[Post-traumatic stress injuries in firefighters: The differential role of critical incident types]

Objectives Firefighters are repeatedly confronted with critical incidents (CIs) at work, which are events that significantly disrupt an individual's normal functioning (e.g. failed interventions, serious accidents, media criticism). Repeated exposure to such incidents increases their vulnerability to developing post-traumatic stress injuries (PTSIs). In Canada, approximately 30% of firefighters meet the clinical thresholds for at least one PTSI; the most commonly observed being depression, post-traumatic stress disorder (PTSD), anxiety, alcohol use, and suicidal ideations. The objectives of this study are to 1) describe the frequency of CIs that firefighters encounter at work and 2) identify the different types of CIs associated with PTSIs. Method This research is based on secondary use of cross-sectional data collected in 2018 as part of a partnership with a Quebec fire department. In this context, 690 firefighters responded to a survey designed to assess their overall psychological health. Participants reported on the CIs they had experienced during their careers. Standardized questionnaires were used to measure symptoms of depression, generalized anxiety, post-traumatic stress disorder, alcohol use disorder, substance use, and suicidal ideations. Results The results indicate that rare and serious incidents, particularly critical equipment failure, are strongly linked to various PTSI, while frequent incidents are associated with generalized anxiety and depression. Negative media criticism also appears to be a major stress factor associated with several PTSIs. Conclusion Given firefighters' increased vulnerability to PTSIs, this study highlights the importance of considering the diversity of CIs encountered at work as well as the influence of contextual factors such as media criticism. It also emphasizes the need for transdiagnostic approaches and intervention measures rooted in the professional reality of these workers to better support their mental health.