Why was the study done?
Like all public safety personnel (PSP), firefighters experience dangerous and stressful situations regularly in their jobs. This experience can lead to an increased risk of physical and mental health issues. It is not just the situations they face on the job that can affect them; organizational and other occupational stressors like shift work can also impact health.
Job-related psychosocial stressors are a combination of work events and the characteristics of the work (e.g., organization structure or job duties) that affect individuals by applying mental and emotional strain.
By reviewing the existing literature, the researchers aimed to answer the question, “What health outcomes are associated with the job-related psychosocial stressors typically experienced in the fire service?”
What was done in the study?
A detailed review of the existing literature was conducted, looking specifically for articles featuring firefighters, which appeared in English and measured psychosocial stress and at least one health outcome. After review, 29 studies met the inclusion criteria. The studies came from Asia, North America, South America, and Europe. Most of the studies used different measures, so direct comparisons were not possible, but general trends were observable.
What did we find out?
- From the 29 articles, researchers identified six major groups of health outcomes influenced by psychosocial stressors: depression-suicidality, non-depressive mental health issues, burnout, alcohol-use disorders, sleep quality, and physiological disorders.
- Studies looking at depression and psychosocial stressors found that increased psychosocial stress increased the likelihood that firefighters would experience depressive symptoms.
- Increased psychosocial stress was related to increased suicidal thoughts and behaviours.
- The researchers also saw several associations with non-depressive mental health symptoms:
- workplace discrimination and harassment increased the frequency and severity of anxiety symptoms;
- work relationship conflicts increased work-related anxiety;
- workplace demands and a perceived level of influence of the employee predicated mental health symptoms; and
- higher levels of perceived job stress were associated with increased incidents of self-reported PTSD.
- Increased job stress and strain were linked to increased burnout.
- Increased job stress predicted an increase in firefighters’ likelihood to abuse alcohol.
- Results were mixed on the relationship between job-related psychosocial stress and sleep quality. Most studies found that increased psychosocial stress did not predict poor sleep quality.
- Three physiological outcomes were found:
- increased blood pressure in those who thought their work had grown more demanding;
- overall increased job-related stress elevated the risk of musculoskeletal problems like lower-back pain; and
- firefighters who experienced a lack of rewards and interpersonal conflict had an increased risk for gastrointestinal disorders.
- Studies showed that firefighters with better resilience were better able to cope with job-related psychosocial stressors.
Where do we go from here?
The review results are limited to the available English-language studies and the methods they used. However, the research does show evidence for a relationship between job-related psychosocial stressors and mental and physical health. The reviewers suggest that future research use an acceptable standardized measure to assess psychosocial stress in firefighters to allow for better comparisons across studies. These results add to a growing body of research that suggests work-related stressors play an important role in developing a variety of health outcomes and behaviours. The current study also highlights the importance of promoting and preserving resilience.
The original wording of the study was changed and condensed for the current research summary.
Igboanugo, S., Bigelow, P.L., & Mielke, J.G. (2021). Health outcomes of psychosocial stress within firefighters: A systematic review of the research landscape. Journal of Occupational Health, 63(1) e12219. https://onlinelibrary.wiley.com/doi/10.1002/1348-9585.12219
Summary prepared by Kossick, E. Edited & reviewed by Barootes, B., & Mielke, J.G.