三大核事故应急人员心理健康后果的系统综述

The impact of three major nuclear accidents on the mental health of emergency responders:a systematic review

目的系统性评价三哩岛、切尔诺贝利、福岛三大核事故对应急人员心理健康状况的影响。方法采用主题词与自由词组合检索的方式,检索PubMed、Web of Science、APA PsycINFO数据库中关于三哩岛、切尔诺贝利、福岛三大核事故应急人员心理健康后果研究的相关文献,进行系统综述。结果共纳入37项研究。核事故后应急人员普遍存在一般心理困扰、抑郁、焦虑、创伤后应激障碍等心理问题。切尔诺贝利核事故的心理影响最为严重,引起清理人员器质性精神障碍、人格障碍等严重精神障碍。不同核事故应急人员的心理健康状况与灾难相关的应急处置工作经历、核事故伴发的社会因素相关。结论核事故后应急人员普遍存在一般心理困扰、焦虑、抑郁、创伤后应激障碍、严重精神障碍等长期心理健康问题,应急人员的基线心理健康状况和心理干预措施有待进一步研究。

Objective To systematically evaluate the impact of the three major nuclear accidents at Three Mile Island,Chernobyl and Fukushima on the mental health status of emergency responders.Methods MeSH and Entry Terms were searched.Relevant literature on the mental health consequences of the emergency responders to the Three Mile Island,Chernobyl,and Fukushima nuclear accidents were retrieved from PubMed,Web of Science,and APA PsycINFO databases,and screened and reviewed.Results Totally 37 studies were included.General psychological distress,depression,anxiety,post-traumatic stress disorder and other abnormal psychological problems are prevalent among emergency responders following nuclear accidents.The psychological impact of the Chernobyl nuclear accident was most profound,causing serious mental disorders such as organic mental disorder and personality disorder among the clean-up workers.The mental health condition of emergency responders was associated with disaster-related emergency response tasks and the social factors brought in nuclear accidents.Conclusions General psychological distress,anxiety,depression,post-traumatic stress reaction/disorder,severe mental disorder and other long-term abnormal psychological problems are common among first responders after nuclear accidents,and baseline mental health and psychological interventions require further study.