Health problems among children and adolescents before and after a disaster.

Aim: In May 2000, a firework factory exploded in a residential area in the Netherlands, resulting in 22 deaths, 947 wounded people and about 1.500 people who lost their homes. Following the explosion, a large-scale monitoring study was implemented to examine disasterrelated health consequences for the residents of the neighbourhood. In this presentation the longitudinal course of the health problems of children and adolescents involved in the disaster are discussed. Methods: Data are collected in general practices through a standardised reporting procedure, in which the general practitioners (GPs) register each contact with their patients in a computerised format. The monitoring provides information about the number of medical consultations and the type of health problems patients present to their GPs. In addition, information is available on demographic characteristics, and on the degree of exposure to the explosion. Health problems are registered by the GPs according to the International Classification of Primary Care (ICPC). Both pre-disaster data and data of a control group are available. Results: Youngsters between 1-20 years of age were examined. Data were available for 1.681 victims (53% male; mean age = 11.0, SD=6.0) and 2.675 controls (50.4% male; mean age = 10.6, SD=5.8). Prior to the disaster 10.4% of the victims presented psychological problems to their GP, compared to 8.1% in the control group. The first year post-disaster still 8.1% of the control group reported psychological problems, while in the victim group the number of youths with psychological problems increased to 26.8%. Results for other types of health problems, for different age groups and risk factors for post-disaster psychological problems will be examined as well. Conclusions: Youngsters exposed to this disaster showed long-term increases in morbidity, especially in psychological problems. Health care providers should be alert for such problems even among very young children. Extreme weather events in Europe and Public Health responses: an overview of contributions to an European conference to this topic and recommendations from the WHO and European experts.