Exposure to Bioterrorism and Mental Health Response among Staff on Capitol Hill

Abstract

The October 2001 anthrax attacks heralded a new era of bioterrorism threat in the U.S. At the time, little systematic data on mental health effects were available to guide authorities' response. For this study, which was conducted 7 months after the anthrax attacks, structured diagnostic interviews were conducted with 137 Capitol Hill staff workers, including 56 who had been directly exposed to areas independently determined to have been contaminated. Postdisaster psychopathology was associated with exposure; of those with positive nasal swab tests, PTSD was diagnosed in 27% and any postanthrax psychiatric disorder in 55%. Fewer than half of those who were prescribed antibiotics completed the entire course, and only one-fourth had flawless antibiotic adherence. Thirty percent of those not exposed believed they had been exposed; 18% of all study participants had symptoms they suspected were symptoms of anthrax infection, and most of them sought medical care. Extrapolation of raw numbers to large future disasters from proportions with incorrect belief in exposure in this limited study indicates a potential for important public health consequences, to the degree that people alter their healthcare behavior based on incorrect exposure beliefs. Incorrect belief in exposure was associated with being very upset, losing trust in health authorities, having concerns about mortality, taking antibiotics, and being male. Those who incorrectly believe they were exposed may warrant concern and potential interventions as well as those exposed.Treatment adherence and maintenance of trust for public health authorities may be areas of special concern, warranting further study to inform authorities in future disasters involving biological, chemical, and radiological agents.Carol S.

Workplace response of companies exposed to the 9/11 World Trade Center attack: a focus‐group study

“…It is also well established that most employees in settings of workplace trauma do not participate in the formal mental health services that are offered (Harvey, 1996;Schouten, Callahan and Bryant, 2004). Research has demonstrated that most employees do not develop PTSD or other psychiatric illness after workplace disasters (North, 2007;North et al, 1989North et al, , 1999North et al, , 2009Smith et al, 1990). Thus, limiting the workplace disaster mental health response to professional mental health services in the postdisaster setting without providing other interventions to address all employees' emotional distress does not align with the types of needs of employee populations and thus is not a sufficient response.…”

Past Epidemics, Natural Disasters, COVID19, and Mental Health: Learning from History as we Deal with the Present and Prepare for the Future

“…This uncertainty commonly leads to fear and can manifest and exacerbate mental instability and illnesses. The anthrax threat demonstrated a time that stress was not only experienced by those directly exposed, but also in those that believed they were exposed [ 23 ]. Individuals who incorrectly believed they were exposed, were shown to be at increased risk of being very upset, losing trust in health authorities, and having concerns about mortality [ 23 ].…”

“…The risk of individuals changing their healthcare behavior based on distrust in authorities is an important risk that can be translated to the COVID-19 pandemic. Whether an individual was exposed or not, the beliefs about their exposure may be a more powerful predictor of mental health outcomes [ 23 ]. With constantly changing and differing policies between countries and states surrounding COVID-19, steps taken to control the spread of disease, and the vast amount of misinformation distributed among the general public, the belief of exposure is likely to widely vary among individuals.…”

Public responses to the novel 2019 coronavirus (2019‐nCoV) in Japan: Mental health consequences and target populations

“…For example, studies of the 2001 anthrax letter attacks in the USA showed long-term mental health adversities as well as lowered health perception of the infected employees and responders. 9 Public fear manifests as discrimination, stigmatization, and scapegoating of specific populations, authorities, and scientists. 10 As we write this letter, the coronavirus emergency is rapidly evolving.…”