Russian Military Medical Academy ReportsRussian Military Medical Academy ReportsИзвестия Российской Военно-медицинской академии2713-23152713-2323Eco-Vector65211410.17816/rmmar652114COZAKQReviewsНаучные обзорыReview ArticleCurrent challenges in evaluating national health systems’ response to technogenic emergenciesСовременные проблемы оценки эффективности реагирования национальных систем здравоохранения на чрезвычайные ситуации техногенного характераhttps://orcid.org/0000-0002-8749-85044955-1482OrlovSergey A.ОрловСергей Александрович
Russian Federation

MD, Cand. Sci. (Medicine)

кандидат медицинских наук

orlovsergio@mail.ruN.A. Semashko National Research Institute of Public HealthНациональный НИИ общественного здоровья им. Н.А. СемашкоNational Medical Research Centre for Therapy and Preventive Medicine of the Ministry of Health of RussiaНМИЦ ТПМ Минздрава России050820254421751870202202524032025Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-ВекторCopyright ©; 2025,2025Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0https://journals.eco-vector.com/RMMArep/article/view/652114

The industrial development is associated not only with economic growth but also by technogenic risks that threaten human health and the environment. Historical incidents such as the Bhopal Disaster (1984), Chernobyl Accident (1986), Fukushima Daiichi Accident (2011), Flint Water Crisis (2014), and many other technogenic accidents and disasters dramatically demonstrate the impact of existing threats to society and healthcare systems. The aim of the study was to identify key challenges and current approaches to evaluate national health systems’ responses to technogenic emergencies. The study analyzed scientific publications from the NCBI, PubMed, and Elibrary databases published between 2000 and 2024. These publications underwent terminological analysis using the VOSviewer software and were peer-reviewed. Based on an analysis of the most relevant publications concerning healthcare system responses to technogenic emergencies, five key areas were identified. These areas integrate resources from healthcare facilities, management systems, and technological innovations. The study highlights the significance of an integrated approach in preparing healthcare systems for technogenic emergencies. It provides a systematiс review of measures focused on improving the effectiveness of response, including simulating disaster scenarios, conducting surveys among staff and victims, raising public awareness, establishing psychological support systems, developing volunteer services, and promoting cooperation with public organizations.

Развитие промышленных технологий сопровождается не только экономическим ростом, но и техногенными рисками, угрожающими здоровью людей и экологии. Исторические примеры, такие как аварии в Бхопале (1984), Чернобыле (1986), Фукусиме-1 (2011), кризис водоснабжения во Флинте (2014) и ряд других техногенных аварий и катастроф, являются ярким подтверждением масштаба существующих угроз для общества и систем здравоохранения. Цель: выявить ключевые проблемы и современные подходы к оценке эффективности реагирования национальных систем здравоохранения на чрезвычайные ситуации техногенного характера. Материалами для исследования стали научные публикации из баз данных NCBI, PubMed и Elibrary за 2000–2024 гг., в отношении которых были проведены терминологический анализ с использованием программы VOSviewer и экспертное рецензирование. По результатам анализа наиболее значимых публикаций для оценки реагирования системы здравоохранения на техногенные чрезвычайные ситуации установлено 5 ключевых направлений, объединяющих ресурсы медицинских организаций, системы управления и технологические разработки. В заключении исследования подчеркнута роль обеспечения комплексного подхода при подготовке системы здравоохранения к техногенным чрезвычайным ситуациям и систематизированы меры, позволяющие повысить эффективность ее реагирования, такие как моделирование сценариев катастроф, проведение опросов персонала и пострадавших, повышение уровня информированности населения, создание систем психологической поддержки, развитие волонтерства и сотрудничество с общественными организациями.

resourceshealthcare systemtechnogenic threatsemergenciesresponse effectivenessресурсысистема здравоохранениятехногенные угрозычрезвычайные ситуацииэффективность реагированияBroughton E. The Bhopal disaster and its aftermath: a review. Environ Health. 2005;4(1):6. doi: 10.1186/1476-069X-4-6Sharma DC. Bhopal: 20 years on. Lancet. 2005;365(9454):111–112. doi: 10.1016/S0140-6736(05)17722-8Valković V. Radioactivity in the Environment. Elsevier Science; 2000: 377–487. eBook ISBN: 9780080540245 doi: 10.1016/B978-044482954-2.50009-5Ruckart PZ, Ettinger AS, Hanna-Attisha M, et al. The Flint Water Crisis: A Coordinated Public Health Emergency Response and Recovery Initiative. J Public Health Manag Pract. 2019;25(Suppl 1):S84–S90. doi: 10.1097/PHH.0000000000000871McGeoghegan D, Whaley S, Binks K, et al. Mortality and cancer registration experience of the Sellafield workers known to have been involved in the 1957 Windscale accident: 50 year follow-up. J Radiol Prot. 2010;30(3):407–431. doi: 10.1088/0952-4746/30/3/001Akleyev AV, Krestinina LY, Degteva MO, Tolstykh EI. Consequences of the radiation accident at the Mayak production association in 1957 (the ‘Kyshtym Accident’). J Radiol Prot. 2017;37(3):R19–R42. doi: 10.1088/1361-6498/aa7f8dAliyu AS, Evangeliou N, Mousseau TA, et al. An overview of current knowledge concerning the health and environmental consequences of the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Environ Int. 2015;85:213–228. doi: 10.1016/j.envint.2015.09.020Chan EY, Wang Z, Mark CK, Da Liu S. Industrial accidents in China: risk reduction and response. Lancet. 2015;386(10002):1421–1422. doi: 10.1016/S0140-6736(15)00424-9Aliakbari F, Hammad K, Bahrami M, Aein F. Ethical and legal challenges associated with disaster nursing. Nurs Ethics. 2015;22(4):493–503. doi: 10.1177/0969733014534877Gastaldi S, Horlait M. Health Care Organizations’ Interoperability during Multi-Organizational Disaster Management: A Scoping Review. Prehosp Disaster Med. 2022;37(3):401–408. doi: 10.1017/S1049023X22000516Treat KN, Williams JM, Furbee PM, et al. Hospital preparedness for weapons of mass destruction incidents: an initial assessment. Ann Emerg Med. 2001;38(5):562–565. doi: 10.1067/mem.2001.118009Boer VM. State authorities in response to natural and man-made emergencies. Lex. Jus. Civitas. 2021;(1(29)):43–46. EDN: YNLPMHSubbarao I, Bond WF, Johnson C, et al. Using innovative simulation modalities for civilian-based, chemical, biological, radiological, nuclear, and explosive training in the acute management of terrorist victims: A pilot study. Prehosp Disaster Med. 2006;21(4):272Ц275. doi:10.1017/s1049023x00003824Coleman CN, Sullivan JM, Bader JL, et al. Public health and medical preparedness for a nuclear detonation: the nuclear incident medical enterprise. Health Phys. 2015;108(2):149–160. doi:10.1097/HP.0000000000000249Kazantsev SYa, Krasilnikov VI. First medical assistance to suffer in a technological catastrophe of accidents and natural disasters. Actual problems of medicine and biology. 2020;(1):7–10. EDN: RAWFTQGowing JR, Walker KN, Elmer SL, Cummings EA. Disaster Preparedness among Health Professionals and Support Staff: What is Effective? An Integrative Literature Review. Prehosp Disaster Med. 2017;32(3):321–328. doi: 10.1017/S1049023X1700019XKirsch TD, Lee CJ, King DB, et al. Validation of Opportunities to Strengthen the National Disaster Medical System: The Military-Civilian NDMS Interoperability Study Quantitative Step. Health Secur. 2023;21(4):310–318. doi: 10.1089/hs.2023.0051Peng M, Xiao T, Carter B, et al. Effectiveness and Cost-Effectiveness of Mental Health Interventions Delivered by Frontline Health Care Workers in Emergency Health Services: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022;19(23):15847. doi: 10.3390/ijerph192315847Abdullabekov RN, Fedorchuk VE, Minnikova TV. Mobile medical complexes in Russia. Medical Technologies. Assessment and Choice. 2021;43(3):45–52. doi: 10.17116/medtech20214303145 EDN: JZQWOPLaksham KB. Unmanned aerial vehicle (drones) in public health: A SWOT analysis. J Family Med Prim Care. 2019;8(2):342–346. doi: 10.4103/jfmpc.jfmpc_413_18Levanov VM, Mamonova EYu, Perevedentsev OV. Possibilities of application of telemedicine technologies at carrying out exercises on liquidation of medical consequences of emergency situations on remote industrial objects. Russian journal of telemedicine and e-health. 2019;5(1):17–24. doi: 10.29188/2542-2413-2019-5-1-17-24 EDN: DHYJSALee CJ, Kimball MM, Deussing EC, Kirsch TD. Use of Information Technology Systems for Regional Health Care Information-Sharing and Coordination During Large-Scale Medical Surge Events. Disaster Med Public Health Prep. 2023;18:e1. doi: 10.1017/dmp.2023.218Grebenyuk AN, Lisina EA, Lisin PL, Starkov AV. Medical technical devices for medical evacuation of wounded and injured in emergency situations. Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations. 2020;(1):21–35. doi: 10.25016/2541-7487-2020-0-1-21-35 EDN: HDYIATArtyukhin VV, Arefyeva EV, Vereskun AV, et al. Risk management of man-made disasters and natural disasters (manual for managers of organizations). The monograph. Faleev MI, ed. Moscow: All-Russian Research Institute for Civil Defense and Emergencies of the Russian Emergencies Ministry; 2016. 270 р. EDN: XXUJBDNazarov VB, Gladkikh VD, Boyarintsev VV, et al. Current issues of forming backlogs of antidote therapy means to eliminate medical and sanitary consequences of emergency situations. Toxicological review. 2011;(6(111)):33–37. EDN: TQAWOXSidorov DA, Grebenyuk AN, Golubenko RA, Miroshnichenko YuV. Modern approaches to creation of medicines reserves for liquidation of consequences of chemical emergencies. Bulletin of the Russian Military Medical Academy. 2015;(3(51)):267–272. EDN: VSTVJVRasheed H, Usman M, Ahmed W, et al. A Shift From Logistic Software to Service Model: A Case Study of New Service-Driven-Software for Management of Emergency Supplies During Disasters and Emergency Conditions by WHO. Front Pharmacol. 2019;10:473. doi: 10.3389/fphar.2019.00473Uiba VV, Nazarov VB, Gladkikh VD, ed. Conceptual approaches to the development of the antidote system in the Russian Federation. Moscow: Federal Medical and Biological Agency of Russia; 2013. 304 р. (In Russ.) ISBN: 978-5-94822-059-8Bobrov AF. Prevention of technological emergency situations: information technology to develop criteria for anthropogenic risks estimation. Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations. 2019;(2):5–16. doi: 10.25016/2541-7487-2019-0-2-05-16 EDN: RDRKWVFaleev MI, Gorbunov SV. Monitoring and Forecasting of Emergency Situations as Component Part of the Emergency Risk Management Framework. Issues of Risk Analysis. 2018;15(6):8–16. doi: 10.32686/1812-5220-2018-15-8-16 EDN: YQZLATVoronov AV, Baldin SYu, Voronov VI, et al. Current pharmaceutical logistics of medical immunobiologicals in Russia. Farmatsiya. 2015;7:20–23. EDN: UNXNPPJiang-Ning L, Xian-Liang S, An-Qiang H, et al. Forecasting emergency medicine reserve demand with a novel decomposition-ensemble methodology. Complex Intell Systems. 2023;9(3):2285–2295. doi:10.1007/s40747-021-00289-xBuchakova MA, Kosorotov AP. Coordination of the activities of the management bodies of the state emergency prevention and response system. Safety issues in the aftermath of emergencies. 2015;(1–1(4)):64–68. EDN: VLCRETMahmudov AA. Application of modern systems for public notification in emergency situations. Ekonomika i sotsium. 2024;10–2(125):767–772. EDN: QVKDCVBaranova NN, Goncharov SF. Current State of the Problem of Organizing and Conducting Medical Evacuation of Victims in Emergencies. Meditsina Katastrof = Disaster Medicine. 2020;(4):57–65. doi: 10.33266/2070-1004-2020-4-57-65 EDN: HPDDLJMoskvichev VV, Nicheporchuk VV, Potapov VP, et al. Information Support of Monitoring and Development Risks for Social, Natural and Technogenic Systems. Issues of risk analysis. 2018;15(2):22–33. EDN: XNSIWDTilavaldiev BT, Abdullaev ZD. Information and communication control technologies under emergency situations. Universum: technical sciences. 2021;(11-1(92)):31–33. doi: 10.32743/UniTech.2021.92.11.12541 EDN: EQOVQAAfanasiev DS, Bardakova EA, Bystryakov D.S. Analitical review sensors of volatiles for the internet of things. Informatsionnye tekhnolodii i telekommunikatsii. 2016;4(4):1–12. EDN: YLNEOXNicheporchuk VV, Nozhenkov AI. Technology integration in the integrated emergency monitoring system. Educational Resources and Technologies. 2016;(2(14)):281–287. EDN: TVFKTLNagata T, Kimura Y, Ishii M. Use of a geographic information system (GIS) in the medical response to the Fukushima nuclear disaster in Japan. Prehosp Disaster Med. 2012;27(2):213–215. doi:10.1017/S1049023X1200060XChen Y, Song G, Yang F, et al. Risk assessment and hierarchical risk management of enterprises in chemical industrial parks based on catastrophe theory. Int J Environ Res Public Health. 2012;9(12):4386–4402. doi:10.3390/ijerph9124386Hemming D, Macneill K. Use of meteorological data in biosecurity. Emerg Top Life Sci. 2020;4(5):497–511. doi:10.1042/ETLS20200078Umyvakin VM, Kurolap SA, Matviec DA, Shvec AV. The aggregated medico-environmental risk in the system of socio-hygienic monitoring assessment. Vozdushno-kosmicheskiye sily. Teoriya i praktika. 2017;3(3):105–112. EDN: YNHPMFWang J, Fu G, Yan M. Investigation and Analysis of a Hazardous Chemical Accident in the Process Industry: Triggers, Roots, and Lessons Learned. Processes. 2020;8(4):477. doi: 10.3390/pr8040477Lenert LA, Kirsh D, Griswold WG, et al. Design and evaluation of a wireless electronic health records system for field care in mass casualty settings. J Am Med Inform Assoc. 2011;18(6):842–852. doi: 10.1136/amiajnl-2011-000229Watherston J, Watson J, Bruce D, et al. An in-field evaluation of rapid DNA instruments for disaster victim identification. Int J Legal Med. 2022;136(2):493–499. doi: 10.1007/s00414-021-02748-zAleksanin SS, Rybnikov VYu, Evdokimov VI, et al. Methodological Aspects of Creating Mobile Medical Teams at Russian Emercom for Mitigating Consequences of Emergency Situations. Ekologiya cheloveka [Human Ecology]. 2017;(11):3–9. doi: 10.33396/1728-0869-2017-11-3-9 EDN: ZSKCGXGoncharov SF, Bystrov MV, Baranova NN, et al. Mobile Medical Formations of Service for Disaster Medicine of Ministry of Health of Russian Federation. Disaster Medicine. 2019;(3(107)):5–11. doi: 10.33266/2070-1004-2019-3-5-11 EDN: TKNYIJBaranova NN, Goncharov SF. Medical evacuation at liquidation of consequences of emergencies: routing, criteria of quality. Emergency medical care. 2019;20(4):4–13. doi: 10.24884/2072-6716-2019-20-4-4-13 EDN: BIBTWWGoncharov SF. Innovative technologies in system of medical support of population affected in emergency situations. Disaster Medicine. 2011;(3(75)):5–10. EDN: OEYXNLShoigu YuS. Organization of the activities of the psychological service of the Ministry of Emergency Situations of Russia. National Psychological Journal. 2012;(1(7)):131–133. EDN: OPPFZZGumenyuk SA, Aleksanin SS, Yarygin NV. Evaluation of the Efficiency of Work and Prospects of Sanitary Aviation Development in Megapolic Environment on the Example of Moscow City. Disaster Medicine. 2022;(1):71–77. doi: 10.33266/2070-1004-2022-1-71-77 EDN: PYFNVHMargus C, Hertelendy A, Tao Y, et al. United States Federal Emergency Management Agency regional clustering by disaster exposure: a new paradigm for disaster response. Nat Hazards (Dordr). 2023;116(3):3427–3445. doi: 10.1007/s11069-023-05817-1Marlow R, Singleton S, Campeau D, et al. The evolution of healthcare disaster preparedness and response training at the FEMA Center for Domestic Preparedness. Am J Disaster Med. 2019;14(1):5–8. doi: 10.5055/ajdm.2019.0310Zhong S, Clark M, Hou XY, et al. Progress and challenges of disaster health management in China: a scoping review. Glob Health Action. 2014;7:24986. doi: 10.3402/gha.v7.24986Zhang JJ, Wang TB, Fan D, et al. Medical Response to the Tianjin Explosions: Lessons Learned. Disaster Med Public Health Prep. 2018;12(3): 411–414. doi: 10.1017/dmp.2017.64Homma M. Development of the Japanese National Disaster Medical System and Experiences during the Great East Japan Earthquake. Yonago Acta Med. 2015;58(2):53–61. PMID: 26306054Yokokura Y. Japan Earthquake 2011 and Fukushima Nuclear Accident: Experience and physicians and veterinarians collaboration to recover. Japan Med Assoc J. 2016;59(1):3–9. PMID: 27738577Hecker N, Domres BD. The German emergency and disaster medicine and management system-history and present. Chin J Traumatol. 2018;21(2):64–72. doi: 10.1016/j.cjtee.2017.09.003