Siddhartha Roy, Marc A. Edwards, Keith J. Petrie, Greg D. Gamble, Ellie Jacques
{"title":"弗林特水危机后儿童可能出现的恐慌效应:来自教师看法和神经心理学评估的证据","authors":"Siddhartha Roy, Marc A. Edwards, Keith J. Petrie, Greg D. Gamble, Ellie Jacques","doi":"10.1017/dmp.2024.106","DOIUrl":null,"url":null,"abstract":"Objective Special education enrollment increased in Flint following the 2014–2015 Flint Water Crisis, but lead exposure is not plausibly responsible. Labeling Flint children as lead poisoned and/or brain damaged may have contributed to rising special education needs (ie, nocebo effect). To better document this possibility, we surveyed schoolteachers and reviewed neuropsychological assessments of children for indications of negative labeling. Methods A survey of Flint and Detroit (control) public schoolteachers using a modified Illness Perception Questionnaire was conducted 5 years post-crisis. We also examined neuropsychological assessments from a recently settled class lawsuit. Results Relative to Detroit (n = 24), Flint teachers (n = 11) believed that a higher proportion of their students had harmful lead exposure (91.8% Flint vs 46% Detroit; <jats:italic>P</jats:italic> = 0.00034), were lead poisoned (51.3% vs 24.3%; <jats:italic>P</jats:italic> = 0.018), or brain damaged (28.8% vs 12.9%; <jats:italic>P</jats:italic> = 0.1), even though blood lead of Flint children was always less than half of that of Detroit children. Neuropsychological assessments diagnosed lead poisoning and/or brain damage from water lead exposure in all tested children (n = 8), even though none had evidence of elevated blood lead and a majority had prior learning disability diagnoses. Conclusion Teachers’ responses and neuropsychological assessments suggest Flint children were harmed by a nocebo effect.","PeriodicalId":54390,"journal":{"name":"Disaster Medicine and Public Health Preparedness","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Possible Nocebo Effect in Children Following the Flint Water Crisis: Evidence From Schoolteacher Perceptions and Neuropsychological Evaluations\",\"authors\":\"Siddhartha Roy, Marc A. Edwards, Keith J. Petrie, Greg D. Gamble, Ellie Jacques\",\"doi\":\"10.1017/dmp.2024.106\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective Special education enrollment increased in Flint following the 2014–2015 Flint Water Crisis, but lead exposure is not plausibly responsible. Labeling Flint children as lead poisoned and/or brain damaged may have contributed to rising special education needs (ie, nocebo effect). To better document this possibility, we surveyed schoolteachers and reviewed neuropsychological assessments of children for indications of negative labeling. Methods A survey of Flint and Detroit (control) public schoolteachers using a modified Illness Perception Questionnaire was conducted 5 years post-crisis. We also examined neuropsychological assessments from a recently settled class lawsuit. Results Relative to Detroit (n = 24), Flint teachers (n = 11) believed that a higher proportion of their students had harmful lead exposure (91.8% Flint vs 46% Detroit; <jats:italic>P</jats:italic> = 0.00034), were lead poisoned (51.3% vs 24.3%; <jats:italic>P</jats:italic> = 0.018), or brain damaged (28.8% vs 12.9%; <jats:italic>P</jats:italic> = 0.1), even though blood lead of Flint children was always less than half of that of Detroit children. Neuropsychological assessments diagnosed lead poisoning and/or brain damage from water lead exposure in all tested children (n = 8), even though none had evidence of elevated blood lead and a majority had prior learning disability diagnoses. Conclusion Teachers’ responses and neuropsychological assessments suggest Flint children were harmed by a nocebo effect.\",\"PeriodicalId\":54390,\"journal\":{\"name\":\"Disaster Medicine and Public Health Preparedness\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Disaster Medicine and Public Health Preparedness\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1017/dmp.2024.106\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Disaster Medicine and Public Health Preparedness","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/dmp.2024.106","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
A Possible Nocebo Effect in Children Following the Flint Water Crisis: Evidence From Schoolteacher Perceptions and Neuropsychological Evaluations
Objective Special education enrollment increased in Flint following the 2014–2015 Flint Water Crisis, but lead exposure is not plausibly responsible. Labeling Flint children as lead poisoned and/or brain damaged may have contributed to rising special education needs (ie, nocebo effect). To better document this possibility, we surveyed schoolteachers and reviewed neuropsychological assessments of children for indications of negative labeling. Methods A survey of Flint and Detroit (control) public schoolteachers using a modified Illness Perception Questionnaire was conducted 5 years post-crisis. We also examined neuropsychological assessments from a recently settled class lawsuit. Results Relative to Detroit (n = 24), Flint teachers (n = 11) believed that a higher proportion of their students had harmful lead exposure (91.8% Flint vs 46% Detroit; P = 0.00034), were lead poisoned (51.3% vs 24.3%; P = 0.018), or brain damaged (28.8% vs 12.9%; P = 0.1), even though blood lead of Flint children was always less than half of that of Detroit children. Neuropsychological assessments diagnosed lead poisoning and/or brain damage from water lead exposure in all tested children (n = 8), even though none had evidence of elevated blood lead and a majority had prior learning disability diagnoses. Conclusion Teachers’ responses and neuropsychological assessments suggest Flint children were harmed by a nocebo effect.
期刊介绍:
Disaster Medicine and Public Health Preparedness is the first comprehensive and authoritative journal emphasizing public health preparedness and disaster response for all health care and public health professionals globally. The journal seeks to translate science into practice and integrate medical and public health perspectives. With the events of September 11, the subsequent anthrax attacks, the tsunami in Indonesia, hurricane Katrina, SARS and the H1N1 Influenza Pandemic, all health care and public health professionals must be prepared to respond to emergency situations. In support of these pressing public health needs, Disaster Medicine and Public Health Preparedness is committed to the medical and public health communities who are the stewards of the health and security of citizens worldwide.