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The influence of a disaster on the health of rescue workers: a longitudinal study

From the Netherlands Institute for Health Services Research (Morren, Dirkzwager, Yzermans), Utrecht; and Occupational Health Service East Netherlands (Kessels), Enschede, the Netherlands.

Correspondence to: Dr. Mattijn Morren, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands; fax +31 30 2729 729; m.morren{at}nivel.nl

Background: Rescue workers strive, after disasters, to help victims and restrict damage, often in dangerous circumstances. We examined the effect of a disaster on the physical and psychological health of rescue workers (firefighters, police officers and medical emergency services personnel) who provided assistance after the explosion of a fireworks depot in the Netherlands in May 2000.

Methods: We carried out a 4-year longitudinal study of 1403 rescue workers employed in or near the affected neighbourhood (the study group) and a control group of 1650 uninvolved rescue workers (from another city of similar size and urbanization). Health outcomes were measured as prevalence, incidence (both measured as the percent of workers who took sick leave), frequency of the absences and number of sick days (both per 100 workers), and duration (mean length of sickness absences, in days).

Results: Sick leave among the study workers increased substantially during the 18 months after the explosion. For example, the prevalence of absences attributed to psychological problems increased from 2.5% of workers during the 6 months before the disaster to 4.6% during the first 6-month period after the explosion and 5.1% during the second. That for respiratory problems rose from 5.4% predisaster to 14.9% 6–12 months afterward. In comparison with controls, immediate increases occurred in musculoskeletal, psychological, respiratory and nonspecific ill health (e.g., malaise, fatigue) during the first year postdisaster. Rates of sick leave for musculoskeletal and respiratory reasons remained elevated until 3 years postdisaster, whereas leave for psychological problems and other ill health had returned to predisaster levels by then. Neurological problems increased after a 1-year delay. No significant increase in gastrointestinal problems was observed among the study workers, in comparison with controls.

Interpretation: Many health problems arise immediately after a disaster and may persist for years. Health care workers should realize, however, that some disaster-related effects may not emerge until a year or more after the event.

This article has been cited by other articles:

				S. Galea The long-term health consequences of disasters and mass traumas Can. Med. Assoc. J., April 24, 2007; 176(9): 1293 - 1294. [Full Text] [PDF]

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