Havenaar J M, van den Brink W
University Hospital Utrecht, The Netherlands.
Clin Psychol Rev. 1997;17(4):359-74. doi: 10.1016/s0272-7358(97)00009-3.
Exposure to toxic substances in the environment is an ever more common event, that may cause physical as well as psychological harm. When an entire community is exposed, the term 'toxicological disaster' is used. The mere threat of such an event may be a source of stress, associated with changes in mental health, physical health, and changes in health-related behaviors. A review is presented of the literature about the effects of the stressful experience of toxicological disasters on health and health-related behaviors. Three questions are examined: (a) do toxicological disasters represent a specific type of stressor, different from other stressors?; (b) which stress-mediated health effects have been observed in the aftermath of toxicological disasters? and (c) is there evidence for a higher vulnerability in certain identifiable risk groups? On the basis of the available literature, it is concluded that toxicological disasters may have profound effects on subjective health, especially on symptom reporting, and on a number of psychophysiological parameters. Evidence for a substantial impact of disaster-related stress on either physical or psychiatric morbidity remains inconclusive. In this respect toxicological disasters do not appear to differ from other stressors. There is some evidence that toxicological disasters may have a more pronounced effect on health-related behaviors, especially on reproductive behavior (number of births and abortions). Women, and especially those who have young children to care for, appear to be more at risk for the observed health effects. The evidence for a higher vulnerability in other risk groups (e.g., former psychiatric patients remains inconclusive.
接触环境中的有毒物质是日益常见的现象，可能会造成身体和心理伤害。当整个社区都接触到有毒物质时，就会使用“毒理学灾难”这一术语。此类事件哪怕只是存在威胁，都可能成为压力源，导致心理健康、身体健康以及与健康相关行为发生变化。本文对有关毒理学灾难压力体验对健康及与健康相关行为影响的文献进行了综述。探讨了三个问题：(a) 毒理学灾难是否代表一种有别于其他压力源的特定压力源类型？(b) 在毒理学灾难之后观察到了哪些压力介导的健康影响？以及 (c) 是否有证据表明某些可识别的风险群体更易受影响？根据现有文献得出结论，毒理学灾难可能对主观健康产生深远影响，尤其是对症状报告以及一些心理生理参数。灾难相关压力对身体或精神疾病发病率产生重大影响的证据尚无定论。在这方面，毒理学灾难似乎与其他压力源并无不同。有证据表明，毒理学灾难可能对与健康相关行为，尤其是生殖行为（生育和堕胎数量）产生更显著影响。女性，尤其是那些有幼儿需要照料的女性，似乎在观察到的健康影响方面风险更高。其他风险群体（如既往精神病患者）更易受影响的证据尚无定论。
