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Psychological Effects of Hazardous Materials Exposures

From the Department of Psychiatry and Behavioral Sciences (D.F.K., J.E.R., P.P.R.-B.), Department of Health Services (K.B.K.), and Occupational and Environmental Medicine Program (C.A.B.), University of Washington, Seattle, WA; Environmental & Occupational Health Unit (J.L.B), University of Arizona Prevention Center, Tucson, AZ; and Section of Biostatistics (J.F.L.), Mayo Clinic, Rochester, MN.

Address reprint requests to: Jefferey L. Burgess, MD, MPH, Environmental and Occupational Health, University of Arizona College of Public Health, 1435 N. Fremont, Tucson, AZ 85719. Email: jburgess{at}u.arizona.edu

OBJECTIVE: To study psychological outcomes after hazardous materials incidents.

METHODS: Individuals exposed to hazardous materials were contacted to complete a telephone questionnaire within 8 to 40 days of the incident. The Brief Symptoms Inventory was used for psychological assessment. General severity index, depression, anxiety, hostility, and somatization were analyzed. Positive findings were defined as two standard deviations above a normative mean.

RESULTS: A total of 202 (60%) of the 339 subjects in 87 incidents were surveyed. For 159 adults with valid Brief Symptoms Inventory scores, all dimensions were within normal ranges of elevation, with 1% to 5% of the subject pool having elevation, except for somatization. Twenty-four (14%) of 160 subjects had elevated somatization scores. Based on logistic regression analysis, prior medical therapy for a psychological condition and transport to a health care facility were predictors of elevated somatization scores.

CONCLUSIONS: Somatization was the most frequently elevated score after exposure to hazardous materials incidents. Further research is needed to determine whether specific risk factors are useful in identifying individuals for intervention after hazardous materials incidents.

Key Words: hazardous materials, • Brief Symptoms Inventory, • psychological effects, • chemical exposures.

Abbreviations: ATSDR = Agency for Toxic Substances and Disease Registry;; BSI = Brief Symptoms Inventory;; GEE = generalized estimating equations;; GSI = general severity index;; PTSD = Post-Traumatic Stress Disorder;; SCL-90-R = Symptoms Checklist 90 Revised;; WPC = Washington Poison Center.

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