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The main methods that the authors appear to use are reported data from disasters that have happened around the globe, including numbers and types of infections, displacement and crowding data, and knowledge of the disaster incidents examined

The main point of the article is to report a conflict of opinions between the NRC and the Disaster Accountability Project on the safety of the communities surrounding the Indian Point Nuclear Power Plant. The NRC and the company running the plant, Entergy, state that those communities within a 10 mile radius are required to have emergency evacuation plans in place should a nuclear emergency occur; those outside this radius, however, are not at as large of risk. The nonprofit, however, cites the NRC's report on the Fukushima disaster, where it recommended the US citizens within 50 miles of the plant should evacuate the area, and suggests that communities within a 50 mile radius of Indian Point have specific nuclear emergency plans at hand and prepared for use. Entergy says that the radius "provides a robust safety margin", and the NRC replies to the Disaster Accountability Project's statement by saying that the incident at Fukushima is not comparable to any nuclear power cite in the US, due to the size and number of reactors in the Fukushima plant.

"The risk for commuicable disease transmission after disasters is associated primarily with the size and characteristics of the population displaced, specifically the proximity of safe water adn functioning latrines, the nutritional status of the displaced population, the level of immunuty to vaccine-preventable diseases..., and the access to healthcare services"

"...natural disasters (regardless of type) that do not result in population displacement are rarely associated with outbreaks"

"When death is directly due to the natural disaster, human remains do not pose a rise for outbreaks"

The author contacted both the NRC and the nonprofit Disaster Accountability Project for statements and information on the safety of the plant and if emergency plans were in place. The NRC gave statements and information on their discussions with the Disaster Accountability Project, and the nonprofit described their process of sending freedom-of-information requests to 20 jurisdictions in NY, NJ, and CT located up to 50 miles from Indian Point, in order to determine if they had emergency plans related to the power plant and what they might be

1: Crowding is shown to be common in displaced populations, and local overpopulation/crowding often facillitates the transmittion of disease

2: Natural disasters that do not cause a displacement of a population are rarely associated with disease outbreaks

3: There is little or no evidence that dead bodies, as some believe, pose a epidemic risk for a population of survivors after a disaster has struck

"The federal Nuclear Regulatory Commission requires communities located within 10 miles of nuclear power plants to develop emergency plans. In New York, the four counties within 10 miles of Indian Point—Westchester, Rockland, Putnam and Orange—have taken such measures. But the Disaster Accountability Project, a nonprofit organization that monitors disaster response programs and the author of the report, cited the commission’s response to the 2011 nuclear accident in Fukushima, Japan, in which it recommended that U.S. citizens within 50 miles evacuate."

"NRC spokesman Neil Sheehan said the Fukushima site isn’t comparable to any in the U.S. 'Quite frankly, we don’t have any nuclear plant complexes where you have so many reactors packed so closely together.'"

"Those communities are exempt from the NRC’s emergency planning zones, so most haven’t developed such plans or conducted studies. According to several of them, they couldn’t without help from the federal government."

I did further research into what the Disaster Accountability Project is and what they are trying to accomplish. I also looked into the NRC and how they are focused on safety of nuclear power in the US, and what some of their differences are with the DAP. Finally, I looked up the Indian Point Energy Center, in order to find out the size and scope of the plant and some of the concerns people have about nuclear power in their area

The main findings of the article are that the relationship between natural disasters and communicable diseases is not as much due to dead bodies or high trauma as it is to population displacement and a lack of preparredness of the local governing body for the disaster and the crowding of survivors that follows a disaster as this

This article has been referenced in a wide variety of emergency medicine journal articles, ranging from flood protocols, use of cell phones in disaster enviroments, earthquakes and medical complications, to the costs of disaster consequences. Many of the articles referencing this paper appear to go into greater depth for some of the epidemics and diseases that were touched on in the research article. These include hepatitis E, Leptospirosis, cholera, and tetanus.