DEATHS AND INJURIES DUE TO THE EARTHQUAKE IN ARMENIA - A COHORT APPROACH

Background. This is the first population-based study of earthquake inj uries and deaths that uses a cohort approach to identify factors of hi gh risk. As part of a special project that collected data about the po pulation in the aftermath of the earthquake that hit Northern Armenia on 7 December 1988, employees of the Ministry of Health working in the earthquake zone on 7 December 1988, and their families, were studied as a cohort to assess the short and long term impact of the disaster. The current analysis assesses short term outcomes of injuries and deat hs as a direct result of the earthquake Methods. From an unduplicated list of 9017 employees, it was possible to contact and interview 7016 employees or their families over a period extending from April 1990 to December 1992. The current analysis presents the determinants of 831 deaths and 1454 injuries that resulted directly from the earthquake in our study population of 32 743 people (employees and their families). Results. Geographical location, being inside a building during the ea rthquake, height of the building, and location within the upper floors of the building were risk factors for injury and death in the univari ate analyses. However, multivariate analyses. using different models, revealed that being in the Spitak region (odds ratio [OR] = 80.9, 95% confidence interval [GI] : 55.5-118.1) and in the city of Gumri (OR = 30.7, 95% Ci : 21.4-44.2) and inside a building at the moment of the e arthquake (OR = 10.1, 95%;, GI:6.5-15.9) were the strongest predictors for death. Although of smaller magnitude, the same factors had signif icant On for injuries. Building height was more important as a factor in predicting death than the location of the individual on Various flo ors of the building except for being on the ground floor of the buildi ng which was protective. Conclusions. Considering that most of the hig h rise buildings destroyed in this earthquake were built using standar d techniques, the most effective preventive effort for this disaster w ould have been appropriate structural approaches prior to the earthqua ke.