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Soc Psychiatry Psychiatr Epidemiol. 2012 Sep;47(9):1441-8. doi: 10.1007/s00127-011-0449-6. Epub 2011 Nov 10.

Posttraumatic stress and tendency to panic in the aftermath of the chlorine gas disaster in Graniteville, South Carolina.

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Shirley L. Buchanan Neuroscience Laboratory, Dorn VA Medical Center, Columbia, SC, USA.



Relatively little is known about psychological effects of environmental hazard disasters. This study examines the development of posttraumatic stress (PTS) and tendency to limited panic attack after a large chlorine spill in a community.


In January 2005, a large chlorine spill occurred in Graniteville, SC. Acute injuries were quantified on an ordinal severity scale. Eight to ten months later, participating victims completed the Short Screening Scale for PTSD (n = 225) and the Holden Psychological Screening Inventory (HPSI) (n = 193) as part of a public health intervention. Forced expiratory volume in 1 s (FEV(1)) and forced vital capacity were likewise measured via spirometry. Two sets of univariate logistic regression models were fit to detect independent effects of each potential covariate and risk factor on PTS score and tendency to panic. A supplemental analysis examined whether poor lung function may be a confounder and/or effect modifier of the effect of acute injury on PTS score and panic.


Of those who completed psychological screening, 36.9% exhibited PTS symptoms. FEV(1), acute injury, and the HPSI psychiatric subscale were independently associated with increased PTS score. Acute injury severity scale and female sex were associated with tendency to panic. Immediate acute injury severity and poor lung function later were independently associated with PTS symptomotology.


The high prevalence of PTS and endorsement of tendency to panic within our sample show a need for mental health treatment after a chemical hazard disaster. Mental health personnel should be considerate of those with serious physical injuries.

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