What work-related exposures are associated with post-traumatic stress disorder? A systematic review with meta-analysis

Abstract

ObjectivesAlthough there is evidence that work-related exposures cause post-traumatic stress disorder (PTSD), there are few quantitative studies assessing the degree to which these factors contribute to PTSD. This systematic review with meta-analysis identified work-related exposures associated with PTSD, and quantified their contribution to this disorder.MethodsWe searched Medline, PsycINFO, Embase, PILOTS and Web of Science (2005–10 September 2019) for longitudinal studies on work-related exposures and PTSD. We described included articles, and conducted meta-analyses for exposures with sufficient homogeneous information. We performed subgroup analyses for risk of bias, study design and PTSD ascertainment. We assessed evidence quality using Grades of Recommendations, Assessment, Development and Evaluation, and estimated population attributable fractions.ResultsAfter screening 8590 records, we selected 33 studies (n=5 719 236). From what was moderate quality evidence at best, we identified various work-related exposures that were associated with PTSD, mainly involving individuals in the military and first responder (eg, police or fire brigade) occupations. These exposures included the number of army deployments (OR: 1.15 (95% CI 1.14 to 1.16)), combat exposure (OR 1.89 (95% CI 1.46 to 2.45)), army deployment (OR 1.79 (95% CI 1.45 to 2.21)) and confrontation with death (OR 1.63 (95% CI 1.41 to 1.90)). Effects were robust across subgroups and exposures attributed modestly (7%–34%) to PTSD. We identified additional exposures in other occupations, including life threats, being present during an attack, and hearing about a colleague’s trauma.ConclusionsWe identified various work-related exposures associated with PTSD and quantified their contribution. While exposure assessment, PTSD ascertainment and inconsistency may have biased our findings, our data are of importance for development of preventive interventions and occupational health guidelines.

Critical incident exposure among custody and noncustody correctional workers: Prevalence and impact of violent exposure to work‐related trauma

“…Findings also indicate that there were significant differences in PTSD, low back diagnosis, and lower job satisfaction for most of the reported CI categories. The findings therefore illustrate how exposure to workplace violence, dangers, and trauma‐inducing experiences may contribute to acute stress reactions 39 . The significant relationship found between all but one of the CIs and low job satisfaction may help to describe the chronic issues of turnover found in the corrections industry 43 .…”

“…The findings therefore illustrate how exposure to workplace violence, dangers, and trauma-inducing experiences may contribute to acute stress reactions. 39 The significant relationship found between all but one of the CIs and low job satisfaction may help to describe the chronic issues of turnover found in the corrections industry. 43 In a metaanalysis, work environment and job attitudes (e.g., job satisfaction)…”

“…Correctional workers that experienced CIs reported lower job satisfaction, greater feelings of PTSD, and more work absences than those who do not experience CIs. Furthermore, nearly half of correctional workers screened positive for PTSD, a mental health condition known to be caused by work‐related exposures 39,40 …”

A phenomenological exploration of work-related post-traumatic growth among high-functioning adults maltreated as children

“…While work provides many social and economic benefits, it also exposes individuals to occupational stressors. Specifically, working in settings in which individuals encounter trauma (either directly or vicariously) may lead to experiencing distress, and possibly Post Traumatic Stress Disorder, PTSD ( Skogstad et al, 2013 ; Coenen and van der Molen, 2021 ). However, encountering such traumatic experiences at work may also cultivate positive transformation, such as PTG.…”

Team Coping: Cross-Level Influence of Team Member Coping Activities on Individual Burnout

“…Some jobs place extremely high demands on employees. Police officers, paramedics, firefighters, and military personnel, for example, are frequently exposed to life-threatening situations and hostile working conditions ( Skogstad et al, 2013 ; Coenen and van der Molen, 2021 ). To prevent such exposure to danger from damaging psychological well-being and mental health (e.g., Pietrzak et al, 2009 ; Ramchand et al, 2015 ), individuals in highly demanding jobs need to engage in coping ( Jex et al, 2001 ).…”