PONE-D-21-06605

How behavior influence flood deaths? A case control study

PLOS ONE

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PLOS ONE

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Additional Editor Comments:

Dear authors,

Thank you for submitting this interesting and important article.

I would like to request you to revise the article according to the comments and suggestions of the auditors.

Kind regards,

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: No

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: I am not sure whether the Journal guideline follows structured way of abstract (aim, methods, results, conclusion..)

I don’t think the introduction flows as it should. Can they first discuss what Disaster is, specifically flood death the problem at the global level, then continent level, and then Iran. Need more to define problem by giving numbers and trends. And then specifically discuss the regional differences in Iran, and possible reasons for all the problems.

What does mean questionnaire and survey@line 46? Subject is not also appropriate way of explanation. Use standard research language.

You should have justification for this padoxical results either literature driven or data driven justification line 51 to 52.

Sentences from Line 2019-2023 are not clear and I don’t think so it is appropriate way of expression.

The explanations in the text such as surveyor, matching, are not self-explanatory.

The methods of analysis did not elaborated in the appropriate place. There is poor presentation

You should use appropriate place and appropriate description of variables. Avoid the bracket description @line 256.

What was your justification to take only these limited variables?

The paper don't have any theoretical framework as the base for the study

Ethical consideration is considered in the case of health related studies. Please follow the journal guideline for such cases.

The description of explanatory and outcome variables are not consistent.

Category of demographic and other variables should have justification.

Education has six categories with no justification. Illiterate is a person who don’t know. Every person has his/her own indigenous knowledge. You better replace it with cannot read and write.

Avoid the SE,Wald...as you are not used in the description. Use only relevant tests for your analysis Table 4

The majority of your studies are in line with previous findings. What was your contribution/what is new in your study?

There are also repetition of ideas over the paper which needs improvement

English proofreading is needed to provide the expected scientific and right English.

Reviewer #2: The present study aimed to investigate the behavioral and demographic risk factors in the deaths due to flood, starting a case-control study that was conducted in the cities affected by flood in Iran. The author measured the odds ratio and investigated the contribution and significance of the factors in relation to mortality. The required data were collected and compared on the individual and behavioral factors of recent flood deaths from the families of the victims and survivors by conducting a survey.

The introduction presents an excellent discussion on the subject, bringing relevant information and statistics about natural disasters, and, more specifically, flood deaths, and the relationship with the behavior of victims, from various sources, such as World Disasters Report e a World Health Organization (WHO).

Regarding the methodology, the authors randomly selected the control samples from the neighbors of the flood victims based on family health dossier number in the Comprehensive Health Services and Health Centers (10 numbers above and below). About de records, 86 cases of flood deaths were reviewed, which had been recorded in various sources of the floods occurring in Iran during 17th March-29th May 2019, ande the study was

performed using the data of 77 flood victims (and 310 subjects completed the survey in the control group). A set of very interesting variables were selected, on demographic characteristics and behavioral aspects, in addition to statistical validation tests, which contributed to the construction of binary logistic regression. In the models, the effects of these factors on the flood deaths were investigated.

The results start with an excellent descriptive analysis of the demographic characteristics of the victims. The results of binary logistic regression analysis indicated that age and literacy level were significantly correlated with flood death. However, the authors could be more explicit about the relationship that exists between more vulnerable sociodemographic profiles with more precarious housing and vulnerable to flood death, in the context of different types of land use and occupation. I suggest that the author make this discussion, as there is selectivity and socio-spatial inequality, in which residents with less education and resources reside in more vulnerable areas. In fact, the greater propensity of people most vulnerable to flood death is already an indication of this socio-spatial inequality, but it is important to carry out the discussion.

The author commented on the fact that greater education may be related to the promotion of the culture of resilience in various communities, but there may be a relationship between the level of exposure of the dwelling and the sociodemographic profile of the population, even considering the profile of the sample selected. After all, when the authors state that The characteristics of the people affected by floods and their ability to respond and ensure the safety of themselves and their relatives during the flood time could determine their vulnerability to floods, it would be interesting to relativize the place of residence. It is not necessary to incorporate it into the models, but just to contextualize it a little more in the analysis of the results.

Otherwise, the findings indicated that factors such as the age of less than 18 years, low literacy, being trapped in buildings/cars, and risky behaviors increased the risk of flood deaths. According to the results, the adoption of support strategies, protecting vulnerable groups, and improving the socioeconomic status of flood-prone areas could prevent and reduce the risk of flood deaths. These are very interesting results, and represent an important contribution to studies on environmental disasters. I congratulate the authors for the excellent article, with solid theoretical review and robust methodology, and whose opinion I already anticipate is positive, for publication in PLOSONE.

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If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Zerihun Yohannes Amare

Reviewer #2: Yes: The present study aimed to investigate the behavioral and demographic risk factors in the deaths due to flood, starting a case-control study that was conducted in the cities affected by flood in Iran. The author measured the odds ratio and investigated the contribution and significance of the factors in relation to mortality. The required data were collected and compared on the individual and behavioral factors of recent flood deaths from the families of the victims and survivors by conducting a survey.

The introduction presents an excellent discussion on the subject, bringing relevant information and statistics about natural disasters, and, more specifically, flood deaths, and the relationship with the behavior of victims, from various sources, such as World Disasters Report e a World Health Organization (WHO).

Regarding the methodology, the authors randomly selected the control samples from the neighbors of the flood victims based on family health dossier number in the Comprehensive Health Services and Health Centers (10 numbers above and below). About de records, 86 cases of flood deaths were reviewed, which had been recorded in various sources of the floods occurring in Iran during 17th March-29th May 2019, ande the study was

performed using the data of 77 flood victims (and 310 subjects completed the survey in the control group). A set of very interesting variables were selected, on demographic characteristics and behavioral aspects, in addition to statistical validation tests, which contributed to the construction of binary logistic regression. In the models, the effects of these factors on the flood deaths were investigated.

The results start with an excellent descriptive analysis of the demographic characteristics of the victims. The results of binary logistic regression analysis indicated that age and literacy level were significantly correlated with flood death. However, the authors could be more explicit about the relationship that exists between more vulnerable sociodemographic profiles with more precarious housing and vulnerable to flood death, in the context of different types of land use and occupation. I suggest that the author make this discussion, as there is selectivity and socio-spatial inequality, in which residents with less education and resources reside in more vulnerable areas. In fact, the greater propensity of people most vulnerable to flood death is already an indication of this socio-spatial inequality, but it is important to carry out the discussion.

The author commented on the fact that greater education may be related to the promotion of the culture of resilience in various communities, but there may be a relationship between the level of exposure of the dwelling and the sociodemographic profile of the population, even considering the profile of the sample selected. After all, when the authors state that The characteristics of the people affected by floods and their ability to respond and ensure the safety of themselves and their relatives during the flood time could determine their vulnerability to floods, it would be interesting to relativize the place of residence. It is not necessary to incorporate it into the models, but just to contextualize it a little more in the analysis of the results.

Otherwise, the findings indicated that factors such as the age of less than 18 years, low literacy, being trapped in buildings/cars, and risky behaviors increased the risk of flood deaths. According to the results, the adoption of support strategies, protecting vulnerable groups, and improving the socioeconomic status of flood-prone areas could prevent and reduce the risk of flood deaths. These are very interesting results, and represent an important contribution to studies on environmental disasters. I congratulate the authors for the excellent article, with solid theoretical review and robust methodology, and whose opinion I already anticipate is positive, for publication in PLOSONE.

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Attachments

Attachment

Submitted filename: PONE-D-21-06605_reviewer (1).pdf

Behavioral, Health- Related and Demographic Risk Factors of Death in Floods: A Case-Control Study

PONE-D-21-06605R1

Dear Dr. Abbas Ostadtaghizadeh,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Shah Md Atiqul Haq

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Dear authors,

Your article is now accepted.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The authors complied with all the comments made by the reviewers. Therefore, my recommendation is in favor of publication.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No