ArticleExtreme physiology & medicine2016
Chronic occupational exposures can influence the rate of PTSD and depressive disorders in first responders and military personnel.
Article in Extreme physiology & medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Comparing the molecular correlates of PTSD in first responders and the broader molecular PTSD literature: a hybrid review.Frontiers in psychology · 2026Pooled it
- Exploring Clinical Trials to Manage Firefighters' Sleep Quality: A PRISMA Compliant Systematic Review.International journal of environmental research and public health · 2023Pooled it
- Evaluating a Mobile Health Intervention (GUIDE App) for First Responders, Military Personnel, and Veterans: Randomized Controlled Trial.Journal of medical Internet research · 2025Trial
- Stress first aid for the harm reduction workforce: pilot test results of an occupational stress intervention.BMC public health · 2026Article
- From Better Sleep to Improved Mood: A Review of the Biopsychosocial Pathways for Cognitive Behavioral Therapy for Insomnia's Antidepressant Effects.Current sleep medicine reports · 2026Review
- Psychopathological symptoms and their five-year change in a tracking cohort of Chinese firefighters: a multi-site observational study using the SCL-90.Frontiers in psychology · 2026Article
- Effectiveness of a Mind-Body Intervention at Improving Mental Health and Performance Among Career Firefighters.International journal of environmental research and public health · 2025Article
- Thriving Under Threat: A Scoping Review of Human Thriving in Recurring Potentially Traumatic, Elevated Threat and High Stress Work Environments.Stress and health : journal of the International Society for the Investigation of Stress · 2025Article
- Assessment of ventilatory functions and associated inflammatory markers among workers in slaughterhouses.International archives of occupational and environmental health · 2024Article
- Cardiac function and posttraumatic stress disorder: a review of the literature and case report.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2023Review
- Walk the line: a systemic perspective on stress experienced by emergency medical personnel by comparing military and civilian prehospital settings.Frontiers in public health · 2023Article
- Development of an Evidence-Informed Solution to Emotional Distress in Public Safety Personnel and Healthcare Workers: The Social Support, Tracking Distress, Education, and Discussion CommunitY (STEADY) Program.Healthcare (Basel, Switzerland) · 2022Review
- Career versus volunteer firefighters: Differences in perceived availability and barriers to behavioral health care.Psychological services · 2022Article
- The impact of neurotoxicant exposures on posttraumatic stress disorder trajectories: The Ft. Devens Gulf War Veterans Cohort.Journal of traumatic stress · 2022Article
- Preventative Care in First Responder Mental Health: Focusing on Access and UtilizationFrontiers in health services · 2022Article
- Development and Validation of an Instrument to Measure Work-Related Stress among Rescue Workers in Traumatic Mass-Casualty Disasters.International journal of environmental research and public health · 2021Article
- Methods for improving thermal tolerance in military personnel prior to deployment.Military Medical Research · 2020Review
- A Scoping Review of Non-Occupational Exposures to Environmental Pollutants and Adult Depression, Anxiety, and Suicide.Current environmental health reports · 2020Article
- Heart Rate Variability and Accelerometry as Classification Tools for Monitoring Perceived Stress Levels-A Pilot Study on Firefighters.Sensors (Basel, Switzerland) · 2020Article
- Resilience as a Protective Factor for Depressive Mood and Anxiety among Korean Employees.Journal of Korean medical science · 2019Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFirst responders and military personnel experience rates of post-traumatic stress disorder (PTSD) far in excess of the general population. Although exposure to acute traumatic events plays a role in the genesis of these disorders, in this review, we present an argument that the occupational and environmental conditions where these workers operate are also likely contributors. PRESENTATION OF THE HYPOTHESIS: First responders and military personnel face occupational exposures that have been associated with altered immune and inflammatory activity. In turn, these physiological responses are linked to altered moods and feelings of well-being which may provide priming conditions that compromise individual resilience, and increase the risk of PTSD and depression when subsequently exposed to acute traumatic events. These exposures include heat, smoke, and sleep restriction, and physical injury often alongside heavy physical exertion. Provided the stimulus is sufficient, these exposures have been linked to inflammatory activity and modification of the hypothalamic-pituitary axis (HPA), offering a mechanism for the high rates of PTSD and depressive disorders in these occupations. TESTING THE HYPOTHESIS: To test this hypothesis in the future, a case-control approach is suggested that compares individuals with PTSD or depressive disorders with healthy colleagues in a retrospective framework. This approach should characterise the relationships between altered immune and inflammatory activity and health outcomes. Wearable technology, surveys, and formal experimentation in the field will add useful data to these investigations. IMPLICATIONS OF THE HYPOTHESIS: Inflammatory changes, linked with occupational exposures in first responders and military personnel, would highlight the need for a risk management approach to work places. Risk management strategies could focus on reducing exposure, ensuring recovery, and increasing resilience to these risk contributors to minimise the rates of PTSD and depressive disorders in vulnerable occupations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.