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Abstract Objective This survey aims to comprehensively understand occupational burnout among pre-hospital emergency medical personnel and explore associated risk factors. Methods A cross-sectional online survey using a census method was conducted between 15 July, 2023, and ends on 14 August, 2023, in Chengdu, SiChuan province, China. The questionnaire included general demographic information, the Maslach Burnout Inventory-General Survey (MBI-GS) with 15 items, and the Fatigue Scale-14 (FS-14) with 14 items. Univariate analysis was conducted on all variables, followed by multivariate logistic regression models to examine the associations between occupational burnout and the risk factors. Results A total of 2,299 participants,99.57% completed the survey effectively The participants were from 166 medical institutions in Chengdu, comprising 1,420 nurses (61.50%) and 889 clinical doctors (38.50%). A total of 33.36% participants experienced burnout, predominantly mild (30.27%), followed by moderate (2.78%) and severe (0.3%). Physicians, higher fatigue scores, age, work experience appeared to be related to burnout. Logistic regression models revealed that individuals aged over 50 were less prone to experience burnout compared to medical staff aged 18–30 (OR: 0.269, 95% CI: 0.115–0.627, p = 0.002). Physicians were more prone to experience burnout compared to nursing staff (OR: 0.690, 95% CI: 0.531–0.898, p = 0.006). Those with 0–5 years of experience were more prone to experience burnout compared to those with 6–10 years or over 15 years of experience (OR: 0.734, 95% CI: 0.547–0.986, p = 0.040; OR: 0.559, 95% CI: 0.339–0.924, p = 0.023). Additionally, for each 1-point increase in the fatigue score, the likelihood of burnout in medical staff increased by 1.367 times (OR: 1.367, 95% CI: 1.323–1.412, p

Objective: This survey aims to comprehensively understand occupational burnout among pre-hospital emergency medical personnel and explore associated risk factors. Methods: A cross-sectional online survey using a census method was conducted between 15 July, 2023, and ends on 14 August, 2023, in Chengdu, SiChuan province, China. The questionnaire included general demographic information, the Maslach Burnout Inventory-General Survey (MBI-GS) with 15 items, and the Fatigue Scale-14 (FS-14) with 14 items. Univariate analysis was conducted on all variables, followed by multivariate logistic regression models to examine the associations between occupational burnout and the risk factors. Results: A total of 2,299 participants,99.57% completed the survey effectively The participants were from 166 medical institutions in Chengdu, comprising 1,420 nurses (61.50%) and 889 clinical doctors (38.50%). A total of 33.36% participants experienced burnout, predominantly mild (30.27%), followed by moderate (2.78%) and severe (0.3%). Physicians, higher fatigue scores, age, work experience appeared to be related to burnout. Logistic regression models revealed that individuals aged over 50 were less prone to experience burnout compared to medical staff aged 18–30 (OR: 0.269, 95% CI: 0.115–0.627, p = 0.002). Physicians were more prone to experience burnout compared to nursing staff (OR: 0.690, 95% CI: 0.531–0.898, p = 0.006). Those with 0–5 years of experience were more prone to experience burnout compared to those with 6–10 years or over 15 years of experience (OR: 0.734, 95% CI: 0.547–0.986, p = 0.040; OR: 0.559, 95% CI: 0.339–0.924, p = 0.023). Additionally, for each 1-point increase in the fatigue score, the likelihood of burnout in medical staff increased by 1.367 times (OR: 1.367, 95% CI: 1.323–1.412, p < 0.0001). Conclusion: Pre-hospital emergency medical personnel demonstrate a notable prevalence of mild job burnout. These results provide a groundwork for future focus on the various stages of job burnout within pre-hospital emergency staff, alerting hospital and departmental managers to promptly address the mental well-being of their personnel and intervene as needed. [ABSTRACT FROM AUTHOR]

This systematic review investigates the association between coping strategies and burnout in emergency workers. Three electronic databases were searched. Eleven eligible articles were extracted, and quality assessed. Findings were integrated through narrative synthesis, highlighting clear methodological issues around conceptualizing, and measuring coping strategies and burnout with agreed upon tools. This review found no convincing evidence to suggest coping strategies have a meaningful relationship with burnout in emergency workers, questioning the evidence base for psychological interventions focusing on modifying coping strategies to target burnout. To understand the true impact of coping strategies on burnout, more longitudinal designs, and an agreed, validated measure for coping is needed. [ABSTRACT FROM AUTHOR]

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To clarify the long-term health effects from radiation exposure in emergency workers who responded to the radiation accident at the Fukushima Daiichi Nuclear Power Plant of Tokyo Electric Power Company, which was hit by a tsunami caused by the 2011 off the Pacific coast of Tohoku earthquake, the Epidemiological Study of Health Effects in Fukushima Emergency Worker (currently, the Epidemiological Study on the Health Effects of Radiation Workers) was initiated in 2014. We aimed to compile the results of the Health Examination Study conducted from January 2016 to March 2019 to demonstrate the characteristics of the study participants during this period. We included individuals who completed the first health examination and provided consent to use their survey results in our study. A total of 5,718 people were included, among which 5,707 (99.8%) were men. The mean age of the study participants was 51.6 years at the time of the health examination. Compared to Japanese men, the study participants were more likely to have obesity, to be current smokers, and to consume alcohol at least once a month. There were no significant differences in the blood test results between the study participants and healthy Japanese men. To clarify the long-term health effects of radiation exposure on the emergency workers, it is important to make efforts to prevent the study participants from dropping out of the cohort over time and to keep them participating in the Health Examination Study.

Introduction: The Howard Springs Quarantine Facility (HSQF) is located in tropical Northern Australia and has 875 blocks of four rooms (3,500 rooms in total) spread over 67 hectares. The HSQF requires a large outdoor workforce walking outdoor pathways to provide individual care in the ambient climate. The personal protective equipment (PPE) required for the safety of quarantine workers varies between workgroups and limits body heat dissipation that anecdotally contributes to excessive sweating, which combined with heat stress symptoms of fatigue, headache, and irritability, likely increases the risk of workplace injuries including infection control breaches.Study Objective: The purpose of this study was the description of qualitative and quantitative assessment for HSQF workers exposed to tropical environmental conditions and provision of evidenced-based strategies to mitigate the risk of heat stress in an outdoor quarantine and isolation workforce.Methods: The study comprised two components - a cross-sectional physiological monitoring study of 18 workers (eight males/ten females; means: 41.4 years; 1.69m; 80.6kg) during a single shift in November 2020 and a subjective heat health survey completed by participants on a minimum of four occasions across the wet season/summer period from November 2020 through February 2021. The physiological monitoring included continuous core temperature monitoring and assessment of fluid balance.Results: The mean apparent temperature across first-half and second-half of the shift was 34.7°C (SD = 0.8) and 35.6°C (SD = 1.9), respectively. Across the work shift (mean duration 10.1 hours), the mean core temperature of participants was 37.3°C (SD = 0.2) with a range of 37.0°C - 37.7°C. The mean maximal core temperature of participants was 37.7°C (SD = 0.3). In the survey, for the workforce in full PPE, 57% reported feeling moderately, severely, or unbearably hot compared to 49% of those in non-contact PPE, and the level of fatigue was reported as moderate to severe in just over 25% of the workforce in both groups.Conclusion: Heat stress is a significant risk in outdoor workers in the tropics and is amplified in the coronavirus disease 2019 (COVID-19) frontline workforce required to wear PPE in outdoor settings. A heat health program aimed at mitigating risk, including workplace education, limiting exposure times, encouraging hydration, buddy system, active cooling, and monitoring, is recommended to limit PPE breaches and other workplace injuries in this workforce. [ABSTRACT FROM AUTHOR]

This study analyzed the differences between firefighters and other working categories (urban policemen, employees in the service industry) in psychological well-being, anxiety, depression, personality and stress. Much research has evidenced that people who have to deal with emergencies are more subjected to psychological diseases. Our results showed that firefighters have lower levels of anxiety, depression, emotional instability and negative emotions in relation to urban policemen and employees. In addition, there are no significant differences in psychological well-being. Further research is necessary to define the specific psychological attitudes or traits which allow firefighters to deal with psychological disease and stress.

Background: Firefighters endure large occupational burdens and generally operate under conditions of chronic sleep deficiency and circadian disruption due to long shifts, plus interrupted sleep due to emergency calls during the night. A typical shift for firefighters is 24‐h on/48‐h off, and firefighters are expected to use time‐off to recover from any sleep debt, while balancing social, family, and home responsibilities. This qualitative study sets out to assess family dynamics and how firefighters prioritize sleep and recovery at home based on relationship or family status, as well as a fire department's current shift schedule. Methods: Focus groups were conducted via convenience sampling in Portland, OR, with full‐time firefighters, battalion chiefs, and their spouses. Grounded theory, using NVivo 12 Plus, was used to code transcripts to reveal reoccurring concepts and themes. Results: Major themes centered around the increase of nonemergent calls contributing to compassion fatigue. Spouses can help improve the sleep of firefighters by creating opportunities for recuperative sleep at home. However, spouses also conveyed underlying tones of "resentment" relating to their firefighter being unavailable for emotional and instrumental support. While married firefighters discussed choosing family and home obligations over reducing sleep debt to maintain relationships, single and divorced firefighters spoke of fewer conflicts impeding their ability to prioritize sleep at home. Conclusions: These results improve our understanding of how firefighters prioritize sleep at home based on family dynamics and can inform future decision‐making for fire departments in addressing concerns related to work–family conflict, sleep loss, and compassion fatigue among their members. [ABSTRACT FROM AUTHOR]

This study analyzed the differences between firefighters and other working categories (urban policemen, employees in the service industry) in psychological wellbeing, anxiety, depression, personality and stress. Much research has evidenced that people who have to deal with emergencies are more subjected to psychological diseases. Our results showed that firefighters have lower levels of anxiety, depression, emotional instability and negative emotions in relation to urban policemen and employees. In addition, there are no significant differences in psychological wellbeing. Further research is necessary to define the specific psychological attitudes or traits which allow firefighters to deal with psychological disease and stress. [ABSTRACT FROM AUTHOR]

Background In the aftermath of the 2011 Fukushima nuclear plant accident, many workers helped restore the contaminated site, exposing themselves to a highly radioactive environment. They were referred to as the 'Fukushima 50' and applauded as heroes who saved Japan. A cohort study targeting those emergency workers is, currently, underway. We object to the study on ethical grounds. Methods Ethical and content analyses. Results First, the low participation rate raises ethical questions about why potential participants declined. Content analyses of nuclear power plant workers' narratives from a television broadcast extracted eight recurrent themes: disposable, treated like a sacrificial pawn, taboo, fear of contamination, readiness to risk one's life, distrust and dissatisfaction with the nation's response, regret over participating and uncertainty about the future. Second, the unscientific nature of the cohort design undermines the ethical basis for conducting it. Third, public resources were allocated in a way that compromises justice. Conclusions We urge re-considering the current Fukushima 50 research study. We also urge applying the public funds now invested in this research project to activities that would directly benefit the Fukushima 50, such as offering free lifetime healthcare and direct financial compensation. [ABSTRACT FROM AUTHOR]

Working as healthcare workers (HCWs) and emergency workers (EWs) during the first wave of COVID-19 has been associated with high levels of stress and burnout, while hardiness, coping strategies and resilience have emerged as protective factors. No studies have so far investigated these psychological factors during the second wave. We aimed to verify the trend of stress levels, burnout, coping strategies and resilience during the pandemic in Italian healthcare and emergency workers by comparing a first sample recruited from the first COVID-19 wave (N = 240) with a second sample relating to the second wave (N = 260). Through an online platform we administered questionnaires to measure stress, burnout, resilience, hardiness and coping strategies. The results showed that in the two waves the total stress levels of HCWs and EWs did not differ, while the physical stress and hardiness scores in the second wave were greater. No differences were found in the coping strategies used. An analysis of burnout levels in the second wave sample found that stress showed a high predictive power in the emotional exhaustion and depersonalization scales. Hardiness and resilience emerged as protective factors in reducing stress. The implications for the need to provide support and to improve hardiness for HCWs and EWs are discussed.

Shortly after the establishment of police forces in England, Parliament provided that it was an offence to assault an officer who was acting in the execution of their duty at the material time. This long-established offence is now to be found in s. 89(1) of the Police Act 1996. As this article seeks to demonstrate, establishing that an officer was acting within the execution of their duty has sometimes caused problems for the prosecution. It is argued here, however, that such difficulties need no longer arise following the enactment of s. 1 of the Assaults on Emergency Workers (Offences) Act 2018. Without the matter being debated in Parliament, and despite the silence of the 2018 Act, the creation of the new statutory offence of assaulting an emergency worker while they are carrying out functions as such makes it highly likely that in the future, assaults on police officers will no longer be prosecuted under s. 89(1). [ABSTRACT FROM AUTHOR]

Background: Research supports that public safety personnel (PSP) are regularly exposed to potentially psychologically traumatic events and occupational stress, which can compromise their well-being. To help address PSP well-being and mental health, peer support is increasingly being adopted (and developed) in PSP organizations. Peer support apps have been developed to connect the peer and peer supporter anonymously and confidentially, but little is known about their effectiveness, utility, and uptake., Objective: We designed this study to evaluate the functionality and use of the PeerConnect app, which is a vehicle for receiving and administering peer support. The app connects peers but also provides information (eg, mental health screening tools, newsfeed) to users; thus, we wanted to understand why PSP adopted or did not adopt the app and the app's perceived utility. Our intention was to determine if the app served the purpose of connectivity for PSP organizations implementing peer support., Methods: A sample of PSP (N=23) participated in an interview about why they used or did not use the app. We first surveyed participants across PSP organizations in Ontario, Canada, and at the end of the survey invited participants to participate in a follow-up interview. Of the 23 PSP interviewed, 16 were PeerConnect users and 7 were nonusers. After transcribing all audio recordings of the interviews, we used an emergent theme approach to analyze themes within and across responses., Results: PSP largely viewed PeerConnect positively, with the Connect feature being most popular (this feature facilitated peer support), followed by the Newsfeed and Resources. App users appreciated the convenience of the app and felt the app helped reduce the stigma around peer support use and pressure on peer supporters while raising awareness of wellness. PSP who did not use the app attributed their nonuse to disinterest or uncertainty about the need for a peer support app and the web-based nature of the app. To increase app adoption, participants recommended increased communication and promotion of the app by the services and continued efforts to combat mental health stigma., Conclusions: We provide contextual information about a peer support app's functionality and use. Our findings demonstrate that PSP are open to the use of mental health and peer support apps, but more education is required to reduce mental health stigma. Future research should continue to evaluate peer support apps for PSP to inform their design and ensure they are fulfilling their purpose., (©Gillian Foley, Rosemary Ricciardelli. Originally published in JMIR Formative Research (https://formative.jmir.org), 06.11.2023.)

Objectives: The perceived threat of HIV transmission through spitting and biting is evidenced by the increasing use of “spit hoods” by Police Forces in the UK. In addition, a draft parliamentary bill has called for increased penalties for assaults on emergency workers, citing the risk of communicable disease transmission as one justification. We aimed to review literature relating to the risk of HIV transmission through biting or spitting. Methods: A systematic literature search was conducted using Medline, Embase and Northern Lights databases and conference websites using search terms relating to HIV, AIDS, bite, spit and saliva. Inclusion and exclusion criteria were applied to identified citations. We classified plausibility of HIV transmission as low, medium, high or confirmed based on pre‐specified criteria. Results: A total of 742 abstracts were reviewed, yielding 32 articles for full‐text review and 13 case reports/series after inclusion and exclusion criteria had been applied. There were no reported cases of HIV transmission related to spitting and nine cases identified following a bite, in which the majority occurred between family (six of nine), in fights involving serious wounds (three of nine), or to untrained first‐aiders placing fingers in the mouth of someone having a seizure (two of nine). Only four cases were classified as highly plausible or confirmed transmission. None related to emergency workers and none were in the UK. Conclusions: There is no risk of transmitting HIV through spitting, and the risk through biting is negligible. Post‐exposure prophylaxis is not indicated after a bite in all but exceptional circumstances. Policies to protect emergency workers should be developed with this evidence in mind. [ABSTRACT FROM AUTHOR]

Individuals who perform rescue and recovery duties, as part of their daily work activities, confront diverse stressors that can affect their mental state and overall well-being. The study aimed to assess the prevalence and the factors associated with self-assessed PTSD, perceived well-being and burnout among rescue workers operating at Lesvos during the European refugees crisis. 217 rescuers participated in the study, while the PTSD Checklist-Civilian Version (PCL-C), the Maslach Burnout Inventory (MBI) and the Well-being Index (WHO-5) were utilized. The prevalence of self-assessed PTSD and perceived burnout syndrome was 17.1% and 57% respectively, while 72.8% of the rescuers reported low levels of perceived well-being. Self-assessed PTSD was positively correlated with perceived burnout and inversely correlated with perceived well-being. Perceived burnout was also inversely correlated with perceived well-being. A number of significant predictors were identified for self-assessed PTSD, perceived burnout and well-being, including: family status, age, duration of shifts, collection of dead adults or dead children bodies. The impact of the refugee crisis is visible on the rescue workers that offer rescue and first aid services. There is an urgent need for implementing effective interventions focusing on the identified determinants in order to enhance the occupational psychological burden of rescuers. [ABSTRACT FROM AUTHOR]

Background Emergency service workers are often exposed to trauma and have increased risk of a range of mental health (MH) conditions. Smartphone applications have the potential to provide this group with effective psychological interventions; however, little is known about the acceptability and preferences regarding such initiatives. Aims To describe the preferences and opinions of emergency service workers regarding the use of smartphone MH applications and to examine the impact of age on these preferences. Methods Participants were recruited from four metropolitan Fire and Rescue NSW stations and responded to questionnaire items covering three key domains: current smartphone use, potential future use and preferences for design and content as well as therapeutic techniques. Results Overall, approximately half the sample (n = 106) claimed they would be interested in trying a tailored emergency-worker MH smartphone application. There were few differences between age groups on preferences. The majority of respondents claimed they would use an app for mental well-being daily and preferred terms such as 'well-being' and 'mental fitness' for referring to MH. Confidentiality, along with a focus on stress, sleep, exercise and resiliency were all considered key features. Behavioural therapeutic techniques were regarded most favourably, compared with other therapies. Conclusions Emergency workers were interested in utilizing smartphone applications focused on MH, but expressed clear preferences regarding language used in promotion, features required and therapeutic techniques preferred. [ABSTRACT FROM AUTHOR]

OBJETIVO: Identificar as prevalências de Transtorno de Estresse Pós-Traumático (TEPT) em profissionais dos serviços de emergências e conhecer os fatores associados ao desfecho. MÉTODOS: Foram consultadas sete bases de dados (MEDLINE via Pubmed, PsycINFO, LILACS, SciELO, BDENF, DISASTRES e MEDCARIB) entre os dias 10 e 25 de setembro de 2009, restringindo-se a pesquisa a artigos em português, inglês ou espanhol publicados no período de 2004 a 2009. Os descritores utilizados abarcaram termos relacionados a profissionais/serviços de emergência, transtorno de estresse pós-traumático e condições de trabalho e saúde ocupacional. Foram incluídos estudos observacionais quantitativos que investigaram a prevalência de TEPT e fatores determinantes ou associados à doença em amostras de bombeiros, profissionais de ambulância, profissionais da Cruz Vermelha e profissionais de emergência em hospitais. Foram excluídos estudos com base em amostras inadequadas para os objetivos da revisão (policiais, voluntários e filhos de profissionais de emergência) ou que não incluíram sintomas de TEPT como variável dependente em pelo menos um dos objetivos. RESULTADOS: A leitura dos títulos e resumos resultou em 30 artigos. A revisão das publicações completas permitiu a inclusão e análise de 17 artigos. Os estudos selecionados adotaram diferentes delineamentos, instrumentos, critérios diagnósticos e técnicas estatísticas de análise. A prevalência da doença variou da ausência de registro de casos à taxa de 38,5%. Características sociodemográficas, biológicas e psicológicas, morbidade, exposição a eventos traumáticos ocupacionais e não-ocupacionais, e características do trabalho e do emprego associaram-se ao TEPT em profissionais de emergência. CONCLUSÃO: Variáveis individuais e de contexto são consideradas fatores associados ou de risco para o TEPT e explicitam o caráter mutidimensional do desfecho em foco.OBJECTIVE: To identify the prevalence of Posttraumatic Stress Disorder (PTSD) in emergency workers and determine the factors associated with outcomes. METHODS: Seven databases were consulted (Medline via Pubmed, PsycINFO, LILACS, SciELO, BDENF, DISASTERS, and MEDCARIB) between September 10 and 25, 2009. The search only included articles published in Portuguese, English or Spanish between 2004 and 2009. The key-words involved terms related to emergency services/workers, Posttraumatic stress disorder, working conditions, and occupational health. Quantitative observational studies on PTSD prevalence and determinant or associated factors regarding the health of firefighters, emergency ambulance personnel, Red Cross workers, and medical emergency workers were included. Studies using samples unrelated to the purposes of this review (police officers, volunteers and emergency workers' children) or that did not include PTSD symptoms as the dependent variable in at least one of the objectives of the study were excluded. RESULTS: 30 articles were selected by reading the titles and abstracts. 17 complete articles were reviewed and analyzed. Studies adopted different research designs, instruments and diagnostic criteria for statistical analysis. The prevalence of the disease ranged from absence of reported cases to a rate of 38.5%. Socio-demographic, biological and psychological characteristics, morbidity, exposure to occupational and non-occupational traumatic events, and work and job features were associated with the prevalence of PTSD in emergency workers. CONCLUSION: Individual and contextual variables are considered as factors associated with PTSD, which explains the multidimensional nature of the outcome studied.

Environmental and social changes associated with climate change are likely to have impacts on the well-being, health, and productivity of many working populations across the globe. The ramifications of climate change for working populations are not restricted to increases in heat exposure. Other significant risks to worker health (including physical hazards from extreme weather events, infectious diseases, under-nutrition, and mental stresses) may be amplified by future climate change, and these may have substantial impacts at all scales of economic activity. Some of these risks are difficult to quantify, but pose a substantial threat to the viability and sustainability of some working populations. These impacts may occur in both developed and developing countries, although the latter category is likely to bear the heaviest burden.This paper explores some of the likely, non-heat-related health issues that climate change will have on working populations around the globe, now and in the future. These include exposures to various infectious diseases (vector-borne, zoonotic, and person-to-person), extreme weather events, stress and mental health issues, and malnutrition.

Objective: Emergency workers, such as fire-fighters, are routinely exposed to potentially traumatic events. While a number of studies have examined the occurrence of post-traumatic stress disorder, the role of multiple traumas on other mental health sequelae, such as depression and alcohol misuse, among emergency workers remains unclear. This study aimed to assess the prevalence of post-traumatic stress disorder, depression and alcohol misuse in a sample of current and retired fire-fighters and examine their relationship with cumulative trauma exposure. Method: A cross-sectional survey was completed by current (n = 488) and retired (n = 265) fire-fighters from Fire and Rescue New South Wales, Australia. Demographic and occupational information was collected, including the number of fatal incidents fire-fighters reported attending across years of service. Validated, self-report measures were used to determine probable caseness for post-traumatic stress disorder, depression and heavy drinking. Results: Among current fire-fighters, rates of post-traumatic stress disorder and depression were 8% and 5%, respectively, while 4% reported consumption of more than 42 alcoholic drinks per week. Retired fire-fighters reported significantly greater levels of symptomatology, with the prevalence estimates of post-traumatic stress disorder at 18% (p = 0.001), depression at 18% (p < 0.001) and heavy drinking at 7%. There was a significant positive linear relationship between the number of fatal incidents attended and rates of post-traumatic stress disorder, depression and heavy drinking. Conclusion: Fire-fighters suffer from high rates of mental disorders, with rates of post-traumatic stress disorder, depression and heavy drinking continuing to rise in a linear manner with each additional trauma exposure. The level of psychiatric morbidity among retired fire-fighters appears to be particularly high. Our findings have important implications for the ongoing debates surrounding the detection of mental disorders in high-risk occupations and for policy considerations around the welfare of current and retired emergency workers. [ABSTRACT FROM AUTHOR]

Although firefighting is known to engender a high rate of injury, few studies have examined the contribution of physical exercise, burnout and coping strategies to firefighting-related injuries. Data were collected from a population-based sample of 220 male firefighters. In a descriptive study, the nature and site of the injuries and the relationships among firefighter injuries, physical exercise, burnout and coping strategies were examined. Sprains were the most prevalent type of injury (98%), followed by tendinitis (40%) and muscle tears (30%). More than two thirds of these injuries were located at the ankle. Weekly hours of physical exercise, cognitive weariness at work, social support seeking, problem-focused coping and emotional exhaustion were significantly related to these injuries. The findings suggest that physical exercise and cognitive weariness can be considered as risk factors for French firefighter injuries, whereas problem-focused coping can be seen as a protective factor. More research is needed to explain the relationship between social support seeking and injury. [ABSTRACT FROM AUTHOR]

Psychosocial constraints at work are a major concern, since they can have a pathogenic effect on the mental and physical health of workers. The purpose of this study was to provide an overview of these constraints in paramedics in Quebec. A cross-sectional study was conducted during the fall of 2010 and winter of 2011. In it, 295 paramedics responded to questionnaires related to two psychosocial risk models : the job demand-control-support model defined by Karasek and Theorell, and the effort/reward imbalance model defined by Siegrist. ANOVA with two between factors (gender and experience) was performed on all the measures obtained with the two models. Men were more exposed to lower social support, iso-strain, and job-strain than were women. Social support (from colleagues and superiors) decreased with years in employment, while remuneration was estimated highest in mid-career. Decision latitude and recognition represented favourable dimensions. The most critical dimensions were the lack of social support from colleagues and superiors, as well as extrinsic excessive efforts. The overall picture that emerged showed that three-quarters of the responding paramedics would seem to be exposed to a high risk of physical and mental health problems at work.

The nature of the job of people working in emergency situations is such that they may experience high levels of stress. The study analyses the relationship between social support and coping in 182 Emergency Service professionals of three professional categories operating in dangerous situations: military, frontier police and firemen. The research confirms the relationship between coping and social support, emphasising the importance of the family source. The results also confirm what has been reported in literature about the prevalence of situational coping for professionals working in emergency situations. In this area, such research may provide a base for developing stress management programs in emergencies and for protecting and reinforcing the wellness of emergency workers, who, in turn, are victims as well. [ABSTRACT FROM AUTHOR]

This paper presents the results of a retrospective cohort study of cancer incidence and mortality among emergency workers of the Chernobyl accident, for the follow-up period 1992-2009. The cohort selected for analysis consists of 67,568 emergency workers who worked in the Chernobyl exclusion zone in 1986-1987. External radiation whole-body absorbed dose varied from 0.0001 gray (Gy) to 1.24 Gy, with a median of 0.102 Gy. Over the follow-up period 1992-2009, a total of 4,002 solid cancers of different sites were identified as the result of annual compulsory health examination, and a total of 2,442 deaths from all solid cancers in the study cohort were reported. Poisson regression was applied for the analysis of cancer incidence and mortality. The analysis of the standardized incidence ratio (SIR) has shown a statistically significant increase in cancer incidence in the cohort as compared with baseline cancer incidence among males of Russia. The average excess over the entire follow-up period is 18 % [SIR = 1.18, 95 % confidence interval (CI) 1.15; 1.22]. In contrast, however, no increase in the mortality from all cancers among the emergency workers as compared to the baseline mortality in Russian men was found. Values of excess relative risk of cancer incidence and mortality per 1 Gy (ERR Gy) are 0.47 (95 % CI 0.03; 0.96, p value = 0.034) and 0.58 (95 % CI 0.002; 1.25, p value = 0.049), respectively. These values are statistically significant. [ABSTRACT FROM AUTHOR]

Background Workplace safety is a recognized concern in emergency medical services (EMS). Ambulance crashes are common and injury rates exceed that of the general working public. Fatigue and sleepiness during shift work pose a safety risk for patients and EMS workers. Changing EMS worker behaviors and improving alertness during shift work is hampered by a lack of instruments that reliably and accurately measure multidimensional beliefs and habits that predict alertness behavior. Objectives We sought to test the reliability and validity of a survey tool (the sleep, fatigue, and alertness behavior survey [SFAB]) designed to identify the cognitions of EMS workers concerning sleep, fatigue, and alertness behaviors during shift work. Methods We operationalized the integrative model of behavioral prediction (IMBP) and developed a pool of 97 candidate items and sub-items to measure eight domains of the IMBP. Five sleep scientists judged the content validity of each item and a convenience sample of EMS workers completed a paper-based version of the SFAB. We retained items judged content valid by five sleep scientists and performed exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and tests of reliability and internal consistency. We identified a simple factor structure for each scale and calculated means and standard deviations for each item and scale. Results We received 360 completed SFAB surveys from a convenience sample of 800 EMS workers attending two regional continuing education conferences (45% participation rate). Forty-seven candidate items and sub-items/options were removed following content validation, EFA, and CFA testing. Analyses revealed a simple factor structure for seven of eight domains and a final pool of 50 items and sub-items/options. Domains include: attitudes, normative beliefs, knowledge, salience, habits, environmental constraints, and intent. EFA tests of self-efficacy items failed to identify a simple factor structure. We retained two self-efficacy items based on Spearman–Brown correlation of 0.23 ( p < 0.0001). Conclusions Measurement of sleep, fatigue, and alertness behavior among EMS workers is challenging. We describe the development and psychometric testing of a survey tool that may be useful in a variety of applications addressing sleep, fatigue, and alertness behavior among EMS workers. [ABSTRACT FROM AUTHOR]

Despite threats to wellbeing inherent in paramedicine, little is known about how paramedics cope. This study explored the breadth of healthy and unhealthy coping strategies used by paramedics and student paramedics. A convenience sample of 198 paramedics and student paramedics completed an online survey. Wellbeing was measured using WHO-5 and coping using the Coping Index. Primary outcomes were summarised using descriptive statistics. Most of the sample had wellbeing (68%); student paramedics had significantly better wellbeing than paramedics. There was no significant difference between paramedics and student paramedics on healthy or unhealthy coping. Participants with ill-being had significantly fewer healthy and more unhealthy coping strategies than those with wellbeing, and relatively few used professional support (28%). Internationally, few studies have reported coping strategies in paramedics. This study expands our understanding of healthy and unhealthy coping strategies used by paramedics and student paramedics. The results support research that shows paramedic work affects wellbeing, however not that paramedics are at greater risk of unhealthy coping than students or the general population. The results have implications for both the prevention of overwhelming distress in the workplace and the need to increase the use of professional support to prevent unhealthy coping, including suicidality., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.)

This case study discusses the treatment of an emergency responder to the 2007 shooting on Virginia Tech’s campus where 33 students and faculty members were killed. After a thorough assessment, prolonged exposure (PE) was used to treat the emergency worker, referred to as Jack, for posttraumatic stress disorder (PTSD). Assessment measures administered at the conclusion of treatment, 1 month post-treatment, and 6 months post-treatment suggest that the treatment gains were maintained following the culmination of treatment. The primary aim of this article is to provide support for the effectiveness of PE among emergency responders who develop PTSD. In addition, this case presentation is particularly important given the prevalence of mass shootings in the United States. Several complicating factors, including a delay in treatment seeking, arose over the course of treatment and are discussed. [ABSTRACT FROM AUTHOR]

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Some studies reported high levels of severe burnout syndrome in emergency workers. We compared different categories of health care workers (129 of Medicine Department e 47 of Laboratory analysis Department) and emergency workers (42 of 118 and 37 of Emergency Department) Subjects were administered the Organizational Checkup System (OCS) to evaluate subjects' risk of burnout and their perception of their own work role and of their organizational environment The operators of 118 showed a condition of wellbeing and a less tendency to burnout. This Finding was accompanied to a better perception of their own work role and of their organizational environment. [ABSTRACT FROM AUTHOR]

The purpose of this cross-sectional study was to investigate confidentiality as a possible barrier to emotional support in a sample of 464 Norwegian nurses, rescue workers, police officers, chaplains, and undertakers. Informal discussions more than formal meetings were settings where emotional work experiences could be aired. The most important sources of emotional support were partners and colleagues. The need to maintain confidentiality was associated with lower utilization of personal support network. Confidentiality, the need to demonstrate emotional capability, and professional integrity were identified as barriers for seeking support. These barriers were present regardless of organizational strategies to support each other in formal and informal meetings. [ABSTRACT FROM AUTHOR]

Environmental and social changes associated with climate change are likely to have impacts on the well-being, health, and productivity of many working populations across the globe. The ramifications of climate change for working populations are not restricted to increases in heat exposure. Other significant risks to worker health (including physical hazards from extreme weather events, infectious diseases, under-nutrition, and mental stresses) may be amplified by future climate change, and these may have substantial impacts at all scales of economic activity. Some of these risks are difficult to quantify, but pose a substantial threat to the viability and sustainability of some working populations. These impacts may occur in both developed and developing countries, although the latter category is likely to bear the heaviest burden. This paper explores some of the likely, non-heat-related health issues that climate change will have on working populations around the globe, now and in the future. These include exposures to various infectious diseases (vector-borne, zoonotic, and person-to-person), extreme weather events, stress and mental health issues, and malnutrition. [ABSTRACT FROM AUTHOR]

This study, involving a sample of 764 emergency workers, investigates dimensions of quality of life at work (Compassion fatigue, Burnout and Compassion satisfaction), and their relationships with Coping strategies and some psychosocial variables (Sense of Community, Collective Efficacy and Self-efficacy). Results indicate the usefulness of distinguishing between positive and negative indicators of emergency workers’ quality of life. Compassion satisfaction is positively correlated with efficacy beliefs, Sense of Community and the use of Active coping strategies. Burnout and Compassion fatigue are especially correlated with the use of dysfunctional coping strategies like distraction and self-criticism. Volunteer emergency workers enjoy a higher well being than full-time professional workers. Results and their implications for interventions aimed at increasing rescue workers’ quality of life by enhancing psychosocial competences are discussed. [ABSTRACT FROM AUTHOR]

Background This study was conducted following the London bombings of 7 July 2005. [ABSTRACT FROM PUBLISHER]

The objective of this study was to assess the relationships between occupational stress, sense of coherence, burnout and work engagement of emergency workers in Gauteng and to determine whether sense of coherence moderates the effects of occupational stress on burnout and work engagement. A cross-sectional survey design was used. A convenience sample (N = 323) was taken from emergency workers in Gauteng. The Maslach Burnout Inventory - Human Services Survey, the Utrecht Work Engagement Scale, the Emergency Worker Stress Inventory and the Orientation to Life Questionnaire were administered. The results showed that occupational stress (as a result of a lack of job resources) and a weak sense of coherence predicted emotional exhaustion and depersonalisation. Sense of coherence predicted personal accomplishment and work engagement. However, sense of coherence did not moderate the effects of occupational stress on emotional exhaustion, depersonalisation, personal accomplishment or work engagement. [ABSTRACT FROM AUTHOR]

The objectives of this study were to determine the construct validity, internal consistency, construct equivalence and item bias of the Emergency Worker Stress Inventory (EWSI) and to identify occupational stressors for emergency workers. A cross-sectional survey design was used. An accidental sample (N = 405) of emergency workers in Gauteng was used. The EWSI was developed as a measuring instrument and administered together with a biographical questionnaire. Three internally consistent stress factors, namely Lack of Resources, Job Demands and Inherent Emergency Work Stressors w ere extracted. Low structural equivalence regarding perceived stressors was detected for the Nguni-language group. No practically significant differences were found between occupational stressors of emergency workers in different positions and language groups. Opsomming Die doelstellings van hierdie navorsing was om die konstrukgeldigheid, interne konsekwentheid, konstrukekwivalensie en itemsydigheid van die Nooddienswerker Stresvraelys (NWSV) te bepaal en beroepstressore vir nooddienswerkers te identifiseer. ’n Dwarssnee opname-ontwerp is gebruik. Die studiepopulasie is met behulp van ’n beskikbaarheidsteekproef (N = 405) van nooddienswerkers in Gauteng verkry. Die NWSV is ontwikkel vir die studie en saam met ’n biografiese vraelys afgeneem. Drie interne konsekwente stresfaktore, naamlik Tekort aan Hulpbronne, Poseise en Inherente Nooddiens Stressore is onttrek. Lae konstrukekwivalensie is ten opsigte van waargenome stressore vir die Nguni taalgroep gevind. Geen prakties betekenisvolle verskille is tussen die beroepstressore van nooddienswerkers in verskillende posisies en taalgroepe gevind nie.

In recent years, several clinicians have advocated for the use of single session crisis debriefing (CD) groups for relieving the distress of emergency service workers encountering traumatic events in the line of duty. Researchers have subsequently questioned the efficacy of this approach. This study addresses the efficacy of CD groups for 164 Australian firefighters following a critical incident. Findings indicated that the majority of firefighters attending crisis debriefing groups perceived that the intervention was beneficial in reducing their level of stress. However, there was no significant association between attending CD groups and scores on the Beck Depression Inventory. Attending a CD group was associated with higher scores on intrusion subscale of the Impact of Events Scale. [ABSTRACT FROM AUTHOR]

Emergency workers, including urban fire fighters and paramedics, must cope with a variety of duty-related stressors including traumatic incident exposures. Little is known about coping responses of emergency workers or whether their coping responses predict future mental health outcomes. The previously formulated Coping Responses of Rescue Workers Inventory (CRRWI) underwent a principal components analysis employing a sample (N = 220) of urban fire fighters and paramedics. Six empirically and theoretically distinct CRRWl components were identified which were relatively stable over a 6-month period. Scores on one of the CRRWI scales, but neither years of service nor their past half year's traumatic incident exposures, predicted future changes in self-reports of posttraumatic stress symptomatology. [ABSTRACT FROM AUTHOR]

Little is known about the variables that might be associated with posttraumatic stress symptomatology in high-risk occupational groups such as professional firefighters and paramedics. A sample of 173 urban professional firefighter/EMT's and firefighter/paramedics rated and ranked the stressfulness of 33 actual and/or potential duty-related incident stressors. They also reported whether they had experienced each of these incident stressors within the past 6 months and, if they had, to recall on how many occasions within the past 6 months. A principal components analysis of their rescaled incident stressor ratings yielded five components: Catastrophic Injury to Self or Co-worker, Gruesome Victim Incidents, Render Aid to Seriously Injured, Vulnerable Victims, Minor Injury to Self and Death & Dying Exposure. [ABSTRACT FROM AUTHOR]

Police, fire, emergency medical and hospital personnel were surveyed following two disasters in the same county: An apartment building explosion followed 1 year later by a devastating tornado. They completed a symptom checklist, the Coping Inventory, and rated the extent of their support networks. Reported symptoms revealed clinically significant emotional effects postdisaster. More post-traumatic symptoms were reported following the tornado. Coping theory emphasizing cognitive appraisal was used as the conceptual framework for studying reported adjustment strategies. Workers' comments illustrated the cognitive processes intervening between the emergency events and reactions to them. The most frequently endorsed coping strategies following both events involved attempts to reach cognitive mastery over the event and to ascertain meaning. Strategies of altering activities and finding new interests were not frequently endorsed. A greater number of coping responses were endorsed fob wing the tornado along with strategies which involved seeking support from others. Factor analysis of Coping Inventory responses revealed four factors: seeking of meaning, regaining mastery through individual action, regaining mastery through interpersonal action, and philosophical self-contemplation. [ABSTRACT FROM AUTHOR]

Working as healthcare workers (HCWs) and emergency workers (EWs) during the first wave of COVID-19 has been associated with high levels of stress and burnout, while hardiness, coping strategies and resilience have emerged as protective factors. No studies have so far investigated these psychological factors during the second wave. We aimed to verify the trend of stress levels, burnout, coping strategies and resilience during the pandemic in Italian healthcare and emergency workers by comparing a first sample recruited from the first COVID-19 wave (N = 240) with a second sample relating to the second wave (N = 260). Through an online platform we administered questionnaires to measure stress, burnout, resilience, hardiness and coping strategies. The results showed that in the two waves the total stress levels of HCWs and EWs did not differ, while the physical stress and hardiness scores in the second wave were greater. No differences were found in the coping strategies used. An analysis of burnout levels in the second wave sample found that stress showed a high predictive power in the emotional exhaustion and depersonalization scales. Hardiness and resilience emerged as protective factors in reducing stress. The implications for the need to provide support and to improve hardiness for HCWs and EWs are discussed. [ABSTRACT FROM AUTHOR]