Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers
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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.
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.
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.
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.
KeywordsPosttraumatic stress disorder Prevalence Rescue workers Disaster Meta-analysis
This work was supported by CNPq (Nacional Research Council)—Federal Government of Brazil, FAPERJ—Programa de Apoio às Instituições de Ensino e Pesquisa (Projeto E-6/110.324/2007), and Confederação Nacional do Comércio de Bens, Serviços e Turismo (CNC). Drs. Berger, Coutinho, Figueira and Mendlowicz were partially supported by grants from CNPq. Dr. Marmar was partially supported by grant R01-MH056350-06 from the National Institute of Mental Health. Dr. Neylan was partially supported by the NIMH grants: MH057157 and MH73978.
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