Toxic Turmoil

by Havenaar, Johan M.; Cwikel, Julie G.; Bromet, Evelyn J.

• ISBN13: 9780306467844
• ISBN10: 0306467844
• Format: Hardcover
• Copyright: 2002-07-01
• Publisher: Plenum Pub Corp

Summary

Over the past two decades the world has witnessed an increasing number of disasters involving massive exposure of the population to radiation, chemical toxins, or other hazardous agents. The recent bombings of the World Trade Center in New York - setting aside all other personal, economic, or geopolitical aspects encompassed by this tragic event - is yet another unfortunate example. Besides the massive loss of life, a large segment of the population of Manhattan was willfully exposed to large clouds of dust and smoke, asbestos, and other harmful materials. As a consequence of this terrorist act, apprehension about possible further attacks, perhaps with biological or chemical weapons, will continue to hold the country in its grip for quite some time. The term 'ecological disaster' is used to indicate these incidents, some minor, some catastrophic or apocalyptic. Often these accidents are followed by widespread fear of future adverse health effects. In many cases these fears are justified or partly justified for those who became exposed. However sometimes illness may occur in the absence of significant exposure to toxic substances. Concerns and worries about health tend to facilitate the appearance of medically unexplained symptoms or syndromes. This mental health component has received relatively little attention in the disaster literature. It can occur simultaneously with direct physical consequences and is not always clearly distinguishable from it. This situation appears to be particularly likely to occur in the wake of chemical and nuclear events, which are usually followed by years of disputes about facts and opinions about health effects and their relation to the disaster. This book presents an overview of research on the psychological and societal consequences of ecological disasters. It gives in-depth case studies on most of the major incidents that have occurred in the 1980s and 1990s. It summarizes the accumulated knowledge in this area and identifies areas of future research. It can serve as a resource for practitioners and policymakers dealing with current and future ecological calamities and may help them to define an adequate response to the complex public health challenges these incidents represent.

Table of Contents

PART I: INTRODUCTION
Ecological Disaster: A Concern for the Future	3	(16)
Johan M. Havenaar
When Worst Comes to Worst	4	(3)
What Are Ecological Disasters?	7	(2)
Pathogenic Mechanisms in Ecological Disasters	9	(2)
Common Controversies about the Health Effects of Ecological Disasters	11	(3)
Can the Psychological and Societal Health Effects of Ecological Disasters Be Prevented?	14	(1)
Outline of the Book	15	(1)
References	16	(3)
Public Health Aspects of Chemical Catastrophes	19	(20)
Peter J. Baxter
Medical Consequences of Chemical Disasters	21	(2)
Incident Investigation	23	(1)
Chemical Syndromes	23	(2)
Routes of Exposure	25	(6)
Evacuation Incidents	31	(1)
Epidemics Suspected of Having a Chemical Origin	31	(1)
Psychological and Societal Impacts	32	(1)
Disaster Mitigation and Health-Risk Assessment	33	(1)
References	34	(5)
Understanding the Psychological and Societal Response of Individuals, Groups, Authorities, and Media to Toxic Hazards	39	(30)
Julie G. Cwikel
Johan M. Havenaar
Evelyn J. Bromet
Introduction	39	(2)
Stress-Related Health Effects of Ecological Disasters	41	(2)
The Social Epidemiological Model for Understanding Health Effects of Ecological Disasters	43	(2)
Agent Factors	45	(2)
Host Factors	47	(2)
Environmental Factors	49	(2)
Identifying High-Risk Groups	51	(1)
The Role of Public Information	52	(6)
Applied Social Epidemiology---Community Interventions with Immigrants to Israel from the Areas around Chernobyl	58	(2)
Conclusion	60	(1)
References	61	(8)
PART II: CASE EXAMPLES OF ECOLOGICAL DISASTERS
Psychological Response of Mothers of Young Children to the Three Mile Island and Chernobyl Nuclear Plant Accidents One Decade Later	69	(16)
Evelyn J. Bromet
Leighann Litcher
Introduction	69	(2)
Method	71	(3)
Analysis	74	(1)
Results	74	(7)
Comment and Conclusion	81	(2)
References	83	(2)
The Chaotic Aftermath of an Airplane Crash in Amsterdam: A Second Disaster	85	(16)
Joris Yzermans
Berthold P. R. Gersons
Introduction	85	(1)
Facts and Chronology	86	(8)
Discussion	94	(4)
References	98	(3)
The Gulf War and Its Aftermath	101	(28)
Simon Wessely
Gulf War Syndrome	102	(1)
The Evidence So Far	103	(3)
The Explanations	106	(6)
Attributions and Explanations	112	(7)
Conclusions	119	(3)
References	122	(7)
Bhopal Gas Leak Disaster: Impact on Mental Health	129	(20)
R. Srinivasa Murthy
Introduction	129	(1)
The Disaster	130	(1)
Impact on Health	131	(2)
Impact on Mental Health	133	(4)
Mental Health Interventions	137	(4)
Lessons from the Bhopal Disaster	141	(4)
Conclusions	145	(1)
References	145	(4)
Psychological and Physical Health Effects of the 1995 Sarin Attack in the Tokyo Subway System	149	(14)
Nozomu Asukai
Kazuhiko Maekama
Introduction	149	(1)
Overview of the Event	150	(1)
Acute Effects	151	(6)
Long-Term Effects	157	(2)
Conclusion	159	(1)
References	160	(3)
Perceived Health and Psychosocial Well Being in the Aral Sea Area: Results from a Survey in an Area of Slow Environmental Degradation	163	(22)
Joost B. W. van der Meer
Ian B. Small
Eric J. Crighton
Nathan Ford
Introduction	163	(2)
History	165	(2)
Social and Health Effects	167	(1)
Measuring Perceived Health and Psychosocial Well-Being	168	(2)
Results of the Psychosocial Assessment	170	(5)
Discussion	175	(5)
References	180	(5)
PART III: DEALING WITH ECOLOGICAL DISASTER
Methodological Issues in the Investigation of Chemical Accidents	185	(14)
Hilary M. P. Fielder
Stephen R. Palmer
Gary Coleman
Epidemiology of Incidents	186	(2)
Preparedness for Epidemiological Study---The Chemical Incident Plan	188	(2)
Response Phase and Follow Up	190	(3)
The Chronic Phase: Long-Term Exposures and Effects	193	(2)
Conclusion	195	(1)
References	196	(3)
Responding to the Psychosocial Effects of Toxic Disaster: Policy Initiatives, Constraints, and Challenges	199	(18)
Steven M. Becker
Introduction	199	(1)
Background	200	(1)
Psychosocial Interventions after Toxic Disaster	200	(6)
Addressing the Psychosocial Effects of Toxic Disaster: Policy Initiatives	206	(3)
The Big Picture: A Paucity of Policy Initiatives	209	(1)
Constraints and Impediments	209	(5)
Conclusion	214	(1)
References	215	(2)
Voices from the Inside: Psychological Responses to Toxic Disasters	217	(20)
Anne Speckhard
Introduction	217	(1)
Comprehending Ecological Disaster	218	(1)
Eyewitness and Early Accounts	218	(2)
Initial Reactions	220	(6)
Long-Term Responses	226	(6)
Reactions to Official Responses	232	(2)
Conclusion	234	(1)
References	235	(2)
Disasters and the Selection of Public Mental Health Priorities: A Perspective from Developing Countries	237	(22)
Joop de Jong
Introduction	237	(1)
Public Mental Health Criteria	237	(18)
Weighing the Seven Criteria	255	(1)
References	256	(3)
Epilogue: Lessons Learned and Unresolved Issues	259	(14)
Johan M. Havenaar
Julie G. Cwikel
Evelyn J. Bromet
Introduction	259	(3)
Quality of Interventions in Ecological Disasters	262	(6)
Conclusion	268	(2)
References	270	(3)
Index	273