Transtorno de estresse pós-traumático (TEPT) em bombeiros de Belo Horizonte

Abstract

Introduction: Emergency professionals work in unpredictable environments that require quick responses aiming the effectiveness of care. The activities developed by these workers pose risks to their own lives and the lives of the victims. The nature of the tasks performed (operational stressors) and the organization of work (organizational stressors) can both lead to mental health problems, particularly in firefighters, focus of this study. Among mental health problems associated with operational and organizational stressors, Posttraumatic Stress Disorder (PTSD) is one of the most important. PTSD is also interrelated to other outcomes, including mood disorders (depression) and unhealthy life habits (smoking). Objectives: 1) to estimate the prevalence of PTSD, depression and smoking in firefighters of Belo Horizonte, Minas Gerais; and 2) to investigate the relationship between occupational stressors and the outcomes. Materials and Methods: Cross-sectional study was developed in the universe of firefighters of Belo Horizonte, Minas Gerais (n = 711). Information was obtained by self-administered structured questionnaire. The questions were clustered into the following blocks: sociodemographic characteristics, lifestyle habits, health status, exposure to adverse life events and job related information. Occupational stressors were measured by the Posttraumatic Diagnostic Scale tailored to emergency professionals (PDS-PE) and the Job Content Questionnaire (JCQ). Outcomes were assessed by self-report scales (Posttraumatic Stress Disorder Checklist - PCL - for PTSD symptoms, Beck Depression Inventory - BDI - for depression symptoms; single question for smoking) and analyzed using logistic regression. Results: Prevalences were: 1) 6.9% for PTSD, 5.5% for depression, 3) 7.6% for smoking. The logistic models indicated significant associations between: 1) operational stressors and PTSD; 2) operational stressors and smoking; 3) organizational stressors (high physical and psychological demands and low job control) and PTSD; 4) organizational stressors (low physical and psychological demands) and smoking. Conclusion: This study aimed to identify associations between occupational stressors, psychiatric disorders and unhealthy life habits in firefighters of Belo Horizonte, Minas Gerais. Initial hypotheses suggested high prevalences and direct associations between occupational stressors and outcomes. These hypotheses were supported for PTSD, but not for depression and smoking. PTSD was the only one with a higher prevalence compared with the general populations prevalence rate. Occupational stressors were directly associated with PTSD (operational and organizational) and smoking (operational). The relationship between organizational stressors and smoking was significant, but inverse (low physical and psychological demands). Conditions of employment and health selection (Healthy Worker Effect) were considered in the discussion of such unexpected results. Prospective studies can explore issues raised in this research.