A quarter of the doctors involved in treating victims of the Omagh bomb blast are suffering from post traumatic stress disorder, a study has found.

The medics experience recurrent flashbacks of the horrific day, disturbed sleep, tiredness and irritation, according to researchers.

Twenty-nine people - nine of them children - died following the terrorist explosion in the small town in Northern Ireland on 15 August 1998, while many hundreds more were injured.

Hospitals across the region received casualties with dozens of doctors, including GPs, helping to treat the injured.

A survey of all workers in the Sperrin Lakeland Health and Social Care Trust - of which the Erne Hospital in Enniskillen and the Tyrone County hospital in Omagh are members - was carried out by researchers at the trust and clinical psychologists from the University of Northumbria at Newcastle.

Of the 1,000 plus returned questionnaires from staff at the hospitals - which were the main recipients of the wounded - 41 doctors gave answers which were complete enough to be analysed.

From the responses, clinical psychologists and occupational therapists were able to make diagnoses of PTSD.

Authors of the report, published in the British Medical Journal on Friday, say the answers highlight "the popular myth that professional helpers are somehow immune from the same stresses as those they are helping".

The report also found that people who are exposed to more than one traumatic effect are much more likely to develop PTSD.

Report author Professor Jenny Firth-Cozens said: "The effects of more than one traumatic event are cumulative. It is certainly not the case that the more you see, the more immune to it you become."

The report says that although the health trust provided "considerable help" for staff, half of the doctors diagnosed with PTSD had not sought assistance.

Prof Firth-Cozens said: "Medical staff are notoriously bad at getting any help for themselves. And because they encounter death and injury as a part of their job, they feel they ought to be able to cope with it."

Symptoms not recognised

She said that PTSD could be "extremely debilitating" and could have an adverse effect on work and personal relationships.

She said: "We would certainly like to see more training about PTSD and its effects. Most doctors do not recognise the symptoms of PTSD in themselves or in others.

"We would also like to see counselling offered as standard three to four weeks after an employee has encountered trauma."

She said that everyone needed three to four weeks to come to terms with serious trauma, but that if bad sleeping patterns and flashbacks persisted after this time, PTSD might be a diagnosis.

She said: "What we do know is that it is much more beneficial to treat PTSD in its early stages rather than when it has become entrenched."

She said that the health trust was the biggest employer in the Omagh area, and as a result, most of its employees had had some contact with the after-effects of the bomb.

But she said that lessons learned from this study might be able to be applied to other areas where trauma is experienced, such as accident and emergency units.

She added: "We will also be able to look at the coping mechanisms used by the staff who have not developed PTSD and use those in counselling."

An analysis of the study's findings on nurses and other hospital staff is due to be published in 2000.