

CONCLUSION

A climate-adaptive city, as derived from the findings of this study, is a city that, through effective resource management, future-oriented planning, education, knowledge utilization, innovation in governance and industry, decentralized management, and low-carbon economy, leads to the adaptability, resilience, sustainability, and flexibility of the capacity of individuals, communities, institutions, businesses, and systems within a city against all climate change impacts and reduces their negative consequences.

Immediate Injury Deaths Related to the Remnants From Hurricane Ida in New York City, September 1-2, 2021

The remnants from Hurricane Ida in September 2021 caused unprecedented rainfall and inland flooding in New York City (NYC) and resulted in many immediate deaths. We reviewed death records (electronic death certificates and medical examiner reports) to systematically document the circumstances of death and demographics of decedents to inform injury prevention and climate adaptation actions for future extreme precipitation events. There were 14 Ida-related injury deaths in NYC, of which 13 (93%) were directly caused by Ida, and 1 (7%) was indirectly related. Most decedents were Asian (71%) and foreign-born (71%). The most common circumstance of death was drowning in unregulated basement apartments (71%). Themes that emerged from the death records review included the suddenness of flooding, inadequate exits, nighttime risks, and multiple household members were sometimes affected. These deaths reflect interacting housing and climate crises, and their disproportionate impact on disadvantaged populations needing safe and affordable housing. Climate adaptation actions, such as improving stormwater management infrastructure, informing residents about flood risk, implementing Federal Emergency Management Agency recommendations to make basements safer, and expanding emergency notification measures can mitigate risk. As climate change increases extreme precipitation events, multi-layered efforts are needed to keep residents safe.

Health impacts of extreme weather events - Cascading risks in a changing climate

Background

Extreme weather events represent one of the most tangible impacts of anthropogenic climate change. They have increased in number and severity and a further increase is expected. This is accompanied by direct and indirect negative consequences for human health.

Methods

Flooding events, storms and droughts are analysed here for Germany from a systemic perspective on the basis of a comprehensive literature review. Cascading risks beyond the initial event are also taken into account in order to depict downstream consequences.

Results

In addition to the immediate health burdens caused by extreme weather events such as injuries, long-term consequences such as stress-related mental disorders occur. These stresses particularly affect certain vulnerable groups, e.g. older persons, children, pregnant women or first responders.

Conclusions

A look at the cascading risks described in the international literature allows us to develop precautionary measures for adaptation to the consequences of climate change. Many adaptation measures protect against different risks at the same time. In addition to planning measures, these include, above all, increasing the population's ability to protect itself through knowledge and strengthening of social networks.

Enhancing flood susceptibility modeling using multi-temporal SAR images, CHIRPS data, and hybrid machine learning algorithms

Flood susceptibility maps are useful tool for planners and emergency management professionals in the early warning and mitigation stages of floods. In this study, Sentinel-1 dB radar images, which provide Synthetic-Aperture Radar (SAR) data were used to delineate flooded and non-flooded locations. 12 input parameters, including elevation, lithology, drainage density, rainfall, Normalized Difference Vegetation Index (NDVI), curvature, ground slope, Stream Power Index (SPI), Topographic Wetness Index (TWI), soil, Land Use Land Cover (LULC), and distance from the river, were selected for model development. The importance of each input parameter on flood occurrences was assessed via the Mutual Information (MI) technique. Several machine learning models, including Radial Basis Function (RBF), and three hybrid models of Bagging (BA-RBF), Random Committee (RC-RBF), and Random Subspace (RSS-RBF), were developed to delineate flood susceptibility areas at Goorganrood watershed, Iran. The performance of each model was evaluated using several error indicators, including correlation coefficient (r), Nash Sutcliffe Efficiency (NSE), Mean Absolute Error (MSE), Root Mean Square Error (RMSE), and the Area Under the Receiver Operating Characteristic (ROC) Curve (AUC). The results showed that the hybrid techniques enhanced the modeling performance of the standalone model, and generally, all hybrid models are more accurate than the standalone model. Although all developed models have performed well, RC-RBF outperforms all of them (AUC = 0.997), followed by BA-RBF (AUC = 0.996), RSS-RBF (AUC = 0.992), and RBF (AUC = 0.975). Generally, about 12 % of the study area has high and very high susceptibility to future flood occurrences.

Scale Development and Psychometric Evaluation of a Questionnaire for Measuring the Risk Factors for Death in Floods

Purpose

Determination of the causes of flood-related deaths is the precondition for effective interventions aimed at the reduction of such deaths. There is a gap in the design and the development of a valid and reliable instrument for measuring underlying factors of death in the flood.

Methods

This study was carried out in two phases. In the first phase, item pool generation and questionnaire design were carried out through systematic review of literature and qualitative study. the initial questionnaire was divided into two parts of objective and subjective factors. In the second phase, the psychometric evaluation of the questionnaire included face, content, and construct validity in the subjective part. The reliability was also evaluated by calculating test-retest intraclass correlation coefficient and Cronbach's alpha. Exploratory factor analysis (EFA) was used for the data collected from 369 individuals in the flood-affected communities experiencing flood deaths. Data analysis was performed in SPSS version 23.

Results

In the EFA, 33 items and seven dimensions were extracted that explained 57.82% of the variance of influential factors in flood death, including the cognition of the flood (four items), general knowledge (four items), public beliefs (four items), risk perception (nine items), attitude (five items), prevention (five items), and social norms (two items). The internal consistency of the instrument using Cronbach's alpha coefficient was 0.92. Finally, in order to perform the stability test, the Pearson correlation coefficient was calculated for all questions. This was above .05 and acceptable.

Conclusions

According to the results, the factors affecting flood death questionnaire (FAFDQ) could be used to make decisions, identify groups at risk of flood-related deaths, and implement flood-related death-reduction interventions. Indeed, these measures have led to the development of a comprehensive and reliable questionnaire for measuring the factors affecting flood deaths.

Criteria for Locating Temporary Shelters for Refugees of Conflicts: A Systematic Review

BACKGROUND

We aimed to identify the indicators and criteria to locate temporary shelters for conflict refugees.

METHODS

This systematic review evaluated the full-text of the related articles in international electronic databases, such as Web of Science, Scopus, PubMed, Cochran, and Google Scholar from the beginning and without time limit to 1 June 2019. In addition, this search was based on a strategy developed by the researchers. The studies were selected regardless of their methods and two data extraction forms were used to extract the most relevant and important information.

RESULTS

Among 10124 cases of primary documents, 38 articles were selected, and 25 articles were analyzed in full-text. Totally, 45 indicators were identified and classified into two main categories of physical and non-physical indicators with six subcategories of land ownership, host government, access to infrastructures, site safety, land characteristics, and economic, social, and cultural considerations.

CONCLUSION

The selection of temporary shelters for the conflict refugees requires the identification of all the specific influential factors not properly addressed. The final indicators obtained in our review could be incorporated into the development of the models required in this regard.

Behavioral, health- related and demographic risk factors of death in floods: A case-control study

During the first half of 2019, many provinces of Iran were affected by floods, which claimed the lives of 82 people. The present study aimed to investigate the behavioral, health related and demographic risk factors associated with deaths due to floods. We measured the odds ratio and investigated the contribution and significance of the factors in relation to mortality. This case-control study was conducted in the cities affected by flood in Iran. Data were collected on the flood victims using a questionnaire. Survivors, a member of the flood victim's family, were interviewed. In total, 77 subjects completed the survey in the case group, and 310 subjects completed the survey in the control group. The findings indicated that factors such as the age of less than 18 years, low literacy, being trapped in buildings/cars, and risky behaviors increased the risk of flood deaths. Regarding the behavioral factors, perceived/real swimming skills increased the risk of flood deaths although it may seem paradoxical. This increment is due to increased self confidence in time of flood. On the other hand, skills and abilities such as evacuation, requesting help, and escape decreased the risk of flood deaths. According to the results, the adoption of support strategies, protecting vulnerable groups, and improving the socioeconomic status of flood-prone areas could prevent and reduce the risk of flood deaths.

Coastal drowning: A scoping review of burden, risk factors, and prevention strategies

Objective

Coastal drowning is a global public health problem which requires evidence to support safety initiatives. The growing multidisciplinary body of coastal drowning research and associated prevention countermeasures is diverse and has not been characterised as a whole. The objective of this scoping review was to identify key concepts, findings, evidence and research gaps in the coastal drowning literature to guide future research and inform prevention activities.

Methods

We conducted a scoping review to identify peer reviewed studies published before May 2020 reporting either (i) fatal unintentional coastal drowning statistics from non-boating, -disaster or -occupational aetiologies; (ii) risk factors for unintentional fatal coastal drowning; or (iii) coastal drowning prevention strategies. Systematic searches were conducted in six databases, two authors independently screened studies for inclusion and one author extracted data using a standardised data charting form developed by the study team.

Results

Of the 146 included studies, the majority (76.7%) were from high income countries, 87 (59.6%) reported coastal drowning deaths, 61 (41.8%) reported risk factors, and 88 (60.3%) reported prevention strategies. Populations, data sources and coastal water site terminology in the studies varied widely; as did reported risk factors, which most frequently related to demographics such as gender and age. Prevention strategies were commonly based on survey data or expert opinion and primarily focused on education, lifeguards and signage. Few studies (n = 10) evaluated coastal drowning prevention strategies.

Discussion

Coastal drowning is an expansive, multidisciplinary field that demands cross-sector collaborative research. Gaps to be addressed in coastal safety research include the lack of research from lower resourced settings, unclear and inconsistent terminology and reporting, and the lack of evaluation for prevention strategies. Advancing coastal drowning science will result in a stronger evidence base from which to design and implement effective countermeasures that ultimately save lives and keep people safe.