Tornado-Associated Fatalities -- Arkansas, 1997

On March 1, 1997, approximately nine tornadoes originating from two separate thunderstorms swept across Arkansas, from Hempstead County in the southwest to Clay County in the northeast (approximately 260 miles) (Figure_1). The tornadoes caused 26 deaths and an estimated $115 million in property damage, reflecting damage to residences, nonresidential buildings, bridges, and roads and agriculture and timber losses. The strongest tornadoes touched down southwest of Little Rock in Clark, Saline, and Pulaski counties; the estimated widths of the tornado paths ranged from 1/2 to 1 mile, and wind speeds were greater than 200 miles per hour (National Weather Service {NWS}, unpublished data, 1997). This report summarizes circumstances of the tornado-associated fatalities from information collected by the American Red Cross (ARC); 14 of the 26 fatalities occurred among persons who were in mobile homes.

ARC collected data about fatalities associated with the tornadoes by contacting area hospitals and medical examiner's and coroner's offices in affected counties. Fatalities were verified by death certificates obtained from the Arkansas Department of Vital Statistics. A total of 26 fatalities resulted from injuries sustained during the tornadoes; one additional death resulted from electrocution during storm-related clean-up activities in Pulaski County. Twenty-two deaths occurred in the three most heavily affected counties (Clark, Saline, and Pulaski) (Figure_1). Decedents' ages ranged from 14 to 79 years (median: 48 years) (Table_1), and 14 were male. When tornadoes touched down, 14 of those who died were in mobile homes; four, in single-family dwellings; three, in nonresidential buildings; three, in motor vehicles; and two, outdoors. Most deaths resulted from multiple injuries; head injuries were specifically listed in 14 deaths. Twenty-two persons died at the scene of injury; three died at or while being transported to a hospital; and one died in a hospital the following day.

ARC reported 400 nonfatal injuries that were treated at area emergency departments. Of these, 296 (74%) persons were treated and released, and 104 (26%) required hospitalization.

Interviews with family or neighbors of 10 (71%) decedents revealed that the mobile homes in which these deaths occurred (both in parks and stand-alone mobile homes) lacked access to underground storm shelters. Reports from local public health officials indicated that the remaining four mobile homes in which deaths occurred also probably did not have storm shelters (family or neighbor contacts for these decedents could not be located).

On the day of the tornadoes, the NWS issued storm warnings to 55 Arkansas counties, including tornado warnings in 33 counties. Lead time between warning issuance and tornado touchdown was 15 minutes for most affected counties. Lead times for all counties in which death or injury occurred ranged from 18 to 32 minutes (NWS, unpublished data, 1997). Warning systems varied by county but generally consisted of warning sirens supplemented by television and/or radio bulletins. CDC and the Arkansas Department of Health are conducting a survey to evaluate public awareness and response to the tornado warnings during this disaster.

Reported by: Health depts in Pulaski, Saline, and Clark counties; TM Holmes, PhD, SB Nichols, MD; T McChesney, DVM, State Epidemiologist, Arkansas Dept of Health. American Red Cross Disaster Health Svcs, Falls Church, Virginia. National Weather Service, National Oceanic and Atmospheric Administration, US Dept of Commerce. Maternal and Child Health Br, Div of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion; Health Studies Br, Div of Environmental Hazards and Health Effects, National Center for Environmental Health, CDC.

Editorial Note

Editorial Note: In the United States, tornadoes cause an average of 51 deaths and approximately 1000 injuries each year (1). Occupancy of a mobile home is an important risk factor for tornado-related deaths and injuries (2-4), and the presence of on-site storm shelters in mobile-home parks is effective in reducing tornado-related injury and death (4).

During the storm in Arkansas on March 1, more than half of the fatalities occurred among persons in mobile homes, and persons in these structures did not have access to storm shelters. To reduce injury and death from tornadoes, strategies and efforts are needed to provide residents of mobile homes with access to underground shelters. Other needs include evaluation of public-education campaigns and shelter-seeking behaviors; during a storm in Alabama in 1994, only 31% of persons who heard a tornado warning sought shelter (5). Public health departments should assist with efforts to improve public awareness of safety measures that will reduce injury and death during a tornado. For example, local public health clinics are a setting for distributing educational brochures that outline tornado safety guidelines (see boxTable_B1). Public awareness or education campaigns should specifically target residents of mobile homes.

References

1. Lillibridge SR. Tornadoes. In: Noji E, ed. The public health consequences of disasters. New York, New York: Oxford University Press 1997:228-44.

2. Glass RI, Craven RB, Bregman DJ, et al. Injuries from the Wichita Falls tornado: implications for prevention. Science 1980;207:734-8.

3. Eidson M, Lybarger JA, Parsons JE, MacCormack JN, Freeman JI. Risk factors for tornado injuries. Int J Epidmiol 1990;19:1051-6.

4. CDC. Tornado disaster -- Kansas, 1991. MMWR 1992;41:181-3.

5. Liu S, Quenemoen LE, Malilay J, Noji E, Sinks T, Mendlein J. Assessment of a severe-weather warning system and disaster preparedness, Calhoun County, Alabama, 1994. Am J Public Health 1996;86:87-9.

6. Office of Meteorology, National Weather Service, National Oceanic and Atmospheric Administration. Tornado safety. Washington, DC: National Oceanic and Atmospheric Administration, National Weather Service, 1996; publication no. 1996-413-872.

7. National Center for Environmental Health. Tornado: a guide for your personal health and safety. Atlanta, Georgia: US Department of Health and Human Services, Public Health Service, CDC, 1997 (in press).

   
   
   

+------------------------------------------------------------------- ----+ | Erratum: Vol. 46, No. 19 | |             | |             | | In the article, "Tornado-Associated Fatalities -- Arkansas, | | 1997," an error appears in one case in the line listing of cases in | | Table 1 on page 414. The 29-year-old female decedent in Jackson | | County should have been listed as a 30-year-old male. Other than | | slightly changing the demographic profile of the decedents, this | | change does not affect the findings of the report. | |             | +------------------------------------------------------------------- ----+
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Table_1
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TABLE 1. Tornado-related deaths, by time and county of death and decedent's age,
sex, location when injured, and nature of injury -- Arkansas, 1997
=======================================================================================================
Time/County      Age      Sex      Location when injured          Nature of injury
-----------------------------------------------------------------------------------------------------
Impact
  Clark           14       F       Mobile home                    Trauma impact
  Clark           14       F       Mobile home                    Trauma impact
  Clark           45       F       Mobile home                    Trauma impact
  Clark           42       M       Mobile home                    Trauma impact
  Clark           39       F       Office building                Trauma impact
  Clark           45       M       Motor vehicle                  Motor-vehicle crash
  Saline          23       F       Mobile home                    Multiple head and internal injuries
  Saline          35       F       Mobile home                    Multiple head and internal injuries
  Saline          52       F       Mobile home                    Multiple head and internal injuries
  Saline          55       F       Mobile home                    Multiple head and internal injuries
  Saline          15       M       Mobile home                    Multiple head and internal injuries
  Saline          49       M       Mobile home                    Multiple head and internal injuries
  Saline          55       M       Mobile home                    Multiple head and internal injuries
  Saline          72       M       Mobile home                    Tornado, not otherwise specified
  Saline          61       F       Single- amily home             Multiple head and internal injuries
  Saline          64       M       Single- amily home             Multiple head and internal injuries
  Pulaski *       40       F       Mobile home                    Closed head injury; multiple trauma
  Pulaski         62       M       Single- amily home             Multiple blunt force head trauma
  Pulaski         69       M       Single- amily home             Multiple blunt force head trauma
  Pulaski         61       M       Store                          Tornado, not otherwise specified
  Pulaski *       74       F       Motor vehicle                  Multiple blunt force trauma
  Jackson *       79       M       Mobile home                    Tornado, not otherwise specified
  Jackson         29       F       Outdoors, ditch                Multiple head and internal injuries
  Jackson         21       M       Outdoors                       Tornado, not otherwise specified
  Greene *+       47       M       Building                       Massive head injury
  Pope            57       M       Motor vehicle                  Cardiopulmonary arrest; massive
                                                                    thoracic trauma

Clean-up
  Pulaski +       35       M       Outdoors                       Electrocution
-----------------------------------------------------------------------------------------------------
* Died at or while being transported to a hospital.
+ Death occurred the day after the tornado.

Source: American Red Cross-CDC Health Impact Surveillance System for Disasters.
=======================================================================================================

Recommendations for Persons in Areas Under a Tornado Warning
---------------------------------------------------------------------------------
- Move from homes and buildings to basements or underground shelters.
- If underground shelters are unavailable, move to interior rooms or hallways on
  the lowest floor and get under a piece of sturdy furniture.
- Leave vehicles and lie flat in nearby ditches or depressions.
- Leave mobile homes and move to underground shelters. If underground shel-
  ters are unavailable, lie flat in nearby ditches or depressions.
---------------------------------------------------------------------------------
Source: National Weather Service and CDC (6,7).
===================================================================================

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