ArticleJournal of the American College of Emergency Physicians open2025
Prevalence of Exposures and Moral Injury in First Responders.
Article in Journal of the American College of Emergency Physicians open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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.
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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
5 citing papers in PubMed.
- Prevalence of Post-Traumatic Stress Injuries Among Canadian Public Safety Communicators: A Nationwide Comparative Study: Prévalence des blessures de stress post-traumatique chez les communicateurs en sécurité publique canadiens : étude comparative nationale.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2026Article
- Reliability and validity of the Chinese version of the Psychological Climate Scale among nuclear emergency responders.Frontiers in psychology · 2026Article
- We are still in it: a conceptual model for moral injury and burnout in alternative response programs to guide intervention.Frontiers in psychiatry · 2026Article
- Drivers, processes, and outcomes related to burnout and moral injury in the public safety workforce: a scoping review.Frontiers in health services · 2026Review
- Cross-disciplinary insights on moral injury conceptualization and care: a qualitative study of expert perspectives.Frontiers in psychiatry · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: Workers in high-stakes occupations, such as first responders, are at risk of exposure to potentially morally injurious events (PMIEs) and moral injury, yet research with first responders has been scarce. This study aimed to assess the frequency of exposure to PMIEs, the prevalence of moral injury, and the correlation between moral injury and other mental health symptoms. Methods: In this cross-sectional study, firefighters, emergency medical technicians (EMTs), and paramedics working for a large urban Fire Department in California were invited to complete an online, confidential survey using validated scales to assess exposure to PMIEs, moral injury symptoms, and symptoms of posttraumatic stress disorder, anxiety, depression, alcohol use, and burnout between February 21, 2024, and April 16, 2024. We calculated item frequencies and correlation and reliability analysis on each scale separately and between the total scores from all measures using Pearson, polyserial, and polychoric methods. Reliability was assessed using Guttman's lambda and Cronbach's alpha. Results: Participants ( Conclusion: Exposure to PMIEs was common in these professional first responders, and a substantial proportion of participants reported clinically meaningful moral injury symptoms. These data fill an important gap and provide information that can help with moral injury assessment and treatment for first responders.
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Registered trials
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