Nivel-Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
ARQ National Psychotrauma Centre, Diemen, The Netherlands.
Eur J Public Health. 2021 Oct 11;31(4):715-721. doi: 10.1093/eurpub/ckaa244.
Little is known about the public health impact of chronic exposure to physical and social stressors in the human environment. Objective of this study was to investigate the immediate and long-term health effects of living in an environment with gas-mining induced earthquakes and related stressors in the Netherlands.
Data on psychological, somatic and social problems recorded routinely in electronic health records by general practitioners during a 6-year period (2010-2015) were combined with socioeconomic status and seismicity data. To assess immediate health effects of exposure to ML≥1.5 earthquakes, relative risk ratios were calculated for patients in the week of an earthquake and the week afterwards, and compared to the week before the earthquake. To analyse long-term health effects, relative risks of different groups, adjusted for age, sex and socioeconomic status, were computed per year and compared.
Apart from an increase in suicidality, few immediate health changes were found in an earthquake week or week afterwards. Generally, the prevalence of health problems was higher in the mining province in the first years, but dropped to levels equal to or even below the control group in subsequent years, with lower relative risks observed in more frequently exposed patients.
From a public health perspective, the findings are fascinating. Contrary to our expectation, health problems presented in general practice in the earthquake province decreased during the study period. More frequently exposed populations reported fewer health issues to general practitioners, which might point at health adaptation to chronic exposure to stressors.
人们对人类环境中慢性暴露于物理和社会应激源对公共卫生的影响知之甚少。本研究的目的是调查在荷兰，生活在一个存在采矿诱发地震和相关应激源的环境中对健康的即时和长期影响。
将常规记录在电子健康记录中的心理、躯体和社会问题数据与社会经济地位和地震活动数据结合起来。为了评估暴露于 ML≥1.5 级地震对健康的即时影响，计算了地震周及其后一周患者的相对风险比，并与地震前一周进行了比较。为了分析长期健康影响，根据年龄、性别和社会经济地位调整了不同组别的相对风险，每年进行比较。
除自杀率增加外，在地震周或其后一周并未发现明显的即时健康变化。通常，在采矿省的前几年，健康问题的患病率较高，但在随后的几年中降至与对照组相等甚至更低的水平，在更频繁暴露的患者中观察到的相对风险较低。
从公共卫生的角度来看，这些发现令人着迷。与我们的预期相反，在研究期间，地震省的普通实践中呈现的健康问题有所减少。更多地接触应激源的人群向普通医生报告的健康问题更少，这可能表明对慢性暴露于应激源的健康适应。
