Resources for Windstorms

Hurricane Palms

Image credit: Wiley – Chieh Cheng/Getty Images

Last updated: 13 September 2018

Introduction (reviews available at the end of the introduction)

Air is always moving. Wind is one of the most basic parameters of our weather, but also one of the most destructive hazards on our planet. Literally, “a disturbance of the atmosphere”, storms come in many forms and sizes. The most intense windstorms on earth are tornadoes, which may be only a hundred metres across and last for last for less than an hour, but which can destroy anything in their path. Tropical cyclones (also known as hurricanes or typhoons) are revolving storms that can reach sizes of many hundreds of kilometres and devastate large areas with wind speeds of more than 120 Extra-tropical cyclones are also revolving storms, which can extend to thousands of kilometres and with a lifetime of days to weeks, potentially causing extensive damage at continental scale.

Windstorms are associated not only with wind, but also with rain or snow, and often with hail and lightning. This is particularly the case for tropical cyclones, which are typically most feared for their winds at sea, for the associated ocean storm surges along the coast, and for their rainfall once they move inland. In the devastating 2017 hurricane season in the Atlantic, Hurricanes Harvey, Irma, and Maria caused serious damage in the southern United States and nearly destroyed multiple Caribbean islands through powerful winds, heavy rainfall and storm surges. Initial estimates gave more than 200 people reported killed, more than one million affected, and damages of nearly 100 billion USD[1].

The damage caused by a windstorm depends both on the vulnerability of the affected society and the severity of the storm. Winds, floods and storm surges can damage homes and infrastructure, such as roads, power supply, and communications, but factors like strong building regulations, a history of previous exposure to storms, and good storm warning systems can all reduce the impact of a storm. Advances in weather forecasting enable evacuations to be carried out ahead of tropical cyclone arrival, though the psychological challenges of ‘leaving the safety of one’s own home’ mean that evacuation rates are often low. For tornadoes, warning times are much shorter, providing only enough time for immediate action, such as taking cover in a shelter.

Storms threaten health in multiple ways. The short-term effects on morbidity and mortality are associated with the direct impact of a storm, such as traumatic injuries from being hit by airborne debris or drowning in a storm surge. However, it is also clear that a wide range of other longer-term health impacts are caused indirectly by storms. These can affect a much larger number of people, some of the most significant being exacerbation of existing health conditions from increased stress or the loss of healthcare services due to damages to roads, power supply, or to the health system or facilities themselves; injuries sustained while clearing damage; carbon monoxide poisoning from indoor power generators and cookers used during electrical failures; or respiratory infections among people displaced to emergency shelters. Mental health impacts are also being increasingly recognised. At least in part, these come from the psychological response to the shock of ‘invasion of the home’, especially when the home no longer exists, or takes a long time to be habitable again. These mental health impacts can be of long duration and may return whenever similar conditions threaten. Those particularly at risk are people tied to homes built in unsafe places, and those with limited resources to cope: the poor, women and children, the sick and the aged are disproportionately represented in mortality statistics.

Our collection covers a wide range of papers addressing issues of importance to the health impact of windstorms, with an emphasis on tracking and warning systems, willingness and readiness to evacuate, and the impact of storms on health systems, vulnerable groups, and mental health. We hope that the collection will provide humanitarian practitioners with an easily accessible and accurate evidence base for good practice in emergency planning and response.

Introduction authored by: Professor Brian Golding (Met Office, London, UK) and Dell Saulnier (PhD student at the Department of Public Health Sciences, Karolinska Institutet, Sweden)


Photo: Caritas/ CAFOD, November 2013

If you would like to use an appraisal framework when considering the relevance and quality of the full reviews that Evidence Aid links to, a few useful tools are: AMSTARCASP and ROBIS. Guidance is also available on reporting reviews: PRISMA.

Systematic Reviews

Community responses and needs

Fu C., & Underwood C. A meta-review of school-based disaster interventions for child and adolescent survivorsJournal of Child & Adolescent Mental Health, 2015:27(3);161-71.

Greene G., Turley R., Mann M., et al. Differing community responses to similar public health threats: A cross-disciplinary systematic literature review. Science of The Total Environment, 2014:470;759-67.

Laditka S.B., Murray L.M., & Laditka J.N. In the eye of the storm: Resilience and vulnerability among African American women in the wake of Hurricane KatrinaHealth Care for Women International, 2010:31(11);1013-27.

Tyree T.C., & Hill M.A. Hurricane Katrina 10-years later: A qualitative meta-analysis of communications and media studies of New Orleans Black communityInternational Journal of Emergency Management, 2016:12(3);304-27.

Deciding and preparing to evacuate

Ahsan M.N., Takeuchi K., Vink K. et al. A systematic review of the factors affecting the cyclone evacuation decision process in BangladeshJournal of Disaster Research, 2016:11;741.

Huang S.K. Households evacuation decision in response to Hurricanes Katrina and Rita. 2014 – Doctoral dissertation.

Huang S.K., Lindell M.K., & Prater C.S. Who leaves and who stays? A review and statistical meta analysis of hurricane evacuation studiesEnvironment and Behavior, 2016:48(8);991-1029.

Ochi S., Hodgson S., Landeg O., et al. Disaster driven evacuation and medication loss: a systematic literature reviewPLoS Currents. 2014:Jul 18; 6.

Rojek A., & Little M. Evacuating hospitals in Australia: What lessons can we learn from the world literature? Emergency Medicine Australasia, 2013:25(6);496-502.

Thompson R.R., Garfin D.R., & Silver, R.C. Evacuation from natural disasters: a systematic review of the literatureRisk Analysis, 2017:37(4);812-39.

Dust storms and air pollution

Abdo N., Khader Y. S., Abdelrahman M., et al. Respiratory health outcomes and air pollution in the Eastern Mediterranean Region: a systematic review. Reviews on Environmental Health, 2016:31(2);259-80.

Delpisheh A., Direkvand Moghadam A., & Direkvand Moghadam F. The impact of air pollution on pregnancy outcomes: A Systematic Review. The Iranian Journal of Obstetrics, Gynecology and Infertility, 2014:17(102);7-11.

Ferrer A.L.C., Thomé A.M.T., & Scavarda A.J.. Sustainable urban infrastructure: A review. Resources, Conservation and Recycling, 2018:128;360-72.

Hashizume M., Ueda K., Nishiwaki Y., et al. Health effects of Asian dust events: a review of the literature. Nihon eiseigaku zasshi [Japanese Journal of Hygiene], 2010:65(3);413-21.

Zhang X., Zhao L., Tong D.Q., et al. A systematic review of global desert dust and associated human health effectsAtmosphere, 2016:7(12);158.

Floods and water impacts

Ahmed T., Scholz M., Al-Faraj F., et al. Water-related impacts of climate change on agriculture and subsequently on public health: A review for generalists with particular reference to PakistanInternational journal of environmental research and public health, 2016:13(11);1051.

Johanning E., Auger P., Morey P.R., et al. Review of health hazards and prevention measures for response and recovery workers and volunteers after natural disasters, flooding, and water damage: mold and dampnessEnvironmental Health and Preventive Medicine, 2014:19(2);93.

Veenema T.G., Thornton C.P., Lavin R.P., et al. Climate change-related water disasters’ impact on population healthJournal of Nursing Scholarship, 2017:49(6);625-34.

Health impacts

Goldman A., Eggen B., Golding B., et al. The health impacts of windstorms: a systematic literature review. Public Health, 2014:128(1);3-28.

Harville E.W., Xiong X., & Buekens, P. Disasters and perinatal health: a systematic review. Obstetrical & Gynecological survey, 2010:65(11);713.

Klinger C., Landeg O., Murray V. M. Power outages, extreme events and health: a systematic review of the literature from 2011-2012.  PLoS Currents. 2014:Jan 2; 6.

Kouadio I.K., Aljunid S., Kamigaki T., et al. Infectious diseases following natural disasters: prevention and control measuresExpert Review of Anti-Infective Therapy, 2012:10(1);95-104.

Louis V., Phalkey R., Le Polain De Waroux O., et al. The health and health care system impacts of earthquakes, windstorms and floods –a systematic review. MICRODIS paper series. Brussels: Center for Research on the Epidemiology of Disasters, 2008, 1Á62.

Ryan B., Franklin R.C., Burkle Jr F.M., et al. Identifying and describing the impact of cyclone storm and flood related disasters on treatment management, care and exacerbations of non-communicable diseases and the implications for public healthPLoS Currents. 2015:Sep 28;7.

Saulnier D.S., Ribacke K.B. & von Schreeb J. No calm after the storm: A systematic review of human health following flood and storm disastersPrehospital and Disaster Medicine 2017:32(5);1-12.

Smith S.L., & Smith H.G. The impact of hurricanes on mechanisms of burn injuryJournal of Burn Care & Research, 2018:39(1);S52.

Steinmann W.C. Why current medical management is failing victims of Hurricane Katrina: a review of past successes and failures in postdisaster psychosocial treatmentSouthern Medical Journal, 2007:100(10);991-8.

Mental health impacts

Chan C.S., & Rhodes J.E. Measuring exposure in Hurricane Katrina: a meta-analysis and an integrative data analysis. PLoS One, 2014:9(4);e92899.

Fernandez A., Black J., Jones M., et al (2015). Flooding and mental health: a systematic mapping review. PloS One, 2015:10(4);e0119929.

Kõlves K., Kõlves K.E., & De Leo D. Natural disasters and suicidal behaviours: a systematic literature review. Journal of Affective Disorders, 2013:146(1);1-14.

Lock S., Rubin G. J., Murray V., et al. Secondary stressors and extreme events and disasters: A systematic review of primary research from 2010-2011PLoS Currents. 2012, Oct 29; 4.

Readiness, Forecasting, Mitigation, and Adaptation

Bartholdson, S., & von Schreeb, J. Natural disasters and injuries: what does a surgeon need to know? Current Trauma Reports, 2018:1-6.

Curtis L. Midlevel dry intrusions as a factor in tornado outbreaks associated with landfalling tropical cyclones from the Atlantic and Gulf of MexicoWeather and Forecasting, 2004:19(2);411-27.

Ejeta L.T., Ardalan A., & Paton D. Application of behavioral theories to disaster and emergency health preparedness: A systematic review. PLoS currents, 2015:July 1;7.

Hilts A.S., Mack S., Eidson M., et al. New York state public health system response to Hurricane Sandy: An analysis of emergency reportsDisaster Medicine and Public Health Preparedness, 2016:10(3);308-13.

Hoque M.A.A., Phinn S., & Roelfsema C. A systematic review of tropical cyclone disaster management research using remote sensing and spatial analysisOcean & Coastal Management, 2017:146;109-20.

Horn D.P. Storm surge warning, mitigation, and adaptation. In Coastal and Marine Hazards, Risks, and Disasters, 2015 (pp. 153-180).

Lumbroso D., Suckall N., Nicholls R., et al. Enhancing resilience to coastal flooding from severe storms in the USA: international lessonsNatural Hazards and Earth System Sciences, 2017:17;1357-73.

Manning S., & Kushma J. A systematic review of the international disaster case management literature in the aftermath of Hurricane KatrinaInternational Journal of Emergency Management, 2016:12(3);241-62.

Mills D.M. Climate change, extreme weather events, and us. Health impacts: What can we say? Journal of Occupational and Environmental Medicine, 2009:51(1);26-32.


Other resources (not systematic reviews)

Other resources, not systematic reviews

Evidence Aid Special Collections

DG ECHO Emergency Response Coordination Centre Analytical Team: Tropical cyclone seasons 2012-17

Disaster needs assessment: MIRA Approach: Process, Methodologies and Tools – Download bundle of the PDFs

Disaster risk management for health: Fact sheets

Philippines response website:

WHO Regional Office for Europe: Floods in the WHO European Region: Health effects and their prevention


Archive of Evidence Aid feature posts for major windstorms

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