Workplace Trauma Research Articles

Book ReviewThe Hidden Psychology of Pain: The Use of Understanding to Heal Chronic PainHealing the Folks Who Live Inside: How EMDR Can Heal Our Inner Gallery of RolesUnlocking the Emotional Brain: Eliminating Symptoms at Their Roots Using Memory ReconsolidationHandbook of Child Sexual Abuse: Identification, Assessment, and TreatmentDefining and Redefining EMDR: New Clinical StrategiesInternational Handbook of Workplace Trauma SupportThe Rite of

Book ReviewThe Hidden Psychology of Pain: The Use of Understanding to Heal Chronic PainHealing the Folks Who Live Inside: How EMDR Can Heal Our Inner Gallery of RolesUnlocking the Emotional Brain: Eliminating Symptoms at Their Roots Using Memory ReconsolidationHandbook of Child Sexual Abuse: Identification, Assessment, and TreatmentDefining and Redefining EMDR: New Clinical StrategiesInternational Handbook of Workplace Trauma SupportThe Rite of

Organizational Outcomes Following Traumatic Workplace Incidents: A Practice-Based Exploration of Impact of Incident Severity Level

Traumatic workplace events (critical incidents) occur with unfortunate regularity and with significant repercussions for affected organizations. Critical incident stress management (CISM) units, often a specialty component of employee assistance programs, provide consultation and support for workplace incidents. While CISM seeks to support both individual and organizational outcomes, trauma research oriented toward individual traumatic stress dominates the literature, mirroring practitioner training that tends to emphasize clinical over organizational practice. This research contributes to less-prevalent studies that explore organizational-level outcomes. Despite the facts that social workers play a central role in critical incident response and CISM units collect massive amounts of practice data, there are no published social work studies capitalizing on the potential of existing critical incident data. Employing the methodology of clinical data mining, this practice-based, exploratory research examines the propositions that incident severity level associates with several post-incident organizational outcomes. Several findings translate into considerations for evidence-informed CISM practice in the areas of intake assessment, organizational consultation, and incident response planning.

Symptoms of Posttraumatic Stress among Child Welfare Workers Who Experience a Maltreatment Fatality on their Caseload

Annually, 1,000–2,000 child welfare workers experience the death of a child client. The child welfare field has paid increasing attention to the impact of workplace trauma events on the psychological distress of child welfare workers. In this article the author assesses the relationship between experiencing a maltreatment fatality and workers' posttraumatic stress among a multi-state sample of 385 child welfare workers. Results indicate that a maltreatment fatality is not associated with higher rates of posttraumatic stress. Among child welfare workers who experienced a fatality, those who feel greater culpability for the death report higher levels of posttraumatic stress. Implications for future research and practice are discussed.

Is humor the best medicine? The buffering effect of coping humor on traumatic stressors in firefighters

SummaryAlthough our understanding of workplace stressors has grown across the past 30 years, this research has generally ignored traumatic workplace stressors. This is a serious omission, given that many occupations (e.g., firefighters, emergency medical technicians, and police) are frequently exposed to traumatic stressors. As such, the first purpose of the current study was to examine the impact of exposure to traumatic stressors in firefighters. Post‐traumatic stress disorder (PTSD), burnout, and absenteeism were investigated as cognitive, affective, and behavioral outcomes. Additionally, we sought to investigate coping humor as a mechanism for dealing with traumatic stressors. We frame these expectations by discussing humor from a transactional theory of emotion/coping perspective, as well as through humor's social bonding feature and its ability to combat the physiological impact of stressors. We surveyed 179 firefighters at two time points on relevant variables, with dependent variables collected at Time 2. The results indicated that traumatic events significantly predicted burnout, PTSD, and absenteeism and that coping humor buffered this relationship for burnout and PTSD. We discuss the implications of these findings and call for more research investigating occupations in which traumatic stressors are a concern, as well as for more integration of humor into the workplace literature. Copyright © 2013 John Wiley & Sons, Ltd.

International handbook of workplace trauma support

International handbook of workplace trauma support

Launch of Mental Health Support to the Fukushima Daiichi Nuclear Power Plant Workers

Launch of Mental Health Support to the Fukushima Daiichi Nuclear Power Plant Workers

Predictors of mortality following severe pelvic ring fracture: Results of a population-based study

Introduction Traumatic disruption of the pelvic ring is uncommon but is associated with a high risk of mortality. These injuries are predominantly due to high energy blunt trauma such as a fall from height, road or workplace trauma, and severe associated injuries are prevalent, increasing the complexity of managing this patient group. The aim of this population-based study was to investigate predictors of mortality following severe pelvic ring fractures managed in an inclusive, regionalised trauma system. Methods Cases aged ≥ 15 years from 1st July 2001 to 30th June 2008 were extracted from the population-based statewide Victorian State Trauma Registry for analysis. Patient demographic, prehospital and admission characteristics were considered as potential predictors of mortality. Multivariate logistic regression was used to identify predictors of mortality with adjusted odds ratios (AOR) and 95% confidence intervals (CI) calculated. Results There were 348 cases over the 8-year period. The mortality rate was 19%. Patients aged ≥ 65 years were at higher odds of mortality (AOR 7.6, 95% CI: 2.8, 20.4) than patients aged 15–34 years. Patients hypotensive at the scene (AOR 5.5, 95% CI: 2.3, 13.2), and on arrival at the definitive hospital of care (AOR 3.7, 955 CI: 1.7, 8.0), were more likely to die than patients without hypotension. The presence of a severe chest injury was associated with an increased odds of mortality (AOR 2.8, 95% CI: 1.3, 6.1), whilst patients injured in intentional events were also more likely to die than patients involved in unintentional events (AOR 4.9, 95% CI: 1.6, 15.6). There was no association between the hospital of definitive management and mortality after adjustment for other variables, despite differences in the protocols for managing these patients at the major trauma services (Level 1 trauma centres). Conclusions The findings highlight the importance of effective control of haemodynamic instability for reducing the risk of mortality. As most patients survive these injuries, further research should focus on long term morbidity and the impact of different treatment approaches.

Transplantation of Olfactory Ensheathing Cells as Adjunct Cell Therapy for Peripheral Nerve Injury

Traumatic events, such as work place trauma or motor vehicle accident violence, result in a significant number of severe peripheral nerve lesions, including nerve crush and nerve disruption defects. Transplantation of myelin-forming cells, such as Schwann cells (SCs) or olfactory ensheathing cells (OECs), may be beneficial to the regenerative process because the applied cells could mediate neurotrophic and neuroprotective effects by secretion of chemokines. Moreover, myelin-forming cells are capable of bridging the repair site by establishing an environment permissive to axonal regeneration. The cell types that are subject to intense investigation include SCs and OECs either derived from the olfactory bulb or the olfactory mucosa, stromal cells from bone marrow (mesenchymal stem cells, MSCs), and adipose tissue-derived cells. OECs reside in the peripheral and central nervous system and have been suggested to display unique regenerative properties. However, so far OECs were mainly used in experimental studies to foster central regeneration and it was not until recently that their regeneration-promoting activity for the peripheral nervous system was recognized. In the present review, we summarize recent experimental evidence regarding the regenerative effects of OECs applied to the peripheral nervous system that may be relevant to design novel autologous cell transplantation therapies.

A descriptive study of a specialized worker's psychological trauma program

Psychological trauma in the workplace is gaining recognition as an important cause of workplace disability but little is known about the workers who are affected. The Psychological Trauma Program (PTP) in Toronto (Canada) is a specialized provincial worker's compensation board assessment program for workers with psychological sequelae of workplace trauma. To characterize workers presenting to the PTP in terms of demographic, occupational, traumatic exposure and diagnostic variables. A retrospective secondary analysis of all workers referred to the PTP for assessment within 1 year of traumatic event between 1999 and 2006. Five hundred and thiry-one referred workers were included in the study. Most workers were working-age male (76%), married (65%) and labourers (43%). Nearly half were born outside Canada. Post-traumatic stress disorder was the primary diagnosis in 44%. Fifty-eight percent had one or more secondary diagnoses. For just over half of the workers, the traumatic event resulted in a permanent physical impairment. Specialist referral may be indicated for workers experiencing prolonged recovery following workplace trauma. Male workers and those with co-morbidities or permanent injuries may be more likely to require referral. Individualized treatment approaches are likely important; however, more research is needed to guide future interventions.

Identifying PTSD personality subtypes in a workplace trauma sample

The authors sought to identify personality clusters derived from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Personality Psychopathology Five Scales in a sample of workplace claimants with posttraumatic stress disorder (PTSD). Three clusters--low pathology, internalizing, and externalizing were recovered similar to those obtained by M. W. Miller and colleagues (2003, 2004, 2007) in samples of combat veterans and sexual assault victims. Internalizers and externalizers scored comparably on measures of PTSD symptom severity, general distress, and negative affect. Internalizers were uniquely characterized by anhedonia and depressed mood; externalizers by antisocial behavior, substance abuse, and anger/aggression.

EMDR Treatment of Workplace Trauma A Case Series

Violence and aggression in the workplace is an increasing international concern. No studies have yet determined the most efficacious psychotherapeutic strategies to alleviate the consequences of workplace violence, and none have identified interventions that might fortify workers who are repeatedly exposed to danger. This case series describes the eye movement desensitization and reprocessing (EMDR) treatment of seven bank employees and one transportation worker who suffered repeated acute traumatization. The Impact of Events Scale, the Post-Traumatic Stress Syndrome 10-Questions Inventory, and the Beck Depression Inventory were used to measure changes in symptom severity. Results showed that EMDR effectively reduced symptoms and may provide a possible protective buffer in situations of ongoing workplace violence.

Suicidality among police

This paper reviews recent international literature on suicide among police officers. Research examining the incidence and prevalence of suicide and suicidality among police, particularly the extent to which they constitute a high-risk group, has produced conflicting results. Police appear to be at greater risk of posttraumatic stress reactions (resulting from higher exposures to trauma) and job burnout (resulting from the way in which police work is organized), both of which increase the risk of psychosocial problems and suicide. Though worker suicide is the result of a complex interaction of personal vulnerabilities, workplace stressors, and environmental factors, research into police suicide has largely emphasized only two of these components: workplace trauma as a determinant of posttraumatic stress reactions; and organizational stressors as a determinant of job stress and burnout. Personality factors and coping styles have received less attention and there have been few attempts to understand the complex interactions between all of these factors. Prevention strategies have focused on psychological debriefing for traumatic incidents and organizational change designed to improve job commitment and reduce job burnout.

Association between Body Mass Index and Acute Traumatic Workplace Injury in Hourly Manufacturing Employees

In this study, the authors examined the distribution and odds of occupational injury among hourly employees of a US aluminum manufacturing company by body mass index (weight (kg)/height (m)(2)). In 2002, height and weight data on 7,690 workers at eight plants were extracted from medical records from annual physicals, and body mass index was categorized. Information on traumatic injuries recorded between January 1, 2002, and December 31, 2004, was obtained from a company injury surveillance system. Twenty-nine percent of the employees (n = 2,221) sustained at least one injury. Approximately 85 percent of injured workers were classified as overweight or obese. The odds of injury in the highest obesity group as compared with the ideal body mass index group were 2.21 (95% confidence interval: 1.34, 3.53), after adjustment for sex, age, education, smoking, physical demands of the job, plant process and location, time since hire, time in the job, and significant interaction terms. Injuries to the leg or knee were especially prevalent among members of this very obese group. Research findings support an association between body mass index and traumatic workplace injuries among manufacturing employees. Workplace safety personnel might consider adding policies or programs that address weight reduction and maintenance as part of ongoing comprehensive workplace safety strategies.

Resiliency in the Aftermath of Repetitious Violence in the Workplace

Summary The definition and occurrence of traumatic events is expanding and impacts everyone's lives in some way. The degree to which a violent event impacts an individual, a group, a workplace or the community varies. Unfortunately violent events are all too common. Businesses are realizing the significance of violence as a workplace problem and the varying degrees of trauma that has a devastating impact on employee retention, workplace functionality and personal well-being. The events can include industrial or natural disasters; worksite accidents; organizational changes; suicide; homicides; robbery; assault; threats of violence and even terrorism. How prepared an organization is varies and may be correlated with how resilient individuals and the entire workplace are after workplace violence/trauma. This article focuses on what workplace violence and trauma includes, the effects of repeat events, how resilient people are while trying to prevent additional events if possible in the workplace.

Work-Related Trauma Effects in Child Protection Social Workers

Child welfare workers are exposed to a variety of workplace events that could overwhelm them. This study examined whether negative workplace events were associated with workplace trauma effects amongst child welfare workers, and considered whether job support or job satisfaction moderated the influence of events on effects. Vicarious events were more highly associated with trauma effects (r = 0.54, p < 0.000) than were direct events (r = 0.28, p < 0.000), and neither job support nor job satisfaction moderated the relationship. Workplace trauma events accounted for substantial variability in workplace trauma effects (R2 = 0.344) in the final regression model tested. The discussion addresses opportunities for increasing worker safety, methods for supporting workers in managing negative effects and implications for future research.

How Much Work-Related Injury and Illness is Missed By the Current National Surveillance System?

We sought to estimate the undercount in the existing national surveillance system of occupational injuries and illnesses. Adhering to the strict confidentiality rules of the U.S. Bureau of Labor Statistics, we matched the companies and individuals who reported work-related injuries and illnesses to the Bureau in 1999, 2000, and 2001 in Michigan with companies and individuals reported in four other Michigan data bases, workers' compensation, OSHA Annual Survey, OSHA Integrated Management Information System, and the Occupational Disease Report. We performed capture-recapture analysis to estimate the number of cases missed by the combined systems. We calculated that the current national surveillance system did not include 61% and with capture-recapture analysis up to 68% of the work-related injuries and illnesses that occurred annually in Michigan. This was true for injuries alone, 60% and 67%, and illnesses alone 66% and 69%, respectively. The current national system for work-related injuries and illnesses markedly underestimates the magnitude of these conditions. A more comprehensive system, such as the one developed for traumatic workplace fatalities, that is not solely dependent on employer based data sources is needed to better guide decision-making and evaluation of public health programs to reduce work-related conditions.

Workplace Trauma Concepts, Assessment and Intervention

Workplace Trauma Concepts, Assessment and Intervention

A model of care for managing traumatic psychological injury in a workers' compensation context

Work-related traumatic psychological injuries are a significant health problem that can result in distress and disability. To improve outcomes following a workplace trauma, the Workers' Compensation Board of Alberta (WCB-AB) has developed and implemented an evidence-based care model (CM) to assist its staff to manage these claims. A CM acts as a disability management "road map" that illustrates typical recovery patterns, treatment best practices, and checkpoints where decisions for further service provision can be made. The model was developed from a recent literature review, and the opinions of local and international experts in the field of traumatic psychological injury. A formal evaluation of the effectiveness of this model is being planned.

Chapter 12: Wells Fargo's Employee Assistance Consulting Model

Wells Fargo and Company's Employee Assistance Consulting (EAC) is an established and successful internal corporate-based EAP that delivers organizationally congruent services to a diversified financial services company with 80+ businesses and over 146,000 team members. While some elements of traditional EAPs are evident in the services provided by this entity, EAC also provides highly specialized and customized consultations to its corporate partners, business group customers and employees. Using a highly integrated service model that aligns closely with the specific strategy and operations of each Wells Fargo business, EAC is an invited guest at many of the company's most influential tables. EAC collaboratively partners with senior and line management, Human Resources, the Employment Law Department, Disability Management (called WorkAbility at Wells Fargo) and Risk Management, Corporate Benefits, Corporate Security, Learning and Development, and others to provide leadership and organizational influence on such wide ranging issues as threat assessment and management, business incident management, workplace trauma, health and productivity, and organizational and employee effectiveness. This article describes proven methods and strategies for maximizing organizational influence and positioning EAP consultants as effective business partners.

Occupational Injury Risk Assessment: An Unintended and Unanticipated Consequence of the Red Book

The authors of the National Research Council's report Risk Assessment in the Federal Government: Managing the Process, called the “Red Book,” included reference to “other hazards” and “other Federal programs to reduce health risks.” With the focus on chemicals and cancer, the authors probably never considered that the risk assessment and risk management processes that they debated would find application in evaluating traumatic workplace injuries to reduce disability and death on the job. The severity of the consequences of workplace hazards, which are mostly immediate and do not have the long latency associated with cancer, is a significant public health risk. Quantitative risk assessment, to determine the incremental effects of additional exposure, also plays an important role in the workplace. This paper discusses these issues and reviews some of the important papers that explain occupational injury risk assessment and its applicability to risk management.