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Monitoring Adverse Psychosocial Outcomes One and Two Years After the Lac-Mégantic Train Derailment Tragedy (Eastern Townships, Quebec, Canada)

Published online by Cambridge University Press:  28 May 2019

Mélissa Généreux ,
Danielle Maltais ,
Geneviève Petit  and
Mathieu Roy
Mélissa Généreux*
Affiliation:
Eastern Townships Public Health Department, Centre Intégré Universitaire de Santé et de Services Sociaux – Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada Department of Community Health Sciences, Faculty of Medicine & Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
Danielle Maltais
Affiliation:
Department of Human and Social Sciences, Université du Québec à Chicoutimi, Saguenay, Quebec, Canada
Geneviève Petit
Affiliation:
Eastern Townships Public Health Department, Centre Intégré Universitaire de Santé et de Services Sociaux – Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada Department of Community Health Sciences, Faculty of Medicine & Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
Mathieu Roy
Affiliation:
Health Technology and Social Services Assessment Unit, Centre Intégré Universitaire de Santé et de Services Sociaux – Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada Department of Family Medicine and Emergency Medicine, Faculty of Medicine & Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
*
Correspondence: Mélissa Généreux, MD, MSc, FRCPC Eastern Townships Public Health Department 300 King East Street (Room 300) Sherbrooke, Québec J1G 1B1 Canada E-mail: melissa.genereux@usherbrooke.ca
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Abstract

Introduction:

In July 2013, a train carrying 72 cars of crude oil derailed in the town of Lac-Mégantic (Eastern Townships, Quebec, Canada). This disaster provoked a major conflagration, explosions, 47 deaths, the destruction of 44 buildings, the evacuation of one-third of the local population, and an unparalleled oil spill. Notwithstanding the environmental impact, many citizens of this town and in surrounding areas have suffered and continue to suffer substantial losses as a direct consequence of this catastrophe.

Problem:

To tailor public health interventions and to meet the psychosocial needs of the community, the Public Health Department of Eastern Townships has undertaken repeated surveys to monitor health and well-being over time. This study focuses on negative psychosocial outcomes one and two years after the tragedy.

Methods:

Two cross-sectional surveys (2014 and 2015) were conducted among large random samples of adults in Lac-Mégantic and surrounding areas (2014: n = 811; 2015: n = 800), and elsewhere in the region (2014: n = 7,926; 2015: n = 800). A wide range of psychosocial outcomes was assessed (ie, daily stress, main source of stress, sense of insecurity, psychological distress, excessive drinking, anxiety or mood disorders, psychosocial services use, anxiolytic drug use, gambling habits, and posttraumatic stress symptoms [PSS]). Exposure to the tragedy was assessed using residential location (ie, six-digit postal code) and intensity of exposure (ie, intense, moderate, or low exposure; from nine items capturing human, material, or subjective losses). Relationships between such exposures and adverse psychosocial outcomes were examined using chi-squares and t-tests. Distribution of outcomes was also examined over time.

Results:

One year after the disaster, an important proportion of participants reported human, material, and subjective losses (64%, 23%, and 54%, respectively), whereas 17% of people experienced intense exposure. Participants from Lac-Mégantic, particularly those intensely exposed, were much more likely to report psychological distress, depressive episode, anxiety disorders, and anxiolytic drug use, relative to less-exposed ones. In 2015, 67% of the Lac-Mégantic participants (76% of intensely exposed) reported moderate to severe PSS. Surprisingly, the use of psychosocial services in Lac-Mégantic declined by 41% from 2014 to 2015.

Conclusion:

The psychosocial burden in the aftermath of the Lac-Mégantic tragedy is substantial and persistent. Public health organizations responding to large-scaling disasters should monitor long-term psychosocial consequences and advocate for community-based psychosocial support in order to help citizens in their recovery process.

Keywords

adaptationpsychologicaldisasterdisaster planningpublic healthpublic health surveillance
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 34 , Issue 3 , June 2019 , pp. 251 - 259
Copyright
© World Association for Disaster and Emergency Medicine 2019 

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