New study of East Palestine, Ohio, train disaster finds high rates of PTSD and depression in affected communities

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Researchers show persistent psychological toll on residents exposed to chemical spill in Ohio, Pennsylvania, andWest Virginia, with half of those living near the disaster also reporting worsening physical health symptoms anddistrust in government information. The research also suggests improved methods for public health officialsresponding to community disasters, including weather events such as flooding.

CHARLOTTESVILLE, Va. — A new peer-reviewed study led by a national team of psychologists and public health expertsfound elevated rates of posttraumatic stress disorder (PTSD) as well as major depression in communities affected by the2023 East Palestine, Ohio, train derailment. The study offers one of the first large-scale diagnostic snapshots of mentalhealth outcomes following the technological disaster.

The derailment of a Norfolk Southern train on February 3, 2023, released over 1 million pounds of hazardous chemicals, like vinyl chloride, into the surrounding communities, triggering widespread concerns about toxic exposures and long-term health harms. The new study surveyed 1,000 adults living within 65 miles of the derailment site, covering parts of Ohio,Pennsylvania, and West Virginia. 

Key Findings

• Mental health problems remain elevated nine months post-disaster.

15% of respondents met criteria for presumptive PTSD (over twice the national average), and 13% for majordepression (60% greater than the national average).

• Half of the residents surveyed reported new or worsening physical symptoms.

Issues such as coughing, fatigue, and eye irritation were common, with higher reports from those living closer to the derailment.

• Distrust of public officials and uncertainty about chemical exposure were key predictors of mentalhealth issues.

More than half of residents said they had little to no confidence in official information during and after thecrisis.

• Proximity to the disaster site is not a driver of mental health issues. Mental health symptoms were just as likely among residents farther from the derailment—highlighting that perceived risk, not just physical proximity, shaped psychological outcomes.
• Low social support and prior trauma history heightened vulnerability.

Residents with a history of interpersonal trauma or less social support were significantly more likely toexperience PTSD or depression.

Psychologists are increasingly viewing natural and technological disasters like this one to be potentially traumatic events that can trigger or worsen psychiatric problems. “With its rapid onset, widespread nature, and uncertainty about the extent of exposures, an event like this can result in a lot of persistent psychological stress,” said study author Cameron Pugach of the Medical University of South Carolina. “Our study today suggests that this concern has lingered post disaster and may be elevating the rate of psychological disorders that can result from stress and trauma.”

Although only 1,000 residents completed the survey, survey results were weighted to reflect the wider population living within a 65-mile radius of the disaster. “We can say with confidence that a majority of people living near this disaster site remain concerned about what they may have been exposed to and feel that these potential exposures resulted in real physical health symptoms,” said study co-author Aaron Reuben of the University of Virginia. These concerns and symptoms in turn appear to elevate risk for psychological disorder that is severe enough to warrant treatment.

“In the future we may need to attend more in advance to limit psychological uncertainty after these events,” says study coauthor Dean Kilpatrick.  “Providing communities with timely and credible information about the likelihood of exposures should be considered front-line responses.” For now, Ohio, Pennsylvania, and West Virginia residents potentially exposed to the East Palestine train derailment may benefit from expanded services to address continuing physical and mental health concerns.

The report is authored by:

• Cameron P. Pugach, Medical University of South Carolina (Department of Psychiatry and Behavioral Sciences)
• Aaron Reuben, University of Virginia (Department of Psychology)
• Angela D. Moreland, Medical University of South Carolina (Department of Psychiatry and Behavioral Sciences)
• Alex O. Rothbaum, Emory University (Department of Psychiatry and Behavioral Sciences)
• John Boyle, ICF International
• Michael G. Schmidt, Medical University of South Carolina (Department of Microbiology and Immunology)
• James Dayton, ICF International
• Rachel Kinder, ICF International
• Sandro Galea, Washington University in St. Louis (School of Public Health)
• Salma Abdalla, Washington University in St. Louis (School of Public Health)
• Mohammed Abba-Aji, Washington University in St. Louis (School of Public Health)
• Dean G. Kilpatrick, Medical University of South Carolina (Department of Psychiatry and Behavioral Sciences)

The study, “Prevalence of PTSD and Major Depression in Ohio, Pennsylvania, and West Virginia 9 Months After the EastPalestine Train Derailment,” is published in the Journal of Traumatic Stress. It was funded, in part, by the National Institutes of Health.

Full study available at:

https://doi.org/10.1002/jts.70003

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