title: Psychological, musculoskeletal, and respiratory problems and sickness absence before and after involvement in a disaster: a longitudinal study among rescue workers.
abstract: BACKGROUND
  On 13 May 2000 a firework depot situated in a residential area in the Netherlands exploded. Many rescue workers were involved in the aftermath of this explosion.
  
  
  OBJECTIVE
  To examine the longitudinal course of psychological, musculoskeletal, and respiratory problems and sickness absence among rescue workers involved.
  
  
  METHODS
  The study population was composed of 1036 rescue workers. Data on health and sickness absence both before and after the disaster were collected from the electronic database of the rescue workers' occupational physicians. Health problems were coded according to an adapted version of the ICD-10.
  
  
  RESULTS
  After the disaster a long term increase was found in psychological, musculoskeletal, and respiratory problems. Compared to six months before the disaster, the average length of sickness absence in the first half year after the disaster increased from 6.6 to 11.6 days, and decreased slowly in the following six month periods.
  
  
  CONCLUSIONS
  Rescue workers involved in a disaster may experience subsequent impairment in occupational functioning.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), PO Box 1568, 3500 BN Utrecht, Netherlands. a.dirkzwager@nivel.nl
authors.forename: A J E
authors.initials: AJ
authors.lastname: Dirkzwager
authors.forename: C J
authors.initials: CJ
authors.lastname: Yzermans
authors.forename: F J M
authors.initials: FJ
authors.lastname: Kessels
mesh_terms: D000041:Absenteeism; D000328:Adult; D016009:Chi-Square Distribution; D004190:Disasters; D005107:Explosions; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D009140:Musculoskeletal Diseases / Q000209:etiology*; D009426:Netherlands; D009784:Occupational Diseases / Q000209:etiology*; D018635:Rescue Work; D012120:Respiration Disorders / Q000209:etiology*; D018582:Sick Leave / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000150:complications