Work and nonwork stressors, negative affective states, and pain complaints among firefighters and paramedics

Abstract

Prior research has suggested that occupational stressors may contribute to the etiology, progression, and chronicity of pain problems in workers. This study used anonymous survey methods to assess the prevalence and frequency of selfreported pain symptoms and their relationships to demographic variables, sources of occupational stressors, nonwork stressors attd affective distress in a large sample (N -~ 2000) of employed career public sector firefighters and paramedics. The findings were consistent with those of previous studies of high strain workers. More than 95% of the firefighter/paramedic sample reported at least one pain complaint (using a 1 week assessment time frame). A hierarchical multiple regression analysis entering demographic, occupational, and nonwork stressors, as 224Beaton, Murphy, and Pike INTRODUCTIONEvidence from a 1991 survey of American companies indicated that U.S. workers were plagued by job stress-related illnesses including muscle pain, headaches, and painful gastrointestinal disorders (NWNL, 1991). The results of two recent studies of blue-collar plant employees showed that psychological distress and job task dissatisfaction predicted future low back and other musculoskeletal pain problems (Leino & Magni, 1993; Bigos, Battie, Fisher, Fordyce, Hansson, Nachemson, & Spengler, 1990). However, there are apparently no published epidemiological data identifying the frequency or prevalence of pain complaints, nor their associations with job-related stressors and distress, in two closely aligned, high strain occupational groups: namely, professional firefighters and paramedics. Yet, if such data were available, preventive, and remedial stress management strategies could be designed and implemented.Mitchell and Bray (1990) considered muscle aches, headaches, and upset stomach to be common signs/symptoms of a cumulative emergency services stress reaction "... caused by a combination of a wide range of work and nonwork stressors" (p.52). Recent data supportive of the claims of Mitchell and Bray indicate that musculoskeletal sprains and strains account for nearly half of the line-of-duty injuries in firefighters and that on-the-job "back injury" alone accounts for nearly one-third of all premature disability retirements in firefighters (IAFF, 1992). Pain syndromes, even when they are not disabling, can adversely affect an individual's quality of life and social functioning (Kerns & Jacob, 1992). If pain impairs communication in firefighters and paramedics, the effects may be dire since team work and reliance upon one another are required in "time urgent" life and death situations.The theoretical framework adopted for this investigation was the multidimensional processional systems model developed by Hurrell (1987) and other researchers at the National Institute for Occupational Safety and Health (NIOSH). The model consists of six major interrelated domains: job stressors, individual factors, nonwork factors, buffer factors, acute reaction, and illness as the outcome. The NIOSH model postulates...

Occupational Risk Factors in the Emergency Medical Services

“…A number of occupationally related stressors have been identified as significant in EMS. [49][50][51] These occupationally related stressors fall broadly into two conceptual categories: (1) chronic stressors; and (2) critical incident stressors. Chronic stress, as defined by Pearlin, encompasses "relatively enduring problems, conflicts and threats that many people face in their daily lives".…”

Predictors of posttraumatic stress and preferred sources of social support among Canadian paramedics

“…2,4,7,8 Additional stressors associated with the provision of care include the risks of exposure to blood-borne pathogens, 9-11 verbal or physical violence, 7,12,13 and injury or death from vehicle-related crashes. [14][15][16] To a lesser extent, other research efforts have found that paramedics may also experience chronic work-related stressors, including insufficient salaries, 17,18 conflict with administrators, 17,19,20 lack of support from or conflict with colleagues, 2,3,5,[17][18][19][20][21] and interference with nonwork-related activities. 3,5,17,21 Exposure to work-related stressors has been linked to stress reactions, most frequently to posttraumatic stress.…”

“…[14][15][16] To a lesser extent, other research efforts have found that paramedics may also experience chronic work-related stressors, including insufficient salaries, 17,18 conflict with administrators, 17,19,20 lack of support from or conflict with colleagues, 2,3,5,[17][18][19][20][21] and interference with nonwork-related activities. 3,5,17,21 Exposure to work-related stressors has been linked to stress reactions, most frequently to posttraumatic stress. 1,3,5,6,18,[22][23][24][25][26][27][28][29] Most research in this area has focused on the link between critical incident stress and posttraumatic stress symptomatology (PTSS).…”

Development of the Emergency Medical Services Role Identity Scale (EMS-RIS)

“…These risks may include direct threats to the safety of the responder (e.g., assault, back injury, car accident, exposure to blood borne pathogens), as well as the secondary exposure to the injury or illness of their patients (e.g., the death of a child, a mass casualty incident, responding friends or family) (Alexander & Klein, 2001;Becker, Zaloshnja, Levick, Li, & Miller, 2003;Boal, Hales, & Ross, 2005;Boyle, Koritsas, Coles, & Stanley, 2007;Brough, 2005;Sterud, Ekeberg, & Hem, 2006). In addition to direct and indirect threats to safety, responders face chronic work stresses, including long work hours, inadequate pay, sleep deprivation, and conflict with administration and colleagues (Beaton, Murphy, & Pike, 1996;Nirel, Goldwag, Feigenberg, Abadi, & Halpern, 2008;Patterson, et al, 2011;van der Ploeg & Kleber, 2003;Young & Cooper, 1997).…”