title: Deaths and injuries due to the earthquake in Armenia: a cohort approach.
abstract: BACKGROUND
  This is the first population-based study of earthquake injuries and deaths that uses a cohort approach to identify factors of high risk. As part of a special project that collected data about the population 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 deaths 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 earthquake, height of the building, and location within the upper floors of the building were risk factors for injury and death in the univariate analyses. However, multivariate analyses, using different models, revealed that being in the Spitak region (odds ratio [OR] = 80.9, 95% confidence interval [CI]: 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 earthquake (OR = 10.1, 95% CI: 6.5-15.9) were the strongest predictors for death. Although of smaller magnitude, the same factors had significant OR for injuries. Building height was more important as a factor in predicting death than the location of the individual on various floors of the building except for being on the ground floor of the building which was protective.
  
  
  CONCLUSIONS
  Considering that most of the high rise buildings destroyed in this earthquake were built using standard techniques, the most effective preventive effort for this disaster would have been appropriate structural approaches prior to the earthquake.
authors.affiliation: Department of Epidemiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
authors.forename: H K
authors.initials: HK
authors.lastname: Armenian
authors.forename: A
authors.initials: A
authors.lastname: Melkonian
authors.forename: E K
authors.initials: EK
authors.lastname: Noji
authors.forename: A P
authors.initials: AP
authors.lastname: Hovanesian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001136:Armenia / Q000453:epidemiology; D002028:Building Codes; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004189:Disaster Planning; D004190:Disasters; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality; D018570:Risk Assessment; D014947:Wounds and Injuries / Q000453:epidemiology*