title: Mental health and alcohol problems among Estonian cleanup workers 24 years after the Chernobyl accident.
abstract: OBJECTIVE
  To study the long-term mental health consequences of the 1986 Chernobyl nuclear accident among cleanup workers from Estonia.
  
  
  METHODS
  In 2010, 614 Estonian Chernobyl cleanup workers and 706 geographically and age-matched population-based controls completed a mail survey that included self-rated health, the Posttraumatic Stress Disorder Checklist (PCL), alcohol symptoms (AUDIT), and scales measuring depressive, anxiety, agoraphobia, fatigue, insomnia, and somatization symptoms. Respondents were dichotomized into high (top quartile) and low symptom groups on each measure.
  
  
  RESULTS
  Logistic regression analysis detected significant differences between cleanup workers and controls on all measures even after adjustment for ethnicity, education, marital status, and employment status. The strongest difference was found for somatization, with cleanup workers being three times more likely than controls to score in the top quartile (OR = 3.28, 95% CI 2.39-4.52), whereas for alcohol problems the difference was half as large (OR = 1.52, 95% CI 1.16-1.99). Among cleanup workers, arrival at Chernobyl in 1986 (vs. later) was associated with sleep problems, somatization, and symptoms of agoraphobia.
  
  
  CONCLUSIONS
  The toll of cleanup work was evident 24 years after the Chernobyl accident among Estonian cleanup workers indicating the need for focused mental health interventions.
authors.affiliation: Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia. kaia.laidra@tai.ee.
authors.forename: Kaia
authors.initials: K
authors.lastname: Laidra
authors.affiliation: Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
authors.forename: Kaja
authors.initials: K
authors.lastname: Rahu
authors.affiliation: Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
authors.forename: Mare
authors.initials: M
authors.lastname: Tekkel
authors.affiliation: Department of Psychiatry, University of Tartu, Raja 31, 50417, Tartu, Estonia.
authors.forename: Anu
authors.initials: A
authors.lastname: Aluoja
authors.affiliation: Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.|Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, 14189, Huddinge, Sweden.
authors.forename: Mall
authors.initials: M
authors.lastname: Leinsalu
mesh_terms: D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D016022:Case-Control Studies; D047852:Chernobyl Nuclear Accident; D004957:Estonia / Q000453:epidemiology; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*
keywords: Alcohol problems; Chernobyl nuclear accident; Cleanup workers; Estonia; Mental health