Posttraumatic Stress Disorder, Depression, and Alcohol and Tobacco Use in Public Health Workers After the 2004 Florida Hurricanes

Objective: We examined the relationship of probable posttraumatic stress disorder (PTSD), probable depression, and increased alcohol and/or tobacco use to disaster exposure and work demand in Florida Department of Health workers after the 2004 hurricanes. Methods: Participants (N=2249) completed electronic questionnaires assessing PTSD, depression, alcohol and tobacco use, hurricane exposure, and work demand. Results: Total mental and behavioral health burden (probable PTSD, probable depression, increased alcohol and/or tobacco use) was 11%. More than 4% had probable PTSD, and 3.8% had probable depression. Among those with probable PTSD, 29.2% had increased alcohol use, and 50% had increased tobacco use. Among those with probable depression, 34% indicated increased alcohol use and 55.6% increased tobacco use. Workers with greater exposure were more likely to have probable PTSD and probable depression (ORs=3.3 and 3.06, respectively). After adjusting for demographics and work demand, those with high exposure were more likely to have probable PTSD and probable depression (ORs=3.21 and 3.13). Those with high exposure had increased alcohol and tobacco use (ORs=3.01 and 3.40), and those with high work demand indicated increased alcohol and tobacco use (ORs=1.98 and 2.10). High exposure and work demand predicted increased alcohol and tobacco use, after adjusting for demographics, work demand, and exposure. Conclusions: Work-related disaster mental and behavioral health burden indicate the need for additional mental health interventions in the public health disaster workforce.