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Occupational Risk Factors in the Emergency Medical Services
Abstract
INTRODUCTION: During a medical emergency, the American public often relies on the expertise of emergency medical technicians (EMTs). These professionals face a number of occupational hazards, and the literature suggests that EMTs are at a greater risk of developing physical and mental stress-related disorders. The purpose of this paper is to systematically examine gaps in the extant literature and to present a theoretically driven conceptual model to serve as a basis for future intervention and research efforts. METHODS: A systematic review of the literature was conducted utilizing relevant databases (e.g., PsychInfo, Medline). All empirical articles regarding emergency medical responders were reviewed, but given the limited research available, relevant theoretical and conceptual literature on the constructs of interest in other, related populations also were included. Based on this extensive review, a modification of the stress process model is suggested to explain the relationships among occupational stress exposure, post-traumatic stress disorder (PTSD), and high-risk alcohol and other drug use. RESULTS: Exposure to traumatic events was reported to be between 80% and 100% among EMTs, and rates of PTSD are >20%. High-risk alcohol and drug use rates among other emergency response professionals were reported to be as high as 40%. The proposed model suggests direct linkages between occupationally related stress exposure, including chronic and critical incident stress, PTSD, and high-risk alcohol and other drug use. Social support and personal resources (e.g., coping, locus of control) are proposed to have mediating and moderating influences on the three main constructs, and cohesion is introduced as an important, idiosyncratic influence in this population. The moderating influences of gender, age, ethnicity, marital status, and socioeconomic status, level of training, and years of service are included in the proposed model. CONCLUSIONS: High-risk alcohol and other drug use and post-traumatic symptomatology pose substantial risks for EMTs, and consequently, for the patients they serve. It is imperative that researchers develop and test a theoretically grounded model of risk and protective factors that will guide intervention development and future study. The model suggested in this paper, based on a comprehensive literature review and development of theory, represents a critical first step in the intervention research process.
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“The literature suggests exposure to critical incidents is common among paramedics, with one study reporting 64% of paramedics were exposed to two or more critical incidents over five years and a further study reporting 72-97% of paramedics had been exposed to at least one critical incident (E. Donnelly & Siebert, 2009; Oginska-Bulik & Kobylarczyk, 2015; Skeffington, Rees, & Mazzucchell”
From Understanding the Occupational Factors that Influence Paramedic Health and Wellbeing (2024) · cites this paper as E. Donnelly & Siebert, 2009
In the citing paper
“Other symptoms can manifest following chronic exposure to stress and common occupational challenges (extended shift times), such as fatigue, headaches, and gastrointestinal disturbances (E. Donnelly & Siebert, 2009; Halpern, Gurevich, Schwartz, & Brazeau, 2009; Klimley, Van Hasselt, & Stripling, 2018; Knutsson & B¿ggild, 2010; Rice, Glass, Ogle, & Parsian, 2014; Sterud et al.,”
From Understanding the Occupational Factors that Influence Paramedic Health and Wellbeing (2024) · cites this paper as E. Donnelly & Siebert, 2009
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Self-citation
Metadata
- Authors
- Donnelly, E., & Siebert, D.
- Affiliations
- Florida State University (US)
- Corresponding author
- Donnelly, Elizabeth
- Venue
- Prehospital and Disaster Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-10
- Volume
- 24
- Issue
- 5
- Pages
- 422-429
- ISSN
- 0882-7397 (ISSN-L)
- 1049-023X
- 1945-1938
- OpenAlex
- W1975869750
- Cited by
- 107
- References
- 77
- Citations by year
- 2026: 9 · 2025: 5 · 2024: 12 · 2023: 10 · 2022: 11 · 2021: 7 · 2020: 10 · 2019: 9 · 2018: 5 · 2017: 3 · 2016: 7 · 2015: 2 · 2014: 5 · 2013: 3 · 2012: 6
- FWCI
- 3.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Prehospital and Disaster Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Performance
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- emergency medical technicians, occupational stress, post-traumatic stress disorder, substance use, critical incident stress, stress process model, social support, coping, locus of control, cohesion, protective factors, risk factors
- MeSH terms
- Adaptation, Psychological, Alcohol Drinking, Emergency Medical Services, Emergency Medical Technicians, Humans, Models, Psychological, Risk Factors, Social Support, Stress Disorders, Post-Traumatic, Stress, Psychological, Occupational Health, Occupational Exposure, Workplace, Substance-Related Disorders
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