title: Development of a Comprehensive Programme to Prevent and Reduce the Negative Impact of Railway Fatalities, Injuries and Close Calls on Railway Employees.
abstract: OBJECTIVE
  This article presents a strategy to prevent trauma, support and care for railway personnel who experience critical incidents (CI) on the job, usually fatalities by accident or suicide.
  
  
  METHODS
  We reviewed all publications on CI management, support and care practices in the railway industry, as well as practices in place in Canada (unpublished protocols). Semi structured interviews were conducted with 40 train engineers and conductors involved in CIs and the content was coded and analysed quantitatively.
  
  
  RESULTS
  Employees' satisfaction with the help received after the incident varies according to the behaviour of the local manager, company officers and police, the level of compliance with existing company protocols to help them, the presence of unmet expectations for support and care, their perceived competency of clinicians they consulted and the level of trust toward their employers.
  
  
  CONCLUSIONS
  On the basis of the interview results, the review of existing railway practices and discussions with railway stakeholders, a model protocol was developed for a comprehensive workplace prevention, support and care protocol to reduce the negative impact of railway critical incidents on employees. This protocol includes preventive actions before traumatic events occur, immediate responses at the site of incident, interventions within the first few days after the incident and longer term support and interventions provided by the company and by outsourced experts.
authors.affiliation: Center for Research and Intervention on Suicide and Euthanasia (CRISE), Université du Québec À Montréal (UQAM), c.p. 8888, Succ. Centre-Ville, Montréal, QC, H3C 3P8, Canada, tron-bardon.cecile@uqam.ca.
authors.forename: Cécile
authors.initials: C
authors.lastname: Bardon
authors.forename: Brian L
authors.initials: BL
authors.lastname: Mishara
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control / Q000523:psychology; D002170:Canada; D006801:Humans; D007407:Interviews as Topic; D016272:Occupational Health; D060051:Occupational Injuries / Q000401:mortality / Q000517:prevention & control* / Q000523:psychology; D016730:Program Development; D011890:Railroads