Posttraumatic stress and other health consequences of catastrophic avalanches: A 16-year follow-up of survivors

• 16% of survivors met criteria for avalanche-specific PTSD 16 years post-disaster.
• PTSD hyperarousal symptoms are more prevalent in survivors than an unexposed group.
• Sleep problems, especially PTSD-related, are associated with avalanche exposure.
• Stress-related physical conditions are more common among avalanche survivors than an unexposed group.

To date, no study has investigated the effects of avalanches on survivor's health beyond the first years. The aim of this study was to examine long-term health status 16 years after exposure to avalanches using a matched cohort design. Mental health, sleep quality and somatic symptoms among avalanche survivors (n = 286) and non-exposed controls (n = 357) were examined. Results showed that 16% of survivors currently experience avalanche-specific PTSD symptoms (PDS score > 14). In addition, survivors presented with increased risk of PTSD hyperarousal symptoms (>85th percentile) (aRR = 1.83; 98.3% CI [1.23–2.74]); sleep-related problems (PSQI score > 5) (aRR = 1.34; 95% CI [1.05–1.70]); PTSD-related sleep disturbances (PSQI-A score ≥ 4) (aRR = 1.86; 95% CI [1.30–2.67]); musculoskeletal and nervous system problems (aRR 1.43; 99% CI 1.06–1.93) and gastrointestinal problems (aRR 2.16; 99% CI 1.21–3.86) compared to the unexposed group. Results highlight the need for treatment for long-term PTSD symptoms and sleep disruption in disaster communities.