Public health lessons from the Bhopal chemical disaster

Article Abstract:

The terrible tragedy at Bhopal, India in 1984, when a chemical tank exploded and the chemicals killed and injured thousands of people, has much to teach us about epidemiology, toxicology, health economics, medical ethics, and other special topics in the arena of public health. A report in the December 5, 1990 issue of The Journal of the American Medical Association reviews the medical literature concerning the effects of the disaster. The health effects of natural disasters are very difficult to analyze epidemiologically, since these incidents are succeeded by chaos, poor communication, and fallibility of data collection methods. Epidemiologists usually concentrate on morbidity and mortality, exposure (to the agent of disaster), and environmental damage. The larger goals include identification and treatment of those affected; improving contingency planning for the future; determining short- and long-term health effects; and linkage of exposure to health effects for litigation or reimbursement. Better mortality estimates in Bhopal could have been made if a team of interviewers had been sent out immediately afterwards to gather data. While it may seem relatively simple to collect information when people are less mobile than usual, this is not the case: records are often missing and equipment to evaluate environmental damage may not exist. Accurate determination of the amount of exposure is particularly difficult unless a biological marker, such as a blood level of the toxin, can be obtained. Such was not the case at Bhopal. The report regrettably states that the data concerning morbidity and mortality are not ''firm'', a state of affairs that ultimately compounds the tragedy. Successful epidemiological investigation after disasters results from good planning beforehand. Prevention, though, will always be preferable to learning from a tragedy what should have been done. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Research, Case studies, Evaluation, Workplace accidents, Disaster relief, Epidemiological research, Cross sectional studies, Bhopal Union Carbide Plant Disaster, Bhopal, India, 1984

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Caloric Imbalance and Public Health Policy

Article Abstract:

The US must develop a national obesity prevention strategy. More than half of US adults are overweight, and 22% are obese. The number of overweight and obese Americans has increased dramatically and genes alone are not responsible. More likely, Americans are simply eating more calories and exercising less. The best approach is to prevent obesity in children. The best way to do this is to bring back physical education in the schools. Adults also need to become more physically active, but this may involve re-designing communities so there are more walking and biking trails.

Editorial, Prevention, Obesity

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Current and Future Public Health Challenges

Article Abstract:

The US Centers for Disease Control and Prevention list 10 public health goals for the 21st century. They include designing a rational health care system, eliminating health disparities, focusing on children, prolonging life, promoting physical activity and a healthy diet, protecting the environment, responding to emerging infectious diseases, reducing violence, promoting mental health, and using technological advances wisely.

Science and technology policy, Public health, 21st century AD, United States. Centers for Disease Control and Prevention

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