Long-term effects of a disaster on physical and psychological health

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The long-term effects of a disaster on physical and psychological health are the focus of a new study of rescue workers who provided assistance after the explosion of a fireworks depot in the Netherlands in May 2000.

Using a unique Dutch electronic medical record database that allows pre- and post-disaster comparisons as well as comparisons between case and control cities, Dr. Mattijn Morren and colleagues were able to follow the workers for 4 years.

Interesting patterns emerged. For instance, the rate of sick leave doubled (e.g. prevalence of absences increased from 2.5% during 6 months before the disaster to 4.6% during 6 months afterward). Of particular interest is that the increased sick leave taken for musculoskeletal and respiratory reasons did not normalize until 3 years after the explosion, whereas leaves taken due to psychological problems and nonspecific symptoms (e.g. fatigue or feeling generally unwell) had returned to predisaster rates before then. Some problems, such as neurological difficulties, did not increase until one year after the disaster.

In a related commentary, Dr. Sandro Galea notes that this research provides an opportunity for reflection not only on the long-term consequences of disasters and mass traumas, but also about their implications for population health and health care needs in general.

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