THE EFFECT OF MAJOR RAILWAY ACCIDENTS ON THE PSYCHOLOGICAL HEALTH OF TRAIN DRIVERS .2. A LONGITUDINAL-STUDY OF THE ONE-YEAR OUTCOME AFTER THE ACCIDENT

The psychological impact on 101 train drivers of accidents causing maj or injuries or death to persons was studied by means of clinical inter views and questionnaires (Impact of Event Scale, General Health Questi onnaire and a questionnaire addressing stress symptoms plus past and p re accident expectancies of being involved in accidents). The drivers were examined within hours to a few days after the accident and later at 1 month and 1 year. One month after the accident the symptoms of di stress were significantly reduced and most so among the drivers with n o preaccident risk experience according to self reports during the acu te phase. A minor further reduction of distress was found at 1 year. D rivers with two or more previous accident experiences and those who ha d worried about being involved in accidents showed highest symptoms of distress at follow-up. Eleven out of 101 drivers reported sick leave more of than 1 week after the accident and this was related to higher intrusion scores. The few drivers who report longterm psychological di stress are best predicted by a combination of acute high IES scores, e xperience of previous accidents and risk expectancy prior to the curre nt accident. The study suggests that premorbid and non-accident relate d variables are more important for the 1 year psychological outcome of healthy drivers after on-the-track accidents than the stress event it self.