On October 17, 1989, at 5:04 p.m. Pacific daylight time, an
earthquake registering 7.1 on the Richter scale, with an
epicenter in the Loma Prieta section of the San Andreas fault,
occurred in northern California (Figure 1). The earthquake
released seismic energy equivalent to a 7-megaton nuclear
explosion, generated lateral acceleration forces exceeding 60% of
the earth's gravitational pull, and caused an estimated $5.6
billion in property damage (excluding damage to highways,
bridges, and state office buildings) in the seven disaster
counties (Alameda, Monterey, San Benito, San Francisco, San
Mateo, Santa Clara, and Santa Cruz (combined January 1, 1989,
resident population approximately 4,672,300) (1)).
Using contact information in Medical Examiner and Coroner
Jurisdictions in the United States (2), public health officials
asked county medical examiners and coroners (ME/Cs) in the
disaster counties to report 1) the number of earthquake-related
deaths investigated in their jurisdictions from October 17
through October 31 and 2) information about the demographic
characteristics, cause, and circumstance of each death. There is
no universally accepted definition of an "earthquake-related
death"; for this report, the determination was made by each
county ME/C.
County ME/Cs in the disaster area reported 63
earthquake-related deaths (60 directly related and three
indirectly related). Of the 60 directly related deaths, 57 (95%)
resulted from injuries sustained within 2 minutes of the
earthquake; three resulted from injuries sustained within 8 hours
of the earthquake (Table 1). Three deaths occurring within 24
hours of the earthquake were indirectly related (Table 1). The
highest county-specific mortality rate for all earthquake-related
deaths occurred in Alameda County (3.4 per 100,000 population)
(Figure 1, Table 2).
Reported by: DP Cain, CC Plummer, Sheriff-Coroners Office,
Alameda County; DB Cook, Sheriff-Coroners Office, Monterey
County; HS Nyland, Sheriff-Coroners Office, San Benito County; JE
Surdyka, BG Stephens, MD, Medical Examiner-Coroners Office, San
Francisco County; PB Jensen, Coroners Office, San Mateo County;
NL Gossett, JE Hauser, MD, Medical Examiner-Coroners Office,
Santa Clara County; AF Noren, Sheriff-Coroners Office, Santa Cruz
County; SJ Martel, PhD, Earth Sciences Div, Lawrence Berkeley
Laboratory, Univ of California, Berkeley; TR Toppozada, PhD, Div
of Mines and Geology, California Dept of Conservation; RB Trent,
PhD, Emergency Preparedness and Injury Control Program, JW
Stratton, MD, Hazard Evaluation Section, DC Mortenson, RA
Kreutzer, MD, LR Goldman, MD, Environmental Epidemiology and
Toxicology Section, KH Acree, MD, DO Lyman, MD, Preventive
Medical Svcs Div, KW Kizer, MD, Director, California Dept of
Health Svcs. Div of Field Svcs, Epidemiology Program Office; Div
of Environmental Hazards and Health Effects, Center for
Environmental Health and Injury Control, CDC.
Editorial Note
Editorial Note: An earthquake's magnitude (measured with the
logarithmic Richter scale (3)) is one of the most important
factors influencing the extent of earthquake-related destruction
and mortality. Other contributing factors include population
density, proximity to the epicenter, local geology, building
codes and compliance with them, building materials, number of
stories and age of structures, and capabilities of local
emergency medical services (4).
As with Hurricane Hugo (5,6), ME/Cs, who are responsible for
investigating deaths related to trauma and violence, rapidly
determined the extent of earthquake-related mortality and
provided detailed information on circumstances of death, as well
as demographic information on decedents. Mortality associated
with the California earthquake was lower than for recent
earthquakes of similar magnitude. Potentially responsible factors
include local geology and building patterns; incorporation of
aseismic (earthquake-resistant) engineering features in buildings
in the densely populated downtown sections of Oakland, San
Francisco, and San Jose; and absence of major, widespread fires
following the earthquake. The lower mortality in the recent
earthquake also contrasts with the mortality in the 1906
earthquake in San Francisco (approximately 667 deaths per 100,000
population) (7).
The California Emergency Medical Service Authority and the
California Department of Health Services, in cooperation with the
Region IX Office of the Public Health Service and CDC, have
developed comprehensive plans for an emergency medical/ public
health response to a catastrophic earthquake. These plans
established state and federal support mechanisms to enhance local
governments' ability to respond. This support includes the
National Disaster Medical System; coordination of procurement and
distribution of medical supplies; provision of medical personnel,
equipment, and public health services; and, if necessary,
establishment of field hospitals and evacuation of casualties.
Following the earthquake, initial reports indicate that local
medical and public health resources were generally adequate.
State and federal assistance was provided as needed; however, the
catastrophic earthquake response plans were not activated. Local,
state, and federal agencies are reviewing the response to this
event; the California Department of Health Services is
investigating additional public health aspects of the earthquake,
including cause-specific morbidity and mortality, public
preparedness, and the adequacy of emergency response.
References
Department of Finance. Population estimates of California
cities and counties: January 1, 1988-January 1, 1989. Sacramento:
Department of Finance, 1989. (Report 89 E-1).
Parrish RG, Ing R. Medical examiner and coroner jurisdictions
in the United States. Colorado Springs, Colorado: American
Academy of Forensic Sciences, 1988.
California Department of Conservation, Division of Mines and
Geology. How earthquakes are measured. Calif Geol
1979;32(Feb.):35-7.
Stratton J. Earthquakes. In: Gregg MB, ed. Public health
consequences of disasters. Atlanta: US Department of Health and
Human Services, Public Health Service (in press).
CDC. Deaths associated with Hurricane Hugo--Puerto Rico. MMWR
1989;38:680-2.
CDC. Medical examiner/coroner reports of deaths associated
with Hurricane Hugo--South Carolina. MMWR 1989;38:754,759-62.
Hansen GC. San Francisco numbers game. Calif Geol
1987;40(Dec.):271-4.
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