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OBJECTIVE: Underground mining is associated with obvious risks that can lead to mass casualty incidents. Information about such incidents was analyzed in an integrated literature review.

METHODS: A literature search (1980-2015) identified 564 modern-era underground mining reports from countries sharing similar occupational health legislation. These reports were condensed to 31 reports after consideration of quality grading and appropriateness to the aim. The Haddon matrix was used for structure, separating human factors from technical and environmental details, and timing.

RESULTS: Most of the reports were descriptive regarding injury-creating technical and environmental factors. The influence of rock characteristics was an important pre-event environmental factor. The organic nature of coal adds risks not shared in hard-rock mines. A sequence of mechanisms is commonly described, often initiated by a human factor in interaction with technology and step-wise escalation to involve environmental circumstances. Socioeconomic factors introduce heterogeneity. In the Haddon matrix, emergency medical services are mainly a post-event environmental issue, which were not well described in the available literature. The US Quecreek Coal Mine incident of 2002 stands out as a well-planned rescue mission.

CONCLUSION: Evaluation of the preparedness to handle underground mining incidents deserves further scientific attention. Preparedness must include the medical aspects of rescue operations.

BACKGROUND: EU Decision 1082/2013/EU on serious cross-border health threats provides a legal basis for collaboration between EU Member States, and between international and European level institutions on preparedness, prevention, and mitigation in the event of a public health emergency. The Decision provides a context for the present study, which aims to identify good practices and lessons learned in preparedness and response to Middle East Respiratory Syndrome (MERS) (in UK, Greece, and Spain) and poliomyelitis (in Poland and Cyprus).

METHODS: Based on a documentary review, followed by five week-long country visits involving a total of 61 interviews and group discussions with experts from both the health and non-health sectors, this qualitative case study has investigated six issues related to preparedness and response to MERS and poliomyelitis: national plans and overall preparedness capacity; training and exercises; risk communication; linking policy and implementation; interoperability between the health and non-health sectors; and cross-border collaboration.

RESULTS: Preparedness and response plans for MERS and poliomyelitis were in place in the participating countries, with a high level of technical expertise available to implement them. Nevertheless, formal evaluation of the responses to previous public health emergencies have sometimes been limited, so lessons learned may not be reflected in updated plans, thereby risking mistakes being repeated in future. The nature and extent of inter-sectoral collaboration varied according to the sectors involved, with those sectors that have traditionally had good collaboration (e.g. animal health and food safety), as well as those that have a financial incentive for controlling infectious diseases (e.g. agriculture, tourism, and air travel) seen as most likely to have integrated public health preparedness and response plans. Although the formal protocols for inter-sectoral collaboration were not always up to date, good personal relations were reported within the relevant professional networks, which could be brought into play in the event of a public health emergency. Cross-border collaboration was greatly facilitated if the neighbouring country was a fellow EU Member State.

CONCLUSIONS: Infectious disease outbreaks remain as an ongoing threat. Efforts are required to ensure that core public health capacities for the full range of preparedness and response activities are sustained.

Within the broad context of EU Decision 1082/2013/EU on serious cross-border threats to health, the European Centre for Disease Prevention and Control (ECDC) has initiated a case study project to investigate the synergies between communities affected by serious public health threats and the institutions (both health- and non-healthrelated) mandated to prepare for and respond to them. The premise for the project is that affected communities are increasingly recognised as key resources that can be used during public health emergencies, and that the concerns and experience of ordinary people should be harnessed as an important part of the response. The aim of this qualitative comparative case study project is to identify good practices related to community preparedness for tick-borne diseases. Two EU countries, Spain and the Netherlands, were selected for inclusion. Work in Spain focused around two cases of autochthonous infection with Crimean-Congo haemorrhagic fever (CCHF) virus that emerged in the Autonomous Community of Castilla y León in August 2016. Work in the Netherlands focussed on the first two endemic cases of tick-borne encephalitis (TBE) in the country, appearing in July 2016 in the Utrecht and Twente regions. The response to the TBE cases was undertaken within the wider context of prevention work on lyme borreliosis (LB) in the country. Specifically, the study aims to: - Identify good practices and patterns of cooperation between affected communities and the official institutions mandated to address tick-borne diseases; - Identify inter-sectoral collaboration between health and non-health-related sectors with regard to tick-borne diseases; - Identify practices that could be of use for other EU countries in the area of public health preparedness.

Within the broad context of EU Decision 1082/2013/EU on serious cross-border health threats, the European Centre for Disease Prevention and Control (ECDC) has initiated a case study project to investigate the synergies between communities affected by serious public health threats and the institutions (both health- and non-healthrelated) that are mandated to prepare for and respond to them. The premise for the project is that affected communities are increasingly being recognised as key resources that can be used during public health emergencies, and that the concerns, understanding and experience of ordinary people should be harnessed as an important part of the response. The aim of this case study project is to identify good practices related to community preparedness for tick-borne diseases. This report focuses on two cases of Crimean-Congo Haemorrhagic Fever (CCHF) that emerged in Spain in August– September 2016, the first autochthonous clinical cases of CCHF in south-western Europe. Specifically, the study aims: - to identify good practices and patterns of cooperation between affected communities and the official institutions mandated to address tick-borne diseases such as CCHF; - to identify inter-sectoral collaboration between health and non-health-related sectors with regard to tickborne diseases, such as CCHF; - to identify actions that could be taken by other EU countries.

​The last cases of poliomyelitis due to wild poliovirus in Poland and Cyprus were registered in 1984 and 1995, respectively. Current efforts against polio are therefore aimed at maintaining the two countries’ polio-free status. The overall objective of this report is to support these two EU Member States in updating their polio preparedness planning. The specific aims of the case study were to: critically review implemented actions and identify gaps in order to propose approaches for strengthening the national polio plans; identify health system elements that are important in polio preparedness planning; and provide examples of collaborative efforts between these sectors in planning measures for outbreak response to polio as a cross-border health threat.