title: Risk factors for psychological and physical health problems after a man-made disaster. Prospective study.
abstract: BACKGROUND
  There are few prospective studies on risk factors for health problems after disasters in which actual pre-disaster health data are available.
  
  
  OBJECTIVE
  To examine whether survivors' personal characteristics, and pre-disaster psychological problems, and disaster-related variables, are related to their post-disaster health.
  
  
  METHODS
  Two studies were combined: a longitudinal survey using the electronic medical records of survivors' general practitioners (GPs), from 1 year before to 1 year after the disaster, and a survey in which questionnaires were filled in by survivors, 3 weeks and 18 months after the disaster. Data from both surveys and the electronic medical records were available for 994 survivors.
  
  
  RESULTS
  After adjustment for demographic and disaster-related variables, pre-existing psychological problems were significantly associated with post-disaster self-reported health problems and post-disaster problems presented presented to the to the GP. This association was found for both psychological and physical post-disaster problems.
  
  
  CONCLUSIONS
  In trying to prevent long-term health consequences after disaster, early attention to survivors with pre-existing psychological problems, and to those survivors who are forced to relocate or are exposed to many stressors during the disaster, appears appropriate.
authors.affiliation: Netherlands Institute for Health Services Research, Utrecht, The Netherlands. a.dirkzwager@nivel.nl
authors.forename: Anja J E
authors.initials: AJ
authors.lastname: Dirkzwager
authors.forename: Linda
authors.initials: L
authors.lastname: Grievink
authors.forename: Peter G
authors.initials: PG
authors.lastname: van der Velden
authors.forename: C Joris
authors.initials: CJ
authors.lastname: Yzermans
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004641:Emigration and Immigration; D004781:Environmental Exposure / Q000009:adverse effects; D005107:Explosions; D005194:Family Practice; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000523:psychology; D006801:Humans; D007348:Insurance, Health; D008297:Male; D001523:Mental Disorders / Q000209:etiology* / Q000523:psychology; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000209:etiology / Q000523:psychology; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology; D017741:Survivors / Q000523:psychology; D014947:Wounds and Injuries / Q000209:etiology / Q000523:psychology