Journal of Public Health Policy

, Volume 30, Issue 3, pp 311–327 | Cite as

The impact of traumatic stressors in civilian occupational settings

  • Alexander C McFarlane
  • Penny Williamson
  • Christopher A BartonEmail author
Original Article


We use the literature reporting prevalence and aetiology of post-traumatic stress disorder (PTSD) in first responders as a catalyst to discuss for organisations the policy implications for prevention and intervention of psychiatric morbidity. We searched PubMed and Google to identify studies and reports of mental health and behavioural problems in occupations including police, fire, and emergency service workers. The prevalence of PTSD ranged from 6 per cent to 32 per cent. Biological markers of PTSD, such as neuroendocrine activity, appear less useful than psychological markers, such as levels of hostility and self-efficacy, to predict PTSD. Prevalence of PTSD was generally less than that found among victims themselves, but higher than general community prevalence. Theoretically, if prevention and intervention strategies were working effectively, there should be a minimal rate of psychiatric morbidity attributable to these individuals’ workplaces. Against this background, there is a case for routine screening on an annual basis for those at risk.


first responders emergency service worker healthy worker effect post-traumatic stress disorder 



The review presented here was adapted from a general literature review conducted as part of the planning process for the Defence Deployed Middle East Area of Operations Health Study funded by the Australian Government Department of Defence. Other than by the funds given to conduct the review, the content of the review has not been directed or influenced by the Department of Defence. The support of the National Health and Medical Research Grant Program grant number 300 403 is also acknowledged.


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Copyright information

© Palgrave Macmillan 2009

Authors and Affiliations

  • Alexander C McFarlane
    • 1
  • Penny Williamson
    • 1
  • Christopher A Barton
    • 1
    Email author
  1. 1.Centre for Military and Veterans’ Health, School of Population Health and Clinical Practice, The University of AdelaideAdelaideAustralia

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