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

Occupational exposure and post-traumatic stress disorder: A rapid review

BACKGROUND

Post-Traumatic Stress Disorder (PTSD) can result from occupational exposures and poses a considerable burden to workers, their families, workplaces and to society in general.

OBJECTIVE

Our objective was to conduct a rapid review of the literature to answer the question: "Which occupations have exposures that may lead to a PTSD diagnosis?"

METHODS

A rapid review was conducted in six steps: review question development, literature search, study selection (inclusion/exclusion), study characterization, data extraction, and data synthesis.

RESULTS

The search identified 3428 unique references which were reviewed to find 16 relevant studies in 23 articles. The articles revealed associations between PTSD and rescue workers (police, firefighters, etc.), health care professionals, transit drivers, and bank employees which seem well supported by the literature. Some studies also suggest potential associations with PTSD and construction and extraction, electricians, manufacturing, installation, maintenance and repair, transportation and material moving, and clerical workers.

CONCLUSIONS

A rapid review of the peer-reviewed scientific literature of PTSD prevalence or treatment suggests many occupations have exposures that could be associated with PTSD. Occupational traumatic events were most often associated with PTSD diagnosis. More research is needed to better understand the association between occupation and PTSD.

"Dual causation accident": a third type of work-related accident and its importance for occupational health surveillance

The scope of this study is to contribute to the improvement of Occupational Health Surveillance in the Unified Health System (UHS), through the recognition and inclusion of a third type of work-related accident in the current Brazilian legislation classification: the dual causation accident. This classification aims at facilitating the establishment of a causal connection, thus broadening the understanding of the relationship between work process and the production of diseases. It also aims at improving legal rules to protect the health of workers. This approach, besides enabling the identification of sentinel events (starting point of surveillance activities), might contribute not only to a decrease in underreporting of work-related accidents, but also to the uniformity of concepts and the implementation of integrated actions of the National Social Security Institute (NISS), the UHS, the Ministry of Labor (MLE) and the Judiciary for the protection of workers. To propose a third type of occupational accident, a study of occupational accidents and causes of underreporting was conducted, with reference to the Brazilian labor legislation in the context of the National Policy on Occupational Health and the UHS.

Work related injury among aging women

This article reports the experiences of women aged 55 to 75 with mobility impairments who attributed aspects of their limitations to workplace injuries and provides insight into worker's compensation policies. The study sample includes Mexican American (MA) and non-Hispanic White (NHW) women aged 55 to 75 who participated in a 4-year ethnographic study of disablement. Ninety-two of the 122 participants in the study attributed aspects of their functional limitations to employment, and their experiences were analyzed using data from 354 meetings. Using Lipscomb and colleagues' conceptual model of work and health disparities, the women's experiences were grouped into three categories according to type of injury, assistance gained, and the consequences of a workplace injury; the results have broad implications for policies that influence aging outcomes. Workplace injuries causing permanent functional limitations compound the effects of age and gender on employment outcomes. Policies addressing health disparities should consider work related influences.

Transtorno de estresse pós-traumático decorrente de acidente de trabalho: implicações psicológicas, socioeconômicas e jurídicas

Entre as possíveis consequências dos acidentes de trabalho ressalta-se que, embora os prejuízos físicos sejam mais facilmente percebidos, sintomas e transtornos psiquiátricos têm sido cada vez mais observados. Nesse contexto, o Transtorno de Estresse Pós-Traumático (TEPT) é um dos transtornos mais comuns, causando prejuízos para os trabalhadores e tendo grande impacto na sua qualidade de vida. O objetivo deste artigo foi apresentar uma revisão teórica sobre o TEPT decorrente de acidente de trabalho, bem como revisar as implicações psicológicas, sócio-econômicas e jurídicas desencadeadas pelo transtorno. A partir da revisão da literatura apresentada, fica evidente a repercussão do TEPT para a vida do indivíduo, com prejuízos significativos nas relações familiares, sociais e, sobretudo, no ambiente de trabalho. Finalmente, a discussão sobre o TEPT no contexto do trabalho suscita para a consideração em torno de diferentes eixos: prevenção, avaliação, tratamento e ressarcimento acerca dos prejuízos causados.

Factors associated with working status among workers assessed at a specialized worker's compensation board psychological trauma program

BACKGROUND

Psychological morbidity following trauma occurring in the workplace can impact return to work but few studies have investigated this.

METHODS

This study was a secondary analysis of administrative data from a specialized workers' compensation board psychological trauma program in Toronto, Canada. Unadjusted and adjusted logistic regression analyses were used to examine factors associated with working status at the time of assessment for workers referred within 1 year of traumatic event.

RESULTS

Having a disrupted marriage (OR = 3.06, 95% CI 1.14-8.20), sustaining a permanently impairing physical injury (OR = 2.76, 95% CI 1.01-7.55) and the presence of secondary psychiatric diagnoses (OR = 2.55, 95% CI 1.34-4.83) were significantly associated with not working at the time of assessment. When the analyses were subset to workers without permanently impairing physical injuries, only the presence of additional psychiatric diagnoses was significantly associated with not working (OR = 3.81, 95% CI 1.48-9.83).

CONCLUSIONS

Return to work after trauma can be a complicated and difficult to treat problem. Social supports, physical rehabilitation and treatment of complex mental health problems likely play a crucial role in improving outcomes.