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Occupational Medicine 2007 57(6):404-410; doi:10.1093/occmed/kqm070
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Post-traumatic stress disorder in occupational settings: anticipating and managing the risk

Alexander C. McFarlane1 and Richard A. Bryant2

1 Centre of Military and Veterans Health, University of Adelaide, 122 Frome Street, Adelaide, South Australia 5000, Australia
2 School of Psychology, University of New South Wales, Sydney NSW 2052, Australia

Background Post-traumatic stress disorder has had a substantial impact on employer liability for workplace psychological injury. The emergency services are an example of high-risk workforces that demand clear policies and procedures within an organization. The challenge is to minimize the injury to individuals and lessen the cost to organizations through the optimal application of preventative strategies.

Methods This field is not well represented in standard keyword searches and Medline was examined with linked fields of practice and research. Consensus guidelines that refer to this domain were also utilized. Few conclusions can be reached from the literature which directly examined occupational settings.

Results Organizations need to anticipate the possible traumatic exposures that may affect the workforce and have strategies to deal with the effects in the workplace, particularly the negative mental health outcomes in some personnel. This domain is relevant to all employers as accidents and violence are possible in most workplaces. Screening should be considered for high-risk individuals, particularly following a major traumatic event or cumulative exposure, such as in the emergency services. While psychological debriefing has no demonstrated benefit, the benefits of early intervention necessitate ready access to evidence-based treatments that have minimum barriers to care. Employers should be aware that distress may present indirectly in a similar way as conflict with management, poor performance and poor general health.

Conclusion The knowledge about the impact of traumatic events obliges employers to have an active strategy to anticipate and manage the aftermath of such events as well as cumulative traumatic exposures.

Keywords      Emergency services; introduction; occupation; prevention; PTSD; risk management; screening


Correspondence to: Alexander C. McFarlane, Centre of Military and Veterans Health, University of Adelaide, 122 Frome Street, Adelaide, South Australia 5000, Australia. Tel: +61 303 5200; fax: +61 303 5368; e-mail: alexander.mcfarlane{at}adelaide.edu.au


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