Under supervision of :-

Prof .Dr. Saneya ElBana

Prof .Dr. Mona Sadek
Prof .Dr. Afaf Ibrahim
Prepared by:-
Neama Mohamed Mousa

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 Objectives
At the end of this presentation, each candidate will be able to :
o Discuss disaster.

o List types of disaster.

o Illustrate impact of disasters.

o Discuss disaster phases.

o Apply disaster preparedness steps.

o Discuss Occupational Hazards.

o Apply occupational health nurse role at disaster preparedness.

 Outlines
o Introduction.
o Definition of disaster.
o Examples of some recent disaster in Egypt.
o Types of disaster.
o Impact of disasters.
o Disaster phases.
o Disaster preparedness steps.
o Types of Occupational Hazards.
o Occupational health nurse role at disaster
preparedness.
 Introduction
• Disaster is a serious disruption of the functioning of a
community or society causing widespread human, material,
economic or environmental loses which exceed the ability
of the affected community/society to cope by using its own
resources.
• Developing countries suffer the greatest costs when a
disaster hits – more than 95% of all deaths caused by
hazards occur in developing countries, and losses due to
natural hazards are 20 times greater.
 Definition of disaster
 A disaster is a sudden, calamitous event that
seriously disrupts the functioning of a community
or society and causes human, material, and
economic or environmental losses that exceed the
community’s or society’s ability to cope using its
own resources. Though often caused by nature,
disasters can have human origins.

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WHO defines disaster as:-
 "Any occurrence that cause damage, economic
disruption, loss of human life, deterioration health
and health services on a scale sufficient to warrant
an extraordinary response outside the affected
community or Area ".

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 Definition of Disaster
• World Health Organization (WHO), 2017 definition of
disaster: “A disaster is an occurrence disrupting the normal
conditions of existence and causing a level of suffering that
exceeds the capacity of adjustment of the affected
community”.
• Federal Emergency Management Agency (FEMA), 2017
defines disaster as “An occurrence that has resulted in
property damage, deaths, and/or injuries to a community.
 Recent disaster in Egypt
• The torrential rains, which began late on Wednesday 26
October 2016, coupled with exceptionally high winds,
have forced the authorities to shut four sea ports in
Suez and Port Said provinces and to close some schools
and main roads.
• At least 6,500 families — approximately 32,500 people
— need emergency food, shelter, water and sanitation.
Twenty-six people have been killed and 72 injured. (
OCHA, 2016)
 Recent disaster in Egypt cont.,)
• Upper Egypt and Red Sea mountainous regions, impoverished
areas with poor infrastructure, receive torrential downpours
annually in late October and early November.

• Due to bad weather, the heavy rainfall and floods hit several
governorates of Egypt (South Sinai, Red Sea, Sohag, Qena,
and Assuit). In addition to deaths and injuries, houses have
been swept away, main roads were closed and telephone and
power lines were cut especially in Red Sea Governorate (
IFRC, 2016).
Types of disaster
 Characteristics of Disasters
1. A casualty is a human being who is injured or killed by
or as a direct result of an accident. Although major
disasters sometimes occur without any injury or loss of
life, disasters are commonly characterized by the
number of casualties involved.
2. The possibility of being prepared is another
characteristic that varies with different types of
disasters. For instance, the path and time of landfall of
a hurricane can be tracked, so that residents in the
storm’s path can be evacuated and families and
businesses can be protected.
3. some disasters strike without warning .For example,
the terrorist attacks.
 Characteristics of Disasters (cont.,)
4. The scope of a disaster is the range of its effect, either
geographically or in terms of the number of victims. The
collapse of a 500-unit high-rise apartment building has a
greater scope than does the collapse of a bridge that occurs
while only two cars are crossing.

5. The intensity of a disaster is the level of destruction

and devastation it causes. For instance, an earthquake
centered in a large metropolitan area and one centered
in a desert may have the same numeric rating on the
Richter scale, yet have very different intensities in terms
of the destruction they cause.
 Factors Contributing to Disasters
• It is useful to apply the host, agent, and environment model
to understand the factors contributing to disasters,
because manipulation of these factors can be instrumental
in planning strategies to prevent or prepare for disasters.
 Factors Contributing to Disasters (cont.,)
1. Host Factors
• The host is the human being who experiences the
disaster .Host factors that contribute to the likelihood of
experiencing a disaster include age, general health,
mobility, psychological factors, and even
socioeconomic factors. For instance ,elderly residents
of a mobile home community may be unable to
evacuate independently in response to a tornado
warning if they no longer can drive. Impoverished
residents of a low-income apartment complex in a
large city may notice that their building is not
compliant with city fire codes but may avoid alerting
authorities for fear of being forced to move to more
expensive housing.
 Factors Contributing to Disasters (cont.,)
2. Agent Factors
The agent is the natural or technologic element that
causes the disaster. For example, the high winds of a
hurricane and the lava of an erupting volcano are agents,
as are radiation ,industrial chemicals, biologic agents,
and bombs.
3. Environmental Factors
are those that could potentially contribute to or mitigate a
disaster. Some of the most common environmental factors
are a community’s level of preparedness; the presence of
industries that produce harmful chemicals or radiation; the
presence of flood-prone rivers, lakes ,or streams; average
amount of rainfall or snow fall.
The impact of disaster
 Mortality & Morbidity

Disasters cause deaths, injuries, and illnesses

Disasters may overwhelm medical resources and
health services.

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 Health Care Infrastructure

Disasters may destroy hospitals.

Disasters may disrupt routine health services.
Disasters may disrupt preventive activities.
Consequence: long-term increases in morbidity and
mortality.
 Environment & Population

Disasters may increase potential for communicable

diseases.
Disasters may exacerbate environmental hazards.
Consequences: increases in morbidity and premature
death, decreased quality of life.
 Psychological and Social Behavior

Disasters may cause generalized panic or paralyzing

trauma.
Disasters may provoke increases in anxiety, depression
and neuroses.
Disasters may lead to post-traumatic stress disorder
(PTSD) at epidemic levels
 Food Supply
Disasters may disrupt the food supply.
Disasters leading to food shortages may cause specific
micronutrient deficiencies.
Disasters may provoke severe nutritional consequences
including famine and starvation.
 Population Displacement
Disasters may cause large spontaneous or organized
population movements.
Population movement may increase morbidity and mortality.
Population movement may precipitate epidemics of
communicable diseases in both displaced and host
communities.
Crowding of populations and overlay of refugee and host
populations may lead to injuries and violence.
 Phases of Disaster mangement
1. Mitigation: Preventing
future disasters &
minimizing their effects.
2. Preparedness: Preparing
to handle a disaster.
3. Response: Responding to
a disaster and putting
plans into action.
4. Recovery: Actions taken
to return to normalcy or
safer conditions.
 Mitigation
• Activities that reduce or eliminate a hazard
– Prevention
– Risk reduction

• Examples
– Immunization programs
– Public education
 Preparedness
• Activities that are taken to build capacity and
identify resources that may be used
– Know evacuation shelters
– Emergency communication plan
– Preventive measures to prevent spread of disease
– Public Education
 Response
• Activities a hospital, healthcare system, or public
health agency take immediately before, during,
and after a disaster or emergency occurs.
 Recovery
• Activities undertaken by a community and its
components after an emergency or disaster to
restore minimum services and move towards
long-term restoration.
– Debris Removal
– Care and Shelter
– Damage Assessments
– Funding Assistance
 Occupational Hazards
1-Physical hazards:
 Physical hazards Cont;
Example Possible Sources Health Effects
Working near furnaces. Heat stroke, Heat Syncope
Hot Environments Summer outdoor work (fainting)

Working outdoors in cold Hypothermia, Frostbite,

Cold Environments weather. Working in cold Trench foot
storage.
Working near x-ray machines. Radiation sickness within
Handling radioactive hours or days after exposure
materials. Uranium mining. to very high radiation levels.
Ionizing Radiation Working in nuclear energy Cancer after several years of
power plants. Working in low-level exposure.
nuclear research laboratories.
Exposure to electro magnetic Does not produce ions in the
Non-Ionizing waves, lights and lasers. See body chemicals. Reach by
Radiation the chart below. causing heat and other
effects
 Physical hazards Cont;
Example Possible Sources Health Effects

Sunlight, Arc welding, Blacklight Skin Cancer, Eye damage,

lamps, Germicidal lamps Retinal damage
Ultraviolet

Microwave ovens, radio and TV Heating of the body, Central

Microwave and transmission, radar, antenna, cell Nervous System (CNS) effects
Radio-frequency phones

Power Frequency Working near electric power Indications of leukemia in

Electromagnetic transmission or distribution children.
Field (ELF) lines.
Slippery and cluttered floors and Bodily injury, broken bones,
Slips, Trips and working surfaces. permanent disability
Falls
 2- Mechanical hazards:

• Mechanical hazards are hazards created by

the use of or exposure to either powered or
manually operated equipment, machinery and
plant. Mechanical injuries are mostly caused
either by contact or entanglement with
machinery.
 3- Psychological hazards:

• Psychological hazards are aspects of the work

environment and the way that work is
organized that are associated with mental
disorders and/or physical injury or illness.
When psychosocial hazards are not effectively
managed, they can negatively impact on
organizational measures including
productivity, absenteeism and turnover.
 4- Chemical hazards:

• A sub type of occupational hazards that may

be Synthetic or natural occurring chemicals
that are toxic or irritating to body system by
inhalation, skin absorption and ingestion.
 5- Biological hazards:

• Biological hazards are organic substances that

threaten people's health. They exist in all
forms of occupation; this is due to the fact
that these dangers do not always come from
visible sources and it can have a negative
impact on one's health these health effects
can range from skin and respiratory system
irritation to infection transmission.
Activities during Construction and Operation
along with Mitigation Measures

Control / Mitigation Hazards Associated with

Measures Activities
Exercise/ warm up-get help Manual Handling
when needed control Strains and sprains -
loads-rest breaks/ no incorrect lifting - too heavy
exhaustion-no loads -twisting - bending -
rapid movement/ twisting/ repetitive movement -
bending/repetitive body vibration.
movement - good
housekeeping.
 Activities during Construction and Operation
along with Mitigation Measures (cont.,)

Control / Mitigation Hazards Associated with

Measures Activities
Housekeeping - tidy workplace - Falls - Slips - Trips
guardrails, Falls on same level - falls to
handholds, harnesses, hole surfaces below -
cover, hoarding, poor housekeeping- slippery
no slippery floors/trip hazards - surfaces uneven
clear/ safe surfaces -poor access to work
access to work areas-egress from areas climbing on
work areas and off plant-unloading materials
- dust/water controlled - PPE. into
excavations wind - falling objects.
 Activities during Construction and Operation
along with Mitigation Measures (cont.,)

Control / Mitigation Hazards Associated with

Measures Activities
Leads good condition and Electricity
earthed – no temporary repairs - Electrocution – overhead /
no exposed wires-good underground services
insulation-no overloading - use of - any leads damaged or poorly-
protective devices - testing and insulated temporary
tagging -no overhead/ repairs -no testing and tagging-
underground services circuits
overloaded-nonuse of protective
devices.
 Activities during Construction and Operation
along with Mitigation Measures (cont.,)
Control / Mitigation Hazards Associated with
Measures Activities
Combustible/ flammable Fire
materials properly Flammable liquids/Gases like
stored /used -good LPG, Diesel
housekeeping-fire Storage area and combustible
extinguishers made available & building materials
Fire hydrant - poor housekeeping - grinding
Network with reserve Fire water sparks - open
(As per flames, absence of Fire hydrant
NFPA Code) - Emergency Plan in network.
case of
Fire or collapse of structure.
 Activities during Construction and Operation
along with Mitigation Measures (cont.,)
Control / Mitigation Hazards Associated with
Measures Activities
Head / face- footwear- Absence of Personal
hearing / eye-skin- Protective Equipment
respiratory Lack of adequate footwear-
protection provided – head protection
training-maintenance. hearing/ eye protection -
respiratory protection-
gloves-
goggles.
 Activities during Construction and Operation
along with Mitigation Measures (cont.,)
Control / Mitigation Measures Hazards Associated with Activities
Welding flash and burns controlled Gas Cutting and Welding
with PPE and shields -fumes Fire-welding flash, burns, fumes,
controlled with ventilation and PPE electrocution
(in good condition and properly in wet conditions- flashback in
positioned),Gas cylinders be kept oxygen set,
upright & secured position (properly leaking cylinders, acetylene
tied) - combustible materials to be cylinders lying
kept at secured place to avoid fire & down-poorly maintained leads.
Fire Extinguishers to be kept in fire
prone area with training to people
for its use.
 Activities during Construction and Operation
along with Mitigation Measures (cont.,)
Control / Mitigation Measures Hazards Associated with Activities
Materials to be secured-kept Falling Material
away from Fall during carrying/ Lifting
edge- toe boards -Use of materials-dislodged
hard hats. tools and materials from
overhead
work areas.
 Role of Nurse in different phases of disaster
management
1)During preventive phase, the nurse should:
 Be anticipatory guidance that encourage
expressing feelings about disaster before it occurs
to minimize its impact.
 Monitoring risk factors.
 Increase community awareness and preparation.
 Develop and implement programs and education
to prevent disasters from occurring. 43
2) During preparedness phase, the nurse should:
 Assist in developing disaster plan.
Elements of disaster plan:
 Chain of authority
 Lines of communication
 Modes of transport
 Mobilization
 Warning
 Equation

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 Rescue and recovery
 Triage
 Treatment
 Support of victims and families
 Care of dead bodies
 Disaster worker rehabilitation.

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 Assessment includes past history of disasters in the
community, available community resources, personnel
available in the community for the disaster plans and
management, local agencies and organizations involved
in the disaster management activities, availability of
health care facilities in the community.
 The nurse should be a community advocate.
 Assess and report the environmental hazards.
 Provide community with adequate warning system and a
back up
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3) During response phase, the nurse
should:
 Identify the population.
 Triaging the victim.
 Care for injured persons.
 Transporting patients.
 Arranging for physical facilities for the victim.

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4) During recovery phase, the nurse should
provide:
 Counseling.
 Rehabilitation.
 Reconstruction and repair of damage.
 Continuing care.
 Vocational training.
 Behavior modification.
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5)Other roles of community health nurse
include:
 Evaluate the disaster impact on community and
surrounding regions
 Evaluate effectiveness of disaster plan
 Evaluate the response of personnel involved in
disaster relief

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 References
 Blanchot, M. (2015). The writing of the disaster. U of Nebraska Press.

 Lindell, M. K. (2013). Disaster studies. Current Sociology, 61(5-6),

797-825.

 Robert Powers, (2010): Introduction to disasters and disaster

nursing, .mm, Research in the Utstein Style. World Association for
Disaster and Emergency Medicine, p.p 1-11
 Federal Emergency Management Agency, (FEMA), (2013):
Emergency management, Within the United Nations system
responsibility for emergency response rests with the Resident
Coordinator within the affected country. 50
ANY QUESTIONS?

THANK YOU