title: Best practice intervention for post-traumatic stress disorder among transit workers.
abstract: BACKGROUND
  Transportation industry workers are at high risk for exposure to traumatic incidents in the workplace. A considerable number of those exposed to such incidents will develop post-traumatic stress disorder (PTSD) symptoms, which leads to high rates of absenteeism and are costly to the public transit corporation and workplace safety compensation insurance.
  
  
  OBJECTIVE
  To determine whether the newly implemented Best Practice Intervention (BPI) provides superior outcomeswhen compared with Treatment-as-Usual (TAU) interventions in improving workers' rates of return to work (RTW), decreasing duration of time lost from work and overall reduction in severity of PTSD symptoms 6 months after exposure.
  
  
  METHODS
  A sequential mixed methods approach was used with qualitative analysis followed by a pre-post intervention design. Sixty-two participants were recruited to the (TAU) phase of the study and 79 to the (BPI) phase.
  
  
  RESULTS
  Significant differences were observed between the TAU and BPI groups in number of lost work days (TAU: 20 days vs. BPI: 52 days, p = 0.02). PTSD symptoms decreased with time (MPPS score: 51.3 vs. 24.35; p < 0.001). One-fifth of the participants (21 %) did not return to work by the end of the 6 months follow-up period.
  
  
  CONCLUSIONS
  The study demonstrated the value of workplace interventions in improving awareness of psychological symptoms after exposure to a traumatic incident and the value of screening for PTSD symptoms.
authors.affiliation: Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors.forename: Ash
authors.initials: A
authors.lastname: Bender
authors.affiliation: Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
authors.forename: Rahel
authors.initials: R
authors.lastname: Eynan
authors.affiliation: Department of Safety and Environment, Toronto Transit Commission Toronto, ON, Canada.
authors.forename: John
authors.initials: J
authors.lastname: O'Grady
authors.affiliation: St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Rosane
authors.initials: R
authors.lastname: Nisenbaum
authors.affiliation: Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
authors.forename: Ravi
authors.initials: R
authors.lastname: Shah
authors.affiliation: Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Links
mesh_terms: D000062:Accidents, Occupational / Q000523:psychology*; D000328:Adult; D019317:Evidence-Based Medicine; D000069581:Exposure to Violence / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D062707:Return to Work; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000628:therapy*; D013406:Suicide, Attempted / Q000523:psychology; D013997:Time Factors; D014186:Transportation; D064450:Workplace Violence / Q000523:psychology
keywords: Best Practices Intervention; Workplace mental health; acute psychological trauma; post-traumatic stress disorder; public transportation