Medium-Term Effects of a Train Derailment on the Physical and Psychological Health of Men

Posttraumatic Stress Following the 2023 Odisha Train Accident: A Cross-sectional Comparison Study of Passengers, Health Professionals, and the Local Community

OBJECTIVES

We studied posttraumatic stress symptoms (PTSS) and disorder (PTSD), associated factors, and quality of life (QOL) of a group of passengers (n = 58) affected by the 2023 Odisha train accident, comparing it with health professionals (n = 42) such as doctors and nurses who treated them, and individuals from the local community (n = 65). We also checked the anxiety and depression of passengers.

METHODS

In a cross-sectional study, we assessed accident experience and used the PTSD checklist, WHO-QOL-BREF, General Anxiety Disorder, and Patient Health Questionnaire scales.

RESULTS

The PTSS were common; specifically, intrusive memories (36.4%), feeling upset while reminded of the experience (33.9%), and avoidance of memories (30.9%). Strong negative feelings, loss of interest, feeling distant, and irritability or anger outbursts were significantly more common among passengers than others. PTSD was present in 20.7% of passengers, 19.0% of health professionals, and 7.7% of local participants. Seeing dead bodies significantly contributed to PTSD. Clinical levels of anxiety (58.3%) and depression (50%) were present in passengers, which were significantly associated with PTSD, along with fear of death. Passengers had the worst QOL and health satisfaction among the groups.

CONCLUSIONS

Following the train accident, stress-related psychiatric problems were common and highlighted the intervention needs of the affected people.

Anatomy of a catastrophe: Managing psychosocial consequence of the 2023 Odisha train accident

The 2023 Odisha train accident in India is one of the deadliest train accidents in recent history, which is expected to have a massive psychological impact on the survivors and their families. Despite train accidents being common, there is an apparent lack of a process to support the psychosocial needs of the survivors. This narrative review highlights the catastrophic nature of the accident and possible psychological consequences of train accidents based on the literature and discusses approaches that can be taken to provide mental health support for the survivors. While there was appreciable support for the treatment of the injuries, financial compensation, and other practical help, it appeared that there were unmet needs for psychological support. With a greater understanding of trauma manifestation and effective strategies, it is feasible to set up an implementation plan that can take care of survivors from crisis support to long-term psychological intervention and rehabilitation. It would need multidisciplinary and multilevel cooperation and support. While preventing accidents should be the primary focus, providing timely and appropriate care for the survivors is of paramount importance. This review highlights the gap in psychological support for train accident survivors and provides a feasible approach that can be easily integrated into the existing health and social care system.

A Salutogenic Approach to Disaster Recovery: The Case of the Lac-Mégantic Rail Disaster

In July 2013, a train carrying crude oil derailed in Lac-Mégantic (Canada). This disaster provoked a major fire, 47 deaths, the destruction of 44 buildings, a massive evacuation, and an unparalleled oil spill. Since 2013, Public Health has undertaken several actions to address this challenging situation, using both quantitative and qualitative methods. Community-based surveys were conducted in Lac-Mégantic in 2014, 2015 and 2018. The first two surveys showed persistent and widespread health needs. Inspired by a salutogenic approach, Public Health has shifted its focus from health protection to health promotion. In 2016, a Day of Reflection was organized during which a map of community assets and an action plan for the community recovery were co-constructed with local stakeholders. The creation of an Outreach Team is an important outcome of this collective reflection. This team aims to enhance resilience and adaptive capacity. Several promising initiatives arose from the action plan-all of which greatly contributed to mobilize the community. Interestingly, the 2018 survey suggests that the situation is now evolving positively. This case study stresses the importance of recognizing community members as assets, rather than victims, and seeking a better balance between health protection and health promotion approaches.