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Post-disaster health effects: strategies for investigation and data collection. Experiences from the Enschede firework disaster
  1. J Roorda1,
  2. W A H J van Stiphout1,
  3. R R R Huijsman-Rubingh1,2
  1. 1Enschede Firework Disaster Health Monitoring Project, Netherlands
  2. 2Netherlands Ministry of Health, Welfare and Sport
  1. Correspondence to:
 Mr J Roorda
 GGD Regio Twente, PO Box 1400, 7500 BK Enschede, Netherlands;


Background: Public health policy is increasingly concerned with the care for victims of a disaster. This article describes the design and implementation of an epidemiological study, which seeks to match care services to the specific problems of persons affected by a large scale incident. The study was prompted by the explosion of a firework depot in Enschede, the Netherlands.

Study population: All those directly affected by this incident (residents, emergency services personnel, and people who happened to be in the area at the time), some of whom suffered personal loss or injury. The project investigates both the physical and psychological effects of the disaster, as well as the target group’s subsequent call on healthcare services.

Study design: A questionnaire based follow up survey of those directly affected and an ongoing monitoring of health problems relying on reports from healthcare professionals. The follow up survey started three weeks after the incident and was repeated 18 months and almost four years after the incident. The monitoring is conducted over a four year period by general practitioners, the local mental health services department, occupational health services, and the youth healthcare services department. It provides ongoing information.

Results and Conclusions: The results of the study are regularly discussed with healthcare professionals and policy makers, and are made known to the research participants. The paper also explains the considerations that were made in designing the study to help others making up their research plans when confronted with possible health effects of a disaster.

  • disaster
  • surveillance
  • psychosocial problems

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  • Conflicts of interest: none declared.

  • For the Enschede Firework Disaster Health Monitoring Project steering committee and project group: J G A Derks, J Roorda, K Smit, GGD Regio Twente (Regional Health Authority), Enschede, Netherlands; R R R Huijsman-Rubingh, Netherlands Ministry of Health, Welfare and Sport, The Hague, Netherlands; W A H J van Stiphout, Stjohout Training in Practice (STIP), Zweelo, Netherlands; E Lebret, J Meulenbelt, L Grievink, National Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands; B P R Gersons, M L Meewisse, Academic Medical Centre (AMC), Amsterdam, Netherlands; P G van der Velden Institute for Psychotrauma (IVP), Zaltbommel, Netherlands; C J Yzermans, Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands; E L Noorthoorn, Mediant/Institute for Research and Education in Mental Health (STOOGG), Enschede, Netherlands.

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