Work and nonwork stressors, negative affective states, and pain complaints among firefighters and paramedics

Prior research has suggested that occupational stressors may contribute to the etiology, progression, and chronicity of pain problems in workers. This study used anonymous survey methods to assess the prevalence and frequency of self-reported pain symptoms and their relationships to demographic variables, sources of occupational stressors, nonwork stressors and affective distress in a large sample (N≈2000) of employed career public sector firefighters and paramedics. The findings were consistent with those of previous studies of high strain workers. More than 95% of the firefighter/paramedic sample reported at least one pain complaint (using a 1 week assessment time frame). A hierarchical multiple regression analysis entering demographic, occupational, and nonwork stressors, as well as measures of negative affective states targeting total pain scores, yielded significant relationships. Five occupational stressors were associated with respondent pain complaints. The results also suggest that negative affective states mediated the relationships between work and nonwork variables, and pain complaint outcomes. The implications of these findings for the development of preventive interventions for firefighters and paramedics as well as other emergency service workers are considered.

[1]  G H Spivey,et al.  Health Habits and Risk Factors among Truck Drivers Visiting a Health Booth during a Trucker Trade Show , 1993, American journal of health promotion : AJHP.

[2]  P. Leino,et al.  Depressive and distress symptoms as predictors of low back pain, neck-shoulder pain, and other musculoskeletal morbidity: a 10-year follow-up of metal industry employees , 1993, Pain.

[3]  Robert Karasek,et al.  Healthy Work : Stress, Productivity, and the Reconstruction of Working Life , 1990 .

[4]  G. Everly,et al.  The nature and treatment of the stress response , 1981 .

[5]  G. Everly,et al.  The nature and treatment of the stress response : a practical guide for clinicians , 1981 .

[6]  M E Robinson,et al.  Negative affect and the experience of chronic pain. , 1992, Journal of psychosomatic research.

[7]  J. Quick,et al.  Work, stress, and well-being , 1994 .

[8]  A. L. Edwards The measurement of personality traits by scales and inventories , 1970 .

[9]  R. Beaton,et al.  Self-reported symptoms of stress with temporomandibular disorders: comparisons to healthy men and women. , 1991, The Journal of prosthetic dentistry.

[10]  S. Dworkin,et al.  Epidemiologic Studies of Chronic Pain: A Dynamic-Ecologic Perspective , 1992, Annals of Behavioral Medicine.

[11]  R. Heidel,et al.  Healthy People 2000: national health promotion and disease prevention objectives (excerpts). US Public Health Service. , 1991, Journal of allied health.

[12]  A. Lilienfeld Foundations of Epidemiology , 1980 .

[13]  E. Rideout,et al.  The prevalence of pain complaints in a general population , 1984, Pain.

[14]  L W Sullivan,et al.  Healthy People 2000 , 1990, Environmental Health Perspectives.

[15]  C G Mathias,et al.  Occupational skin diseases, United States. Results from the Bureau of Labor Statistics Annual Survey of Occupational Injuries and Illnesses, 1973 through 1984. , 1988, Archives of dermatology.

[16]  K Hytten,et al.  Fire fighters: A study of stress and coping , 1989, Acta psychiatrica Scandinavica. Supplementum.

[17]  D. Grigsby,et al.  Work-Stress Burnout among Paramedics , 1988 .

[18]  L. Carstensen,et al.  Social desirability and the measurement of psychological well-being in elderly persons. , 1983, Journal of gerontology.

[19]  J. M. Mishra,et al.  Stress and Stress Management , 1995 .

[20]  I. Kuorinka,et al.  Psychological and biochemical strain in firemen's work. , 1980, Scandinavian journal of work, environment & health.

[21]  K. Cain,et al.  Firefighters and Paramedics , 1994, AAOHN journal : official journal of the American Association of Occupational Health Nurses.

[22]  F. Franklin,et al.  Psychosocial changes during the first year of medical school , 1991, Medical education.

[23]  Michael Von Korff,et al.  An epidemiologic comparison of pain complaints , 1988, Pain.

[24]  J. Turner,et al.  Chronic pain and depression: does the evidence support a relationship? , 1985, Psychological bulletin.

[25]  R. Beaton,et al.  Sources of Occupational Stress Among Firefighter/EMTs and Firefighter/Paramedics and Correlations with Job-related Outcomes , 1993, Prehospital and Disaster Medicine.

[26]  J. Kellgren,et al.  Rheumatic Complaints in an Urban Population , 1953, Annals of the rheumatic diseases.

[27]  W. Fordyce,et al.  A Prospective Study of Work Perceptions and Psychosocial Factors Affecting the Report of Back Injury , 1991, Spine.

[28]  R. Sternbach Survey of Pain in the United States: The Nuprin Pain Report , 1986 .

[29]  On babies and bathwater: Disease impact and negative affectivity in the self-reports of persons with rheumatoid arthritis. , 1995 .

[30]  David Watson,et al.  General affective dispositions in physical and psychological health. , 1991 .

[31]  Steven L. Sauter,et al.  Work and Well-Being: An Agenda for the 1990s , 1992 .

[32]  Gunilla Brattberg,et al.  The prevalence of pain in a general population. The results of a postal survey in a county of Sweden , 1989, Pain.

[33]  R. Beaton,et al.  Gender differences in fire fighter job stressors and symptoms of stress. , 1995, Women & health.