The Association Between Roofing Material and Head Injuries During the 2008 Wenchuan Earthquake in China
Received 29 August 2008; received in revised form 4 November 2008 and 27 January 2009; accepted 30 March 2009. published online 27 April 2009.
Study objective
We analyze the spectrum of earthquake-related head injuries resulting in hospitalization and arising from the 2008 Wenchuan Earthquake in China. An additional objective is to assess injury patterns associated with 2 types of roofing structures found in this region of China.
Methods
This descriptive study included data on trauma patients at 8 hospitals in Jiangyou for the 14 days immediately after the earthquake. The patients were either from Jiangyou County, which experienced a modified Mercalli intensity level of VIII, or from Beichuan County (Mercalli intensity level of X). Of the 5,775 earthquake-related injuries, 1,484 (25.7%) involved the head and were classified into 4 categories. Seven injury mechanisms were also analyzed to determine the association with the 4 types of head injuries.
Results
Scalp injuries (43%) were the most common type of head injuries, followed by facial injuries, 482 (32%), intracranial injuries, 218 (15%), and skull fractures, 117 (8%). Differences in injury type and cause were apparent, with scalp injuries being more common (49%) in Jiangyou than in Beichuan (30%) and falling clay tiles contributing more (40%) to this injury in the former city than the latter (6%). In contrast, precast concrete plank roofing caused 20% of scalp injuries in Beichuan compared with 3% in Jiangyou.
Conclusion
Scalp injuries were the most common head injury type. Falling clay roofing tiles and precast concrete plank roofs are important injury mechanisms, and their contribution may reflect differences in building construction.
aDepartment of Oral and Maxillofacial Surgery, Fourth Military Medical University, School of Stomatology, Xi'an, PR China
bDepartment of Prosthodontics, Fourth Military Medical University, School of Stomatology, Xi'an, PR China
cDepartment of Orthodontics, Fourth Military Medical University, School of Stomatology, Xi'an, PR China
dDivision of Epidemiology, Fourth Military Medical University, Xi'an, PR China
Address for correspondence: Yi-min Zhao, PhD, Fourth Military Medical University, School of Stomatology, 145 West Chang Le Road, Xi'an 710032, PR China; 86-29-84776001, fax 86-29-83223047
Supervising editor: Robert A. De Lorenzo, MD, MSM
Author contributions: YMZ conceived of the idea for the article and obtained research funding. LW, DLL, and YPL reviewed the literature on the subject. LW, DLL, JC, and JHW undertook the collection of the data; DLL chaired the data oversight committee. LW, DLL, and LSH wrote and reviewed the article, as well as the references and the tables. YL and MC provided statistical advice and analyzed the data. LW and DLL contributed equally to this work and should be regarded as joint first authors. LW and YMZ take responsibility for the paper as a whole.
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This study was funded by a grant from the Army of China (to Dr. Yi-min Zhao).
Publication date: Available online April 24, 2009.
ABSTRACT