Abstract
BackgroundResearchers have become increasingly aware that ambulance personnel may be at risk of developing work-related health problems. This article systematically explores the literature on health problems and work-related and individual health predictors in the ambulance services.MethodsWe identified the relevant empirical literature by searching several electronic databases including Medline, EMBASE, PsychINFO, CINAHL, and ISI Web of Science. Other relevant sources were identified through reference lists and other relevant studies known by the research group.ResultsForty-nine studies are included in this review. Our analysis shows that ambulance workers have a higher standardized mortality rate, higher level of fatal accidents, higher level of accident injuries and a higher standardized early retirement on medical grounds than the general working population and workers in other health occupations. Ambulance workers also seem to have more musculoskeletal problems than the general population. These conclusions are preliminary at present because each is based on a single study. More studies have addressed mental health problems. The prevalence of post-traumatic stress symptom caseness was > 20% in five of seven studies, and similarly high prevalence rates were reported for anxiety and general psychopathology in four of five studies. However, it is unclear whether ambulance personnel suffer from more mental health problems than the general working population.ConclusionSeveral indicators suggest that workers in the ambulance services experience more health problems than the general working population and workers in other health occupations. Several methodological challenges, such as small sample sizes, non-representative samples, and lack of comparisons with normative data limit the interpretation of many studies. More coordinated research and replication are needed to compare data across studies. We discuss some strategies for future research.
Highlights
Researchers have become increasingly aware that ambulance personnel may be at risk of developing work-related health problems
A review addressing the relation between stress and strain in ambulance workers published 10 years ago [7] concluded that more research is needed to evaluate the prevalence of post traumatic stress disorder among ambulance personnel, and to compare their level of depression and anxiety to the general population [7]
Studies dealing with the aftermath of the "9/11" attack (n = 4) were excluded because of the special circumstances and the inclusion of volunteers
Summary
Researchers have become increasingly aware that ambulance personnel may be at risk of developing work-related health problems. In the past few years, researchers have become increasingly aware that ambulance personnel may be at risk of developing work-related health problems [1,2] This is the first systematic review to address the health status of workers in the ambulance services. BMC Health Services Research 2006, 6:82 http://www.biomedcentral.com/1472-6963/6/82 rapid action and provide medical care under life-anddeath circumstances in unfamiliar and inconvenient circumstances while being scrutinized by bystanders and relatives [4]. They often have to deal with unpredictable and non-specific threats, such as the possibility of contracting diseases from patients or being attacked by mentally unstable or violent patients [5]. A review addressing the relation between stress and strain in ambulance workers published 10 years ago [7] concluded that more research is needed to evaluate the prevalence of post traumatic stress disorder among ambulance personnel, and to compare their level of depression and anxiety to the general population [7]
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