Social Psychiatry and Psychiatric Epidemiology

, Volume 47, Issue 6, pp 1001–1011 | Cite as

Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers

  • William Berger
  • Evandro Silva Freire Coutinho
  • Ivan Figueira
  • Carla Marques-Portella
  • Mariana Pires Luz
  • Thomas C. Neylan
  • Charles R. Marmar
  • Mauro Vitor Mendlowicz
Original Paper

Abstract

Purpose

We sought to estimate the pooled current prevalence of posttraumatic stress disorder (PTSD) among rescue workers and to determine the variables implicated in the heterogeneity observed among the prevalences of individual studies.

Methods

A systematic review covering studies reporting on the PTSD prevalence in rescue teams was conducted following four sequential steps: (1) research in specialized online databases, (2) review of abstracts and selection of studies, (3) review of reference list, and (4) contact with authors and experts. Prevalence data from all studies were pooled using random effects model. Multivariate meta-regression models were fitted to identify variables related to the prevalences heterogeneity.

Results

A total of 28 studies, reporting on 40 samples with 20,424 rescuers, were selected. The worldwide pooled current prevalence was 10%. Meta-regression modeling in studies carried out in the Asian continent had, on average, higher estimated prevalences than those from Europe, but not higher than the North American estimates. Studies of ambulance personnel also showed higher estimated PTSD prevalence than studies with firefighters and police officers.

Conclusions

Rescue workers in general have a pooled current prevalence of PTSD that is much higher than that of the general population. Ambulance personnel and rescuers from Asia may be more susceptible to PTSD. These results indicate the need for improving pre-employment strategies to select the most resilient individuals for rescue work, to implement continuous preventive measures for personnel, and to promote educational campaigns about PTSD and its therapeutic possibilities.

Keywords

Posttraumatic stress disorder Prevalence Rescue workers Disaster Meta-analysis 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • William Berger
    • 1
    • 2
    • 3
  • Evandro Silva Freire Coutinho
    • 4
  • Ivan Figueira
    • 1
  • Carla Marques-Portella
    • 1
  • Mariana Pires Luz
    • 1
  • Thomas C. Neylan
    • 2
    • 3
  • Charles R. Marmar
    • 2
    • 3
  • Mauro Vitor Mendlowicz
    • 1
    • 5
  1. 1.Institute of PsychiatryUniversidade Federal do Rio de Janeiro (IPUB-UFRJ)Rio de JaneiroBrazil
  2. 2.Department of PsychiatryUniversity of California, San Francisco (UCSF)San FranciscoUSA
  3. 3.San Francisco Department of Veterans Affairs Medical Center (DVAMC)Psychiatry ServiceSan FranciscoUSA
  4. 4.Department of EpidemiologyEscola Nacional de Saúde Pública (ENSP-FIOCRUZ)Rio de JaneiroBrazil
  5. 5.Department of Psychiatry and Mental HealthUniversidade Federal Fluminense (MSM-UFF)NiteróiBrazil

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