Psychological consequences of a firework factory disaster in a local community

The causal effect of mental health on labor market outcomes: The case of stress-related mental disorders following a human-made disaster

As disasters increase due to climate change, population density, epidemics, and technology, information is needed about postdisaster consequences for people's mental health and how stress-related mental disorders affect multiple spheres of life, including labor-market attachment. We tested the causal hypothesis that individuals who developed stress-related mental disorders as a consequence of their disaster exposure experienced subsequent weak labor-market attachment and poor work-related outcomes. We leveraged a natural experiment in an instrumental variables model, studying a 2004 fireworks factory explosion disaster that precipitated the onset of stress-related disorders (posttraumatic stress disorder, anxiety, and depression) among individuals in the local community (N = 86,726). We measured labor-market outcomes using longitudinal population-level administrative data: sick leave, unemployment benefits, early retirement pension, and income from wages from 2007 to 2010. We found that individuals who developed a stress-related disorder after the disaster were likely to go on sickness benefit, both in the short- and long-term, were likely to use unemployment benefits and to lose wage income in the long term. Stress-related disorders did not increase the likelihood of early retirement. The natural experiment design minimized the possibility that omitted confounders biased these effects of mental health on work outcomes. Addressing the mental health and employment needs of survivors after a traumatic experience may improve their labor-market outcomes and their nations' economic outputs.

Psychological, Physical and Behavioral Health of Adults, 3 Years After Exposure to a Train Derailment

In July 2013, a train derailment profoundly disrupted the tranquility of the population of Lac-Mégantic for months and even years. In 2016, we conducted a representative population-based survey among 387 people from Lac-Mégantic and 413 from other municipalities with the aim to document psychological and physical health of adults exposed to the disaster. This article examines differences between 3 groups of respondents: those who were highly, moderately or not exposed to the train accident. Khi Square analyses, odds ratios and logistic regressions were used to examine differences between the 3 groups of respondents (high, moderate and no exposure). Results show that the level of exposure to this technological disaster is strongly associated with psychological suffering, post-traumatic growth, physical heath, drinking patterns, and use of prescribed and non-prescribed drugs. We can explain these results by the nature and cause of the event as well as its consequences.

Medium-Term Effects of a Train Derailment on the Physical and Psychological Health of Men

In July 2013, the derailment of a train caused the death of 47 people and the destruction of Lac-Mégantic's downtown area (Canada). Three years after this event, a population survey was conducted among a representative sample of 800 adults, including 282 men. Several significant differences were observed among respondents of a survey based on their level of exposure to this tragedy, including their physical (changes in physical health) and psychological health (post-traumatic stress disorder, mood and anxiety disorders, psychological distress, signs of depression, consultation of social workers and psychologists) as well as their use of prescribed (anxiolytics and antidepressants) and nonprescribed drugs. Such results can be explained by the nature, magnitude, and cause of the event.

Health-related quality of life for medical rescuers one month after Ludian earthquake

BACKGROUND

An earthquake struck Ludian in Yunnan province of China on August 3, 2014, resulting in 3143 injuries, 617 deaths, and 112 missing persons. Our study aimed at estimating the quality of life and associated determinants among medical rescuers after Ludian earthquake.

METHODS

A cross-sectional survey was performed among personnel from three hospitals that assumed rescue tasks in Ludian earthquake. Descriptive statistics, t-tests, ANOVA and stepwise linear regression analysis were used for data analysis.

RESULTS

The mean scores on the physical component summary (PCS) and mental component summary (MCS) were 49.86 (SD = 6.01) and 35.85(SD = 6.90), respectively. Lower PCS in the aftermath of an earthquake was associated with non-military medical rescuers, elderly age, and being trapped/in danger while lower MSC in the aftermath of an earthquake was associated with non-military medical rescuers, young age, being female, being trapped/in danger and low education degree.

CONCLUSIONS

In conclusion, our study demonstrates that medical rescuers are at risk for a lower HRQoL after exposure to Ludian earthquake. The results of this study help expand our knowledge of health-related quality of life among medical rescuers after the Ludian earthquake.

Gender, trauma type, and PTSD prevalence: a re-analysis of 18 nordic convenience samples

BACKGROUND

The aim of the study was to examine a possible trauma type related variance in the gender difference of posttraumatic stress disorder (PTSD) prevalence.

METHODS

An analysis was conducted on 18 convenience sample studies including data from a total of 5220 participants. The studies all applied the Harvard Trauma Questionnaire - part IV to assess PTSD. Cohen's d was used to measure variance in gender differences. Trauma types included disasters and accidents, violence, loss, chronic disease and non-malignant diseases.

RESULTS

The results showed an overall gender difference in PTSD prevalence similar to previous findings. Thus, women had a two-fold higher prevalence of PTSD than men. Besides categorical analyses, dimensional analyses of PTSD severity were also performed; the latter were associated with twice as large effect sizes. Females were more vulnerable to PTSD after disasters and accidents, followed by loss and non-malignant diseases. In violence and chronic disease, the gender differences were smallest.

CONCLUSIONS

The findings support the existence of a trauma type related variance in gender differences in PTSD prevalence.

The long-term psychological effect of fatal accidents at sea on survivors: a cross-sectional study of North-Atlantic seamen

OBJECTIVE

This study aimed to ascertain whether disasters at sea had an enduring traumatic effect on psychological functioning, accident proneness, and on their interest to continue working at sea.

METHOD

Crew members of selected sea-disasters were contacted. The chosen disasters were of differing severity and in some cases fatalities had occurred. The disasters had taken place on average 8 years previously. Those who agreed to participate were interviewed in a semi-structured interview. They also answered the CIDI; DIS; GHQ-30; IES, and PTSS-10. One hundred-and-twelve seamen who had been in disasters were compared with a comparison group consisting of 59 peers who had not been in a disaster.

RESULTS

Survivors of fatal disasters experienced more long-lasting negative effects than did others where lives were not lost. They had more frequently unpleasant intrusive thoughts on the IES (p < 0.01) compared with their peers. On the DIS, they also more frequently experienced heightened arousal (p < 0.001), sleep problems (p < 0.01), and nightmares (p < 0.01). The duration of PTSD symptoms from the time of the disaster was on average 18 months. Over 33% of the disaster group had experienced some PTSD symptoms within the past 12 months. Disaster survivors had not quit seamanship as frequently as non-disaster seamen.

CONCLUSION

The most severe and long-lasting symptoms were found among those who had been in disasters where one or more crew members had perished. Loss of life in disasters therefore seems significant in the process of creating or extending the endurance of symptoms of psychological vulnerability.

Mental health of workers in Toulouse 2 years after the industrial AZF disaster: first results of a longitudinal follow-up of 3,000 people

INTRODUCTION

On September 21, 2001, the AZF petrochemical factory near Toulouse (France) exploded. A cross-sectional survey of Toulouse workers took place in 2002 and then, a cohort follow-up began in 2003. The aim of this paper is to study the associations between various factors describing exposure to the disaster, and anxiety and depressive symptoms, assessed at cohort inclusion 2 years afterwards.

METHODS

In 2003, 3,006 people were included in the cohort. Psychological distress was measured by the GHQ28 at inclusion. Factors related to exposure to the disaster, such as personal distance from the site, physical injury, immediate psychological symptoms, and material and social effects, came from the 2002 cross-sectional survey. The links between mental health symptoms and exposure were studied in multivariate analyses by logistic regression.

RESULTS

The prevalence of psychological distress was 47% at inclusion in the cohort. It varied according to sex and occupational class: blue-collar workers and self-employed people were most highly affected. Factors such as a history of depression, injury to a close friend or family member, sick-leaves and immediate psychological symptoms were associated with psychological distress 2 years later. These associations differed according to sex.

CONCLUSION

This study shows links between the industrial disaster and psychological distress 2 years afterwards. The results about risk factors differ according to sex, and identify particularly vulnerable populations. It should guide preventive interventions in such situation.

Predictive factors for somatization in a trauma sample

Background

Unexplained somatic symptoms are common among trauma survivors. The relationship between trauma and somatization appears to be mediated by posttraumatic stress disorder (PTSD). However, only few studies have focused on what other psychological risk factors may predispose a trauma victim towards developing somatoform symptoms.

Methods

The present paper examines the predictive value of PTSD severity, dissociation, negative affectivity, depression, anxiety, and feeling incompetent on somatization in a Danish sample of 169 adult men and women who were affected by a series of explosions in a firework factory settled in a residential area.

Results

Negative affectivity and feelings of incompetence significantly predicted somatization, explaining 42% of the variance. PTSD was significant until negative affectivity was controlled for.

Conclusion

Negative affectivity and feelings of incompetence significantly predicted somatization in the trauma sample whereas dissociation, depression, and anxiety were not associated with degree of somatization. PTSD as a risk factor was mediated by negative affectivity.

Risk factors predict post-traumatic stress disorder differently in men and women

BACKGROUND

About twice as many women as men develop post-traumatic stress disorder (PTSD), even though men as a group are exposed to more traumatic events. Exposure to different trauma types does not sufficiently explain why women are more vulnerable.

METHODS

The present work examines the effect of age, previous trauma, negative affectivity (NA), anxiety, depression, persistent dissociation, and social support on PTSD separately in men and women. Subjects were exposed to either a series of explosions in a firework factory near a residential area or to a high school stabbing incident.

RESULTS

Some gender differences were found in the predictive power of well known risk factors for PTSD. Anxiety predicted PTSD in men, but not in women, whereas the opposite was found for depression. Dissociation was a better predictor for PTSD in women than in men in the explosion sample but not in the stabbing sample. Initially, NA predicted PTSD better in women than men in the explosion sample, but when compared only to other significant risk factors, it significantly predicted PTSD for both men and women in both studies. Previous traumatic events and age did not significantly predict PTSD in either gender.

CONCLUSION

Gender differences in the predictive value of social support on PTSD appear to be very complex, and no clear conclusions can be made based on the two studies included in this article.

Participation in a trauma-focused epidemiological investigation may result in sensitization for current health problems

OBJECTIVES

Participation in health survey research may result in a worsening of self-assessed health status and enhanced service-use by increasing self-awareness of current health status. The present study investigated whether participation in a trauma-focused epidemiological study sensitized participants for health problems irrespective of trauma exposure.

METHODS

A total of 1,019 rescue workers and 453 residents involved in varying degrees in a large scale aviation disaster participated. Data collection took place between December 2000 and April 2003. There were two measurements: one during the epidemiological investigation at a general hospital and one 12 weeks after the first measurement. Follow-up data were gathered in 80% of a randomly selected group of rescue workers and in 62% of the residents. Main outcome measures were: health anxiety, somatic sensitivity, the tendency to be reassured by a physician, psychopathology, post-traumatic stress symptoms, fatigue and quality of life.

RESULTS

Both rescue workers and residents reported less reassurance, and increased health anxiety and somatic sensitivity 12 weeks after the investigation compared to the first measurement. Exposure to the aviation disaster was not predictive of these changes in health perception, but higher levels of psychological and physical symptoms at baseline were. Only 0.2-1.6% of the residents and rescue workers indicated at baseline that the investigation had had a very negative impact on their mental and/or physical well-being. No evidence for systematic trends or changes in baseline scores for anxiety about health or subjective complaints during the 15 months inclusion period were found.

CONCLUSIONS

Participation in an epidemiological study of the long-term sequelae of disaster exposure does not lead to very strong negative reactions in most of the participants, but can result in an increased awareness of somatic sensations, enhancement of health worries and lowered reassurability by physicians, especially in participants with higher levels of psychological and physical symptoms at baseline. Future studies are needed to investigate the temporal stability of these inadvertent and unobtrusive negative consequences.