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The Fort McMurray Mommy Baby Study: A Protocol to Reduce Maternal Stress Due to the 2016 Fort McMurray Wood Buffalo, Alberta, Canada Wildfire.

ABSTRACT: Introduction: Data show that maternal stress triggered by exposure to a natural disaster before, during or just after pregnancy is associated with adverse pregnancy and newborn outcomes. In this paper, the first aim is to describe our efforts to test a simple, low-cost intervention to large numbers of women following a major natural disaster. The second aim is to outline the challenges faced and lessons learned during the execution of this natural disaster study. Methods: The setting was the May 2016 Fort McMurray Wood Buffalo wildfire in northern Alberta, Canada. Women who were pregnant or preconception at the time of the disaster were invited to participate via social media. This prospective cohort study included a randomized controlled trial to test the effectiveness of an expressive writing intervention on the levels of prenatal maternal stress and maternal, birth, and early childhood outcomes. At recruitment and at multiple timepoints postpartum, a battery of questionnaires was administered to evaluate objective and subjective stress exposure to the fire as well as maternal mental health, resilience and its contributing factors as well as infant developmental milestones. Qualitative content analysis of the expressive writing was conducted. Discussion: There is an increasing need to develop effective, wide-spread, rapid, and low-cost interventions to reduce prenatal maternal stress, increase resilience, and improve pregnancy outcomes following a natural disaster. Though analysis of data is ongoing, we highlight the strengths of this study which include strong community participation, rapid recruitment of eligible participants, low-cost intervention and data acquisition, and successful testing of the intervention. We acknowledge the challenges we encountered including the high rate of participant disqualifications or losses due to incomplete collection of online data; evacuation, dispersal, and inconsistent return to homes; and the high levels of stress accumulated post-disaster which led to inability to complete the study. Despite potential challenges, there remains a need for such research amid natural disasters.

SUBMITTER: Hyde A

PROVIDER: S-EPMC8249202 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:An unprecedented wildfire impacted the northern Alberta city of Fort McMurray in May 2016 causing a mandatory city wide evacuation and the loss of 2,400 homes and commercial structures. A two-hectare wildfire was discovered on May 1, grew to ~157,000ha by May 5, and continued to burn an estimated ~590,000ha by June 13. A comprehensive air monitoring network operated by the Wood Buffalo Environmental Association (WBEA) in and around Fort McMurray provided essential health-related real-time air quality data to firefighters during the emergency, and provided a rare opportunity to elucidate the impact of gaseous and particulate matter emissions on near-field communities and regional air pollution concentrations. The WBEA network recorded 188 fire-related exceedances of 1-hr and 24-hr Alberta Ambient Air Quality Objectives. Two air monitoring sites within Fort McMurray recorded mean/maximum 1-hr PM2.5 concentrations of 291/5229?gm-3 (AMS-6) and 293/3259?gm-3 (AMS-7) during fire impact periods. High correlations (r2=0.83-0.97) between biomass combustion related gases (carbon monoxide (CO), non-methane hydrocarbons (NMHC), total hydrocarbons (THC), total reduced sulfur (TRS), ammonia) and PM2.5 were observed at the sites. Filter-based 24-hr integrated PM2.5 samples collected every 6 days showed maximum concentrations of 267?gm-3 (AMS-6) and 394?gm-3 (AMS-7). Normalized excess emission ratios relative to CO were 149.87±3.37?gm-3ppm-1 (PM2.5), 0.274±0.002ppmppm-1 (THC), 0.169±0.001ppmppm-1 (NMHC), 0.104±0.001ppmppm-1 (CH4), 0.694±0.007ppbppm-1 (TRS), 0.519±0.040ppbppm-1 (SO2), 0.412±0.045ppbppm-1 (NO), 1.968±0.053ppbppm-1 (NO2), and 2.337±0.077ppbppm-1 (NOX). A subset of PM2.5 filter samples was analyzed for trace elements, major ions, organic carbon, elemental carbon, and carbohydrates. Sample mass reconstruction and fire specific emission profiles are presented and discussed. Potential fire-related photometric ozone instrument positive interferences were observed and were positively correlated with NO and NMHC.

Project description:In Fort McMurray, Alberta, Canada, the wildfire of May 2016 forced the population of 88,000 to rapidly evacuate in a traumatic and chaotic manner. Ten percentage of the homes in the city were destroyed, and many more structures were damaged. Since youth are particularly vulnerable to negative effects of natural disasters, we examined possible long-term psychological impacts. To assess this, we partnered with Fort McMurray Public and Catholic Schools, who surveyed Grade 7-12 students (aged 11-19) in November 2017, 2018, and 2019-i.e., at 1.5, 2.5, and 3.5 years after the wildfire. The survey included validated measurement scales for post-traumatic stress disorder (PTSD), depression, anxiety, drug use, alcohol use, tobacco use, quality of life, self-esteem, and resilience. Data analysis was done on large-scale anonymous surveys including 3,070 samples in 2017; 3,265 samples in 2018; and 3,041 samples in 2019. The results were unexpected and showed that all mental health symptoms increased from 2017 to 2019, with the exception of tobacco use. Consistent with this pattern, self-esteem and quality of life scores decreased. Resilience scores did not change significantly. Thus, mental health measures worsened, in contrast to our initial hypothesis that they would improve over time. Of note, we observed higher levels of mental health distress among older students, in females compared to male students, and in individuals with a minority gender identity, including transgender and gender-non-conforming individuals. These findings demonstrate that deleterious mental health effects can persist in youth for years following a wildfire disaster. This highlights the need for multi-year mental health support programs for youth in post-disaster situations. The indication that multi-year, post-disaster support is warranted is relatively novel, although not unknown. There is a need to systematically investigate factors associated with youth recovery following a wildfire disaster, as well as efficacy of psychosocial strategies during later phases of disaster recovery relative to early post-disaster interventions.

Project description:Fort McMurray, a city in northern Alberta, Canada, has experienced multiple traumas in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Eighteen months after the wildfire, major depressive disorder (MDD), generalized anxiety disorder (GAD), and Post Traumatic Stress Disorder (PTSD) symptoms were elevated among school board employees in the city. This study aimed to compare employees of the school board and other employees of Fort McMurray in respect to the impact the 2016 wildfires, the 2019 COVID pandemic, and the 2020 floods had on their mental health. A quantitative cross-sectional survey was conducted in Fort McMurray from 24 April to 2 June 2021. Online questionnaires were administered through REDCap and were designed to capture socio-demographic characteristics, clinical as well as wildfire, COVID-19, and flooding-related variables. Mental health outcome variables were captured using self-reported standardized assessment scales. Data were analysed with descriptive statistics, Chi-square/Fisher's Exact tests, and binary regression analysis. Of the 249 residents who accessed the online survey, 186 completed the survey, giving a response rate of 74.7%. Of these respondents, 93.5% (174) indicated their employment status and were included in the Chi-square analysis. Most of the respondents were female (86.2%, (150)), above 40 years (53.4%, (93)), and were in a relationship (71.3%, (124)). The prevalence values for MDD, GAD and PTSD among respondents were 42.4%, 41.0, and 36.8%, respectively. There was a statistically significant difference between employees of the school board and other employees with respect to likely PTSD prevalence (28% vs. 45%, respectively, p < 0.05), although with other factors controlled for, in a binary logistic regression model, employer type did not significantly predict likely PTSD. The study has established that likely PTSD symptoms were significantly higher in other employees compared to those of school board employees. Greater exposure to the traumatic events and a greater perceived lack of support from other employers might have contributed to the significantly higher prevalence of PTSD in other employees.

Project description:BackgroundIn order to examine the impact of disasters on adolescent mental health, this study compared population mental health survey data from two communities in Alberta, Canada: Fort McMurray, which experienced a major natural disaster, and Red Deer, which did not.MethodsData from 3070 grade 7-12 students from Fort McMurray, Alberta, Canada (collected in 2017, 18 months after the 2016 wildfire) was compared with data from 2796 grade 7-12 students from Red Deer, Alberta, Canada (collected in 2014). The same measurement scales were used for both surveys. Both of these cities have populations of approximately 100,000, and both cities are located in Alberta, Canada. For this reason, Red Deer is an appropriate non-disaster impacted community to compare to the disaster impacted community of Fort McMurray.ResultsThe results of this comparison demonstrate that mental health symptoms were statistically significantly elevated in the Fort McMurray population when compared to the control population in Red Deer. This occurred for scores consistent with a diagnosis of depression (31% vs. 17%), moderately severe depression (17% vs. 9%), suicidal thinking (16% vs. 4%), and tobacco use (13% vs. 10%). Consistent with there being major mental health impacts from the 2016 Fort McMurray wildfire, self-esteem scores and quality of life scores were also statistically significantly lower in Fort McMurray. While the rates of anxiety disorder were similar (15% vs. 16%), the mean scores on the anxiety scale were slightly higher, with this difference reaching statistical significance. There were no statistical differences in the rates or scores for alcohol or substance use.ConclusionsOur results are consistent with previous findings showing a significant negative impact of disasters on many aspects of adolescent mental, with a particular increase in symptoms related to depression and suicidal thinking. These findings highlight first, the need to identify adolescents most at risk of developing psychiatric symptoms after experiencing the trauma of disaster and second, the importance and necessity of implementing short and long term mental health intervention programs specifically aimed at adolescents, in order to help mitigate the negative effects of disasters on their mental health.

Project description:Background: The May 2016 wildfire in Fort McMurray, Alberta, Canada forced evacuation of the population of 88,000 individuals and destroyed 10% of the homes. Youth are particularly impacted by disaster. Methods: Eighteen months after the wildfire, Fort McMurray Public and Catholic Schools surveyed 3,252 of the 4,407 students in Grades 7-12 to determine possible long-term psychological impacts. The survey included validated measurement scales for post-traumatic stress disorder (PTSD), depression, anxiety, use of drugs, alcohol, and tobacco, quality of life, self-esteem, and resilience. Data analysis was possible for only 3,070 students, i.e., 70% of the total student population. Anonymized data were analyzed to compare students who directly experienced lesser or greater impact from the wildfire, with greater impact defined as personally seeing the fire or having one's home destroyed. Also, students with greater or lesser scores on the Child and Youth Resilience Measure (CYRM-12) were compared. Results: Of the 3,070 students, 37% met criteria for probable PTSD; 31% met criteria for probable depression, and 17% for probable depression of at least moderate severity; 27% of students met criteria for probable anxiety, and 15% for probable alcohol or substance use disorder; 46% of all students met criteria for one or more probable diagnosis of PTSD, depression, anxiety, or alcohol/substance abuse, and this included students who were both present and not present in Fort McMurray at the time of the wildfire. Students with greater impact from the wildfire exhibited significantly higher scores on measures of PTSD, depression, anxiety, and alcohol/substance use. They also had lower self-esteem and quality of life scores. Students with lower resilience scores exhibited a similar pattern. Conclusions: These findings highlight first the negative impact of disasters on youth mental health, particularly for those who directly experience wildfire, and second the role of resilience on youth mental health, with lower resilience associated with substantially lower mental health outcomes. These results emphasize the need for long-term mental health supports for youth post-disaster, with specific focus on increasing youth resilience, which may serve as a protective factor against effects of disaster on mental health.

Project description:Introduction: Firefighters were working in exceptionally difficult conditions during the Fort McMurray/Horse River fire in May 2016. Methods: From mid-May, we recruited firefighters from 13 fire services as they returned from the fire. In October 2016 we extended recruitment to all Alberta-based firefighters deployed to the fire. In December 2017-May 2018 we sent a first online follow-up: this concentrated on mental health supports. The second follow-up, in October 2018-January 2019, included screening scales for respiratory ill-health and PTSD. All three contacts included visual analogue scales for chest symptoms and the Hospital Anxiety and Depression Scale. We estimated exposure to PM2.5, and calculated an exposure mitigation index from reports of respiratory protective equipment (RPE). Results: We recruited 1,234 firefighters and examined the relation of respiratory symptoms to estimated particulate exposure. The relation was strong immediately post fire but weakened over time. We found less chest tightness and cough in those whose RPE in the first week mitigated exposure by at least 10%. We examined the relation between particulate exposure and mental ill-health from screening questionnaires and found those with high exposure (reflecting the ferocity of the fire) had poorer mental health scores. Firefighters reporting their "worst moment during the fire" was life threatening were more anxious at second follow-up. Overall both anxiety and depression scores increased at successive contacts, more so in those with mental ill-health recorded in physician billing records before the fire. Discussion: The results from this study overall suggest on-going fire-related health effects in a substantial minority of firefighters, similar to those reported in the longitudinal follow-up of firefighters after the collapse of the World Trade Centre. Self-reports of both respiratory symptoms and mental ill-health were strongly related, soon after the fire, to estimated particulate exposures. Anxiety increased over time since the fire in those who felt their life or safety had been threatened, underlining the need for ongoing support. Our conclusions about the benefits of rapid research relate particularly to the collection of biomarkers of exposure as quickly and widely as possible, and the establishment of a nominal list of participants before they are too widely dispersed.

Project description:Following the 2016 Horse River Wildfire in northern Alberta, the provincial health authority, the ministry of health, non-profit and charitable organizations, and regional community-based service agencies mobilized to address the growing health and mental health concerns among Indigenous residents and communities through the provision of services and supports. Among the communities and residents that experienced significant devastation and loss were First Nation and Métis residents in the region. Provincial and local funding was allocated to new recovery positions and to support pre-existing health and social programs. The objective of this research was to qualitatively describe the health systems response to the health impacts following the wildfire from the perspective of service providers who were directly responsible for delivering or organizing health and mental wellness services and supports to Indigenous residents. Semi-structured qualitative interviews were conducted with 15 Indigenous and 10 non-Indigenous service providers from the Regional Municipality of Wood Buffalo (RMWB). Interviews were transcribed verbatim and a constant comparative analysis method was used to identify themes. Following service provider interviews, a supplemental document review was completed to provide background and context for the qualitative findings from interviews. The document review allowed for a better understanding of the health systems response at a systems level following the wildfire. Triangulation of semi-structured interviews and organization report documents confirmed our findings. The conceptual framework by Mirzoev and Kane for understanding health systems responsiveness guided our data interpretation. Our findings were divided into three themes (1) service provision in response to Indigenous mental health concerns (2) gaps in Indigenous health-related services post-wildfire and (3) adopting a health equity lens in post-disaster recovery. The knowledge gained from this research can help inform future emergency management and assist policy and decision makers with culturally safe and responsive recovery planning. Future recovery and response efforts should consider identifying and addressing underlying health, mental health, and emotional concerns in order to be more effective in assisting with healing for Indigenous communities following a public health emergency such as a wildfire disaster.

Dataset Information

The Fort McMurray Mommy Baby Study: A Protocol to Reduce Maternal Stress Due to the 2016 Fort McMurray Wood Buffalo, Alberta, Canada Wildfire.

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