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Year : 2017  |  Volume : 5  |  Issue : 2  |  Page : 41-45

Impacts of flood on health: Evidence from northern Iran

1 Attendant Expert of Emergencymanagemen Center (EMS) for Golestan University of Medical Sciences, Golestan Province, Iran
2 Assistant Professor of Faculty of Economics and Department of Management, Bahonar University of Kerman, Iran
3 M.Sc in Environmental Geology and Attendant Expert of Kerman Studying and Training Crisis Management Center, Iran
4 Nurse of 5-Azar Hospital of Golestan University of Medical Sciences, Golestan Province, Iran
5 Graduate Masters in Crisis Management of Bahonar University of Kerman, Kerman, Iran

Date of Web Publication31-Aug-2017

Correspondence Address:
Ali Mohajervatan
Golestan University of Medical Sciences, Golestan Province
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijhsdm.ijhsdm_4_17

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Introduction: Unexpected events such as floods and earthquakes have long existed in the world and have imposed large losses to society. Every year, these events endanger lives and property of many people all over the world. Floods are the most common of all natural disasters which their consequences depend on factors such as flood causes, geographical location, economic situation, as well as society vulnerability. The aim of this study was to assess the vulnerability of different regions of the Golestan province of Iran to the flooding crisis. Methodology: This retrospective study was done to collect information in the census of all the documentation floods occurred from 1991 to 2013. Results: The results of this study show that 106 floods with frequency 514 have occurred in Golestan province and most severe floods have occurred in the first half of the years (69.8%) occurred. Most losses of human life's due to flooding occurred in the first half of the years. Conclusion: Flood has major impact on health in Golestan province. Therefore, the development of awareness and educational programs on natural disasters must be a priority, because human development largely depends on the ability of society to reduce its vulnerability.

Keywords: Crisis, flash flood, natural hazards, vulnerability

How to cite this article:
Mohajervatan A, Karnama A, Sadeghi Z, Hosseini Z, Alizad F, Dehghani M. Impacts of flood on health: Evidence from northern Iran. Int J Health Syst Disaster Manage 2017;5:41-5

How to cite this URL:
Mohajervatan A, Karnama A, Sadeghi Z, Hosseini Z, Alizad F, Dehghani M. Impacts of flood on health: Evidence from northern Iran. Int J Health Syst Disaster Manage [serial online] 2017 [cited 2021 Feb 24];5:41-5. Available from: https://www.ijhsdm.org/text.asp?2017/5/2/41/213886

  Introduction Top

Natural hazards are defined as extreme events that originated on Earth, the lithosphere, hydrosphere, or atmosphere; they are a threat to people and property. The effects of natural hazards in the community are considerable and are clearly increasing. The deaths from storms, floods and earthquakes, and such natural hazards are more than the social and political issues and internal conflicts. Hence, it is clear that more people are affected.[1] Most people exposed to the effects are on developed and developing regions, are from the low-income economic and social spectrum.[2] Iran is a developing country and one of the most prone geographical areas which disasters happen in it. Approximately, 90% of its population is exposed to natural disasters, and in recent decades, in addition to local flooding and slight earthquakes, every 10 years, a national disaster will occur.[3] Natural disasters with devastating effects mainly destroy the ability of a society in ensuring needs and demands.[4] Effects and damage caused by them have the dramatic and undeniable impact on the lives and health of humans so that every year, a large number of people are died and dozens of them wounded and disabled.[5] These events offer unique series of challenges which need a developed series of guidelines particularly when responding to them involve many organizations.[6] During the last four decades, natural disasters such as droughts, floods, and storms are cause of death of human beings, the loss of livelihoods, the economic damage and the destruction of social infrastructure and environmental degradation.[7] In 10 years of the end of 2011, flooding is most common type of disaster in the world, and the cause of half of all victims of natural disasters and economic losses close to $185 billion.[8] Increasing the frequency and severity of flooding is due to rising sea levels and more frequent and intense rainfall;[9] also, one of the most frequently cited impacts of future climate change is a potential increase in the river flood hazard.[10] For example, a warmer climate would increase the risk of floods.[11] In addition, the increasing of urbanization extent means that people are going to be more vulnerable to flood.[12] Flood consequences are including the more patient, making people vulnerable to illness, death, and social disruption and economic, especially in low-income countries, including developing countries that are highly vulnerable.[13] The consequences of the floods on the health depend on factors such as geographical and socioeconomic and also the vulnerability of the affected population [12],[14] that according to the dimension of time are classified into three categories: short-term, medium-term, and long-term. In the short-term consequences of floods include drowning, burns, skin rashes, and outbreaks of digestive infections and respiratory infections.[15],[16],[17] The outcomes in the medium term are including infected wounds, complications from injuries, poisoning, starvation, weakness of mental health, and infectious disease.[12] The potential legacy left by the flood in the long term which can be noted, is chronic illness, disabilities, mental health problems, and nutritional deficiencies.[12],[18] Golestan province, with an area of over 20,437/7 km 2, between 53° and 57 min to 56° 22 min east longitude and 36° and 30 min to 38° and 8 min north latitude in the northern part of the country is located. The province has accounted for 1.2% of the country, is limited from the North to Turkmenistan, from southern Semnan province, from East to North Khorasan province and from the West to the Caspian Sea and Mazandaran province.[19] The province is part of the Caspian Sea basin, which has formed 11.7% of the catchment area of the Caspian Sea and includes Atrak Sofla watershed, Gorgan River, the Ghareh Sou, the East Bay Gorgan, and is Neka River Olya. The area of this watershed is different so that the largest basin in the province is catchment of Gorgan River with 10,120 km 2, and the rest of the basins based on their extent are the catchment of Sofla Atrak by 8600 km 2 and the catchment of Gharehsou 1610 km 2, the catchment of the East Bay Gorgan 340 km 2, and catchment of Olya Neka river with 330 km 2.[20] Golestan province is the most prominent areas in Iran that we saw rain and storm is short in warm seasons. In most cases rainfall has led to severe flooding and devastating especially in the eastern part of the province, that causes large financial damages and human losses,[21] Mr. Lashkary said in a study that the pattern of rainfall in the province follow four types. The first pattern is migratory high pressure pattern, that is, cold advection over the Caspian Sea to European migratory high pressure system and hot and humid convection from East and South East by monsoon low pressure system at ground level and entrance of cold air in the Nawa divergence area of the North Russia which is in the upper levels of the atmosphere over the Caspian Sea, so among floods caused by the system can point to flood August 11, 2001 (according to Iranian calendar 20 Mordad 1380). The second pattern is the pattern of low pressure Sudanese entrance of European migratory high pressure system from North East and flowing polar cold air on the one hand and the entrance of the Sudanese low pressure system from South and South West on the other hand also entrance subtropical high elevation system to the central parts of the Caspian Sea in the middle layers of the atmosphere and locating the Caspian Sea in the Nawa divergence area of the North Aral created this system that the happened flood on August 11, 2001 (according to Iranian calendar 20 Mordad 1380), is caused by this system. The third model is Siberian high pressure caused by cold air advection on the Caspian Sea by the Siberian high pressure system and hot and humid convection in the East and Southeast of the country on the surface and continued hot and humid convection and entrance cold air in behind of the Nawa divergence area on the Caspian Sea. The flood caused by the pattern can be named 1 to 3 September 2000. The fourth type is European pressure pattern and Siberian high pressure, which is caused by the advection of cold air on the surface by European migratory and the Siberian high pressure systems, and warm air and locating the area in front of the deep Nawa of the Black Sea region, along with the heat ridges of middle levels. He concluded that rainfall causing floods in the province follow the four mentioned patterns. Hence, the most severe rainfall follows the second pattern.[21] The study of natural disasters in the past provides the opportunity to have sufficient knowledge and information to prepare for the next disaster.[22] Therefore, this study has aimed to assess the consequences of the floods on the health in the province that a clear picture of the effects of floods on human health as well as an understanding of natural disasters, especially floods during the past two decades displayed in the province.

  Methods Top

This retrospective study was to gather information and documentation on a census of all floods occurred between 1991 and 2013 has been done in the Golestan province. To collect information on the basis of the available information in the health centers, the Department of Natural Resources has been done. Excel Worksheet was used for data entry. SPSS software was used to analytical statistics. A conventional significance level of P < 0.05 was used. To map vulnerable areas, floods spatial data by GIS software is provided on [Figure 2]. The data in this paper were obtained from the Form flood country. The survey was conducted in all districts of Golestan province [Figure 1]. In each district, a severely flooded commune and a less affected commune (control commune) were selected with reference to the district's Form flood, all information related to the years 1991–2013 has been recorded. There were 514 forms checked out. Data quality was controlled by the field supervisors as well as by the investigators of this survey.
Figure 1: Location map of the study area in Iran

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Figure 2: Distribution of deaths caused by floods in the Golestan province

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Ethical considerations

Before collecting data, the protocol was submitted to the internal Faculty of Management and Economics Committee Bahonar University adopted. Information has been collected in a neutral investigator.

  Results and Discussion Top

The results of this study showed that in during 1991 till 2013 in total of 106 cases of rainfall led to flooding had happened in the Golestan province. The most frequent occurrence of rains led to flooding is 13 cases in 2012 (26.12%) and the lowest incidence is related to 2013. The spatial frequency of floods was 514 cases during the study [Table 1].
Table 1: Frequency of floods in the years 1991-2013

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The results of our study showed that although there is varied climatic in the province, rain was the significant origin for 100% of occurred floods.

Frequency of floods on the season

The results of this study showed that 118 floods happened in July (23%) which is the most frequency. Respectively among other months, floods have occurred in September with a frequency of 85 (16.5%), abundance of 83 (16.1%) in October and August with a frequency of 62 (12.1%) during the study period, also February without flooding among the months of the year to be allocated. According to the results of our study: The highest incidence of floods during the year is related to the summer season with a frequency of 265 (51.6%). Winter flooding with 20% (nine cases) had the lowest incidence during the study period. Three hundred and fifty-eight cases (69.8%) had happened in the first six months and the rest into the second half of year [Table 2].
Table 2: Frequency of floods on the season (n=514)

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Relationship between the number of casualties and months

The results of this study showed the relationship between the number of casualties and months of the year showed the greatest human losses in August with a frequency of 375 people 92.6%) and least abundant in November with an abundance of one (0.2%) that the findings determined statistically significant (P = 0.00).

During the 23-year study 514 floods occurred, the information of time interval of rainfall and flood has been recorded in 418 cases that have been analyzed [Table 3]. Studied floods show the most frequent floods (28.9%) have an interval of more than 360 min between the start the end of the precipitation.
Table 3: The time interval of start rainfall and start flooding of area (n=418)

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Flood and human

The results of this study showed that during the study period, 29 cases of floods in Golestan province (5.6%) had fatal damage. Accordingly, 416 people killed after the flooding, 261 injured, 92 missing. Our results showed that a total of 29 floods led to casualties, only depth of flooding of 18 cases has been documented.

Relation death and flooded depth

The analysis was conducted based on 18 floods, and the results showed that 75.4% of the human losses had happened in areas with 300 cm depth of flooding, which showed statistically significant difference (P = 0.00) [Table 4].
Table 4: Frequency of human losses based on the flooded depth

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Our results show that everything we move from west to east in Golestan province The number of deaths from floods is increased and Major floods occur in the foothills where the concentration of population is located. According to the results of this study, in Golestan province with cultural, social, geographical, and specific ethnic diversity, flooding is one of the main disasters. The study results showed that rainfall has been caused 100% of the flooding and during the study floods caused by waves and melting snow have not occurred. Furthermore, findings determined that in 1991–2013, 106 precipitations led to the flood which happened in 514 areas. During the past 22 years, flooding occurred in average of 23 points per year and had economic losses over 667,912/3674 billion. It seems that our results would agree with statistics released by the international (in the 10 years before 2011) that the flood was responsible for almost half of the victims of natural disasters and cause economic losses of nearly 185 billion.[9] The number of recorded floods in 1991 was three flood; the statistic in 2012 has reached to 13. It seems that flooding has caused by increasing in the frequency and severity of rainfall and rising sea level.[12] In addition, extending of urbanization means that people are more at risk of flooding.[13] Check occurred floods in Golestan province showed that most floods had happened in summer (with 51.67%). During the months of the year, the floods with a frequency of 23% were in July. The results of our analysis of flooding occurred in different parts of the province showed that the interval time of starting precipitation until starting flood, in less than 27% of cases at different points was less than 60 min. Moreover, in more than 70% of cases was greater than 60 min. The results of this study showed that in less than 18% of cases, the duration of flood waterlogging was less than 360 minutes(6 hours) And in other cases more than 360 minutes(6 hours). The immediate consequences of the floods on the health in the Golestan were including deaths and injuries. Our study showed that during the study period, 416 deaths, 261 injured and 92 people were lost. It seems that the impression of placing people at risk of flooding would be caused kills and injuries, is true in Golestan province.[9] Floods in Golestan province have caused deaths more than other disasters and natural calamities. Comprehensive study on the deaths of other natural disasters does not exist in Golestan province, which determines ratio of deaths caused by floods to all deaths, but it seems that our result agrees with the findings of other studies,[9],[23] in which, floods are responsible for 40%–50% of deaths from natural disasters. The results of this study showed that most deaths in floods were 254 people and related to the flood in August 2001, although this study due to lack of information about the medium- and long-term consequences has examined only the immediate effects of the floods on the health sector. However, it is thought that flood will increase plethora of diseases and expose people at risk of disease, death, social disruption, and economic, and a constant psychological stress for achieving health services as well. The immediate health effects of floods recognized include: drowning, injuries, acute asthma, skin rashes, diarrhea and vomiting and respiratory infections. Medium-term effects of flooding include wound infections, complications from injuries, poisoning, poor mental health, infectious disease, and hunger.[12],[24] Long-term chronic illness, disability, and poor mental health, poverty-related diseases including malnutrition threaten society. Flooding long-term effects on health from disease or other damage might be even more important because the psychological problems caused by flood events may subside for a longer time after the flood continues.[12],[24] It seems that potential need for understanding the medium- and long-term effects of floods remains in Golestan province and it is necessary to keep in mind these aspects for further study. Our findings suggest that mitigation program and also increase the preparation has affected on the decreasing of the number of deaths from flooding in the past to the present, but it seems that the need to improve understanding of hazard and the health damage and its consequences on people's health still remains potential. Our results show that there is a significant correlation in the relationship between the flood (of the location) and the time interval of rainfall to start flooding; About 75% of the deaths occurred in floods, the time interval between the start of rainfall and the beginning of the flood was very shorted. This shows that flash floods have a strong role in the creation of human damage. The findings corresponded to the study last [25] where flash floods occurred in summer and can cause serious injuries.[25] It seems that the employed strategy for controlling of these floods should vary with other floods and be more focused on prediction and early warning to affected areas, that is based on flood evacuation; in this way, we will see a decline in injuries. The results of this study show that there is a significant relationship between the mortality and the depth of the flooding caused by the floods. This means that more than 75% of deaths occurred in floods of more than 300 cm flooding depth, and so increasing the water level plays an important role in increasing death. Using the ways, which are continuously exploring the flowing water volume in rivers and flood areas, can be effective in evacuating affected areas and thus reducing the damage. It seems that the development of awareness programs and training in natural disasters in Golestan province Must be given priority. Programs to improve the methods of forecasting and warning dissemination should be expanded and intensified.[26]

  Conclusion Top

Flood has major impact on health, agriculture, and housing in Golestan province. Therefore, the development of awareness and educational programs on natural disasters must be a priority, because human development largely depends on the ability of society to reduce its vulnerability hazard.


This article is extracted from Master's Thesis of shahid bahonar Kerman, Iran, and the authors would like to thank all those who have contributed to this article.

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  [Figure 1], [Figure 2]

  [Table 1], [Table 2], [Table 3], [Table 4]


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