A LINE ON LIFE

1/15/95

Facing Fears of Firefighters *

David A. Gershaw, Ph.D.

As a small child, I can remember my feelings of envy as bright-red fire engines sped past me with sirens wailing. Of course, I saw only the glory and thrills of being a firefighter. However, there is another side.

Psychologist Wayne Corneil is concerned about Post-Traumatic Stress Disorders (PTSD). PTSD is caused by a traumatic incident outside the range of normal human experience – war, fire, tornado, flood, sexual abuse or other extreme events. Symptoms include repeatedly reliving the event, avoiding any reminder of the event, insomnia, nightmares, inability to concentrate, irritability or even explosions of anger or aggression. Corneil is most concerned with the traumatic ordeals that accumulate with firefighters and paramedics. For 12 years, Dr. Corneil has logged over 10,000 miles riding with firefighters in Europe and North America.

Corneil is a pioneer in employee mental health in Canada. He gave Toronto firefighters detailed questionnaires about their lives and work. For 675 firefighters and paramedics, the information was compared to department records of emergency incidents. Along with personal factors, Corneil examined traumatic effects of exposure to danger, injuries and other aspects of their work.

In addition, for over a year Corneil "lived, ate and breathed with members of Toronto's Metropolitan Fire Department...." He observed their traumas and their reactions to them. Firefighters averaged 3.91 severe emergencies a year – fires, medical emergencies, crimes, suicides, accidents, bombs and hazardous material explosions. For most, medical emergencies were faced more often than fires. Corneil noted that medical emergencies can be more stressful than fires, citing the case of a woman beheaded in an industrial accident.


The incidence of PTSD in firefighters is higher
than the rates in Vietnam veterans.

In the general population, about 1-3% suffers from PTSD. With Corneil's group, 16.5% suffered from PTSD. This is about 1% higher than PTSD rates from Vietnam veterans. Rather than long working hours, PTSD symptoms in firefighters were more related to traumatic incidents like suicides, fires and maiming accidents. Personal injuries were also a factor. Firefighters experienced their traumas over several decades of work, averaging about 4 traumatic experiences a year. In contrast, war veterans experience more intense traumas in a shorter time.

Firefighters are carefully screened for mental and physical health. In Corneil's words, they are "an incredibly healthy population." This makes the high rates of PTSD even more alarming.

Corneil estimated that exposure to a traumatic event increases the probability of PTSD about 150 times. If there were also organizational stresses – heavy job demands or inequitable promotion systems – this probability increases significantly.

Other factors reduced the chance of PTSD. If supervisors and peers supported the firefighters– allowing them to discuss the traumas – the odds of PTSD were reduced by 40%. Family support also decreased the incidence by another 40%.

Corneil established self-help support groups to help firefighters who have been severely burned or injured. In contrast to individual therapy, a support group "allows them to feel they're not the only ones with these problems, and to get away from the conspiracy of silence" typical of firefighters after a trauma.

To reduce predicted stress, Corneil is promoting equipment changes. Protective clothing can be made lighter to allow for more freedom of movement. Clanging bells to wake the firefighters have been replaced by a speaker and softer tones. Firefighters are equipped with radios as they approach the scene, so they can hear what is happening to become more mentally prepared. According to Corneil, "The more mentally prepared they are, the better they perform."

If you want more information, this study will be published by the American Psychological Association later this year in a chapter of a book entitled, Job Stress Interventions: Current Practices and New Directions.

My concerns for firefighters stem from more than childhood dreams and the concerns of a psychologist. Both of my grandfathers died before I was born. One of them – Captain David Rosen, a firefighter from Milwaukee – died of smoke inhalation. I was named after him.


* Adapted from Tori DeAngelis' article, "Firefighters' PTSD at dangerous levels," in the APA Monitor, February, 1995, pages 36-37.

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