Systematic review of mental health symptoms in firefighters exposed to routine duty-related critical incidents.

Abstract

Due to high rates of potentially traumatic exposure (PTE) within the firefighting profession, a large body of literature concerning firefighters’ mental health has developed over recent decades. However, given variable prevalence outcomes and the largely descriptive nature of most studies, it is unclear whether the prevalence of trauma-related mental disorders in firefighters is elevated in comparison with the general population. The present systematic review examined literature on prevalence of posttraumatic stress disorder, depression, and anxiety in firefighters exposed to routine, duty-related PTEs to synthesize prevalence outcomes across the literature. Systematic search of 6 databases was conducted to review eligible articles published between 1980 and 2017 in any language. In all, 40 articles concerned firefighters exposed to routine work-related PTE. We report that strong evidence exists to suggest that the prevalence of posttraumatic stress disorder and depression is elevated in firefighters compared with the general population of Canada, whereas moderate evidence exists for the elevated prevalence of anxiety disorders. However, measurement tool is a substantial source of variability in prevalence estimates across the literature, and few predictive factors bear consistent relationships to posttraumatic stress disorder across samples. Future work should focus on measurement variance and examine possible interactions between commonly assessed predictive factors for disorder risk in firefighters.