Medicolegal Death Scene Investigations after Natural Disaster- and Weather-Related Events: A Review of the Literature

Abstract

Background The number of disaster-related deaths recorded by vital statistics departments often differs from that reported by other agencies, including the National Oceanic and Atmospheric Administration-National Weather Service storm database and the American Red Cross. The Centers for Disease Control and Prevention (CDC) has launched an effort to improve disaster-related death scene investigation reporting practices to make data more comparable across jurisdictions, improve accuracy of reporting disaster-related deaths, and enhance identification of risk and protective factors. We conducted a literature review to examine how death scene data are collected and how such data are used to determine disaster relatedness. Methods Two analysts conducted a parallel search using Google and Google Scholar. We reviewed published peer-reviewed articles and unpublished documents including relevant forms, protocols, and worksheets from coroners, medical examiners, and death scene investigators. Results We identified 177 documents: 32 published peer-reviewed articles and 145 other documents (grey literature). Published articles suggested no consistent approach for attributing deaths to a disaster. Researchers generally depended on death certificates to identify disaster-related deaths; several studies also drew on supplemental sources, including medical examiner, coroner, and active surveillance reports. Conclusions These results highlight the critical importance of consistent, accurate data collection during a death investigation. Review of the grey literature found variation in use of death scene data collection tools, indicating the potential for widespread inconsistency in data captured for routine reporting and public health surveillance. Findings from this review will be used to develop guidelines and tools for capturing disaster-related death investigation data.

Mortality Reporting and Rumor Generation: An Assessment of Crisis and Emergency Risk Communication following Hurricane María in Puerto Rico

“…This expectation of having timely and accurate hurricane-related death counts immediately following a catastrophic disaster represents a failure among scientists and communicators to convey the inherent superiority of excess mortality estimation over "body counts" in complex disaster scenarios where surveillance systems and death certification processes are disrupted (Checchi & Roberts, 2008). Currently, there is little to guide communicators in making this distinction apparent to public audiences; while there is scientific literature related to mortality surveillance (Choudhary, 2012;Farag et al, 2013;Kim et al, 2017;Rocha et al, 2017;Seil et al, 2016) and documenting cause of death (Centre for Research on the Epidemiology of Disasters [CRED], 2016;Lakkireddy et al, 2004;Phillips et al, 2014;Wexelman et al, 2013), there is a paucity of studies exploring the specific concept of communicating disaster mortality to the public. There is no literature base that examines how death counts from a disaster should be communicated to the media, how to best explain information gaps that are common following disasters, how death counts may evolve post-disaster, or how to explain the science behind excess death estimates and what we can or cannot infer from these estimates.…”

Mortality risks associated with floods in 761 communities worldwide: time series study

“…Traditionally, a surveillance approach is used to estimate deaths attributable to floods, but this method has been shown to systematically underestimate numbers 4. The surveillance approach searches death records for specific mentions of links to a flood event and may refer to other documents, including government and media reports, to identify deaths that can be attributed to the flood event 5. This approach can well capture deaths caused by direct physical forces of floods or from unintentional causes linked to hazards created by flood events, such as drowning, electrocution, and hypothermia,4 but a substantial number of deaths from natural causes can be overlooked.…”

Assessing United States County-Level Exposure for Research on Tropical Cyclones and Human Health

“…These studies characterize tropical cyclone health impacts using fatality data aggregated in large part from disaster-related mortality ascertainment and surveillance conducted by agencies like the U.S. Centers for Disease Control and Prevention, the U.S. National Weather Service, and local vital statistics departments. These fatality data are based on case-by-case ascertainment: identifying and characterizing deaths for which there is a clear link with a disaster through death certificate coding or other indicators ( Rocha et al. 2017 ).…”