Initial care system in public transport

(DGUV Research Project No. FF-FP 0335)

Mental illnesses resulting from stressful or traumatic work-related accidents can have a lasting impact on employability. To reduce the effects of post-traumatic stress, accident insurance providers recommend initial care systems in which professional service providers or trained laypeople provide initial care after accidents. Recommendations for layperson-based emergency care have not yet been sufficiently scientifically supported. This research project was conducted for the first scientific evaluation of layperson-based initial care with local public transport employees, a high-risk group for post-traumatic stress.

In the first part, the course of illness and absence from work of 259 employees from two transport companies following work-related accidents between 2003 and 2013 were analyzed using multivariate methods. There were three study groups, each differentiated according to the type of initial care provided (care by colleagues vs. group leaders vs. no initial care). Here, increased absences were observed after minor accidents in the group receiving initial support from group leaders. The risk of developing stress reactions was significantly lower in the group without initial support than in the group receiving initial support from colleagues. Accidents resulting in serious injuries and fatalities resulted in the highest levels of absence and subsequent mental health problems, without any correlation to the different initial support systems.

In the second part of the study, 26 driver employees receiving initial support from colleagues were surveyed after workplace accidents about their experiences with initial support and care. Psychometric questionnaires were also administered. The results of this part of the study show that timely, basic care is crucial for the effectiveness of initial support systems and that there is no need to professionalize care at the scene of the accident. Regarding follow-up care, a need for improved coordination and a reduced number of professional care partners was identified. In minor incidents where follow-up occupational health care is available, care without initial support does not appear to have a negative impact on the assessed stress consequences. However, the driver survey shows that initial support has a very high subjective value and that these systems should therefore be retained.

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