title: Posttraumatic stress disorder, depression, and alcohol and tobacco use in public health workers after the 2004 Florida hurricanes.
abstract: OBJECTIVE
  We examined the relationship of probable posttraumatic stress disorder (PTSD), probable depression, and increased alcohol and/or tobacco use to disaster exposure and work demand in Florida Department of Health workers after the 2004 hurricanes.
  
  
  METHODS
  Participants (N = 2249) completed electronic questionnaires assessing PTSD, depression, alcohol and tobacco use, hurricane exposure, and work demand.
  
  
  RESULTS
  Total mental and behavioral health burden (probable PTSD, probable depression, increased alcohol and/or tobacco use) was 11%. More than 4% had probable PTSD, and 3.8% had probable depression. Among those with probable PTSD, 29.2% had increased alcohol use, and 50% had increased tobacco use. Among those with probable depression, 34% indicated increased alcohol use and 55.6% increased tobacco use. Workers with greater exposure were more likely to have probable PTSD and probable depression (ORs = 3.3 and 3.06, respectively). After adjusting for demographics and work demand, those with high exposure were more likely to have probable PTSD and probable depression (ORs = 3.21 and 3.13). Those with high exposure had increased alcohol and tobacco use (ORs = 3.01 and 3.40), and those with high work demand indicated increased alcohol and tobacco use (ORs = 1.98 and 2.10). High exposure and work demand predicted increased alcohol and tobacco use, after adjusting for demographics, work demand, and exposure.
  
  
  CONCLUSIONS
  Work-related disaster mental and behavioral health burden indicate the need for additional mental health interventions in the public health disaster workforce.
authors.forename: Carol S
authors.initials: CS
authors.lastname: Fullerton
authors.forename: Jodi B A
authors.initials: JB
authors.lastname: McKibben
authors.forename: Dori B
authors.initials: DB
authors.lastname: Reissman
authors.forename: Ted
authors.initials: T
authors.lastname: Scharf
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Kowalski-Trakofler
authors.forename: James M
authors.initials: JM
authors.lastname: Shultz
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ursano
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D055867:Cyclonic Storms; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011634:Public Health; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D064424:Tobacco Use / Q000453:epidemiology*; D000078329:Workforce; D016526:Workload