title: Impact of 2003 power outages on public health and emergency response.
abstract: BACKGROUND
  In 2003, a major power outage occurred in the midwest and northeast United States affecting some 50 million people. The power outages affected multiple systems in state and local municipalities and, in turn, affected public health.
  
  
  METHODS
  Semi-structured interviews were conducted using open-ended questionnaires, with a convenience sample of state- and locally selected subject matter experts from Ohio, Michigan, and New York. Respondents were interviewed in groups representing one of five areas of interest, including: (1) emergency preparedness; (2) hospital and emergency medical services; (3) municipal environmental systems; (4) public health surveillance and epidemiology; and (5) psychosocial and behavioral issues. The reported positive and negative impacts of the power outage on public health, medical services, and emergency preparedness and response were documented. Responses were categorized into common themes and recommendations were formulated.
  
  
  RESULTS
  The amount of time that the respondents' locations were without power ranged from <1 hour to 52 hours. Many common themes emerged from the different locations, including communications failures, alternate power source problems, manpower and training issues, and psychosocial concerns. There was minimal morbidity and mortality reported that could be attributed to the event.
  
  
  CONCLUSIONS
  Power outages negatively impacted multiple municipal infra-structures, and affected medical services, emergency response, and public health efforts. Previous federal funding positively impacted public health and emergency response capabilities. Recommendations were made based upon the common themes identified by the respondents. Recommendations may assist state and local health departments, medical service providers, and emergency responders in planning for future power outage problems.
authors.affiliation: Division of Emergency and Environmental Health Services, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. jckile@aol.com
authors.forename: James C
authors.initials: JC
authors.lastname: Kile
authors.forename: Stephen
authors.initials: S
authors.lastname: Skowronski
authors.forename: Mark D
authors.initials: MD
authors.lastname: Miller
authors.forename: Stephan G
authors.initials: SG
authors.lastname: Reissman
authors.forename: Victor
authors.initials: V
authors.lastname: Balaban
authors.forename: Richard W
authors.initials: RW
authors.lastname: Klomp
authors.forename: Dori B
authors.initials: DB
authors.lastname: Reissman
authors.forename: Hugh M
authors.initials: HM
authors.lastname: Mainzer
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Dannenberg
mesh_terms: D004189:Disaster Planning; D017598:Efficiency, Organizational; D011211:Electric Power Supplies / Q000600:supply & distribution*; D004560:Electricity; D004630:Emergencies; D004632:Emergency Medical Services / Q000458:organization & administration*; D011634:Public Health; D014481:United States