European Journal of Epidemiology

, Volume 20, Issue 10, pp 839–847

Determinants of Response in a Longitudinal Health Study Following the Firework-disaster in Enschede, The Netherlands

  • Marieke B.A. Dijkema
  • Linda Grievink
  • Rebecca K. Stellato
  • Jan Roorda
  • Peter G. van der Velden


Very few longitudinal health studies after disasters published data on the determinants of loss to follow up. However, these determinants provide important information for future disaster studies to improve their response and reduce selection bias. For this purpose we analyzed the data of a longitudinal health survey which was performed among residents and emergency workers, at 3 weeks (n = 3662) and at 18 months (n = 2769) after a major firework disaster in The Netherlands (Enschede, May 13, 2000). The response was lower among immigrants (54%) than among native Dutch (81%). Severe damage to the house due to the disaster (OR: 1.8; 95% CI: 1.1–3.0) and being involved as an emergency workers (OR: 2.1; 95% CI: 1.2–3.4) were associated with higher response among native Dutch, while this was not the case among immigrants. Non-western immigrants with health problems in the first study were more likely to participate in the second study (for example physical symptoms OR: 2.5: 95% CI: 1.4–4.4), while the native Dutch with these symptoms were less likely to participate (OR: 0.7; 95% CI: 0.5–0.9). In conclusion, disaster-related characteristics were associated with higher response in native Dutch. Health problems were associated with higher response among non-western immigrants and with lower response among the native Dutch.


Attrition Determinants Disasters Longitudinal studies Public health 



confidence interval


impact of event questionnaire (15 items)


odds ratio


adjusted odds ratio


posttraumatic stress disorder


questionnaire on general health (36 items)


symptom check list (90 items)


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Copyright information

© Springer 2005

Authors and Affiliations

  • Marieke B.A. Dijkema
    • 1
    • 2
  • Linda Grievink
    • 1
  • Rebecca K. Stellato
    • 1
  • Jan Roorda
    • 3
  • Peter G. van der Velden
    • 4
  1. 1.Centre for Environmental Health Research (MGO) (Pb 10)National Institute for Public Health and the Environment (RIVM)3720, Bilthoven, BAThe Netherlands
  2. 2.Regional Health Authority Amstelland – de MeerlandenAmstelveenThe Netherlands
  3. 3.Regional Health Authority TwenteEnschedeThe Netherlands
  4. 4.Institute for Psychotrauma (IvP)ZaltbommelThe Netherlands
  5. 5.RIVMBilthovenThe Netherlands

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