Disaster Epidemiology Lessons From Bam Earthquake Dec 26, 2003 Iran Part 6: Buildings structure and death in Bam earthquake 1 Ali Ardalan MD, MPH, PhD student in Epidemiology

Learning objectives:  To learn about the main structure of buildings in Bam  To understand the importance of supervision on considering the seismic code  To understand the association of buildings structure and death in Bam earthquake 2

3 Collapse state of houses based on a cross-sectional study on 19th and 20th days of post-disaster period in Bam

4 Total collapse of a clay and mud brick building in Bam

5 Resistance of the curved roof in an old-style building in Bam

6 Other examples of curved roofs resistance in the old-style buildings in Bam

7 Other examples of curved roofs resistance in the old-style buildings in Bam

8 A collapsed old-style building in Bam: Mud bricks bearing walls, with steel roof

9 A collapsed modern-style building with lack of adequate lateral resistance

10 Comparing resistance of buildings with and without bracing in Bam

11 Collapse of the attic on to a house entrance in Bam

12 Appropriate bracing on two sides of “ Kimia building ” in Bam & formation of soft ground

13 Two buildings opposite each other in one street in Bam

14 Non-damaged steel framed buildings with bracing in Bam

15 Non-damaged Central mosque of Bam

Death and injuries in direct relation to Bam earthquake based on a cross-sectional study 16  Death: 18%  Injuries: 48%  Hospitalization of injured: 32 %  Hospitalization of total: 13 %

The most important determinant variable of direct related death to Bam earthquake, based on a cross-sectional study Building collapse status (Total / Partial-None) OR = 5.15 (CI 95%: ) 17

Conclusion:  Because structural collapse is the single greatest risk factor, priority should be given to seismic safety in land-use planning and in the design and construction of safer buildings. 18