Deaths and Hospital Injuries Due to the 1999 Taiwan Earthquake


To assess risk factors associated with deaths and injuries in a major earthquake area. First, we used the official data including 824 seismic deaths, 271 serious injuries, and 302 moderate injuries to elucidate and compare the demographic, structural, and injury characteristics among the three groups. Secondly, a population based case-control study was conducted to examine how structural factors, medical assistance, personal characteristic, and behavior and preparedness contributed to injury. The age-specific proportions of the three groups were similar and higher in the elderly population. Severity of injuries was proportional to the proportion of completely collapsed houses. Fracture was the most frequently observed among the serious injuries and moderate injuries. Head injury was the major body site caused by the collapsed houses for the seismic deaths. In a case-control study, people who were trapped (adjusted OR = 12.31, 95% CI: 6.29 - 24.28) had the greatest risk of serious injuries, followed by those who were illiterate, in completely collapsed houses, and experienced unprepared flares. This study reveals that improvement in anti-seismic construction, head protect, and literacy education could decrease the effect of disaster. Further, using a flashlight to see in the dark, and moving slowly rather than running should be rigorously recommended as common-sense responses.

Share and Cite:

Y. Liao, "Deaths and Hospital Injuries Due to the 1999 Taiwan Earthquake," Open Journal of Safety Science and Technology, Vol. 2 No. 4, 2012, pp. 147-158. doi: 10.4236/ojsst.2012.24019.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] B. S. Huang, K. C. Chen, W. G. Huang, J. H. Wang, D. M. Chang, R. D. Huang, H. C. Chiu and C. C. P. Tsai, “Characteristics of Strong Ground Motion across a Thrust Fault Tip from the September 21 1999, Chi-Chi, Chinese Taipei Earthquake,” Geophysical Research Letters, Vol. 27, No. 17, 2000, pp. 2729-2732. doi:10.1029/2000GL011396
[2] Chi-Chi Earthquake Post-Disaster Reconstruction Commission, “Important Statistics about the Chi-Chi Earthquake Disaster,” 2001. (in Chinese)
[3] R. A. Page, J. A. Blume and W. B. Joyner, “Earthquake Shaking and Damage to Buildings,” Science, Vol. 189, No. 4203, 1975, pp. 601-608. doi:10.1126/science.189.4203.601
[4] D. Alexander, “Death and Injury in Earthquakes,” Disasters, Vol. 9, No. 1, 1985, pp. 57-60. doi:10.1111/j.1467-7717.1985.tb00911.x
[5] Y. H. Liao, L. C. Huang, J. H. Huang, S. F. Lin, M. Shen, C. H. Lin, C. C. Chang, Y. J. Hong, I. L. Lee, Y. Y. Guo and C. T. Yang, “Building Collapse and Human Deaths Resulting from the Chi-Chi Earthquake in Taiwan, September 1999,” Archives of Environmental Health, Vol. 58, No. 9, 2003, pp. 572-578. doi:10.3200/AEOH.58.9.572-578
[6] Z. C. Moh and R. N. Hwang, “1999 Chi Chi Earthquake of Taiwan,” Bulletin of the Seismological Society of America, Vol. 93, No. 1, 2003, pp. 386-396.
[7] E. Gutierrz, F. Taucer, T. De Groeve and D. H. A. Al- Khudhairy, “Analysis of Worldwide Earthquake Mortality Using Multivariate Demographic and Seismic Data,” American Journal of Epidemiology, Vol. 161, No. 12, 2005, pp. 1151-1158. doi:10.1093/aje/kwi149
[8] R. I. Glass, J. J. Urrutia, S. Sibony, H. Smith, B. Garcia and L. Rizzo, “Earthquake Injuries Related to Housing in a Guatemalan Village,” Science, Vol. 197, No. 4304, 1977, pp. 638-643. doi:10.1126/science.197.4304.638
[9] M. F. Lechat, “Disasters and Public Health,” Bulletin of the World Health Organization, Vol. 57, No. 1, 1979, pp. 11-17.
[10] M. De Bruycker, D. Greco, I. Annino, M. A. Stazi, N. De Ruggiero, M. Triassi, Y. P. De Kettenis and M. F. Lechat, “The 1980 Earthquake in Southern Italy: Rescue of Trapped Victims and Mortality,” Bulletin of the World Health Organization, Vol. 61, No. 6, 1983, pp. 1021-1025.
[11] A. Pomons, “The Spitak (Armenia, USSR) Earthquake: Residential Building Typology and Seismic Behavior,” Disasters, Vol. 14, No. 2, 1990, pp. 89-114. doi:10.1111/j.1467-7717.1990.tb01051.x
[12] C. C. Chan, Y. P. Lin, H. H. Chen, T. Y. Chang, T. J. Cheng and L. S. Cheng, “A Population-Based Study on the Immediate and Prolonged Effects of the 1999 Taiwan Earthquake on Mortality,” Annals of Epidemiology, Vol. 13, No. 7, 2003, pp. 502-508. doi:10.1016/S1047-2797(03)00040-1
[13] Y. H. Liao, S. F. Lin, W. H. Liao, J. H. Huang, M. Shen and C. H. Lin, “Deaths Related to Housing in 1999 Chi-Chi, Taiwan, Earthquake,” Safety Science, 43, Vol. 43, No. 1, 2005, pp. 29-37. doi:10.1016/j.ssci.2004.11.002
[14] C. Peek-Asa, M. R. Ramirez, K. Shoaf, H. Seligson and J. F. Kraus, “GIS Mapping of Earthquake-Related Deaths and Hospital Admissions from the 1999 Northridge, California Earthquake,” Annals of Epidemiology, Vol. 10, No. 1, 2000, pp. 5-13. doi:10.1016/S1047-2797(99)00058-7
[15] N. J. Liang, Y. T. Shih, F. Y. Shih, H. M. Wu, H. J. Wang, S. F. Shi, M. Y. Liu and B. B. Wang, “Disaster Epidemiology and Medical Response in the Chi-Chi Earthquake in Taiwan,” Annals of Emergency Medicine, Vol. 38, No. 5, 2001, pp. 549-555. doi:10.1067/mem.2001.118999
[16] T. M. Naghi, K. Kambiz, J. M. Shahriar, T. Afshin, S. K. Reza, P. Behnam and A. H. Bahador, “Musculoskeletal Injuries Associated with Earthquake,” International Journal of Care Injured, Vol. 36, No. 1, 2005, pp. 27-32.
[17] J. Wen, Y. K. Shi, Y. P. Li, I. Wang, I. Chen, Z. Gao and L. Li, “Risk Factors of Earthquake Inpatient Death: A Case Control Study,” Critical Care, Vol. 13, No. 1, 2009, pp. R24. doi:10.1186/cc7729
[18] S. E. Health, P. H. Kass, A. M. Beck and L. T. Glickmam, “Human and Pet-Related Risk Factors for Household Evacuation Failure during a Natural Disaster,” American Journal of Epidemiology, Vol. 153, No. 7, 2001, pp. 659-665. doi:10.1093/aje/153.7.659
[19] C. Peek-Asa, J. F. Kraus, L. B. Bourque, D. Vimalachandra and J. A. Yu, “Fatal and Hospitalized Injuries Resulting from the 1994 Northridge Earthquake,” International Journal of Epidemiology, Vol. 27, No. 3, 1998, pp. 459-465. doi:10.1093/ije/27.3.459
[20] K. I. Shoaf, L. H. Nguyen, H. R. Sareen and L. B. Bourque, “Injuries as a Result of California Earthquakes in the Past Decade,” Disasters, Vol. 22, No. 3, 1998, pp. 218-235. doi:10.1111/1467-7717.00088
[21] Y. Osaki and M. Minowa, “Factors Associated with Earthquake Deaths in the Great Hanshin-Awaji Earthquake, 1995,” American Journal of Epidemiology, Vol. 153, No. 2, 2001, pp. 153-156. doi:10.1093/aje/153.2.153
[22] Y. J. Chou, N. Huang, C. H. Lee, S. L. Tsai, L. S. Chen and H. J. Chang, “Who Is at Risk of Death in an Earthquake?” American Journal of Epidemiology, Vol. 160, No. 7, 2004, pp. 688-695. doi:10.1093/aje/kwh270
[23] S. Doocy, A. Danieis and D. Aspilcueta, “Mortality and Injury Following the 2007 Ica Earthquake in Peru,” American Journal of Disaster Medicine, Vol. 4, No. 1, 2009, pp. 15-22.
[24] M. De Bruycker, D. Greco and M. Lechat, “The 1980 Earthquake in Southern Italy Morbidity and Mortality,” International Journal Association, Vol. 14, No. 1, 1985, pp. 113-117.
[25] M. F. Lechat, “The Epidemiology of Health Effects of Disasters,” Epidemiologic Reviews, Vol. 12, 1990, pp. 192-197.
[26] H. K. Armenian, E. K. Noji and A. P. Oganesian, “A Case-Control Study of Injuries Arising from the Earthquake in Armenia,” Bulletin of the World Health Organization, Vol. 70, No. 2, 1992, pp. 251-257.
[27] M. C. Roces, M. E. White, M. M. Dayrit and M. E. Durkin, “Risk Factors for Injuries Due to the 1990 Earthquake in Luzon, Philippines,” Bulletin of the World Health Organization, Vol. 70, No. 4, 1992, pp. 509-514.
[28] E. K. Noji, H. K. Armenian and A. Oganessian, “Issues of Rescue and Medical Care Following the 1988 Armenian Earthquake,” International Journal of Epidemiology, Vol. 22, No. 6, 1993, pp. 1071-1076. doi:10.1093/ije/22.6.1070
[29] H. K. Armenian, A. M. Konian, E. K. Noji and A. P. Hovanesian, “Deaths and Injuries Due to the Earthquake in Armenia: A Cohort Approach,” International Journal of Epidemiology, Vol. 26, No. 4, 1997, pp. 806-813. doi:10.1093/ije/26.4.806
[30] D. C. Angus, E. A.Pretto, J. I. Abrams, N. Ceciliano, Y. Watoh, B. Kirimitili, A. Certug and L. K. Comfort, “Epidemiologic Assessment of Mortality, Building Collapse Pattern, and Medical Response after the 1992 Earthquake in Turkey,” Prehospital and Disaster Medicine, Vol. 12, No. 2, 1997, pp. 222-231.
[31] H. Tanaka, A. Iwai, J. Oda, Y. Kuwagata, T. Matsuoka, T. Shimazu and T. Yoshioka, “Overview of Evacuation and Transport of Patients Following the 1995 Hanshin-Awaji Earthquake,” The Journal of Emergency Medicine, Vol. 16, No. 3, 1998, pp. 439-444. doi:10.1016/S0736-4679(98)00014-6
[32] Y. S. Wen, C. P. Hsu, T. C. Lin, D. Y. Yang and T. C. Wu, “Chest Injuries Transferred to Trauma Centers after the 1999 Taiwan Earthquake,” American Journal of Emergency Medicine, Vol. 18, No. 7, 2000, pp. 825-827. doi:10.1053/ajem.2000.18132
[33] W. T. Chiu, J. Arnold, Y. T. Shih, K. H. Hsiung, H. Y. Chi, C. H. Chiu and W. C. Tsai, “A Survey of International Urban Search-And-Rescue Teams Following the Ji Ji Earthquake,” Disasters, Vol. 26, No. 1, 2002. pp. 85-94. doi:10.1111/1467-7717.00193
[34] K. T. Chen, W. J. Chen, J. Malilay and S. J. Twu, “The Public Health Response to the Chi-Chi Earthquake in Taiwan, 1999,” Public Health Reports, Vol. 118, No. 6, 2003, pp. 493-499.
[35] H. Ellidokuz, R. Ucku, U. Y. Aydin and E. Ellidokuz, “Risk Factors for Death and Injuries in Earthquake: Cross-Sectional Study from Afyon, Turkey,” Croat Medicine Journal, Vol. 46, No. 4, 2005, pp. 613-618.
[36] H. Kao and W. P. Chen, “The Chi-Chi Earthquake Sequence: Active, Out-of-Sequence Thrust Faulting in Taiwan,” Science, Vol. 288, No. 5475, 2000, pp. 2346-2349. doi:10.1126/science.288.5475.2346
[37] Y. J. Chou, N. Huang, C. H. Lee, S. L. Tsai, J. H. Tsay and L. S. Chen, “Suicides after the 1999 Taiwan Earthquake,” International Journal of Epidemiology, Vol. 32, No. 6, 2003, pp. 1007-1014. doi:10.1093/ije/dyg296
[38] C. Watanabe, J. Okumura, T. Y. Chiu and S. Wakai, “Social Support and Depressive Symptom among Displaced Older Adults Following the 1999 Taiwan Earthquake,” Journal of Trauma Stress, Vol. 17, No. 1, 2004, pp. 63-67. doi:10.1023/B:JOTS.0000014678.79875.30
[39] C. M. Chang, K. M. Connor, T. J. Lai, L. C. Lee and J. R. T. Davidson, “Predicators of Posttraumatic Outcomes Following the 1999 Taiwan Earthquake,” Journal of Nervous and Mental Disease, Vol. 193, No. 1, 2005, pp. 40- 46. doi:10.1097/01.nmd.0000149217.67211.ab
[40] C. L. Seplaki, N. Goldman, M. Weinstein and Y. H. Lin, “Before and after the 1999 Chi-Chi Earthquake: Traumatic Events and Depressive Symptoms in an Older Population,” Social Science & Medicine, Vol. 62, No. 12, 2006, pp. 3121-3132. doi:10.1016/j.socscimed.2005.11.059
[41] F. H. Chou, H. C. Wu, P. Chou, C. Y. Su, K. Y. Tsai, S. S. Chao, M. C. Chen, T. T. P. Su, W. J. Sun and W. C. Ou-Yang, “Epidemiologic Psychiatric Studies on Post-Disaster Impact among Chi-Chi Earthquake Survivors in Yu-Chi, Taiwan,” Psychiatry and Clinical Neuroscience, Vol. 61, No. 4, 2007, pp. 370-378. doi:10.1111/j.1440-1819.2007.01688.x
[42] C. H. Chen, H. K. Tan, L. R. Liao, H. H. Chen, C. C. Chan, J. J. S. Cheng, C. Y. Chen, T. N. Wang and M. L. Lu, “Long-Term Psychological Outcome of 1999 Taiwan Earthquake Survivors: A Study of a High-Risk Sample with Property Damage,” Comprehensive Psychiatry, Vol. 48, No. 3, 2007, pp. 269-275. doi:10.1016/j.comppsych.2006.12.003
[43] Y. P. Liaw, P. W. Wang, C. C. Huang, C. M. Chang and W. C. Lee, “The Suicide Mortality Rates between 1997-1998 and 2000-2001 in Nantou County of Taiwan Following the Earthquake of September 21 in 1999,” Journal of Forensic Sciences, Vol. 53, No. 1, 2008, pp. 199-202. doi:10.1111/j.1556-4029.2008.00592.x
[44] C. Y. Su, K. Y. Tsai, H. C. Chou, W. W. Ho, R. Liu and W. K. Lin, “A Three-Year-Follow-Up Study of the Psychosocial Predictors of Delayed and Unresolved Post Traumatic Stress Disorder in Taiwan Chi-Chi Earthquake Survivor,” Psychiatry and Clinical Neuroscience, Vol. 64, No. 3, 2010, pp. 239-248. doi:10.1111/j.1440-1819.2010.02087.x
[45] C. H. Yang, S. Xirasagar, H. C. Chung, Y. T. Huang and H. C. Lin, “Suicide Trends Following the Taiwan Earthquake of 1999: Empirical Evidence and Policy Implications,” Psychiatry and Clinical Neuroscience, Vol. 112, No. 6, 2005, pp. 442-448. doi:10.1111/j.1600-0447.2005.00603.x
[46] S. Maruo and M. Matumoto, “Spinal Fractures Resulting from the 1995 Great Hanshin Earthquake of the Kobe-Osaka Area of Japan,” Spinal Cord, Vol. 34, No. 7, 1996, pp. 382-386. doi:10.1038/sc.1996.69
[47] C. Peek-Asa, M. Ramirez, H. Seligson and K. Shoaf, “Seismic, Structural, and Individual Factors Associated with Earthquake Related Injury,” Injury Prevention, Vol. 9, 2003, pp. 62-66. doi:10.1136/ip.9.1.62
[48] M. Mahue-Giangreco, W. Mack, H. Seligson and A. B. Bourque, “Risk Factors Associated with Moderate and Serious Injuries Attributable to the 1994 Northridge Earthquake, Los Angles, California,” Annals of Epidemiology, Vol. 11, No. 5, 2001, pp. 347-357. doi:10.1016/S1047-2797(01)00220-4
[49] Nantou County Government, “The Statistical Abstract of Nantou County,” Nantou County Government Press, Nantou, 2011.

Copyright © 2021 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.