Impact of a technological disaster on young children: a five-year postdisaster multiinformant study.

Children exposed to a technological disaster during an understudied part of the lifespan, preschool age and early middle childhood, were assessed in a 5-year follow-up regarding mental health problems, anxiety disorder symptoms, depressive symptoms, physical symptoms, and posttraumatic stress symptoms. Exposed children and their parents (n = 264) reported significantly more problems than controls (n = 515). The differences were greater for conduct problems (including hyperactivity) and physical symptoms, than for anxiety and depression. The long-term effects of a technological disaster on children of pre-school age at exposure appear to differ from those in children, who were victimized at a later age. This may reflect interference with completion of specific developmental tasks.

The importance of estimating selection bias on prevalence estimates shortly after a disaster.

PURPOSE: The aim was to study selective participation and its effect on prevalence estimates in a health survey of affected residents 3 weeks after a man-made disaster in The Netherlands (May 13, 2000). METHODS: All affected adult residents were invited to participate. Survey (questionnaire) data were combined with electronic medical records of residents' general practitioners (GPs). Data for demographics, relocation, utilization, and morbidity 1 year predisaster and 1 year postdisaster were used. RESULTS: The survey participation rate was 26% (N = 1171). Women (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.28-1.67), those living with a partner (OR, 2.00; 95% CI, 1.72-2.33), those aged 45 to 64 years (OR, 2.00; 95% CI, 1.59-2.52), and immigrants (OR, 1.50; 95% CI, 1.30-1.74) were more likely to participate. Participation rate was not affected by relocation because of the disaster. Participants in the survey consulted their GPs for health problems in the year before and after the disaster more often than nonparticipants. Although there was selective participation, multiple imputation barely affected prevalence estimates of health problems in the survey 3 weeks postdisaster. CONCLUSIONS: Estimating actual selection bias in disaster studies gives better information about the study representativeness. This is important for policy making and providing effective health care.

[Reasons not to have your daughter vaccinated against the human papilloma virus in Twente: a questionnaire study]. / Redenen om een dochter niet te vaccineren tegen humaan papillomavirus in Twente; vragenlijstonderzoek.

OBJECTIVE: To gain insight into parents' decision-making process, and their reasons for participation in the human papilloma virus (HPV) vaccination programme in the Twente region, the Netherlands. DESIGN: Cross-sectional study by means of a questionnaire. METHODS: After the first vaccination round, a questionnaire was sent to the parents of 800 13-year-old girls, born in the year 1996 and living in the Twente region. Data were collected on the socio-demographic characteristics of the parents, their daughters' participation in the HPV vaccination programme (in which 13-15-year-olds were offered the vaccine previously offered only to 12-year-olds), and four determinants derived from the Health Belief Model (HBM): perceived susceptibility, severity, benefits and barriers. RESULTS: 371 questionnaires were returned (response rate 46%). 39% of the parents had had their daughters vaccinated. The main reasons for parents to decide not to participate in the vaccination programme were perceived dangers of the vaccine, the risk of minor or major side-effects, and perceived limited efficacy of the vaccine. Religious beliefs also played a limited, but statistically significant, role. Many parents found it difficult to decide whether to let their daughter participate in the vaccination programme. CONCLUSION: Follow-up research into participation is recommended, especially once health-education has been improved and media attention is reduced. Future communication about HPV vaccination should take into account the role played by parents in deciding whether or not to participate in the vaccination programme and should concentrate on their concerns about vaccine side-effects and vaccine safety and the perceived efficacy of the new vaccine.

Physical and mental health shortly after a disaster: first results from the Enschede firework disaster study.

OBJECTIVES: Two to three weeks after the explosion of a fireworks storage facility in a residential area (May 2000, Enschede, The Netherlands) we assessed the self-reported physical and mental health among those affected by the disaster. METHODS: A questionnaire survey was conducted among 3792 residents, passers-by, and rescue workers, who were involved in and/or affected by the disaster and were > or =18 years of age. RESULTS: At least 30% of those affected by the disaster reported serious physical and mental health problems 2-3 weeks after the explosion. Compared with reference values in the general Dutch population, high scores were found for somatic symptoms, sleeping problems, and restrictions in daily functioning due to physical and mental problems, such as anxiety, depression, and feelings of insufficiency. The strength of these differences varied between groups, based on the level of involvement and the level of being affected. CONCLUSIONS: Results indicate that the fireworks disaster had a substantial impact on the health of those affected by the disaster. The health impact was most pronounced for residents and passers-by and also for rescue workers living in the affected area, but to a lesser degree. Physical and mental health problems were strongly associated with the shocking experiences during and shortly after the disaster.

Determinants of response in a longitudinal health study following the firework-disaster in Enschede, The Netherlands.

Very few longitudinal health studies after disasters published data on the determinants of loss to follow up. However, these determinants provide important information for future disaster studies to improve their response and reduce selection bias. For this purpose we analyzed the data of a longitudinal health survey which was performed among residents and emergency workers, at 3 weeks (n = 3662) and at 18 months (n = 2769) after a major firework disaster in The Netherlands (Enschede, May 13, 2000). The response was lower among immigrants (54%) than among native Dutch (81%). Severe damage to the house due to the disaster (OR: 1.8; 95% CI: 1.1-3.0) and being involved as an emergency workers (OR: 2.1; 95% CI: 1.2-3.4) were associated with higher response among native Dutch, while this was not the case among immigrants. Non-western immigrants with health problems in the first study were more likely to participate in the second study (for example physical symptoms OR: 2.5: 95% CI: 1.4-4.4), while the native Dutch with these symptoms were less likely to participate (OR: 0.7; 95% CI: 0.5-0.9). In conclusion, disaster-related characteristics were associated with higher response in native Dutch. Health problems were associated with higher response among non-western immigrants and with lower response among the native Dutch.