1 Department of Environmental Health, French Institute for Public Health Surveillance (InVS), Saint-Maurice, France.
Prehosp Disaster Med. 2013 Oct;28(5):428-33. doi: 10.1017/S1049023X13008662. Epub 2013 Jun 27.
During the night of February 27 and the early morning of February 28, 2010, 15 coastal municipalities situated in two French departments, Vendée and Charente-Maritime, were violently stricken by a severe windstorm named "Xynthia." This storm caused the death of 12 individuals in Charente-Maritime and 29 people in Vendée. Houses, agricultural fields, and shellfish companies were severely flooded with seawater. Several thousand people temporarily had to leave their homes. The objective of this study was to estimate the short-term mental health impact of Xynthia, in terms of psychotropic drug delivery, on the resident population of the 15 coastal municipalities severely hit by the flooding.
The French national health insurance database was used to calculate a daily number of new psychotropic treatments from September 1, 2008 through December 24, 2010. New treatments were calculated for each of the following European Pharmaceutical Marketing Research Association (EphMRA) classes: tranquilizers (N05C), hypnotics (N05B), and antidepressants (N06A). A period of three weeks following the storm was defined as the exposure period. A generalized additive model with a Poisson distribution that allows for over-dispersion was used to analyze the correlation between the Xynthia variable and the number of new psychotropic treatments.
With a relative risk (RR) of 1.54 (95% CI, 1.39-1.62) corresponding to an estimate of 409 new deliveries of psychotropic drugs during the three weeks following the storm, this study confirms the importance of the psychological impact of Xynthia. This impact is seen on all three classes of psychotropic drugs studied. The impact is greater for tranquilizers (RR of 1.78; 95% CI, 1.59-1.89) than for hypnotics (RR of 1.53; 95% CI, 1.31-1.67) and antidepressants (RR of 1.26; 95% CI, 1.06-1.40). The RR was higher for females than for males.
This study shows the importance of the psychological impact of the storm as observed clinically by health workers who intervened in the field during the aftermath of Xynthia. It confirms that administrative databases can be used to show a health impact of a disaster even at a local level. This is one more step in the direction of a comprehensive strategy of collecting information to allow the assessment of the health impact of an extreme event, the detection of vulnerable populations, and the orientation of the short-, mid- and long-term public health response.
2010 年 2 月 27 日夜间至 28 日清晨，法国旺代省和滨海夏朗德省的 15 个沿海市镇遭到一场名为“辛霞”的强风暴的猛烈袭击。这场风暴在滨海夏朗德省造成 12 人死亡，在旺代省造成 29 人死亡。房屋、农田和贝类养殖场被海水严重淹没。数千人被迫暂时离开家园。本研究旨在评估“辛霞”对受灾最严重的 15 个沿海市镇居民的短期心理健康影响，方法是根据欧洲药品市场营销研究协会（EphMRA）的以下分类计算新的精神药物治疗数量：镇静剂（N05C）、催眠药（N05B）和抗抑郁药（N06A）。从 2008 年 9 月 1 日至 2010 年 12 月 24 日，每天计算一个新的治疗方案。为以下每个 EphMRA 类别计算了新的治疗方案：镇静剂（N05C）、催眠药（N05B）和抗抑郁药（N06A）。将风暴后的三周定义为暴露期。采用泊松分布的广义加性模型进行分析，以分析 Xynthia 变量与新精神药物治疗数量之间的相关性。
该研究确认了“辛霞”风暴的心理影响的重要性，其相对风险（RR）为 1.54（95%置信区间，1.39-1.62），这意味着在风暴后的三周内，有 409 例新的精神药物治疗。这种影响在研究的所有三种精神药物类别中都有体现。镇静剂的影响更大（RR 为 1.78；95%置信区间，1.59-1.89），而催眠药的影响较小（RR 为 1.53；95%置信区间，1.31-1.67），抗抑郁药的影响最小（RR 为 1.26；95%置信区间，1.06-1.40）。女性的 RR 高于男性。
这项研究表明，风暴的心理影响非常重要，这在卫生工作者在“辛霞”风暴过后在现场进行临床干预时得到了证实。它证实，行政数据库可用于显示灾害对健康的影响，即使是在地方一级。这是朝着收集信息以评估极端事件对健康的影响、发现弱势群体以及指导短期、中期和长期公共卫生应对方向迈出的又一步。
