Respiratory Emergencies in Disasters: A Narrative Review

Disasters cause a wide spectrum of respiratory injuries and affect hundreds of millions of people each year. Because the respiratory system is in continuous contact with the external environment, it is among the most vulnerable systems in disaster settings. Silica-and asbestos-containing dust released from earthquake debris, fine particulate matter from wildfire smoke, mold spores in flood-damaged interiors, ash and acidic gases from volcanic eruptions, toxic industrial chemicals released during chemical incidents, barotrauma from explosions, and biological or pandemic threats each trigger acute and chronic respiratory diseases through distinct mechanisms. This narrative review addresses respiratory emergencies associated with natural and human-made disasters, the underlying pathophysiological mechanisms, diagnostic and management approaches, vulnerable populations, and the influence of climate change on the rising burden of disaster-related respiratory disease. Evidence was synthesized from PubMed/MEDLINE, Web of Science, and Scopus, supplemented by official reports from the Emergency Events Database, the World Health Organization, and the United Nations Office for Disaster Risk Reduction. Available data indicate that acute respiratory infections are major causes of morbidity and mortality in disaster settings across all age groups. Furthermore, patients with chronic respiratory diseases face an increased risk of exacerbations, while the management of acute respiratory distress syndrome remains a significant challenge, particularly in resource-limited environments. Disaster preparedness planning must prioritize respiratory emergencies and strengthen response protocols for vulnerable groups.