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Evacuation of the World Trade Center (WTC) twin towers and surrounding buildings damaged in the September 11, 2001 attacks provides a unique opportunity to study factors that affect emergency evacuation of high rise buildings.
Problem
The goal of this study is to understand the extent to which structural and behavioral barriers and limitations of personal mobility affected evacuation by occupants of affected buildings on September 11, 2001.
Methods
This analysis included 5,023 civilian, adult enrollees within the World Trade Center Health Registry who evacuated the two World Trade Center towers and over 30 other Lower Manhattan buildings that were damaged or destroyed on September 11, 2001. Multinomial logistic regression was used to predict total evacuation time (<30 to ≤60 minutes, >1 hour to <2 hours relative to ≤30 minutes) in relation to number of infrastructure barriers and number of behavioral barriers, adjusted for demographic and other factors.
Results
A higher percentage of evacuees reported encountering at least one behavioral barrier (84.9%) than reported at least one infrastructure barrier (51.9%). This pattern was consistent in all buildings except WTC 1, the first building attacked, where >90% of evacuees reported encountering both types of barriers. Smoke and poor lighting were the most frequently-reported structural barriers. Extreme crowding, lack of communication with officials, and being surrounded by panicked crowds were the most frequently-reported behavioral barriers. Multivariate analyses showed evacuation time to be independently associated with the number of each type of barrier as well as gender (longer times for women), but not with the floor from which evacuation began. After adjustment, personal mobility impairment was not associated with increased evacuation time.
Conclusion
Because most high-rise buildings have unique designs, infrastructure factors tend to be less predictable than behavioral factors, but both need to be considered in developing emergency evacuation plans in order to decrease evacuation time and, consequently, risk of injury and death during an emergency evacuation.
GroegerJL, StellmanSD, KravittA, BrackbillRM. Evacuating Damaged and Destroyed Buildings on 9/11: Behavioral and Structural Barriers. Prehosp Disaster Med. 2013;28(6):1-11.
Pediatric research ethics is based on respect for children and their best interests. The purpose of biomedical research is to contribute to knowledge, but this laudable goal may put children at risk of harm in clinical research, potentially stripping them of their rights and the respect they deserve. Pediatric research ethics relies on this respect, sometimes at the expense of knowledge that could benefit society. Pediatric medicine became thoroughly recognized in the 19th century, leading to the creation of pediatric hospitals. Two central figures in the pediatric research ethics debate included Paul Ramsey and Richard McCormick. The Common Rule instructs institutional review boards (IRBs) to ensure that the risks to subjects are minimized and that these risks carry reasonably equal weight in relation to the anticipated benefits. Knowledge gained from research must be obtained in a way that recognizes the vulnerability of children and respects their best interests.
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