Prevalence of pain, analgesic self-medication and mental health in German pre-hospital emergency medical service personnel: a nationwide survey pilot-study

Luis Möckel,Angela Gerhard,Mara Mohr,Christina Möckel,Christoph Immanuel Armbrust

doi:10.1007/s00420-021-01730-x

Abstract

PurposeThe aim of this study was to estimate the prevalence of pain, the extent of analgesics intake and the mental health status of German pre-hospital emergency medical service (EMS) personnel.MethodsWe conducted a nationwide online survey, which consisted of sociodemographic and job-related items, questions on pain and analgesics intake and the short-version of the validated Depression–Anxiety–Stress Scale (DASS-21).ResultsA total of 774 EMS personnel with a mean age of 33.03 (standard error [SE] 0.37) years were included into the final analysis of which 23.77% were female. Pain was reported by 58.64% (454 of 774) of the study participants with 10.72% (95% confidence interval [CI] 8.54%; 13.29%) suffering from chronic, 1.68% (95% CI 0.89%; 2.87%) from acute and 46.25% (95% CI 41.49%; 51.30%) from recurrent pain, respectively. Most frequent location of pain was lumbar spine. Analgesics were used by 52.76% (239 of 454) of pre-hospital EMS personnel with pain (acute 76.92% / chronic 69.88% / recurrent 47.90%). Moreover, participants with chronic and recurrent pain indicated significantly higher depression (p ≤ 0.001), anxiety (p ≤ 0.001), and stress (p ≤ 0.001) levels compared to those without pain, respectively.ConclusionThis study indicates a high prevalence of pain and analgesics usage in participating German pre-hospital EMS personnel and a poorer mental health in those with chronic and recurrent pain. Therefore, disease prevention and health promotion measures are needed to preserve health of pre-hospital EMS personnel.

Highlights

People working in pre-hospital emergency medical service (EMS) are an essential group of skilled healthcare professionals, evaluating acute patients and providing first care (Ilper et al 2014; Klepacka et al 2018)
This study indicates a high prevalence of pain among participating German pre-hospital EMS personnel with almost 11% suffering from chronic pain and 59% from any type of pain
Of significant importance is that the majority is using freely available analgesics for self-medication, and that those with chronic and recurrent pain indicate higher depression, anxiety, and stress levels

Summary

Introduction

People working in pre-hospital emergency medical service (EMS) are an essential group of skilled healthcare professionals, evaluating acute patients and providing first care (Ilper et al 2014; Klepacka et al 2018). It is known that people working in pre-hospital EMS are often suffering from back complaints (Imani et al 2018; Maguire et al 2005; Okada et al 2005; Zhang et al 2019). In addition to lower back pain, Okada et al (2005) reported feet, knee, shoulder and neck issues in 15.5–36.7% of EMS personnel. Less is known on the prevalence of gastrointestinal and head pain in EMS personnel, respectively. Still unknown is the extent of analgesic self-medication by German pre-hospital EMS personnel. For German nurses, a population likewise often affected by back pain, it was reported that they are more frequently using analgesics compared to other professionals (Techniker Krankenkasse 2019)

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Conclusion