title: Health problems presented to family practices in the Netherlands 1 year before and 1 year after a disaster.
abstract: BACKGROUND
  Disasters often have negative health consequences. Studies of health problems presented in family practice before and after a disaster are rare. The present study analyzed health problems before and after a disaster and predictors of increased morbidity after the disaster as presented in family practice.
  
  
  METHODS
  A matched cohort study design with measurements 1 year before the disaster and 1 year after the disaster. Victims (N = 9183) and matched controls (N = 7066) were surveyed in the electronic medical records of 30 family practices after the explosions of a fireworks depot in The Netherlands. All health problems were registered using the International Classification of Primary Care.
  
  
  RESULTS
  Victims showed significantly higher prevalence rates for psychological problems after the disaster than before the disaster (422 vs133 per 1000 person-years; P < .001) and for problems of the musculoskeletal system (450 vs 401 per 1000 person-years; P < .05). Relocation because of the disaster (odds ratio, 10.65; 95% confidence interval, 8.15-13.94) and, to a lesser degree, psychological morbidity before the disaster (odds ratio, 2.31; 95% confidence interval, 1.42-3.76) were the strongest predictors of psychological problems after the disaster.
  
  
  CONCLUSIONS
  The results suggested that forced relocation and a history of psychological problems were risk factors to post-disaster psychological problems of victims presenting to a family practice.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands. jh.soeteman@nivel.nl
authors.forename: Rik J H
authors.initials: RJ
authors.lastname: Soeteman
authors.forename: C Joris
authors.initials: CJ
authors.lastname: Yzermans
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Kerssens
authors.forename: Anja J E
authors.initials: AJ
authors.lastname: Dirkzwager
authors.forename: Ge A
authors.initials: GA
authors.lastname: Donker
authors.forename: Petra M H
authors.initials: PM
authors.lastname: ten Veen
authors.forename: Wil J H M
authors.initials: WJ
authors.lastname: van den Bosch
authors.forename: Jouke
authors.initials: J
authors.lastname: van der Zee
mesh_terms: D000059:Accidents / Q000523:psychology / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005107:Explosions; D005194:Family Practice; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D011594:Psychometrics; D012307:Risk Factors; D013997:Time Factors