Background: Paramedics work in high-pressure environments and experience traumatic events, which contribute to high levels of occupational and post-traumatic stress. Such stress can result in alcohol and substance misuse in other health professionals, but this relationship has not been examined in paramedics. This review is the first exploration of the literature on this. Methods: A systematic literature review was conducted using PRISMA guidelines, with databases searched using terms relevant to paramedics and alcohol/substance use. Studies were analysed using descriptive statistics for quantitative data and thematic analysis for qualitative information. Findings: Eleven studies were identified. Nine studies examined alcohol use; seven examined substance use; five examined both. Alcohol and smoking may be linked to occupational stress. Conclusions: The nature and extent of alcohol and substance use in relation to occupational and post-traumatic stress among paramedics need further investigation to facilitate advice and support.

Background: Paramedics undertake visually demanding tasks, which may be adversely affected by low lighting conditions. Aims: The study aimed to: identify difficulties paramedics experience carrying out tasks in low light; and establish occupational health standards and adjustments that may improve working practices. Methods: A scoping review was undertaken informed by a professional panel of paramedics recruited through social media. A meta-analysis was conducted assessing visual acuity under different light levels. Findings: Difficulty in driving and in assessing/treating patients under low light conditions were reported. Sixty relevant studies were identified for review. Visual acuity reduces with decreasing luminance, causing increasing difficulties in performing critical tasks. Conclusion: Visual function testing can assess paramedics' visual health and ability to undertake critical tasks. Adjustments may help to improve conditions. Regular occupational health assessments could identify paramedics who need support. Further research should explore levels of visual function and practical adjustments needed for safe clinical practice.