ARTICLES
Health Problems in Children and Adolescents Before and After a Man-made Disaster

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ABSTRACT

Objective:

The aims of this study were to examine health problems of children (4-12 years old at the time of the disaster) and adolescents (13-18 years old at the time of the disaster) before and after exposure to a fireworks disaster in the Netherlands (May 2000), to compare these health problems with a control group, and to identify risk factors for postdisaster psychological problems.

Method:

Because the electronic medical records of family practitioners were used, longitudinal monitoring of health problems from 1 year predisaster until 2 years postdisaster for both victims (N = 1,628) and controls (N = 2,856) was possible. Health problems were classified according to the International Classification of Primary Care.

Results:

Postdisaster increases were significantly larger in victims than in controls for psychological problems, musculoskeletal problems, stress reactions, and symptoms of the extremities. Children 4-12 years old presented larger increases in sleep problems compared with controls, whereas children 13-18 years old showed larger increases in anxiety problems than their controls. Significant predictors for postdisaster psychological problems included being relocated, presenting predisaster psychological problems, and a low to medium socioeconomic status.

Conclusions:

Children and adolescents exposed to a disaster are at risk of long-lasting increases in both psychological and physical health problems. Postdisaster interventions should focus on those who were relocated and presented predisaster psychological problems.

Section snippets

Participants

All FPs (N = 60) in the city of Enschede were asked to participate in the study. Sixteen FPs (27%) did not participate (mainly because of the expected increase in workload); 89% of all disaster victims appeared to be registered at the 44 participating FPs. To identify nonvictims (controls), a random sample was taken from the patients of the participating FPs who were not recorded as victims. This resulted in 20,055 patients who were registered with the participating FPs on the day of the

Children 4-12 Years Old at the Time of the Disaster

Before the disaster, victims and controls were similar in the number of psychological problems presented to the FP (Table 1). The prevalence rate of psychological problems of the 4- to 12-year-old victims increased dramatically in the first year postdisaster (from 23/1,000 predisaster to 209/1,000 postdisaster). In the second year, the prevalence of these problems decreased significantly but remained more than three times higher than before the disaster. The number of psychological problems

DISCUSSION

The aims of the present study were to examine the health problems children and adolescents presented to their FPs before and after exposure to a man-made disaster and to compare these health problems with those of a control group. In addition, risk factors for postdisaster psychological problems were identified. It was found that psychological problems in particular were increased among the victims compared with both predisaster data and controls. During the first year postdisaster, the number

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  • Cited by (0)

    The study was funded by a grant obtained from the Ministry of Health, Welfare, and Sports in the Netherlands.

    Disclosure: The authors have no financial relationships to disclose.

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