Division of Occupational Health, Department of Occupational Safety and Environment, Regional Government of South Hesse, 65197 Wiesbaden, Germany.
Institute and Outpatient Clinic for Occupational and Social Medicine, University Medical Center Giessen, Justus-Liebig-University, 35392 Giessen, Germany.
Int J Environ Res Public Health. 2020 Dec 14;17(24):9369. doi: 10.3390/ijerph17249369.
There is evidence suggesting that occupational trauma leads to post-traumatic stress disorder (PTSD) and depression. However, there is a lack of high-quality reviews studying this association. We, therefore, conducted a systematic review with a meta-analysis to summarize the evidence of occupational trauma on PTSD and depression. After a database search on studies published between 1994 and 2018, we included 31 studies, of which only four had a low risk of bias. For soldiers exposed to wartime deployment, the pooled relative risk (RR) was 2.18 (95% CI 1.83-2.60) for PTSD and 1.15 (95% CI 1.06-1.25) for depression. For employees exposed to occupational trauma, there also was an increased risk for PTSD (RR = 3.18; 95% CI 1.76-5.76) and for depression (RR = 1.73; 95% CI 1.44-2.08). The overall quality of the evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was moderate; the evidence was high only for the association between workers after exposure to trauma and development of PTSD. The study results indicate an increased risk of PTSD and depression in soldiers after participation in war and in employees after occupational trauma.
有证据表明，职业创伤可导致创伤后应激障碍（PTSD）和抑郁。然而，缺乏高质量的综述研究这一关联。因此，我们进行了一项系统评价和荟萃分析，以总结职业创伤与 PTSD 和抑郁的关系。在对 1994 年至 2018 年期间发表的研究进行数据库检索后，我们纳入了 31 项研究，其中只有 4 项研究的偏倚风险较低。对于暴露于战时部署的士兵，PTSD 的合并相对风险（RR）为 2.18（95%CI 1.83-2.60），抑郁的 RR 为 1.15（95%CI 1.06-1.25）。对于暴露于职业创伤的员工，PTSD（RR=3.18；95%CI 1.76-5.76）和抑郁（RR=1.73；95%CI 1.44-2.08）的风险也增加。根据推荐评估、制定与评价（GRADE）方法，总体证据质量为中等；仅在创伤后工人与 PTSD 发展之间的关联方面证据质量较高。研究结果表明，士兵参与战争后和员工遭受职业创伤后，PTSD 和抑郁的风险增加。
