Terrorist attacks on the aviation sector represent a significant security challenge due to the high-profile status of airports and aircraft. These attacks not only jeopardize global security but also have severe public health repercussions, leading to widespread casualties and psychological distress.

This study conducted a comprehensive retrospective analysis using data from the Global Terrorism Database to explore the patterns, frequencies, and impacts of terrorist attacks on the aviation sector worldwide. The analysis spanned incidents from 1970 to 2020, focusing on attack types, affected regions, and the direct and indirect health consequences arising from these incidents.

Over the 50-year period, the study identified 1183 terrorist attacks targeting the aviation sector. Bombings and explosions emerged as the most common and deadliest forms of attack, responsible for the majority of fatalities and injuries. The data also highlighted significant regional disparities, with certain areas experiencing higher frequencies of attacks and more severe outcomes. Notably, North America bore a disproportionately high number of fatalities, primarily due to the events of September 11, 2001.

The findings emphasize the ongoing and evolving threat of terrorism in the aviation industry, underscoring the critical need for a proactive and comprehensive approach to security and public health preparedness. Future strategies should prioritize the integration of advanced technological solutions, enhanced international cooperation, and thorough public health planning to mitigate the impact of terrorist attacks on aviation effectively.

Wildfires have escalated into a global threat with profound impacts on health, society, and the environment. The increasing frequency and intensity of these disasters, influenced by climate change and urban expansion, necessitate a comprehensive understanding of their direct health consequences.

This study conducted a retrospective analysis of global wildfire disasters from January 2000 to December 2023, utilizing data from the Emergency Events Database (EM-DAT). The analysis focused on the direct health outcomes—mortalities and injuries—excluding indirect effects such as smoke inhalation. Data were meticulously cleaned, categorized, and analyzed using quantitative methods, with statistical tests employed to validate the findings.

The study identified 309 significant wildfire disasters, with forest fires accounting for 80% of these events. These incidents resulted in 1890 fatalities and 14 360 injuries, with the highest tolls observed in Southern Europe, Northern America, and the Australia-New Zealand region. A notable rise in wildfire incidents was observed over the study period, underscoring the critical intersections between climate change, urban expansion, and wildfire risks. The analysis highlighted significant geographical and temporal patterns, emphasizing the regions and factors contributing to heightened wildfire vulnerability.

The findings underscore the urgent need for robust disaster preparedness and effective mitigation strategies. Integrating advanced early warning systems and Traditional Ecological Knowledge into wildfire management practices is essential. The study calls for proactive public health measures and interdisciplinary approaches to address the multifaceted challenges posed by wildfires. Continuous research and policy formulation are crucial to protect vulnerable communities and mitigate the increasing threat of wildfires globally.

With the increase in natural disasters and the expected role of public health nurses (PHNs) in responding, it is crucial to develop evidence-based disaster preparedness and management training programs tailored to the needs of PHNs. This study evaluates the effectiveness of a flipped classroom approach in disaster training for PHNs.

A total of 42 PHNs completed a 5-hour online training program and an in-person 8-hour training session at a local nursing school. Surveys measuring self-reported confidence and knowledge were completed at the beginning and end of the online and in-person training.

The average years of experience as an RN and PHN were 12.3 years and 6.7 years, respectively. Approximately 64% of participants had never deployed during a disaster. The pre- and posttest demonstrated a large effect size, indicating the effectiveness of both online and in-person training. The online training resulted in significant changes in knowledge. The in-person training showed a statistically significant increase in confidence across all measures.

Online and in-person disaster preparedness training programs can effectively enhance the knowledge, skills, and attitudes of PHNs. The majority of participants expressed that the training better prepared them to work in disaster shelters.

Disaster experiences have long-term effects on disaster preparedness. This study examined the long-term (10-y) effect of disaster severity of the 2008 Wenchuan earthquake on survivors’ disaster preparedness and the moderating effects of household vulnerability.

The data were collected in January 2018 covering 30 counties in Wenchuan earthquake-stricken areas. The dependent variable was survivors’ disaster preparedness (including overall, material, knowledge and awareness, and action preparedness) in 2018. Disaster severity included survivors’ housing damage and county death rate caused by the earthquake in 2008. Household vulnerability is a set of conditions that negatively affects the ability of people to prepare for and withstand disaster, proxied by households’ per-capita income and the highest years of schooling of household members. We performed multivariable linear regression models to answer the research questions.

A higher county death rate was associated with better overall preparedness (β = 0.043; P < 0.05) and knowledge and awareness preparedness (β = 0.018; P < 0.05), but housing damage was not significantly associated with disaster preparedness. The positive association of county death rate with overall preparedness (β = −0.065; P < 0.05) becomes weaker when a household has a higher per-capita income. Also, with the household per-capita income increasing, the associations of county death rate with material preparedness (β = −0.037; P < 0.05) and action preparedness (β = −0.034; P < 0.01) become weaker.

Disaster severity has positive and long-term effects on survivors’ disaster preparedness. Also, the positive and long-term effects are affected by household vulnerability. Specifically, the positive and long-term effects of disaster severity on disaster preparedness are more substantial when a household is more vulnerable.

It is of critical importance to determine the factors that contribute to nurses’ disaster preparedness. This study aimed to examine nurses’ perceptions of disaster preparedness and the factors affecting it.

This descriptive study was conducted with 464 nurses working in the East Marmara region of Türkiye. The data were collected online using the “Personal Information Form,” “The Scale of Perception of Disaster Preparedness on Nurses,” and the “Adult Motivation Scale.” Linear regression analysis was used to analyze the influencing factors.

It was found that nurses possessed a high level of perceived disaster preparedness, influenced by individual disaster preparedness, status of receiving disaster-related training, willingness to respond in the case of a disaster, disaster plan awareness, experience with caring for disaster victims, extrinsic motivation, and general motivation.

The results of the study offer evidence that can be implemented by managers and educators to better prepare nurses for disasters. Hospital administrators and policy makers should consider the factors affecting nurses’ perception of disaster preparedness to develop solutions for such disasters.

This study aims to identify the Jordanian nurses’ perception of their disaster preparedness and core competencies.

A descriptive, cross-sectional research design was used. The data was collected via an online self-reported questionnaire using the disaster preparedness evaluation tool and the core disaster competencies tool.

A total of 126 nurses participated in the study. Jordanian nurses had moderate to high levels of core disaster competencies and moderate levels of disaster preparedness. Core disaster competencies and disaster preparedness levels differed based on previous training on disaster preparedness, and the availability of an established emergency plan in their hospitals. Lastly, a previous training on disaster preparedness and core disaster competencies were statistically significant predictors of disaster preparedness among Jordanian nurses.

Organizational factors and environmental contexts play a role in the development of such capabilities. Future research should focus on understanding the barriers and facilitators of developing core disaster competencies and disaster preparedness among nurses.

The aim of this paper is to outline the steps taken to develop an operational checklist to assess primary healthcare (PHC) all-hazards disaster preparedness. It then describes a study testing the applicability of the checklist.

A PHC approach is an essential foundation for health emergency and disaster risk management (H-EDRM) because it can prevent and mitigate risks prior to disasters and support an effective response and recovery, thereby contributing to communities’ and countries’ resilience across the continuum of the disaster cycle. This approach is in line with the H-EDRM framework, published by the World Health Organization (WHO) in 2019, which emphasizes a whole-of-health system approach in disaster management and highlights the importance of integrating PHC into countries’ H-EDRM. Nevertheless, literature focusing on how to practically integrate PHC into disaster management, both at the facility and at the policy level, is in its infancy. As of yet, there is no standardized, validated way to assess the specific characteristics that render PHC prepared for disasters nor a method to evaluate its role in H-EDRM.

The checklist was developed through an iterative process that leveraged academic literature and expert consultations at different stages of the elaboration process. It was then used to assess primary care facilities in a province in Italy.

The checklist offers a practical instrument for assessing and enhancing PHC disaster preparedness and for improving planning, coordination, and funding allocation. The study identified three critical areas for improvement in the province’s PHC disaster preparedness. First, primary care teams should be more interdisciplinary. Second, primary care services should be more thoroughly integrated into the broader health system. Third, there is a notable lack of awareness of H-EDRM principles among PHC professionals. In the future, the checklist can be elaborated into a weighted tool to be more broadly applicable.

Pharmacies have a particularly important responsibility to supply medicine to disaster victims in order to save lives. This study investigated the characteristics of pharmacies that are well prepared for disasters as well as the efforts of the prefectural pharmaceutical association (PPA) to which the pharmacies belong.

Questionnaires on matters related to disaster preparedness were mailed to 50 randomly selected pharmacies in each of Japan’s 47 prefectures as well as all 47 PPAs in Japan. Logistic regression analysis was performed to examine the association of pharmacy background and the activities of the PPA to which they belong with pharmacy disaster preparedness as well as the association with pharmacies’ awareness of disaster preparedness.

Pharmacies in prefectures that conducted disaster preparedness training at least three times a year were better prepared for disasters. In addition, pharmacies with high online utilization and high disaster-preparedness awareness were significantly more prepared for disasters.

Pharmacies that can promptly provide medicine to disaster victims are considered to be well-prepared for disasters. The results suggest that pharmacy preparedness is also influenced by the disaster preparedness activities of their prefectures.

In general, medical students perceive themselves as inadequately prepared to assist in disasters. This study evaluated the impact of a disaster preparedness curriculum and medical students’ views toward required preparedness education for health care professionals.

A comprehensive disaster preparedness curriculum was evaluated on its effect on medical students’ views on preparedness education requirements, preparedness, and prior disaster training using self-report survey methodology.

Results provide evidence to support curricular effectiveness in significantly increasing initial participant views of health professionals’ education requirements, perceived preparedness for integrating professional roles into the emergency response system, and confidence in exposure risk assessment and triage skills. Most participants possessed limited recent prior disaster training and drill experience. Most interestingly, the majority consistently believed throughout the study that disaster preparedness training should be a medical license mandate.

For those instructing current medical students in disaster preparedness, it is suggested that a curriculum be chosen that can create participant initial anticipation, awareness, and belief in the importance of and need for disaster preparedness training. Further investigation is recommended into the relationship between students’ perceived training importance and any future curriculum delivery efforts on behalf of required or mandatory preparedness offerings in continuing professional development.

In June of 2021, a heatwave resulted in high mortality across the Pacific Northwest region. The city of Portland, Oregon, had many advantages: emergency response personnel, science-based policies, political support for climate change adaptation, and collaboration among municipal, county, state, and federal authorities. Though the city’s response likely prevented many deaths, heat-related mortality was high.

This study presents a retrospective case analysis of the 2021 Western North American Heatwave in Portland, Oregon. Specifically, the study examines the limitations of current heatwave response paradigms by means of a narrative review of the heatwave response and impacts.

Most deaths occurred at home, and most of those who died lived alone. Most of the deceased did not have access to functioning air conditioning.

Heatwaves exhibit high predictability in the demographics of those most affected and have rising rates of recurrence. Given the effectiveness of residential cooling systems in preventing heat-related mortality, findings suggest that future public health and policy initiatives should put increased focus on the primary prevention of heat exposure.

There is no universal tool for measuring disaster preparedness in the general population. This study aimed to provide a summary of the domains and psychometric properties of the available scales that assess preparedness for disasters, or one of its main types, among individuals or households.

This study is a systematic review of the literature on disaster preparedness tools. Studies published up to December 2022 were identified through a systematic search of four databases: Google Scholar, PubMed, Scopus, and Web of Science. Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) were used to review and evaluate the psychometric properties. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used to report this article.

Twelve articles met the inclusion criteria. Among them, five scales measured general disaster preparedness, five measured earthquake preparedness, one measured flood preparedness, and one measured bushfire preparedness. The scales had a number of dimensions ranging from one to six. The most common item topics in the included scales were as follows: having an evacuation plan (n = 7), information source (n = 7), fire extinguisher (n = 6), and emergency kit (n = 5). The scales were rated sufficient for content validity (n = 10), structural validity (n = 5), internal consistency (n = 5), and test-re-test reliability (n = 6). One scale was checked for criterion validity and was rated as insufficient according to the COSMIN guidelines.

The findings suggest the need to improve the psychometric properties of the scales, expand their contents, and develop scales relevant to target populations. This study provides useful information for researchers to develop comprehensive assessment tools and valuable sources of items for future scales.

The frequency of disasters world-wide has significantly increased in recent years, leading to an increase in the number of mass-casualty incidents (MCIs). These MCIs can overwhelm health care systems, requiring hospitals to respond quickly and effectively, often with limited resources. While numerous studies have identified the challenges in managing MCIs and have emphasized the importance of hospital disaster preparedness, there is a research gap in the preparedness level and response capacities of district hospitals in Nepal.

This study attempts to fill this gap by understanding the perception of hospital staff in managing MCIs in district hospitals of Nepal.

A qualitative case study was conducted in three district hospitals in Nepal. Semi-structured interviews were conducted with the hospital personnel, using an interview guide. An inductive thematic analysis was carried out to understand their perception on the most recent MCI management.

Three themes emerged from the data analysis: enablers in MCI management, barriers in MCI management, and recommendations for the future. Use of multiple communication channels, mobilization of entire hospital teams, mobilization of police in crowd control, presence of disaster store, and pre-identified triage areas were the major enablers that facilitated successful MCI management. Nonetheless, the study also revealed challenges such as a lack of knowledge on MCI response among new staff, disruptions caused by media and visitors, and challenges in implementing triage.

This study emphasized the importance of hospital disaster preparedness in managing MCIs and highlighted the significance of overcoming barriers and utilizing enablers for an efficient response. The findings of this study can provide the basis for the Ministry of Health and Population Nepal and district hospitals to plan initiatives for the effective management of MCIs in the future.

Ethiopian policy and strategy aim to make health care systems capable of dealing with emergencies. However, Ethiopian health care still lacks a comprehensive “all-hazard” approach and a disaster preparedness program. Thus, this study aimed to assess the level of disaster preparedness in selected public hospitals for mass-casualty incidents (MCIs) in Amhara Regional State, Northwest Ethiopia.

A descriptive cross-sectional study was conducted at general and comprehensive specialized hospitals (CSHs) in Amhara Regional State, Ethiopia using a World Health Organization (WHO) hospital emergency response checklist that included a domain on mass-casualty management (MCM) adapted from a literature review.

Seventeen (17) hospitals were evaluated (response rate: 81%). Five (29.4%) were teaching hospitals (tertiary health care) and 12 (70.5%) were non-teaching (secondary health care) hospitals. With an average mean of 97.3 (SD = 33.68; range 31-160), most hospitals under WHO required an Acceptable level of preparedness. Two were at an Unacceptable (0-67) level of preparedness, 12 (70.5%) hospitals were at an Insufficient (68-134) state, while the other three had an Acceptable (135-192) level of preparedness.

The preparedness level of hospitals is Insufficient for potential MCIs in this region and needs prior attention in implementing existing strategic guidelines to develop and activate hospital disaster plans if and when needed.

The objective of this study was to describe and compare almost all the components of disaster preparedness between private and government hospitals in the Eastern Province of the Kingdom of Saudi Arabia, using the World Health Organization’s (WHO) checklist.

We assessed and compared the disaster preparedness between government and private hospitals in Province, using the 10-key component WHO checklist in a descriptive cross-sectional study. Of 72 hospitals in the region, 63 responded to the survey.

All 63 hospitals had an HDP plan and reported having a multidisciplinary HDP committee. In all responding hospitals, HDP was acceptable in most indicators of preparedness; however, some hospitals to some extent fell short of preparedness in surge capacity, equipment and logistic services, and post-disaster recovery. Government and private hospitals were generally comparable in disaster preparedness. However, government hospitals were more likely to have HDP plans that cover WHO’s “all-hazard” approach, both internal and external disasters, compared to private hospitals.

HDP was acceptable, however, preparedness in surge capacity, equipment and logistic services, and post-disaster recovery fell short. Government and private hospitals were comparable in preparedness with regards to all indicators except surge capacity, post-disaster recovery, and availability of some equipment.

The study aimed to identify the factors that influence the disaster preparedness of hospitals and validate an evaluation framework to assess hospital disaster preparedness (HDP) capability in the Eastern Province of Saudi Arabia.

A cross-sectional survey of all hospitals (n = 72) in the Eastern Region of Saudi Arabia was conducted. A factor analysis method was used to identify common factors and validate the evaluation framework to assess HDP capacity.

Sixty-three (63) hospitals responded to the survey. A 3-factor structure was identified as key predicators of HDP capacity. The first factor was the most highly weighted factor, which included education and training (0.849), monitoring and assessing HDP (0.723), disaster planning (0.721), and command and control (0.713). The second factor included surge capacity (0.708), triage system (0.844), post-disaster recovery (0.809), and communication (0.678). The third factor represented safety and security (0.638) as well as logistics, equipment, and supplies (0.766).

The identified 3-factor structure provides an innovative approach to assist the operationalization of the concept of HDP capacity building and service improvement, as well as serve as a groundwork to further develop instrument for assessing HDP in future studies.