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Cited by 722Posttraumatic Stress Disorder ResearchOccupational Health and PerformanceCOVID-19 and Mental Health

Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers

Open access
Berger, William, Coutinho, Evandro Silva Freire, Figueira, Ivan, Marques-Portella, Carla, Luz, Mariana Pires, Neylan, Thomas C., Marmar, Charles R., Mendlowicz, Mauro Vitor·2012·Social Psychiatry and Psychiatric Epidemiology
DOI 10.1007/s00127-011-0408-2PMC PMC3974968
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Abstract

Purpose We sought to estimate the pooled current prevalence of posttraumatic stress disorder (PTSD) among rescue workers and to determine the variables implicated in the heterogeneity observed among the prevalences of individual studies.Methods A systematic review covering studies reporting on the PTSD prevalence in rescue teams was conducted following four sequential steps: (1) research in specialized online databases, (2) review of abstracts and selection of studies, (3) review of reference list, and (4) contact with authors and experts. Prevalence data from all studies were pooled using random effects model. Multivariate meta-regression models were fitted to identify variables related to the prevalences heterogeneity.Results A total of 28 studies, reporting on 40 samples with 20,424 rescuers, were selected. The worldwide pooled current prevalence was 10%. Meta-regression modeling in studies carried out in the Asian continent had, on average, higher estimated prevalences than those from Europe, but not higher than the North American estimates. Studies of ambulance personnel also showed higher estimated PTSD prevalence than studies with firefighters and police officers.Conclusions Rescue workers in general have a pooled current prevalence of PTSD that is much higher than that of the general population. Ambulance personnel and rescuers from Asia may be more susceptible to PTSD. These results indicate the need for improving pre-employment strategies to select the most resilient individuals for rescue work, to implement continuous preventive measures for personnel, and to promote educational campaigns about PTSD and its therapeutic possibilities.

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  • International estimates of mental disorders among PSP range from 10% to 35%.

    “International estimates of mental disorders among PSP range from 10% to 35%,1,9–13”

    From Mental Disorder Symptoms among Public Safety Personnel in Canada (2018) · cites this paper as [9]

    The Results (page not provided) report a 10.0% pooled worldwide prevalence of PTSD among rescue workers, supporting the lower figure for one mental disorder. The paper does not establish a 10%–35% range for mental disorders generally among public safety personnel, so this citation supports only part of the sentence. (LLM, conf=0.88)

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  • Police officers and firefighters appeared to have the lowest estimates for current PTSD prevalence across PSP categories assessed in a recent international meta-analysis.

    “similarly, police officers and firefighters appeared to have the lowest estimates for current PTSD prevalence across PSP categories assessed in a recent international meta-analysis.9”

    From Mental Disorder Symptoms among Public Safety Personnel in Canada (2018) · cites this paper as [9]

    The Results report lower current PTSD prevalence estimates for firefighters and police officers than for ambulance personnel, and the Discussion identifies police officers as the lowest-prevalence group. However, the paper does not establish that firefighters were also among the lowest across every group assessed. It also specifies that its police findings apply only to officers exposed to a major disaster, not police officers generally (Discussion; page numbers unavailable). (LLM, conf=0.87)

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  • Differences may also be based on populations being served, such as for correctional workers who engage with incarcerated persons in extraordinary environments that can reasonably be hypothesized to increase risk for developing a mental disorder.

    “Differences may also be based on populations being served, such as for correctional workers who engage with incarcerated persons in extraordinary environments that can reasonably be hypothesized to increase risk for developing a mental disorder.9”

    From Mental Disorder Symptoms among Public Safety Personnel in Canada (2018) · cites this paper as [9]

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  • Paramedics report experiencing very high rates of exposure to human suffering for which they often feel responsible, potentiating substantial emotional stress.

    “Similarly, paramedics report experiencing very high rates of exposure to human suffering9 for which they often feel responsible,55 potentiating substantial emotional stress.55,56”

    From Mental Disorder Symptoms among Public Safety Personnel in Canada (2018) · cites this paper as [9]

    The Discussion (page not provided) says ambulance personnel have closer contact with victims and face greater workplace pressure and stress than other rescue teams. It suggests this contact may increase guilt when attempts to help fail, but does not establish that paramedics often feel responsible. (LLM, conf=0.84)

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  • The same meta-analysis did not identify substantial differences in rates when comparing self-report assessments and interview assessments.

    “The same meta-analysis did not identify substantial differences in rates when comparing self-report assessments and interview assessments.”

    From Mental Disorder Symptoms among Public Safety Personnel in Canada (2018) · cites this paper as [9]

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Authors
Berger, W., Coutinho, E. S. F., Figueira, I., Marques-Portella, C., Luz, M. P., Neylan, T. C., Marmar, C. R., & Mendlowicz, M. V.
Affiliations
  • Universidade Federal do Rio de Janeiro (BR)
  • Escola Nacional de Saúde Pública Sergio Arouca (BR)
  • San Francisco VA Medical Center (US)
Corresponding author
Berger, William
ORCID
Venue
Social Psychiatry and Psychiatric Epidemiology
Publisher
Springer Science and Business Media LLC
Published
2011-06-18
Volume
47
Issue
6
Pages
1001-1011
ISSN
  • 0933-7954 (ISSN-L)
  • 1433-9285
DOI
10.1007/s00127-011-0408-2
PMC
PMC3974968
OpenAlex
W2057489037
Cited by
712
References
78
Citations by year
2026: 47 · 2025: 69 · 2024: 57 · 2023: 69 · 2022: 76 · 2021: 69 · 2020: 87 · 2019: 68 · 2018: 46 · 2017: 40 · 2016: 28 · 2015: 27 · 2014: 12 · 2013: 11 · 2012: 5
FWCI
1.38
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01 – MH056350-06, R29MH057157, MH057157, MH73978, R01MH073978, R01MH056350)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords
post-traumatic stress disorder, rescue workers, PTSD prevalence, ambulance personnel, firefighters, police officers, occupational injuries, PTSD prevention
MeSH terms
Asia, Europe, Humans, North America, Occupational Diseases, Population Surveillance, Stress Disorders, Post-Traumatic, Prevalence, Rescue Work, Emergency Responders

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