Study of train disaster finds high rates of PTSD and depression in affected communities

A peer-reviewed study led by a national team of psychologists and public health experts found elevated rates of posttraumatic stress disorder (PTSD) as well as major depression in communities affected by the 2023 East Palestine, Ohio, train derailment.

The study, published in the Journal of Traumatic Stress, offers one of the first large-scale diagnostic snapshots of mental health 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 major depression (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 mental health issues.

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

• 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 to experience PTSD or depression.

Psychologists are increasingly viewing natural and technological disasters like this one as being 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 the 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 co-author 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.