Journal List > Korean J Occup Environ Med > v.24(4) > 1125608

Shin, Jeon, and Sakong: Posttraumatic Stress Disorder and Related Factors in Male Firefighters in a Metropolitan City



This study was conducted in order to evaluate the prevalence of posttraumatic stress disorder (PTSD) and related factors in male firefighters in Daegu, Korea.


A total of 1,261 firefighters from fire stations in Daegu were the subjects of this study. Each firefighter completed a questionnaire on general and occupational matters, experience of traumatic events, and impact of event scale (IES). The IES questionnaire was administered to subjects in order to determine the high risk group for PTSD. We calculated the IES score and determined that an individual was abnormal if the IES score was over 26.


The average IES score of the firefighters was 11.0±14.3, and the prevalence of high risk firefighters with PTSD was 15.1%. It was found that 40 years of age, fire sergeant, and emergency medical service personnel showed higher prevalence of PTSD than other groups. The most experienced event among traumatic events was 'witness death of victims or patients'. The results of multiple logistic regression analysis for the high risk PTSD group showed that fire sergeant (OR=2.28, 95% CI: 1.28~4.06), fire lieutenant (OR=2.47, 95% CI: 1.14~5.37), fire captain (OR=2.88, 95% CI: 1.11~7.45), firefighting department (OR=2.04, 95% CI: 1.00~4.17), emergency medical service personnel (OR=3.68, 95% CI: 1.47~9.23), total frequency of traumatic events experienced (OR=1.01, 95% CI: 1.00~1.02), and total type of traumatic event experienced (OR=1.35, 95% CI: 1.25~1.46) were significant variables with regards to the reference group (fire fighter and administration department).


These findings indicate that the prevalence of PTSD in firefighters is higher than that in the general population, and fire sergeant, fire lieutenant, fire captain, emergency medical service personnel, firefighting department, total frequency of traumatic events experienced, and total type of traumatic event experienced were significant variables for the PTSD high risk group.

Figures and Tables

Table 1
General and job-related characteristics of the study subjects (N=1,261)

*standard deviation.

Table 2
IES* score and PTSDhigh risk group by general and job-related characteristics

*IES: impact of event scale.

PTSD: posttraumatic stress disorder.

HR: high-risk group of PTSD.

§values are calculated by Kruskal Wallis test.

values are calculated by Fisher's exact test.

values are calculated by t test.

**values are calculated by χ2 test.

Table 3
Experienced traumatic events of the study subjects

*standard deviation.

Table 4
Total frequency and type of experienced traumatic events by general and job-related characteristics

*standard deviation.

values are calculated by Kruskal Wallis test.

values are calculated by Mann Whitney U test.

Table 5
Correlation matrix for 3 general and job related characteristics, 2 traumatic event variables and IES score

*p<0.05, **p<0.01.

IES: impact of event scale.

IES score: total score of IES.

Table 6
Crude odds ratio for PTSD high risk group according to general and job related characteristics and traumatic event experience (N=1,261)

*odds ratio,95% confidence interval,reference group.

Table 7
Adjusted odds ratio for PTSD high risk group according to general and job related characteristics and traumatic event experience (N=1,261)

*multiple logistic regression analysis, adjusted with each variables in the table, odds ratio,95% confidence interval.

reference group.


1. Cho SW. Firefighting Administration Data and Statistics. 2012. Seoul: National Emergency Management Agency;144–201. (Korean).
2. Guidotti TL. Human factors in firefighting: ergonomic-, cardiopulmonary- and psychogenic stress-related issues. Int Arch Occup Environ Health. 1992. 64(1):1–12.
3. American Psychiatric Association. Diagnosis and Statistical Manual of Mental Disorders. 2000. Washington DC: American Psychiatric Press;424–427.
4. Min SK. DY Shin . Modern Psychiatry. 2005. Seoul: Ilchogak company;317–321. (Korean).
5. Horowitz M, Wilner N, Alvarez W. Impact of event scale: a measure of subjective stress. Psychosom Med. 1979. 41(3):209–218.
6. Corneil W, Beaton R, Murphy S, Johnson C, Pike K. Exposure to traumatic incidents and prevalence of posttraumatic stress symptomatology in urban firefighters in two countries. J Occup Health Psychol. 1999. 4(2):131–141.
7. Wagner D, Heinrichs M, Ehlert U. Prevalence of symptoms of posttraumatic stress disorder in German professional firefighters. Am J Psychiatry. 1998. 155(12):1727–1732.
8. Dudek B, Koniarek J. Relationship between sense of coherence and post-traumatic stress disorder symptoms among firefighters. Int J Occup Med Environ Health. 2000. 13(4):299–305.
9. Choi ES. A model for post-traumatic stress and burnout in firefighters. J Korean Soc Emerg Med Technol. 2001. 5(5):147–164. (Korean).
10. Kwon SC, Song J, Lee SJ, Kim I, Koh J, Ryou H, Kim SH, Kim D, Jung SA. Posttraumatic stress symptoms and related factors in firefighters of a firestation. Korean J Occup Environ Med. 2008. 20(3):193–204. (Korean).
11. Yang MH, Lee EI, Choi JW, Kim HJ. PTSD and related factors among dispatched firefighters to rescue sites after the great Japanese earthquake(running head: dispatched firefighters' PTSD). Korean J Occup Environ Med. 2012. 24(2):167–179. (Korean).
12. Yi SM, Eun HJ. A study of reliability and validity on the Korean version of impact of event scale. J Korean Neuropsychiatr Assoc. 1999. 38(3):501–513. (Korean).
13. Gavranidou M, Rosner R. The weaker sex? gender and post-traumatic stress disorder. Depress Anxiety. 2003. 17:130–139.
14. Breslau N. Gender differences in trauma and posttraumatic stress disorder. J Gend Specif Med . 2002. 5:34–40.
15. Stein MB, Walker JR, Forde DR. Gender differences in susceptibility to posttraumatic stress disorder. Behav Res Ther. 2000. 38:619–628.
16. Corneil W. Murphy LR, Hurrell JJ, Sauter SL, Keita GP, editors. Traumatic Stress and Organizational Strain in the Fire Service. Job Stress Interventions. 1995. Washington DC: American Psychological Association;185–198.
17. Steve BR. Measuring the emotional impact of an event. cited 13 August 2012. Available:
18. Coffey SF, Gudmundsdottir B, Beck JG, Palyo SA, Miller L. Screening for PTSD in motor vehicle accident survivors using PSS-SR and IES. J Trauma Stress. 2006. 19(1):119–128.
19. Neal LA, Busuttil W, Rollins J, Herepath R, Strike P, Turnbull G. Convergent validity of measures of posttraumatic stress disorder in a mixed military and civilian population. J Trauma Stress. 1994. 7(3):447–455.
20. National emergency management agency. DY Shin . An Analytic Study on Post-traumatic Stress Status in Firefighters. 2008. Ajou university;72–74. (Korean).
21. Chung YK, Kim SY, Cho SM. Posttraumatic stress disorder in firefighters. J Korean Med Assoc. 2008. 51(12):1103–1110.
22. Im HH. Post-traumatic Stress and Related Factors in Firefighters. Unpublished master's dissertation. 2012. Inje university;(Korean).
23. Mitani S, Fujita M, Nakata K, Shirakawa T. Impact of post-traumatic stress disorder and job-related stress on burnout: a study of fire service workers. J Emerg Med. 2006. 31(1):7–11.
24. McFarlane AC. The aetiology of post-traumatic morbidity: predisposing, precipitating and perpetuating factors. Br J Psychiatry. 1989. 154:221–228.
25. Al-Naser F, Everly GS Jr. Prevalence of posttraumatic stress disorder among Kuwaiti firefighters. Int J Emerg Ment Health. 1999. 1(2):99–101.
26. Chang CM, Lee LC, Connor KM, Davidson JR, Jeffries K, Lai TJ. Posttraumatic distress and coping strategies among rescue workers after an earthquake. J Nerv Ment Dis. 2003. 191(6):391–398.
27. Keane TM, Malloy PF, Fairbank JA. Empirical development of an MMPI subscale for the assessment of combat-related posttraumatic stress disorder. J Consult Clin Psychol. 1984. 52(5):888–891.
28. Keane TM, Caddell JM, Taylor KL. Mississippi scale for combat-related posttraumatic stress disorder: three studies in reliability and validity. J Consult Clin Psychol. 1988. 56(1):85–90.
29. Perkins DV, Tebes JA. Genuine versus simulated responses on the impact of event scale. Psychol Rep. 1984. 54:575–578.
30. Stein MB, Walker JR, Hazen AL, Forde DR. Full and partial posttraumatic stress disorder: findings from a community survey. Am J Psychiatry. 1997. 154(8):1114–1119.
31. Orcutt HK, Erickson DJ, Wolfe J. A prospective analysis of trauma exposure: the mediating role of PTSD symptomatology. J Trauma Stress. 2002. 15:259–266.
32. Saijo Y, Ueno T, Hashimoto Y. Post-traumatic stress disorder and job stress among firefighters of urban Japan. Prehosp Disaster Med. 2012. 27(1):59–63.
33. Kang KH, Lee KS, Kim SI, Meng KH, Hong HS, Jeong CH. The Relationship between Alcohol Use and Job Stress among Firemen. Korean J Occup Environ Med. 2001. 13(4):401–412. (Korean).
34. Murphy SA, Beaton RD, Pike KC, Cain KC. Firefighters and paramedics: years of services, job aspirations, and burnout. AAOHN J. 1994. 42(11):534–540.
35. Baek ML. Posttraumatic stress by work in firefighters. J Korean Soc Hazard Mitig. 2009. 9(3):59–65. (Korean).
36. Lee JY, Moon NY, Hong HG, Hyun MH. The relationships of traumatic experiences, emotional intelligence and PTSD symptoms of firefighters. Korean J Health Psychol. 2008. 13(1):25–39. (Korean).
37. Lee SG, Lee YK. Empirical study on the causes and results of job stress among fire fighters: focusing on job characteristics, role confusion, relationships with coworkers and organizational commitment. J Korean Inst Fire Sci Eng. 2007. 21(2):74–86. (Korean).
38. Weiss DS, Marmar CR, Metzler TJ, Ronfeldt HM. Predicting symptomatic distress in emergency services personnel. J Consult Clin Psychol. 1995. 63(3):361–368.
39. Harvey AG, Bryant RA. Predictors of acute stress following motor vehicle accidents. J Trauma Stress. 1999. 12(3):519–525.
40. Asukai N, Kato H, Kawamura N, Kim Y, Yamamoto K, Kishimoto J, Miyake Y. Reliability and validity of the Japanese-language version of the impact of event scale-revised (IES-R-J): four studies of different traumatic events. J Nerv Ment Dis. 2002. 190(3):175–182.
41. Epstein RS, Fullerton CS, Ursano RJ. Posttraumatic stress disorder following an air disaster: a prospective study. Am J Psychiatry. 1998. 155:934–938.
42. Breslau N, Davis GC, Andreski P, Peterson E. Traumatic events and posttraumatic stress disorder in an urban population of young adults. Arch Gen Psychiatry. 1991. 48(3):216–222.
Similar articles