The aims of this study were: (1) to document baseline prevalence and incidence (new cases) of post-traumatic, other stress related symptomatology, and alcohol use in urban fire fighters over a three-year time frame; (2) to describe and document the frequency and intensity of urban fire fighters' exposure to duty-related trauma, i.e. medical, fire and other incidents (e.g. hazardous materials), by reviewing and objectively assessing Fire Department emergency medical and fire incident reports; (3) to determine the effect of traumatic incident exposures on the incidence of post-traumatic, symptomatology, and alcohol use in urban fire fighters over a three-year time frame; (4) to determine the interrelationships of appraised sources of non-traumatic occupation and non-work stressors in fire fighters with duty-related exposure to traumatic events across time in terms of specified adverse health outcomes; and (5) to identify pre-existing moderator and mediating variables that affect the relationships between predictor exposure and appraisal variables and the specified adverse (secondary traumatic stress) health outcomes across time. Perhaps one of the most significant findings of this surveillance investigation of stress-related disorders in urban firefighters was the documented elevated prevalence(s) of posttraumatic stress disorder (PTSD). The prevalence of PTSD, based on a caseness criteria derived from a valid, reliable self-report inventory, was in excess of20% in the sample of U.S. firefighters who participated in this investigation. Thus, the study sample PTSD prevalence rate was approximately 15-20 times that of a comparison male community sample, and these community comparison data were also collected in North America in the 1990's. The PTSD rate documented for this sample was even greater than that reported for wounded Vietnam combat veterans, and higher than published prevalence rates reported for any other occupational groups. The annual incidence (new cases) of PTSD in this sample was also quite high (> 10%). A number of distinctive patterns of PTSD were also observed in the U.S. firefighter sample (over an 18 month time frame) including long-term chronic (>1 year), mid-range chronic (>6months<1 year), "cyclers," acute (and acute-resolved). Based on the firefighter sample participants, it seems likely that a majority of U.S. urban firefighters currently have, or will experience at sometime during their career, clinically significant post-traumatic stress symptomatology.
University of Washington, School of Nursing, PO Box 357263, Seattle, WA 98195-7263
University of Washington, School of Nursing, Seattle, Washington