Abstract

BackgroundOn March 11, 2011, a magnitude 9.0 earthquake, the most powerful ever recorded in Japan, and a massive tsunami struck off the coast of the Sanriku region. A Disaster Medical Assistance Team, a mobile medical team with specialized training that is deployed during the acute phase of a disaster, was dispatched to areas with large-scale destruction and multiple injured and sick casualties. Previous studies have reported critical incident stress (i.e. posttraumatic stress disorder symptoms and depressive symptoms) among rescue workers as well as the need for screening and prevention for posttraumatic stress disorder. So far we have shown in an open trial that posttraumatic stress disorder symptoms in critically injured patients can be reduced by taking omega-3 fatty acids intended to stimulate hippocampal neurogenesis.Method/DesignThis study is designed to determine the effectiveness of attenuating posttraumatic distress with omega-3 polyunsaturated fatty acids among Disaster Medical Assistance Team members after the Great East Japan Earthquake, and is named the APOP randomized controlled trial which is currently ongoing. First, we will provide psycho-education on posttraumatic distress, which is common in responders to the Disaster Medical Assistance Team members deployed to the disaster area. Second, observational research will be conducted to evaluate critical incident stress following the completion of medical activities. Third, team members who provide consent to participate in the intervention research will be randomly divided into a group given an omega-3 fatty acid supplement and a group not given the supplements. Outcome will be evaluated at 12 weeks after the supplements are shipped to the team members.DiscussionMeasures that address critical incident stress in disaster responders are important, but there is no substantial evidence that links such measures with prevention of posttraumatic stress disorder. Thus, any confirmation through this study that the intake of omega-3 fatty acid supplements serves as a simple preventative measure for critical incident stress will be of great significance.Trial registrationUMIN Clinical Trials Registry, UMIN000005367

Highlights

  • On March 11, 2011, a magnitude 9.0 earthquake, the most powerful ever recorded in Japan, and a massive tsunami struck off the coast of the Sanriku region

  • The present study aims to determine the effectiveness of attenuating posttraumatic distress with omega-3 polyunsaturated fatty acids among Disaster Medical Assistance Team (DMAT) members who are deployed during the acute disaster phase following the Great East Japan Earthquake

  • This study named the APOP randomized controlled trial aims to (1) provide psychoeducation on posttraumatic distress common among rescue workers to DMAT members dispatched to disaster areas, (2) assess critical incident stress among the DMAT members following completion of their medical duties, and (3) recruit these DMAT members to a 12-week study investigating the effects of omega-3 fatty acids in reducing stress, with consenting participants randomly allocated to either an omega-3 acid fatty acid supplementation group or a nonsupplementation group

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Summary

Discussion

Declines in physical and mental health due to critical incident stress in disaster aid workers or rescue workers has been demonstrated in previous research, but specific, adequate measures to counter critical incident stress have not been developed. The APOP study was designed at a time of crisis, 1 week after the earthquake occurred, and recruiting sufficient participants was considered difficult if a placebo group were to be used Another limitation of the study is that fatty acid composition of red blood cell membranes could not be measured to confirm intake compliance of the omega-3 fatty acid supplements. With these limitations in mind, we do believe the results of the APOP clinical trial will be of importance: natural and man-made disasters occur across the globe and omega-3 fatty acid supplementation, if found to be efficacious for preventing critical incident stress, could contribute to maintaining the mental health of disaster relief workers in the future. All other authors declare that they have no competing interests with this work

Background
Methods/Design
20. Radloff LS
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