Pediatric health events during disaster response: a multi-disaster analysis of emergency medical team records in Japan, 2016–2020

Children are particularly vulnerable during disasters; however, comprehensive data on pediatric health events across multiple disasters are lacking. This study aimed to characterize the health events affecting children during disaster response using disaster medical records from Japan. We conducted a cross-sectional analysis of records from Japan Surveillance in Post Extreme Emergencies and Disasters (J-SPEED), a standardized disaster medical record system used by Emergency Medical Teams in Japan. Records were collected during seven natural disasters between 2016 and 2020, comprising two earthquakes, three heavy rain events, and two typhoons. For each health event category, we calculated the proportion of consultations at which the event was recorded, separately for children aged 0–14 years and adults aged 15 years and older. The ratio of these two proportions was expressed as a prevalence ratio (PR) with 95% confidence intervals (CIs). Of 15,325 consultations, 1,070 (7.0%) involved children. The most frequently recorded health events among children were acute respiratory infections (ARIs; 19.3%), skin diseases (17.7%), wounds (13.0%), and fever (11.4%). Prevalence was significantly higher among children for fever (PR 3.63, 95% CI 3.00–4.39), skin diseases (PR 2.13, 95% CI 1.85–2.45), bronchial asthma (PR 1.85, 95% CI 1.15–2.97), gastrointestinal infections (PR 1.64, 95% CI 1.17–2.30), and ARIs (PR 1.44, 95% CI 1.27–1.64). No significant difference was detected for wounds, burns, bone fractures, or suspected tetanus. Stress-related symptoms were recorded less frequently among children (PR 0.42, 95% CI 0.32–0.56). ARIs, skin diseases, and fever were recorded frequently and were more common among children than adults, underscoring the importance of pediatric-focused preparedness and preventive measures. Bronchial asthma and gastrointestinal infections should also be considered in this setting. Stress-related symptoms were reported less frequently in children, which likely reflects challenges in recognizing these symptoms rather than a lower underlying burden. These findings can inform pediatric disaster medical care planning and resource allocation, and further research using individual-level data is needed to characterize age-specific risks.