Post-traumatic stress among rescue workers after terror attacks in Norway.
BACKGROUND
On 22 July 2011, Norway was struck by two terror attacks. Seventy-seven people were killed, and many injured. Rescue workers from five occupational groups and unaffiliated volunteers faced death and despair to assist victims.


OBJECTIVE
To investigate the level of, and associations between, demographic variables, exposure and work-related variables and post-traumatic stress symptoms (PTSS).


METHODS
A cross-sectional study of general and psychosocial health care personnel, police officers, firefighters, affiliated and unaffiliated volunteers were conducted ~10 months after the terror attacks. The respondents answered a self-reported questionnaire. Post-traumatic stress disorder (PTSD) Checklist - specific (PCL-S) assessed PTSS.


RESULTS
There were 1790 participants; response rate was 61%. About 70% of the professional rescue workers had previous work experience with similar tasks or had participated in training or disaster drills. They assessed the rescue work as a success. Firefighters and unaffiliated volunteers reported more perceived threat compared with the other groups. Among the professional personnel, the prevalence of sub-threshold PTSD (PCL 35-49) was 2% and possible PTSD (PCL ≥ 50) 0.3%. The corresponding figures among the unaffiliated volunteers were 24% and 15%, respectively. In the multivariate analysis, female gender (β = 1.7), witnessing injured/dead (β = 2.0), perceived threat (β = 1.1), perceived obstruction in rescue work (β = 1.6), lower degree of previous training (β = -0. 9) and being unaffiliated volunteers (β = 8.3) were significantly associated with PTSS.


CONCLUSIONS
In the aftermath of a terror attack, professional rescue workers appear to be largely protected from post-traumatic stress reactions, while unaffiliated volunteers seem to be at higher risk.
Research and Development, Department of Acute Medicine, Oslo University Hospital, 0424 Oslo, Norway, Paramedic Sciences, Oslo and Akershus University College, 0130 Oslo, Norway, Laila.Skogstad@hioa.no laila.skogstad@ous-hf.no.
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Skogstad
Norwegian Centre for Violence and Traumatic Stress Studies, 0484 Oslo, Norway, Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway.
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Heir
Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway, Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway.
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Hauff
Research and Development, Department of Acute Medicine, Oslo University Hospital, 0424 Oslo, Norway, Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway, Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 0317 Oslo, Norway.
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Ekeberg
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D061388:Firefighters / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D016495:Police / Q000523:psychology / Q000706:statistics & numerical data; D015995:Prevalence; D018635:Rescue Work; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology*; D023481:Terrorism / Q000523:psychology*; D000078329:Workforce
Post-traumatic stress disorder; professional rescue workers; terror.; volunteers