Predictors of symptoms of post-traumatic stress disorder after the AZF chemical factory explosion on 21 September 2001, in Toulouse, France.
OBJECTIVE
To analyse in the general population the prevalence and predictors of symptomatology consistent with post-traumatic stress disorder (S-PTSD) 18 months after an industrial explosion.


METHODS
Cross-sectional survey.


METHODS
A random sample of 1191 city inhabitants, including an oversample of the immediate area (<3 km). S-PTSD was measured by the self-administered Impact of Event Scale-Revised. The relation between S-PTSD and individual vulnerability factors, immediate exposure and post-trauma factors was analysed by gender.


RESULTS
S-PTSD was more prevalent in the immediate area than in the peripheral area (women 19% vs 8%; men 8% vs 2%, p<0.01). In the immediate area, S-PTSD was independently associated with birth outside France (men: OR(a) = 13.9, 95% CI 3.7 to 52.8; women: OR(a) = 2.1, 95% CI 1.0 to 4.2), age more than 40 years (men: OR(a) = 4.3, 95% CI 1.01 to 18.2; women: OR(a) = 2.3, 95% CI 1.1 to 4.5), previous psychotropic treatment (men: OR(a) = 11.5, 95% CI 2.4 to 53.6), proximity to the explosion (less educated men only) (OR(a) = 9.3, 95% CI 1.9 to 44.7), rescue efforts (men: OR(a) = 5.2, 95% CI 1.5 to 18.2), temporarily uninhabitable home (men: OR(a) = 5.8, 95% CI 1.9 to 18.1), personal injury (women: OR(a) = 3.7, 95% CI 1.7 to 8.4), financial difficulties (men: OR(a) = 17.4, 95% CI 4.2 to 72.1; women: OR(a) = 3.4, 95% CI 1.7 to 7.1) and inconvenience due to closure of public services (women: OR(a) = 4.1, 95% CI 1.6 to 9.9).


CONCLUSIONS
Individual vulnerability, exposure and post-trauma factors were associated with S-PTSD. Vulnerable subgroups, defined by low socioeconomic characteristics may warrant focused screening after such disasters.
Rivière
S
S
Institut de Veille Sanitaire, Département Santé Travail, Faculté de Médecine, Toulouse, France. stephanie.riviere@cict.fr
Schwoebel
V
V
Lapierre-Duval
K
K
Guinard
A
A
Gardette
V
V
Lang
Th
T
D000328:Adult; D000368:Aged; D002617:Chemical Industry; D003430:Cross-Sectional Studies; D005107:Explosions; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014504:Urban Health