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Work-related posttraumatic stress disorder (PTSD) and other emotional diseases as consequence of traumatic events in public transportation: a systematic review

  • Review Article
  • Published:
International Archives of Occupational and Environmental Health Aims and scope Submit manuscript

Abstract

Background

Drivers in public transportation are at risk of experiencing potential traumatic events such as accidents involving persons, collisions, or suicides. In this context, the question arises to what extent psychological traumatization and posttraumatic diseases occur.

Purpose

The aim of this systematic review was to describe the frequency and nature of work-related posttraumatic disorders, to analyze risk and prognostic factors after potentially traumatic events (accidents resulting in damage to property and/or in injury or death), and address sick leave after such events in the realm of public transportation, based on the available literature.

Methods

Systematic review based on four databases (PubMed, PSYNDEX/MEDLINE, ScienceDirect, PILOTS) between 1980 and June 2013.

Results

We identified seven studies (four longitudinal, three cross-sectional) that examine employees after person under train (PUT) events. PTSD prevalences varied broadly between 0.7 and 17 %. The same applies to dysthymia/neurotic depression (1–26 %). However, similarly low prevalences of major depression (1.3–2.8 %) and panic disorder (0.5–1.3 %) have been observed. Risk factors of PTSD comprised individual, work-related, event-related, and prognostic aspects. Following the traumatic event, a total of 69–81 % of the drivers were absent, and if sick leave occurs, this was on average 3–19 days.

Conclusions

It became evident that drivers in public transportation run a high risk of sick leave. It was also striking that despite the immense impact of PUT and high number of suicides, only an infinitesimal number of studies exists. Due to various differences (period of follow-up, instrument of measurement and study period), it turned out that the comparability of the results of the studies is limited. For various reasons, further research is urgently needed, as from an occupational health point of view the issue of posttraumatic diseases and implications for fitness for service should be addressed.

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Acknowledgments

This review was supported through financial means provided by the Deutsche Gesetzliche Unfallversicherung (DGUV). Furthermore, funds were provided in the form of a scholarship granted by the Hanns Seidel Foundation from financial means provided by the German Federal Ministry for Education and Research. The present work was performed in partial fulfillment of the requirements for obtaining the degree Dr. rer. biol. hum. The authors also would like to thank PD Dr. Katharina Luthenberger for her appreciated and most helpful comments and recommendations.

Conflict of interest

The authors declare that they have no conflict of interest pertaining to the research subject.

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Authors and Affiliations

  1. Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany

    Annika Clarner, Johanna Scholz & Hans Drexler

  2. Center of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany

    Elmar Graessel

  3. Institute of Political Science, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany

    Alexander Niedermeier

  4. Department of Medical Informatics, Biometry and Epidemiology Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany

    Wolfgang Uter

Authors
  1. Annika Clarner
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  2. Elmar Graessel
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  3. Johanna Scholz
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  4. Alexander Niedermeier
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  5. Wolfgang Uter
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  6. Hans Drexler
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Correspondence to Annika Clarner.

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Clarner, A., Graessel, E., Scholz, J. et al. Work-related posttraumatic stress disorder (PTSD) and other emotional diseases as consequence of traumatic events in public transportation: a systematic review. Int Arch Occup Environ Health 88, 549–564 (2015). https://doi.org/10.1007/s00420-014-0980-3

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  • DOI: https://doi.org/10.1007/s00420-014-0980-3

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