Skip to main content
hpa logo
Topics A-Z:
Search the site:

Expert guidance

Chemical hazards
Building related damage and risks
Health implications associated with fires
Cold weather risks
Health Protection advice on water and food during extreme weather event or natural hazard
Other health guidance
Mental Health

Value of having a registry of victims and responders

Chemical hazards

PHE – Incident Checklists

Advice on chemical hazards for health protection

  • Compendium of Chemical Hazards. The Compendium of Chemical Hazards  is the PHE online information resource for those involved in advising and responding to chemical incidents, providing chemical-specific general information, incident management information, and toxicological information.
  •  Internation Programme on Chemical Safety International Chemical Safety Cards – (ICSCs) [external link]
  • US National Library of MedicineTOXNET. Databases on toxicology, hazardous chemicals, environmental health, and toxic releases. [external link]
  • Chemical Agents – Centers for Disease Control and Prevention Emergency preparedness and response: Chemical Agents. [external link]
  • Wireless Information System for Emergency Responders (WISER) – WISER is a system designed to assist first responders in hazardous material incidents. WISER provides a wide range of information on hazardous substances, including substance identification support, physical characteristics, human health information, and containment and suppression advice. [external link]

Generator related risks

Building related damage and risks

  • Respiratory – Exposure to small particle matter resulting from the collapse of buildings can lead to respiratory problems
    WHO: Hazard prevention and control in the work environment: Airborne dust  [external link]
  • Building collapse – CHaPD Report 4 [external link]. Acute and massive building collapse. A case study of the World Trade Centre towers' collapse, examining health and environmental consequences and highlighting some of the unique aspects of an acute building collapse, particularly the chronic aspects of the event including decontamination and clean up, environmental monitoring, and epidemiological follow up. Chemical hazards, populations at risk, and health effects are presented.

Health implications associated with fires

  • A Toxicological Review of the Products of Combustion (PDF, 159 KB) (HPA – HPA CHaPD 004). This detailed review document considers the toxicity of combustion products and aims to identify generalisations which may be made regarding the toxicity of common products present in fire smoke, with respect to the combustion conditions (temperature, oxygen availability, etc.), focusing largely on the adverse health effects to humans following acute exposure to these chemicals in smoke.
  • Shelter and evacuation – US Environmental Protection Agency.Evidence base supporting shelter-in-place advice and discussing expedient shelter-in-place and evacuation.  
    Questions and Answers: EPA Shelter-in-Place Research. [external link]     
  • Burns – Burns can result from fires caused by the disaster or subsequent use of stoves inside buildings. 
    National major incident plan for burn injury  [external link]       
    British Burn Association [external link]

Cold weather risks

Health Protection advice on water and food during extreme weather event or natural hazard

Other health guidance

Mental Health

A devastating event such as an earthquake will expose individuals to traumatic and stressful scenes and experiences. This is likely to have implications for emotional and psychological wellbeing and is perfectly normal.  In a minority of individuals, psychological and emotional reactions may remain during the weeks and months after the incident and after individuals from responding agencies have returned home. There are a number of well-established, evidence-based sources of advice and guidance relating to helping to manage the psychosocial consequences of a traumatic event:


Deaths from tsunami injuries occur in three phases:

  1. injuries within the first few minutes that are incompatible with life (severe head, chest, and spine injuries)
  2. immediate complications set in over the next few minutes to hours (such as bleeding, lung collapse, and blood clots in the lung).
  3. Death from delayed complications over the coming days that are mostly associated with infectious disease (such as wound infections and aspiration pneumonia)

Keim ME.  Cyclones, tsunamis, and human health. The key role of preparedness. Oceanpgraphy 2006; 19 (2):40-9.  [external link: pdf file]

In the section on general practical advice provided for the Haiti earthquake risk assessment 2010, HPA states that dead bodies are unlikely to pose a significant health risk. 

  • This belief that dead bodies pose a health risk is wrongly promoted by the media, as well as some medical and disaster professionals.
  • Dead bodies do not cause epidemics after natural disasters.
  • The political pressure brought about by these rumours of health risks associated with dead bodies causes authorities to use unnecessary measures such as rapid mass burials and spraying so-called 'disinfectants'.
  • The consequences of mismanagement of the dead include mental distress and legal problems for relatives of the victims.
  • The surviving population is much more likely to spread disease.
  • Although dead bodies in themselves are unlikely to pose a risk, be aware of possible chemical contamination from the use of 'disinfectants' such as caustic soda.

Value of having a registry of victims and responders

The importance of systematically following up the health outcomes of individuals involved in major incidents has been well documented in the scientific literature. The steps required to develop such a register could be:

  1. Consider how to identify the population affected.
  2. Consider how to recruit the population affected onto the health register.
  3. Consider how the information gathered would be used, including:
    a. To offer appropriate advice on relevant interventions
    b. To facilitate access to appropriate services

The following articles point to the value of registries of victims and responders:

The following articles and websites concern the practicalities of the process of setting up a health register