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Safeguard OSH Solutions - Thomson Reuters

Safeguard OSH Solutions - Thomson Reuters

Safeguard Magazine

It’s Academic—Front line effect

What impact have the Christchurch earthquakes had on the health – physical and emotional – of front line workers? KIRSTEN LOVELOCK reports on a study now under way.

Front line workers played a vital role in the response to the Christchurch earthquakes and the ongoing aftershocks. For the purposes of this research, front line workers comprise those who have a professional obligation to respond in the aftermath of natural disasters.

Our longitudinal cohort study – the first of its kind to be conducted in New Zealand – focuses on their occupational health. The range of workers includes: St John, police, search and rescue, firefighters, New Zealand Defence Force personnel, Maori wardens, Red Cross communications staff, communications personnel, teachers and utility workers.

International re search demonstrates that exposure to potentially disturbing stimuli and the resulting emotional and cognitive experiences associated with dealing with the dead or seriously injured can lead to psychological trauma and impact the broader health of front line workers 1-2. Front line workers experience risks to their own safety, health and welfare through sleep deprivation, fatigue, exposure to excessive noise, toxic materials and work overload, along with decision-making based on limited information.

In addition to these documented health effects, front line workers can also be at risk of “dual jeopardy” – that is, while at risk of being secondary victims they are also at risk of being primary victims, when family and or friends are injured, dead, traumatised and when/ where their own properties are seriously damaged or lost 3-6.

Consistent psychological reactions amongst first responders have been identified as anxiety, hyperarousal, hyper vigilance, painful recollections and grief. While post-traumatic stress disorder is the most studied condition in this field, it is not the most common single diagnosis after trauma7-8. Other trauma-related conditions include depression, panic disorder, anxiety disorder and acute stress 9-11.

In general, there is a research bias toward psychological conditions, but front line workers also experience physical effects, including musculoskeletal and respiratory conditions, neurological symptoms (headache and fatigue); abdominal pain, skin complaints and cardiovascular symptoms12-13. Delayed onset of conditions is not uncommon7.

In this field there tends to be an over-emphasis on pathology and vulnerability and an insufficient focus on resilience and the role played by social networks and culturally protective practices in times of crisis14-15.

Our study is documenting the health effects of front line work for front line workers in Christchurch, and among a control population of front line workers in the Waikato, over an 18 month period. We are also identifying how social networks, culture and ethnicity, and workplace culture influences vulnerability and resilience, and to identify how seismic events challenged front line service delivery in Christchurch.

We know that social support is very important with respect to positive health outcomes. In addition to the worker survey we are surveying significant others who provide support to these workers.

We are currently collating data for analysis from our first survey round but there are a number of issues emerging in relation to front line workers. The first issue is that it is “risky” to participate in a study of this kind, particularly when the media and other reporting bodies are critically reviewing front line worker roles post-disaster. We are very grateful to those who have participated and aware that some have not because of the scrutiny they have been subjected to post quakes.

We know that the front line workers in this study have experienced dual jeopardy. Many have lost their homes and have experienced damage to, or loss of, their workplaces. Some front line workers have had to draw down on their retirement funds to meet unexpected post-disaster expenses associated with carrying mortgage (s) and covering rent for new accommodation while servicing debt on condemned homes.

Some are also now supporting family members who have relocated elsewhere because of the quakes and continue to work in Christchurch in the absence of these people who are central to social and emotional support. Others are still living with family or friends as their homes are condemned and new property has yet to be procured.

Some of the front line workers have now resigned from their positions and relocated elsewhere (New Zealand and Australia), some have remained front line workers in their new locations, and others have taken up other forms of employment.

While this report provides a brief qualitative assessment of the survey responses to date, it is clear that the occupational health of front line workers responding to natural disasters is an important area of enquiry and the study results will provide us with a better understanding of how these vital workers can be appropriately supported in the future.

See the Safeguard website for a list of references.

DR KIRSTEN LOVELOCK is a senior research fellow in the Department of Preventive and Social Medicine at the University of Otago. The project group also includes her Otago colleague David McBride, and Daniel Shepherd and Rex Billington from AUT.

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