Prevalence of posttraumatic stress disorder and major depression in Ohio, Pennsylvania, and West Virginia 9 months after the East Palestine train derailment.

On February 3, 2023, a Norfolk Southern train derailed in East Palestine, Ohio, releasing toxic compounds into the surrounding air, water, and soil. Technological chemical disasters represent potentially traumatic events capable of influencing mental disorders, such as posttraumatic stress disorder (PTSD) and major depression (MD). This study reports the first comprehensive investigation of the prevalence and correlates of mental disorders among potentially exposed residents of Ohio, Pennsylvania, and West Virginia 9 months postderailment. In this cross-sectional study, a nonprobability sample of 1,000 adults living within 65 miles of the derailment site completed a self-administered clinical survey interview assessing PTSD and MD, physical health symptoms, negative derailment-related beliefs and experiences, and preexisting psychiatric risk factors. Analyses were demographically weighted to yield estimates representative of the 65 mile-radius population. Most respondents were concerned about potential toxic exposure (73.9%) and associated health problems (92.1%), and half did not fully trust the information public health officials provided about the event (52.1%); half (49.7%) also reported at least one new or worsening physical health symptom since the derailment. Presumptive PTSD (15.4%) and MD (13.3%) were prevalent 9 months postderailment. Closer proximity to the derailment site was associated with greater endorsement of health concerns and symptoms, ds = 0.21-0.22, but not with greater mental disorder, OR = 1.02. Chemical disasters could have psychological consequences even without documented exposures, potentially due to uncertainty regarding exposure and associated health effects. The East Palestine community may benefit from increased attention to mental health services as a component of disaster response.