麦克默里堡野火对撤离工人健康的影响：两个队列的随访研究
Effects of the Fort McMurray wildfires on the health of evacuated workers: follow-up of 2 cohorts.
作者信息
Cherry Nicola, Haynes Whitney
机构信息
Affiliation: Division of Preventive Medicine (Cherry, Haynes), University of Alberta, Edmonton, Alta.
出版信息
CMAJ Open. 2017 Aug 15;5(3):E638-E645. doi: 10.9778/cmajo.20170047.
BACKGROUND
Wildfire engulfed Fort McMurray, Alberta on May 3, 2016, leading to a total evacuation. Access to 2 active cohorts allowed us to rapidly assess health effects in those evacuated.
METHODS
People working in Fort McMurray who had been recruited before the fire for 2 occupational health cohort studies completed a questionnaire (online or via telephone) 3-26 weeks after evacuation. The questionnaire asked about respiratory and mental health and experiences since the fire.
RESULTS
Of the 129 participants, 109 were in the Fort McMurray area on May 3. Thirty-seven (33.9%) of the participants who were in Fort McMurray on May 3 reported a health condition, including respiratory symptoms ( = 17) and mental ill health ( = 17), immediately after the fire. At follow-up, a mean of 102 days after the fire, 11 participants (10.1%) reported a fire-related health condition, including mental ill health ( = 8) and respiratory symptoms ( = 2). There was no difference before and after the fire in use of alcohol, cigarettes, recreational drugs or medication. One in 4 participants (32 [24.6%]) had not worked since the fire, and fewer than half (58 [44.6%]) had returned to Fort McMurray. Of the 90 participants evacuated, 15 (16.7%) had scores indicative of moderate or severe anxiety or depression on the Hospital Anxiety and Depression Scale. Those evacuated had significantly higher mean anxiety ( = 0.01) and depression ( = 0.04) scores than those not evacuated. Regression modelling showed that anxiety scores were higher for women, with longer time since the fire and with evacuation to a motel. Depression scores were higher for women and with financial loss because of lack of work.
INTERPRETATION
Although evacuation was associated with higher anxiety and depression scores, persisting ill health was not widespread at early follow-up after the fire. Although these results are encouraging, these "healthy worker" results cannot be generalized to all evacuees.
背景
2016年5月3日，野火席卷了艾伯塔省的麦克默里堡，导致人员全部撤离。对两个现役队列的研究使我们能够迅速评估撤离人员的健康影响。
方法
在火灾发生前就已被招募进入两项职业健康队列研究的麦克默里堡工作人员，在撤离后3至26周完成了一份调查问卷（在线或通过电话）。问卷询问了呼吸系统和心理健康状况以及火灾后的经历。
结果
在129名参与者中，109人于5月3日在麦克默里堡地区。5月3日在麦克默里堡的参与者中，有37人（33.9%）在火灾后立即报告了健康问题，包括呼吸道症状（17人）和心理健康问题（17人）。在随访中，火灾后平均102天，有11名参与者（10.1%）报告了与火灾相关的健康问题，包括心理健康问题（8人）和呼吸道症状（2人）。火灾前后在饮酒、吸烟、使用娱乐性药物或药物方面没有差异。四分之一的参与者（32人[24.6%]）自火灾后就没有工作，不到一半（58人[44.6%]）返回了麦克默里堡。在90名撤离人员中，15人（16.7%）在医院焦虑抑郁量表上的得分表明存在中度或重度焦虑或抑郁。撤离人员的平均焦虑得分（P = 0.01）和抑郁得分（P = 0.04）显著高于未撤离人员。回归模型显示，女性的焦虑得分更高，火灾发生时间更长且撤离到汽车旅馆的焦虑得分更高。女性以及因失业导致经济损失的抑郁得分更高。
解读
尽管撤离与更高的焦虑和抑郁得分相关，但在火灾后的早期随访中，持续的健康问题并不普遍。尽管这些结果令人鼓舞，但这些“健康工作者”的结果不能推广到所有撤离人员。
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