title: Long-term effects of the Niigata-Chuetsu earthquake in Japan on acute myocardial infarction mortality: an analysis of death certificate data.
abstract: OBJECTIVE
  To determine if the Niigata-Chuetsu earthquake of October 2004 increased long-term mortality from acute myocardial infarction (AMI).
  
  
  METHODS
  A comparative study of mortality rates before and after the earthquake, as well as between the disaster and control areas, by analysing death certificate data from 1 October 1999 to 30 September 2007.
  
  
  METHODS
  The disaster area and a control area in Niigata Prefecture (n = 2 448 025 in 1 October 2004) in Japan.
  
  
  METHODS
  The total population of Niigata Prefecture observed for five years (12 333 429 person-years) before and three years (7 279 076 person-years) after the earthquake.
  
  
  METHODS
  Mortality from AMI (ICD-10, I21 and I22).
  
  
  RESULTS
  Overall mortality rates from AMI five years before and three years after the earthquake in the disaster area were 47.3 and 53.9 per 100 000 person-years, respectively. Change (+6.6 or +14.0%) was significantly different (p = 0.0008), compared to the control area, where mortality rates were 42.5 and 42.6 per 100 000 person-years, respectively, and was not significantly different (p = 0.9028). In men, a change in AMI mortality before and after the earthquake in the disaster area was +7.1 per 100 000 person-years (+13.4%, p = 0.0172), and +2.0 (+4.2%, p = 0.2362) in the control area. In women, a change in AMI mortality in the disaster area was +6.2 per 100 000 person-years (+14.9%, p = 0.0184) and -1.6 (-4.2%, p = 0.2735) in the control area.
  
  
  CONCLUSIONS
  The Niigata-Chuetsu earthquake significantly increased long-term mortality from AMI in both men and women. Clinicians and policymakers in public health must recognise the need for long-term prevention of AMI in earthquake disaster areas.
authors.affiliation: Department of Community Preventive Medicine, Niigata University, Chuo-ku, Niigata City 951-8518, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Nakagawa
authors.forename: K
authors.initials: K
authors.lastname: Nakamura
authors.forename: M
authors.initials: M
authors.lastname: Oyama
authors.forename: O
authors.initials: O
authors.lastname: Yamazaki
authors.forename: K
authors.initials: K
authors.lastname: Ishigami
authors.forename: Y
authors.initials: Y
authors.lastname: Tsuchiya
authors.forename: M
authors.initials: M
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002908:Chronic Disease; D004190:Disasters; D055866:Earthquakes / Q000401:mortality*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000523:psychology; D012307:Risk Factors; D017678:Sex Distribution; D013315:Stress, Psychological / Q000209:etiology* / Q000401:mortality; D015996:Survival Rate