Preparedness for a major incident: creation of an epidemiology protocol for a health protection register in England

Public attitudes in England towards the sharing of personal data following a mass casualty incident: a cross-sectional study

OBJECTIVES

To assess public attitudes towards data sharing to facilitate a mental health screening programme for people caught up in a mass casualty incident.

DESIGN

Two, identical, cross-sectional, online surveys, using quotas to ensure demographic representativeness of people aged 18-65 years in England. Participants were randomly allocated to consider a scenario in which they witness a terrorism-related radiation incident or mass shooting, after which a police officer records their contact details.

SETTING

Participants were drawn from an online panel maintained by a market research company. Surveys were conducted before and immediately after a series of terrorist attacks and a large tower block fire occurred in England.

PARTICIPANTS

One thousand people aged 18-65 years participated in each survey.

MAIN OUTCOME MEASURES

Three questions asking participants if it would be acceptable for police to share their contact details, without asking first, with 'a health-related government organisation, so they can send you a questionnaire to find out if you might benefit from extra care or support', 'a specialist NHS team, to provide you with information about ways to get support for any physical or mental health issues' and 'your GP, so they can check how you are doing'.

RESULTS

A minority of participants reported that it would be definitely not acceptable for their details to be shared with the government organisation (n=259, 13.0%), the National Health Service (NHS) (n=141, 7.1%) and their general practitioner (GP) (n=166, 8.3%). There was a small, but significant increase in acceptability for the radiation incident compared with the mass shooting. No major differences were observed between the preincident and postincident surveys.

CONCLUSIONS

Although most people believe it is acceptable for their details to be shared in order to facilitate a mental health response to a major incident, care must be taken to communicate with those affected about how their information will be used.

An International Comparison of the Instigation and Design of Health Registers in the Epidemiological Response to Major Environmental Health Incidents

CONTEXT

Epidemiological preparedness is vital in providing relevant, transparent, and timely intelligence for the management, mitigation, and prevention of public health impacts following major environmental health incidents. A register is a set of records containing systematically collected, standardized data about individual people. Planning for a register of people affected by or exposed to an incident is one of the evolving tools in the public health preparedness and response arsenal.

OBJECTIVE

We compared and contrasted the instigation and design of health registers in the epidemiological response to major environmental health incidents in England, France, Italy, the Netherlands, and the United States.

DESIGN

Consultation with experts from the 5 nations, supplemented with a review of gray and peer-reviewed scientific literature to identify examples where registers have been used.

SETTING

Populations affected by or at risk from major environmental health incidents in England, France, Italy, the Netherlands, and the United States.

METHODS

Nations were compared with respect to the (1) types of major incidents in their remit for considering a register; (2) arrangements for triggering a register; (3) approaches to design of register; (4) arrangements for register implementation; (5) uses of registers; and (6) examples of follow-up studies.

RESULTS

Health registers have played a key role in the effective public health response to major environmental incidents, including sudden chemical, biological, radiological, or nuclear, as well as natural, more prolonged incidents. Value has been demonstrated in the early and rapid deployment of health registers, enabling the capture of a representative population.

CONCLUSION

The decision to establish a health register must ideally be confirmed immediately or soon after the incident using a set of agreed criteria. The establishment of protocols for the instigation, design, and implementation of health registers is recommended as part of preparedness activities. Key stakeholders must be aware of the importance of, and protocols for, establishing a register.Agencies will find value in preparing and implementing registers as part of an effective public health response to major environmental incidents, including sudden chemical, biological, radiological, or nuclear incidents, as well as natural, more prolonged incidents.

Voluntary Health Registry of French Nationals after the Great East Japan Earthquake, Tsunami, and Fukushima Daiichi Nuclear Power Plant Accident: Methods, Results, Implications, and Feedback

Introduction

The 11th of March 2011, a magnitude 9.0 earthquake struck alongside the north-east coast of Honshu Island, Japan, causing a tsunami and a major nuclear accident. The French Institute for Public Health Surveillance (InVS) set up, within one week after the triple catastrophe, an Internet-based registry for French nationals who were in Japan at the time of the disasters. In this string of disasters, in this context of uncertainties about the nuclear risks, the aim of this registry was to facilitate the: (1) realization of further epidemiologic studies, if needed; and (2) contact of people if a medical follow-up was needed. The purpose of this report was to describe how the health registry was set up, what it was used for, and to discuss further utilization and improvements to health registries after disasters.

Methods

The conception of the questionnaire to register French nationals was based on a form developed as part of the Steering Committee for the management of the post-accident phase in the event of nuclear accident or a radiological emergency situation (CODIRPA) work. The questionnaire was available online.

Results

The main objective was achieved since it was theoretically possible to contact again the 1,089 persons who completed the form. According to the data collected on their space-time budget, to the result of internal contamination measured by the French Institute for Radiological Protection and Nuclear Safety (IRSN) and dosimetric expertise published by the World Health Organization (WHO), it was not suitable to conduct an epidemiologic follow-up of adverse effects of exposure to ionizing radiations among them. However, this registry was used to launch a qualitative study on exposure to stress and psychosocial impact of the Great East Japan Earthquake on French nationals who were in Japan in March 2011.

Conclusion

Setting a registry after a disaster is a very important step in managing the various consequences of a disaster. This experience showed that it is quickly feasible and does not raise adverse side effects in involved people.

MotreffY, PirardP, LagréeC, RoudierC, Empereur-BissonnetP. Voluntary health registry of French nationals after the Great East Japan Earthquake, tsunami, and Fukushima Daiichi Nuclear Power Plant accident: methods, results, implications, and feedback. Prehosp Disaster Med.2016;31(3):326–329.

Lessons learned about psychosocial responses to disaster and mass trauma: an international perspective

At the 13th meeting of the European Society for Traumatic Stress Studies in 2013, a symposium was held that brought together international researchers and clinicians who were involved in psychosocial responses to disaster. A total of six disasters that occurred in five countries were presented and discussed. Lessons learned from these disasters included the need to: (1) tailor the psychosocial response to the specific disaster, (2) provide multi-dimensional psychosocial care, (3) target at-risk population groups, (4) proactively address barriers in access to care, (5) recognise the social dimensions and sources of resilience, (6) extend the roles for mental health professionals, (7) efficiently coordinate and integrate disaster response services, and (8) integrate research and evaluation into disaster response planning.