Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel – a cross-sectional study
Open accessAbstract
BACKGROUND: Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. METHODS: Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. RESULTS: Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality. CONCLUSIONS: Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence of positive organizational support mechanisms that can prevent negative effects from the high levels of emotional demands.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The paramedic workforce was exposed to an emotional demand that was statistically significant, and the nature of the work, most notably critical incident exposure, served as a barrier to improving the psychosocial working environment for this occupation.
“Hansen, Rasmussen, Kyed, Nielsen, and Andersen (2012) identified that the paramedic workforce was exposed to an emotional demand that was statistically significant and that the nature of the work, most notably critical incident exposure, served as a barrier to improving the psychosocial working environment for this occupation (Hansen et al., 2012).”
From Understanding the Occupational Factors that Influence Paramedic Health and Wellbeing (2024) · cites this paper as Hansen et al., 2012
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredAmbulance personnel have substantially higher levels of musculoskeletal pain than the core workforce in Denmark.
“but substantially higher levels of musculoskeletal pain.”
From Understanding the Occupational Factors that Influence Paramedic Health and Wellbeing (2024) · cites this paper as Hansen, C., Rasmussen, K., Kyed, M., Nielsen, K. & Andersen, J. 2012
Similar levels of mental health exist between ambulance personnel and the core workforce in Denmark.
“Similar levels of mental health exist between ambulance personnel and the core work force”
From Understanding the Occupational Factors that Influence Paramedic Health and Wellbeing (2024) · cites this paper as Hansen, C., Rasmussen, K., Kyed, M., Nielsen, K. & Andersen, J. 2012
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The second version of the Copenhagen Psychosocial Questionnaire
Pejtersen, J. H., Kristensen, T. S., Borg, V., & Bjorner, J. B. (2010) · Scandinavian Journal of Public Health · doi:10.1177/1403494809349858 · Cited by 1,187 · see citing works
Alexander, D. A., & Klein, S. (2001) · British Journal of Psychiatry · doi:10.1192/bjp.178.1.76 · Cited by 528 · see citing works
Acute and chronic job stressors among ambulance personnel: Predictors of health symptoms
van der Ploeg, E., & Kleber, R. J. (2003) · Occupational and Environmental Medicine · doi:10.1136/oem.60.suppl_1.i40 · Cited by 396 · see citing works
Prati, G., & Pietrantoni, L. (2010) · Journal of Community Psychology · doi:10.1002/jcop.20371 · Cited by 331 · see citing works
Post-traumatic stress among Swedish ambulance personnel
Jonsson, A., Segesten, K., & Mattsson, B. (2003) · Emergency Medicine Journal · doi:10.1136/emj.20.1.79 · Cited by 224 · see citing works
Occupational Risk Factors in the Emergency Medical Services
Donnelly, E., & Siebert, D. (2009) · Prehospital and Disaster Medicine · doi:10.1017/s1049023x00007251 · Cited by 107 · see citing works
Flagged first, then by citations
Research works printed but not linked: 20
- Sterud T Ekeberg Ø Hem E Health status in the ambulance services. A systematic review BMC Health Serv Res 2006 6 82 91 10.1186/1472-6963-6-82 16817949 PMC1559607 · DOI
- Broniecki M Esterman A May E Grantham H Musculoskeletal disorder prevalence and risk factors in ambulance officers J Back Musculoskeletal Rehab 2010 23 165 174 21079295
- Rodgers LM A five-year study comparing early retirements on medical grounds in ambulance personnel with those in other groups of health staff. Part 1: incidences of early retirements Occup Med 1998 48 7 16 10.1093/occmed/48.1.7 9604466 · DOI
- Rodgers LM A five-year study comparing early retirements on medical rounds in ambulance personnel with those in other groups of health service staff. Part 2: causes of retirements Occup Med 1998 48 19 32 9614771
- Cydulka RK Lyons J Moy A Shay K Hammer J Mathews J A follow-up report of occupational stress in urban EMT-paramedics Ann Emerg Med 1989 18 1151 1156 10.1016/S0196-0644(89)80050-2 2817558 · DOI
- Clohessy S Ehlers A PTSD symptoms, response to intrusive memories and coping in ambulance service workers Br J Clin Psychol 1999 38 251 265 10.1348/014466599162836 10532147 · DOI
- Bennett P Williams Y Page N Hood K Woolard M Levels of mental health problems among UK emergency ambulance workers Emerg Med J 2004 21 235 236 10.1136/emj.2003.005645 14988360 PMC1726283 · DOI
- Boudreaux E Mandry C Brantley PJ Stress, job satisfaction, coping, psychological distress among emergency medical technicians Prehosp Disast Med 1997 12 242 249 10179201
- Okada N Ishi N Nakata M Nakayama S Occupational stress among Japanese emergency medical technicians: Hyogo prefecture Prehosp Disast Med 2005 20 115 121 15898491
- Aasa U Brulin C Ængquist KA Barnekow-Bergkvist M Work-related psychosocial factors, worry and health complaints among female and male ambulance personnel Scand J Care 2005 19 251 258 10.1111/j.1471-6712.2005.00333.x 16101853 · DOI · Paper page
- Aasa U Barnekow-Berkvist M Ænquist KA Brulin C Relationships between work-related factors and disorders in the neck-shoulder and low back region among female and male ambulance personnel J Occup Med 2005 47 481 489 16369110
- Tam GYT Yeung SS Percieved effort and low back pain in non-emergency ambulance workers: implications for rehabilitation J Occup Rehab 2006 16 231 240 16705492
- Gentzler M Stader S Posture stress on fire fighters and emergency medical technicians (EMTs) associated with reaching bending, lifting, and pulling tasks Work 2010 37 227 239 20978330
- Partinen M Gislason T Basic Nordic Sleep Questionnaire (BNSQ): a quantitated measure of subjective sleep complaints J Sleep Res 1995 4 Suppl 1 150 155 10607192
- Lassen CF Mikkelsen S Kryger AI Andersen JH Risk factors for persistent elbow, forearm and hand pain among computer workers Scand J Work Environ Health 2005 31 122 131 10.5271/sjweh.859 15864906 · DOI
- Andersen JH Haahr JP Frost P Risk factors for more severe regional musculoskeletal symptoms: a two-year prospective study of a general working population Arthritis Rheum 2007 56 1355 1364 10.1002/art.22513 17393441 · DOI
- Hildebrandt V Bongers P Van Dijk F Kemper H Dul J Dutch musculoskeletal questionnaire: description and basic qualities Ergonomics 2001 44 1038 5055 10.1080/00140130110087437 11780727 · DOI
- Sterud T Hem E Ekeberg Ø Lau B Health problems and help-seeking in a nationwide sample of operational Norwegian ambulance personnel BMC Publ Health 2008 Jan 4 8 3 10.1186/1471-2458-8-3 PMC2254402 18177497 · DOI
- Hansson G-Å Balogh I Unge Byström J Ohlsson K Nordander C Asterland P Sjölander S Rylander L Winkel J Skerfving S Malmö Shoulder-Neck Study Group Questionnaire versus direct technical measurements in assessing postures and movements of the head, upper back, arms and hands Scand J Work Environ Health 2001 27 30 40 10.5271/sjweh.584 11266144 · DOI
- Patterson PD Huang DT Fairbanks RJ Simeone S Weaver M Wang HE Variation in emergency medical services workplaces safety culture Prehosp Emerg Care 2010 14 448 460 10.3109/10903127.2010.497900 20809688 PMC2935310 · DOI
Cited by
Sorted by citations
Perceived occupational stressors among emergency medical service providers: a qualitative study
Afshari, A., Borzou, S. R., Shamsaei, F., Mohammadi, E., & Tapak, L. (2021) · BMC Emergency Medicine · doi:10.1186/s12873-021-00430-6 · Cited by 53 · see citing works
Understanding the Occupational Factors that Influence Paramedic Health and Wellbeing
Betts, C., Stoneley, A., Anderson, J., & Sutton, C. (2024) · International Journal of Paramedicine · doi:10.56068/mnrg8307 · Cited by 2 · see citing works
- Authors
- Hansen, C. D., Rasmussen, K., Kyed, M., Nielsen, K. J., & Andersen, J. H.
- Affiliations
- Aalborg University (DK)
- Danish Ramazzini Center (DK)
- Corresponding author
- Hansen, Claus D
- Venue
- BMC Public Health
- Published
- 2012-07-23
- Volume
- 12
- Issue
- 1
- Pages
- 534-534
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC3439275
- OpenAlex
- W2144631309
- Cited by
- 80
- References
- 6
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 8 · 2023: 12 · 2022: 7 · 2021: 10 · 2020: 6 · 2019: 8 · 2018: 4 · 2017: 2 · 2016: 5 · 2015: 1 · 2014: 6 · 2013: 1
- FWCI
- 7.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- VBN Forskningsportal (Aalborg Universitet) (publishedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Keywords
- ambulance personnel, emergency medical services, psychosocial work environment, physical work environment, musculoskeletal pain, mental health, sleep quality, emotional demands, meaningful work, occupational health, firefighters, self-rated health
- MeSH terms
- Adolescent, Adult, Ambulances, Mental Disorders, Cross-Sectional Studies, Denmark, Emergency Medical Technicians, Female, Humans, Male, Middle Aged, Occupational Diseases, Surveys and Questionnaires, Risk Factors, Sleep Wake Disorders, Multivariate Analysis, Case-Control Studies, Workplace, Young Adult, Diagnostic Self Evaluation, Musculoskeletal Pain, Firefighters
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
