title: Symptomatology attributable to psychological exposure to a chemical incident: a natural experiment.
abstract: BACKGROUND
  Exposure to a complex emergency has a substantial psychological component, which is rarely assessed. This study compares the health impact of physically and psychologically mediated exposure to a complex emergency.
  
  
  METHODS
  The Sea Empress oil tanker spill.
  
  
  METHODS
  A cross-sectional analysis of self-report questionnaire responses collected from inhabitants of 6 different coastal towns-4 of them physically exposed to the oil spill, 2 unexposed-was undertaken. The towns were known to be psychologically homogeneous before the incident. Perceived risk was used as a measure of psychological exposure. Anxiety, depression and symptom reporting were used as measures of health impact.
  
  
  METHODS
  1089 (69%) men and women aged 18-65 years responded.
  
  
  RESULTS
  Perceived risk was associated with raised anxiety and non-toxicologically related symptom reporting, whereas physical exposure to oil was only associated with toxicologically related symptom reporting. The impact of raised perceived risk on the population was greater than that of physical oil exposure, involving more persons over a wider area.
  
  
  CONCLUSIONS
  Psychological exposure was shown to be quantifiable, and to be a substantially more sensitive measure of health impact than physical exposure in relation to psychological outcomes. This type of analysis has important implications for emergency response planning, and for the interpretation of a complex emergency by the general public.
authors.affiliation: Department of Primary Care and Public Health, Cardiff University, Cardiff, UK. pagallacher@cf.ac.uk
authors.forename: John
authors.initials: J
authors.lastname: Gallacher
authors.forename: Karin
authors.initials: K
authors.lastname: Bronstering
authors.forename: Stephen
authors.initials: S
authors.lastname: Palmer
authors.forename: David
authors.initials: D
authors.lastname: Fone
authors.forename: Ronan
authors.initials: R
authors.lastname: Lyons
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D001294:Attitude to Health; D002617:Chemical Industry; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D004190:Disasters; D004644:Emotions; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010578:Petroleum / Q000633:toxicity; D012307:Risk Factors; D013315:Stress, Psychological / Q000209:etiology*; D014852:Wales
chemical_list: D010578:Petroleum