This epidemiological study is one component of the “Post-Fire Health 76 (SPI76)” initiative, which aims to assess the health consequences of the industrial accident. This complementary component confirms the accident’s impact on the mental health (post-traumatic stress disorder, generalized anxiety, and depression) of populations living in exposed areas.

These results also highlight factors traditionally associated with these psychological disorders, such as social isolation, economic deprivation, or a history of mental health issues. They confirm the importance of providing appropriate support to people living near the site of the incident, as well as to those who are economically disadvantaged, socially isolated, or have a history of mental health issues, in the event of future industrial accidents. Already, building on the efforts made during the fire, providing access to appropriate psychological support remains a priority in the area near the industrial accident.

Confirmed links to the mental health of exposed individuals

The results published in July showed that the perception of the nuisances caused by the fire had a negative impact on the health of exposed individuals, as measured by individual questionnaires one year after the event. This impairment was primarily due to an impact on psychological health. Using validated psychometric measurement tools, the complementary component of the ^study¹ made it possible to precisely assess the accident’s impact on probable post-traumatic stress disorder, probable generalized anxiety, and probable depression.

The results obtained show a link between exposure to the fire and the mental health of those exposed, as follows:

• 6% of the population in the exposed area exhibited probable post-traumatic stress disorder attributed to the fire;

• 15% of the population in the exposed area exhibited probable generalized anxiety (compared to 9% in the control area);

• 18% of the population in the exposed area had probable depression (compared to 12% in the control area).

Overall, the results indicate that 23% of respondents in the exposed area had at least one mental health disorder, and that 5% had both probable post-traumatic stress disorder and probable depression.

Disorders linked to proximity to the accident and the nature of exposure

The prevalence of psychological disorders was higher near the site of the fire. Indeed, the population located within a 1,500-meter radius of the burned facilities had the highest prevalence rates for all three disorders compared to those living more than 1,500 meters away:

• 13% with probable post-traumatic stress disorder (compared to 5% among residents living farther away);

• 24% probable generalized anxiety (compared to 14% among residents living farther away);

• 29% with probable depression (compared to 17% among residents living farther away).

The mental health disorders identified among exposed individuals are associated with factors related to the fire. Indeed, having heard or been awakened by the fire was linked to the onset of probable post-traumatic stress disorder and a higher prevalence of probable generalized anxiety. Exposure to odors and asbestos-cement roofing debris, meanwhile, was associated with a higher prevalence of probable depression.

The study identifies other factors associated with these psychological disorders, which are also described in similar epidemiological studies. For instance, social isolation was associated with all three psychological disorders studied; a history of psychological treatment was linked to probable depression; financial difficulties were linked to probable post-traumatic stress disorder; and probable generalized anxiety was more commonly found among women. Furthermore, having a professional connection to one of the companies that burned down was also associated with probable post-traumatic stress.

Expanding psychological support services for residents immediately affected by the accident

Given the results of this mental health study, which confirms the relevance of the psychological support provided immediately after the fire, it appears useful to further improve access to psychological assistance for residents in the area near the industrial accident.

The mental health challenge, identified as soon as the fire broke out, led to the immediate establishment of emergency psychological support for the affected population. The Normandy Regional Health Agency (ARS), in coordination with the prefecture, very quickly mobilized volunteers from the Medical-Psychological Emergency Unit (CUMP) and Red Cross volunteers. A psychological support unit was thus established on October 2, 2019, enabling a team of psychiatrists, psychologists, and nurses—with support from the Red Cross—to assist nearly 50 people at a municipal center in Rouen. When the unit closed on October 11 of that year, individuals requiring psychological support were then referred to their primary care physician, who is encouraged, if necessary, to refer the patient to the following specialized services:

• in the Rouen metropolitan area: to the CASP (Psychiatric Care and Reception Center), the university hospital emergency room, and the UNACOR (Reception and Referral Unit) at the Rouvray Hospital

• and outside urban areas: to the nearest CMP (Medical-Psychological Center) for adults or children.

Based on the Santé publique France report on long-term impacts on the mental health of a portion of the affected population, the ARS Normandie continues to facilitate long-term access to psychological care for those affected. Discussions with the Regional Union of Private Practitioners, the Departmental Council of the Order of Physicians, and Le Rouvray Hospital regarding the region’s CMPs—in coordination with the Territorial Health Council’s specialized mental health commission—will continue to strengthen the existing system in two key areas:

• Raising awareness among general practitioners in the area regarding psychotrauma and anxiety-depressive disorders, in order to equip them with tools and support them in managing their patients

• Organizing a streamlined pathway to the CMPs at Le Rouvray Hospital following an initial assessment by the primary care physician

The importance of anticipating future accidents

These results highlight the impact of the Lubrizol and NL Logistique warehouse fires on the mental health of the exposed populations. In addition to what was offered to the population after the fire, these findings reinforce the need to establish preparedness measures in the event of future accidents and to pay particular attention to residents living near the site of the incident, as well as to economically disadvantaged individuals, those who are socially isolated, or those with a history of psychological treatment or exposure to potentially traumatic events. As a precaution, appropriate psychological support could be expanded. Additionally, reception and information centers could be established to address the needs of local residents. This would help prevent residents from feeling isolated as they grapple with questions related to an industrial accident.

Finally, it is important to emphasize that these issues can persist for several years after the industrial accident. Long-term epidemiological surveillance based on analyses from the National Health Data System (SNDS) will provide information on reimbursements for outpatient care and certain illnesses requiring hospitalization, thereby enabling medium- and long-term monitoring of the health of the survey respondents, as well as that of all residents in the affected area.