title: Work-related posttraumatic stress disorder (PTSD) and other emotional diseases as consequence of traumatic events in public transportation: a systematic review.
abstract: BACKGROUND
  Drivers in public transportation are at risk of experiencing potential traumatic events such as accidents involving persons, collisions, or suicides. In this context, the question arises to what extent psychological traumatization and posttraumatic diseases occur.
  
  
  OBJECTIVE
  The aim of this systematic review was to describe the frequency and nature of work-related posttraumatic disorders, to analyze risk and prognostic factors after potentially traumatic events (accidents resulting in damage to property and/or in injury or death), and address sick leave after such events in the realm of public transportation, based on the available literature.
  
  
  METHODS
  Systematic review based on four databases (PubMed, PSYNDEX/MEDLINE, ScienceDirect, PILOTS) between 1980 and June 2013.
  
  
  RESULTS
  We identified seven studies (four longitudinal, three cross-sectional) that examine employees after person under train (PUT) events. PTSD prevalences varied broadly between 0.7 and 17 %. The same applies to dysthymia/neurotic depression (1-26 %). However, similarly low prevalences of major depression (1.3-2.8 %) and panic disorder (0.5-1.3 %) have been observed. Risk factors of PTSD comprised individual, work-related, event-related, and prognostic aspects. Following the traumatic event, a total of 69-81 % of the drivers were absent, and if sick leave occurs, this was on average 3-19 days.
  
  
  CONCLUSIONS
  It became evident that drivers in public transportation run a high risk of sick leave. It was also striking that despite the immense impact of PUT and high number of suicides, only an infinitesimal number of studies exists. Due to various differences (period of follow-up, instrument of measurement and study period), it turned out that the comparability of the results of the studies is limited. For various reasons, further research is urgently needed, as from an occupational health point of view the issue of posttraumatic diseases and implications for fitness for service should be addressed.
authors.affiliation: Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany, Annika.Clarner@ipasum.med.uni-erlangen.de.
authors.forename: Annika
authors.initials: A
authors.lastname: Clarner
authors.forename: Elmar
authors.initials: E
authors.lastname: Graessel
authors.forename: Johanna
authors.initials: J
authors.lastname: Scholz
authors.forename: Alexander
authors.initials: A
authors.lastname: Niedermeier
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Uter
authors.forename: Hans
authors.initials: H
authors.lastname: Drexler
mesh_terms: D000062:Accidents, Occupational / Q000523:psychology*; D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D018582:Sick Leave; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology; D014186:Transportation; D055815:Young Adult