Agency for Toxic Substances and Disease Registry (ATSDR) Psychological Responses to Hazardous Substances
Background
The workshop was one activity of a larger ATSDR program, the Psychological
Effects Program. The purpose of this program is to examine the possible effects that
psychological stress associated with exposures to hazardous substances can produce on
psychological and physical health. Three situations in which the public could possibly be affected by
hazardous substances are proximity to a chemical accident, residence near a hazardous waste facility, or permanent
relocation from a community because of its contaminated environment. A search of the scientific
literature was performed regarding the neurobiological, psychological, and social
effects of possible exposures in these three settings.
Much of the earlier work on psychosocial responses to exposures to hazardous
substances was field research. To do this research, social scientists recorded their
observations of communities being affected by possible exposures to hazardous substances. Psychologists and
sociologists who observed communities exposed to toxic contaminants, such as the toxic
leachate at Love Canal, New York, and contaminated groundwater in Legler, New Jersey, reported a
splintering of the community into opposing factions and possible increases in psychologic distress
because of the difficulty of the experience (1-3).
Since the early field studies, research has branched in several directions.
First, psychologists and psychiatrists have studied the coping mechanisms involved in how
people deal with the threat of an "invisible" toxic exposure (4-6).
Second, several clinical descriptive studies on the effects of possible
exposures to hazardous substances on communities' psychology have been performed. This line
of inquiry grew out of research into the psychological effects of natural disasters.
Disaster effects research, which began in the 1950s, indicates that a small portion of
residents after various disasters, such as fires, hurricanes, and floods, can develop
psychological complications from the stress involved in these experiences. Stress
can lead to disorders such as major depression, chronic anxiety, and post-traumatic
stress disorder (PTSD). The stress following a natural disaster also can lead to
temporary increases in stress-related physical illnesses.
A third area of research emerged when psychologists focused on the
epidemiology of psychological responses in communities affected by hazardous substances. The
results of these psychiatric epidemiologic studies have been mixed. The work of
Baum and Fleming (7) points to the presence of physiologic changes indicative of long-term chronic stress in a community near a hazardous waste
site. Horowitz and Stefanko (8) reported high levels of demoralization but no clinical disorders
in a community located near a hazardous waste site. A study in Alsen, Louisiana, (9)
revealed high levels of near-clinical anxiety and depression in an African-American
community located near a hazardous waste facility. One recent study (10) conducted in a California community
following an evacuation because of a toxic railroad spill reported significantly
higher levels of depression and anxiety syndromes in the evacuated population versus the control population. Another
recent study by a group of epidemiologists in Texas (11) documented a linear relationship
between the level of exposure to a spilled chemical and the amount of psychological stress
present 2 years after the accident.
If higher than normal levels of psychological stress and psychological
sequelae are being found in communities affected by possible exposures to hazardous
substances, then this presents a public health problem. The effects of long-term
stress on physical health at these sites is unknown and requires further study.
The psychological effects workshop
was convened to outline the extent of this new public health issue and to develop a strategy to address this
potential public health problem.
