Publicatie datum

Longitudinal health effects of disasters.

IJzermans, C.J., Donker, G. Longitudinal health effects of disasters. European Journal of Public Health: 2003, 13(4 sup) 50. Abstract. 11th Annual Eupha Meeting 'Globalisation and Health in Europe: Harmonising Public Health Practices'. Rome, Italy, 20-22 November 2003.
Background and Aim: We are involved in research on the possible health effects of three disasters in the Netherlands: a plane crash in an Amsterdam neighbourhood, the explosion of a firework factory in the city of Enschede and a fire in a discotheque in Volendam. Which methodologies were used and why? What are the common results of those research
projects? What are the public health consequences of disasters for the survivors and for the community? Methods: Six years after the plane crash in Amsterdam we conducted a health survey on its health effects. The Symptom-Checklist 90 (SCL-90) was sent to all people who contacted a call centre, where their health problems were collected. These problems were compared with the medical files of their general practitioners (GPs). In Enschede all problems presented to GPs, company doctors and mental health professionals are monitored. In Volendam, this monitoring is limited to GPs. Since the monitoring procedures were operational one year before the disaster, baseline information on the victims and survivors is available. Learning from the chaotic aftermath of the Amsterdam crash, the Dutch government attempts to prevent long term public health damage by means of a pro-active public health response; monitoring of the health problems is one of the options. Results: Six years after the plane crash some 1,000 people still attributed their health problems to the disaster. There appeared to be a lot of distress (2 SDs higher than in the normal population). Most health problems belonged to the group ‘medically unexplained physical symptoms’ (MUPS). This group of symptoms is also seen in the aftermath (of two years) of the disasters in Enschede (some 9,000 afflicted persons) and Volendam (some 1,000). Besides, psychosocial problems and symptoms of the locomotive, respectively the respiratory system are often presented. Conclusions: In the presentation, we reflect on our experiences using two types of study (health survey and monitoring) and the consequences of using data obtained from the survivors themselves (self-reported) or objectivated by their GP. We present the health problems found in the three studies, focusing on MUPS (some 25% of all problems). Finally, we describe the possible public health consequences of disasters in today’s culture (of threats and fear). (aut.ref.)