Mental health of workers in Toulouse 2 years after the industrial AZF disaster: first results of a longitudinal follow-up of 3,000 people

Soc Psychiatry Psychiatr Epidemiol. 2009 Sep;44(9):784-91. doi: 10.1007/s00127-009-0500-z. Epub 2009 Feb 28.


Introduction: On September 21, 2001, the AZF petrochemical factory near Toulouse (France) exploded. A cross-sectional survey of Toulouse workers took place in 2002 and then, a cohort follow-up began in 2003. The aim of this paper is to study the associations between various factors describing exposure to the disaster, and anxiety and depressive symptoms, assessed at cohort inclusion 2 years afterwards.

Methods: In 2003, 3,006 people were included in the cohort. Psychological distress was measured by the GHQ28 at inclusion. Factors related to exposure to the disaster, such as personal distance from the site, physical injury, immediate psychological symptoms, and material and social effects, came from the 2002 cross-sectional survey. The links between mental health symptoms and exposure were studied in multivariate analyses by logistic regression.

Results: The prevalence of psychological distress was 47% at inclusion in the cohort. It varied according to sex and occupational class: blue-collar workers and self-employed people were most highly affected. Factors such as a history of depression, injury to a close friend or family member, sick-leaves and immediate psychological symptoms were associated with psychological distress 2 years later. These associations differed according to sex.

Conclusion: This study shows links between the industrial disaster and psychological distress 2 years afterwards. The results about risk factors differ according to sex, and identify particularly vulnerable populations. It should guide preventive interventions in such situation.

Publication types

  • Comparative Study

MeSH terms

  • Accidents, Occupational / psychology
  • Accidents, Occupational / statistics & numerical data
  • Adult
  • Chemical Industry / statistics & numerical data
  • Cohort Studies
  • Cross-Sectional Studies
  • Disasters / statistics & numerical data*
  • Explosions / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Health Status
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Prevalence
  • Quality of Life
  • Risk Factors
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology
  • Stress, Psychological / diagnosis
  • Stress, Psychological / epidemiology
  • Surveys and Questionnaires