title: Does exposure type impact differentially over time on the development of mental health disturbances after a technological disaster?
abstract: BACKGROUND
  A longitudinal study was conducted in order to assess the impact of the Ghislenghien disaster (July 30th, 2004) on physical, mental and social health in the affected population. The present study explored the risk for the development of four types of mental health disturbances (MHD) due to exposure to different aspects of this technological disaster in comparison with data obtained from previous health surveys among the population of the same province.
  
  
  METHODS
  Surveys were conducted 5 months (T1) and 14 months (T2) after the disaster. Potential adult victims (≥15 years) were included (n = 1027 and 579 at T1 and T2 respectively). The "Symptom Checklist-90-Revised" (SCL-90-R) has been used in order to compute actual prevalence rates of somatization-, depression-, anxiety- and sleeping disturbances for three defined exposure categories: direct witnesses who have seen human damage (SHD), direct witnesses who have not seen human damage (NSHD) and indirect witnesses (IW). Those prevalence rates were compared with overall rates using the inhabitants of the province of Hainaut (n = 2308) as reference population. A mental health co-morbidity index was computed. Relative risks were estimated using logistic regression models.
  
  
  RESULTS
  Prevalence rates of the four MHD were much higher for the SHD than for the other exposure groups, at T1 and T2. Moreover, NSHD and IW had no increased risk to develop one of the 4 types of MHD compared to the reference population. The SHD had at T1 and T2 good 5-times a higher risk for somatization, about 4-times for depression and sleeping disorders, and 5- to 6-times for anxiety disorders respectively. Further, they suffered 13 times, respectively 17 times more from all mental disorders together.
  
  
  CONCLUSIONS
  The present study calls attention to the fact that mental health problems disturbances are significantly more prevalent and long-lasting among survivors who have directly been exposed to human damage.
authors.affiliation: Department of Scientific and Technological Research, Royal Higher Institute for Defense, Avenue de la Renaissance 30, B-1000 Brussels, Belgium.
authors.forename: Erik
authors.initials: E
authors.lastname: De Soir
authors.affiliation: Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Science, Laboratory of Medical Microbiology, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium.
authors.forename: Ann
authors.initials: A
authors.lastname: Versporten
authors.affiliation: Faculty of psychology and educational sciences, Research Center for Health and Psychological Development, Place du Cardinal Mercier, Université catholique de Louvain, 10, BE-1348 Louvain la Neuve, Belgium.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Zech
authors.affiliation: Scientific Institute of Public Health, Direction Public Health and Surveillance, J. Wytsmanstreet 14, B-1050 Brussels, Belgium.
authors.forename: Herman
authors.initials: H
authors.lastname: Van Oyen
authors.affiliation: Department of Behavioral Sciences, Royal Military Academy, Avenue de la Renaissance 30, B-1000 Brussels, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Mylle
authors.affiliation: Faculty of Social Sciences, Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Rolf
authors.initials: R
authors.lastname: Kleber
authors.affiliation: Faculty of Social Sciences, Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Onno
authors.initials: O
authors.lastname: van der Hart
keywords: Disaster survivors; Mental health disturbances; Technological disaster