ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Anxiety and Stress Disorders
This article is part of the Research Topic15 Years of Frontiers in Psychiatry – Wellbeing and SocietyView all 3 articles
Long-Term Anxiety of Natural and Biological Hazards on Community and Healthcare Workers
Provisionally accepted
- 1Calo Psychiatric Center, Pingtung County, Taiwan
- 2Kaohsiung Chang Gung Memorial Hospital, Niaosong District, Taiwan
- 3Kaoshiung Municipal Feng Shan Hospital, Kaohsiung, Taiwan
- 4Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
- 5National Cheng Kung University College of Medicine, Tainan City, Taiwan
- 6I-Shou University College of Medicine, Yanchao District, Taiwan
- 7National Defense Medical University, Taipei City, Taiwan
- 8National Sun Yat-sen University, Kaohsiung, Taiwan
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Abstract Background: Exposure to natural and biological hazards has been linked to long-term declines in mental health. However, limited research has examined the sustained psychological impact of these disasters over extended follow-up periods. Methods: This study investigated the long-term mental health consequences of natural and biological hazards among healthcare workers and community residents through three longitudinal datasets collected over two decades. Data sources included: (1) 127 healthcare workers exposed to Severe Acute Respiratory Syndrome (SARS) in 2003, with 123 followed up one year later; (2) 152 community residents affected by Typhoon Morakot in 2009, with 125 followed up 1.5 years later; and (3) 458 healthcare workers affected by Coronavirus disease 2019 (COVID-19) in 2020, with 321 followed up two years later. Results: Findings show that mental distress prevalence among community residents remained stable (1.6% initially vs. 1.5% at follow-up), whereas healthcare workers exhibited increasing distress over time (SARS: 4.7% to 15.4%; COVID-19: 9.7% to 11.8%). Pathway modeling revealed that initial anxiety at the onset of SARS, Typhoon Morakot, and COVID-19 was a strong predictor of long-term psychological distress. Conclusions: These results highlight the importance of sustained mental health interventions for healthcare workers facing prolonged exposure to stressors during biological disasters. In addition to early anxiety screening, system-level measures such as adequate staffing, transparent communication, and institutional preparedness are essential to mitigate long-term psychological consequences.
Keywords: natural disasters, Typhoon, SARS, COVID-19, Healthcare workers, mental distress 2
Received: 10 Sep 2025; Accepted: 24 Oct 2025.
Copyright: © 2025 Chen, Lung, Chang and Lung. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: For-Wey Lung, forwey@seed.net.tw
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