Work-related stress and posttraumatic stress in emergency medical services

Prehosp Emerg Care. 2012 Jan-Mar;16(1):76-85. doi: 10.3109/10903127.2011.621044.


Introduction: Recent research efforts in emergency medical services (EMS) has identified variability in the ability of EMS personnel to recognize their level of stress-related impairment. Developing a better understanding of how workplace stress may affect EMS personnel is a key step in the process of increasing awareness of the impact of work-related stress and stress-related impairment.

Objective: This paper demonstrates that for those in EMS, exposure to several types of workplace stressors is linked to stress reactions. Stress reactions such as posttraumatic stress symptomatology (PTSS) have the potential to negatively influence the health of EMS providers. This research demonstrates that two different types of work-related stress and alcohol use influence the development of PTSS.

Methods: A probability sample of nationally registered emergency medical technician (EMT)-Basics and EMT-Paramedics (n = 1,633) completed an Internet-based survey. Respondents reported their levels of operational and organizational types of chronic stress, critical incident stress, alcohol use, and PTSS.

Results: Ordinary least squares regression illustrated that when demographic factors were controlled, organizational and operational forms of chronic stress, critical incident stress, and alcohol use were all significant predictors of PTSS (p < 0.01). Inclusion of an interaction effect between operational stress and critical incident stress (p < 0.01) as well as between operational stress and alcohol use (p < 0.01) created a robust final model with an R(2) of 0.343.

Conclusion: These findings indicate that exposure to both chronic and critical incident stressors increases the risk of EMS providers' developing a posttraumatic stress reaction. Higher levels of chronic stress, critical incident stress, and alcohol use significantly related to an increased level of PTSS. Further, for those reporting high levels of alcohol use or critical incident stress, interactions with high levels of chronic operational stress were associated with higher rates of PTSS. For those interested in the impact of work-related stress in EMS, these findings indicate that attention must be paid to levels of stress associated with both critical incident exposure as well as the chronic stress providers experience on a day-to-day basis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Alcohol Drinking / psychology
  • Emergency Medical Services*
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Mental Health
  • Occupational Diseases / epidemiology
  • Occupational Diseases / ethnology
  • Occupational Diseases / psychology*
  • Occupational Exposure / adverse effects*
  • Psychometrics
  • Regression Analysis
  • Risk Factors
  • Statistics as Topic
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / etiology
  • Stress Disorders, Post-Traumatic / psychology*
  • Stress, Psychological / complications*
  • Stress, Psychological / psychology
  • United States / epidemiology
  • Workplace / psychology