Introduction:Emergency service (ambulance, police, fire) call-takers and dispatchers are often exposed to duty-related trauma, placing them at increased risk for developing mental health challenges like stress, anxiety, depression, and posttraumatic stress disorder (PTSD). Their unique working environment also puts them at-risk for physical health issues like obesity, headache, backache, and insomnia. Along with the stress associated with being on the receiving end of difficult calls, call-takers and dispatchers also deal with the pressure and demand of following protocol despite dealing with the variability of complex and stressful situations.Methods:A systematic literature review was conducted using the MEDLINE, PubMed, CINAHL, and PsychInfo databases.Results:A total of 25 publications were retrieved by the search strategy. The majority of studies (n = 13; 52%) reported a quantitative methodology, while nine (36%) reported the use of a qualitative research methodology. One study reported a mixed-methods methodology, one reported an evaluability assessment with semi-structured interviews, one reported on a case study, and one was a systematic review with a narrative synthesis.Discussion:Challenges to physical health included: shift-work leading to lack of physical activity, poor nutrition, and obesity; outdated and ergonomically ill-fitted equipment, and physically confining and isolating work spaces leading to physical injuries; inadequate breaks leading to fatigue; and high noise levels and poor lighting being correlated with higher cortisol levels. Challenges to mental health included: being exposed to traumatic calls; working in high-pressure environments with little downtime in between stressful calls; inadequate debriefing after stressful calls; inappropriate training for mental-health-related calls; and being exposed to verbally aggressive callers. Lack of support from leadership was an additional source of stress.Conclusion:Emergency service call-takers and dispatchers experience both physical and mental health challenges as a result of their work, which appears to be related to a range of both operational and support-based issues. Future research should explore the long-term effects of these physical and mental health challenges.

Introduction:In the years following the September 11, 2001 terrorist attacks in New York (USA), otherwise known as 9/11, first responders and recovery workers began experiencing a range of physical and mental health challenges. Publications documenting these provide an important evidence-base identifying exposure-related health challenges associated with environmental exposures from the World Trade Center (WTC) site and describe the key lessons learned regarding both physical and mental health challenges (including symptoms and defined conditions) from the 9/11 disaster response.Methods:A systematic literature review was conducted using the MEDLINE, PubMed, CINAHL, and PsychInfo databases (September 11, 2001 to September 11, 2018) using relevant search terms, truncation symbols, and Boolean combination functions. Publications were limited to journal articles that documented the physical or mental health challenges of 9/11 on first responders or recovery workers.Results:A total of 156 publications were retrieved by the search strategy. The majority (55%) reported a quantitative methodology, while only seven percent reported the use of a qualitative research methodology. Firefighters were the group of responders most frequently reported in the literature (35%), while 37% of publications reported on research that included a mix of first responders and recovery workers. Physical health was the focus of the majority of publications (57%). Among the challenges, respiratory issues were the physical health condition most frequently reported in publications, while posttraumatic stress disorder (PTSD) was the most frequent mental health condition reported on. Publications were published in a broad range of multi-disciplinary journals (n = 75).Discussion:These findings will go some way to filling the current gap in the 9/11 evidence-base regarding the understanding of the long-term health challenges for first responders and recovery workers.

The development of appropriate health and safety interventions for farmers and agri-workers is important world-wide but data on present practices and attitudes to change are lacking. A representative quota sample (n = 1,938) of the Irish population was surveyed on lifestyle practices and workplace risk assessment and control measures, in relation to chemical exposure, manual handling and machinery. Focus group discussions were conducted also with 47 representatives of national farming organizations. As compared with the general workforce, farmers had a significantly (p < 0.01) lower level of assessment of risk hazards associated with manual handling and machinery. Both farmers and employees in workplaces with less than 20 employees reported a significantly lower level of safety training. Male farmers had a particularly negative health profile with only 18% reporting regular dental checks, 26% practising skin protection and 29% taking regular exercise. Discussions indicated that barriers to change included low perceived susceptibility, lack of time and resources. Mental health issues were particularly highlighted. We conclude farmers differ significantly in many instances from the rest of the workforce in regard to occupational health and safety issues and specific interventions in key areas are required for the agri-sector.

IntroductionThis study explores the preparedness of undergraduate student paramedics for the mental health challenges of the paramedic profession from the perspective of course coordinators and their students. MethodsTwo surveys were developed and administered to course coordinators and students of the 16 undergraduate degree paramedicine courses across Australia and New Zealand. Sixteen course coordinators and 302 students responded. ResultsResults illustrate there was widespread recognition for the need to include preparation for the mental health challenges of the profession within undergraduate courses. Furthermore, most course coordinators and students had a preference for this topic to be taught using multiple teaching modes with particular preference for teaching the topic via discussion and activity based education. Teaching the topic as a standalone unit was supported by more than a third of course coordinators (43%) and a third of students (32%).ConclusionSix themes were identified as positive by anticipants: caring for people, high acuity work, diversity of work and patients, making a difference to patients and their families, using clinical skills and knowledge and engaging with the community. Students were most confident about communicating with patients and using clinical skills and knowledge. Students were least confident about clinical decision making and the most commonly cited fear was making a clinical mistake. A significant proportion of students (16%) feared for their personal mental wellbeing and 14% reported they were least confident about personal mental health within the profession.

IntroductionBystander cardiopulmonary resuscitation (CPR) can be performed by any member of the public who witnesses a cardiac arrest and has the knowledge, training and skills to perform it. Even though bystander CPR has been shown to greatly improve the victim’s chance of survival, its training and performance rates are alarmingly low.MethodsOne potentially effective intervention to tackle this issue is to implement mandatory CPR training programs in high schools. We undertook in-depth qualitative interviews with 28 recent Australian high school graduates. The interviews were transcribed and then analysed, with participants’ answers used to draw conclusions on the acceptability of mandatory CPR high school training.ResultsResults suggested those that had undertaken basic first aid training in high school would be more open and confident to perform bystander CPR. Among those who had not undertaken training, cost and access were identified as the key barriers. Regardless of whether participants had or had not previously undertaken training, they understood the importance of CPR for the treatment of cardiac arrest victims.ConclusionAmong our sample, there was overwhelming support for the concept of mandatory CPR training being implemented in high schools. Should such a program be applied, there is the potential for this to have an impact on bystander CPR provision, and hence cardiac arrest survival rates, within the wider Australian community.