Sickness absence among peer-supported drivers after occupational trauma.

BACKGROUND: Psychological first aid is a common approach for providing support after potentially traumatic events (PTEs). In Germany, a peer support model is recommended by the German Statutory Accident Insurance (DGUV) to reduce sickness absence after occupational accidents, especially in public transportation. However, data on the effectiveness of peer support are very sparse. AIMS: To analyse whether peer support has an impact on sickness absence after work-related traumatic events in public transportation. METHODS: An analysis was conducted in two German public transportation corporations. Due to ethical requirements, we used a historical cohort study comparing peer support by colleagues (VAG-1), peer support at supervisor level (VGF) and a non-intervention group (VAG-0). The study period was from March 2003 to December 2012. We used a negative binominal regression model to estimate the relative risk associated with the interventions and potential confounders. RESULTS: A total of 259 incident PTEs in employees were observed. A regression analysis identified the severity of PTE (severe and fatal events), VGF and age as significant factors in predicting duration of post-event sickness absence. In a stratified analysis, the mode of peer support (VGF) and age predicted sickness absence for less severe PTEs but this was not significant for severe PTEs. CONCLUSIONS: Severe and fatal PTEs had the strongest impact on sickness absence after PTEs. For less severe PTE, peer support provided by colleagues may be superior to supervisor support.

[Psychotrauma after occupational accidents in public transportation. A pilot study to support concepts, influencing factors and occupational health-care]. / Psychische Traumatisierung nach Arbeitsunfällen im öffentlichen Personennahverkehr. Eine Pilotstudie zu Betreuungskonzepten, Einflussfaktoren und arbeitsmedizinischer Versorgung.

BACKGROUND AND AIM OF THE STUDY: Accidents, assaults and suicides occur quite frequently in public transportation. As a result of such extreme events at work, drivers are particularly prone to psychotrauma (PT). Therefore accident insurers stipulate support from the accident site to workplace reintegration with the inclusion of occupational medicine. The present study investigates the incidence, factors influencing psychological trauma as well as the occupational health-care after critical incidents. METHODS: In a Bavarian public transportation corporation 59 employees were evaluated according to ICD-10 for trauma-related disorders, using full collection after application of a specific mental first aid programme and a subsequent occupational health examination. RESULTS: The incidence of PT was 44.1%, with 8.5% showing a post-traumatic stress disorder (PTSD) as consequence of the accident. As significant influencing factors the nature of the accident, the severity of third party injury, and own physical injuries were identified. The occupational medical care depended on the severity of the disease. PT led to the need for rehabilitation. Sick leave was most pronounced in drivers with PTSD. CONCLUSION: The study group showed high levels of emotional strain within the first month. With respect to occupational health-care, particular attention should be paid to drivers after serious accidents or those who sustained own injuries. As foundation for evidence based health-care measures after PT in transport must be scientifically evaluated and the identified risk factors must be well-founded as well.