Injuries and Deaths Following an Airplane Crash at Phuket International Airport, Thailand, 16 September 2007

Abstract

        On 16 September 2007, an airplane crashed at Phuket International Airport (PIA) becoming a second serious event of airplane crash in Thailand over 10 year period. The objectives of this epidemiological investigation were to describe characteristics of injuries and deaths following this plane crash event in order to recommend improvement of public health emergency response.

       The records of Emergency Medical Service teams, medical records, autopsy results, the manual for emergency policies and procedures of PIA published 10 days prior to the crash, were reviewed. In-depth interviews were conducted among rescue team personnel, PIA staffers, NGO volunteers, crash victims and health care workers. Data triangulation was performed and obstacles and pitfalls were identified.

        An MD-82 plane with 123 passengers and 7 crew members departed from Bangkok to PIA. The airplane crashed while the pilot was attempting to land at its destination. Of the 123 people on board, 89 (68%) died. Most of the fatal cases were in the front of the aircraft due to massive impact force. Major causes of deaths were head injuries (37%), chest/abdomen trauma (14%), and spine fracture (10%). Other causes of death were burn (19%) asphyxia (11%) and unknown (9%). Sixtysix percent (27/41) of the survivors had severe injuries which comprised vertebral spine fracture (52%). The most common fracture level was at T12-L1 spine, a fulcrum point for lap/waist seat belt. Inadequate space between seat rows was identified as one of obstacles for an appropriate sitting position during the emergency landing. Sixty-three percent (26/41) of the survivors were transferred to hospitals by limousines of PIA. Ineffective communication, heavy rain, unsynchronized response and a delay in rescue of injured passengers in the aircraft were identified in this investigation.

        The majority of serious injury among survivors were vertebral spine injuries especially T12- L1 due to horizontal force during the plane crash. Cause of deaths was mainly impact force resulted in head injuries. The emergency public health response to the airplane accident was relatively satisfied in term of collaboration between organizations. However, better responses can be made by improving communications, capacity building of rescue teams, and regular drills on response to plane crash under different contexts.

Key words: plane crash, investigation, injury, spine fractures, Thailand