Occup Environ Med 60:i40-i46 doi:10.1136/oem.60.suppl_1.i40
  • Papers

Acute and chronic job stressors among ambulance personnel: predictors of health symptoms

  1. E van der Ploeg1,
  2. R J Kleber2,*
  1. 1Department of Clinical Psychology, Utrecht University, The Netherlands
  2. 2Department of Clinical Psychology, Utrecht University, The Netherlands
  1. Correspondence to:
 Rolf J Kleber, Department of Clinical Psychology, Utrecht University, P.O box 80.140, 3508 TC Utrecht, The Netherlands;
  • Accepted 1 March 2003


Objectives: To predict symptomatology (post-traumatic distress, fatigue, and burnout) due to acute and chronic work related stressors among ambulance personnel.

Methods: Data were gathered from 123 ambulance workers in The Netherlands in a longitudinal design. At two measurements they completed standardised questionnaires to assess health symptoms, such as the Impact of Event Scale, the Maslach Burnout Inventory, and the Checklist Individual Strength. Acute stressors were assessed with specific questions, and chronic work related stressors were measured with the Questionnaire on the Experience and Assessment of Work.

Results: Most of the ambulance workers had been confronted with acute stressors in their work. They also reported more chronic work related stressors than a reference group. Of the participants, more than a tenth suffered from a clinical level of post-traumatic distress, a tenth reported a fatigue level that put them at high risk for sick leave and work disability and nearly a tenth of the personnel suffered from burnout. Best predictors of symptomatology at time 2 were lack of social support at work and poor communication, such as not being informed about important decisions within the organisation.

Conclusions: Ambulance personnel are at risk to develop health symptoms due to work related stressors. Although, acute stressors are related to health symptoms, such as fatigue, burnout, and post-traumatic symptoms, it was not found to predict health symptoms in the long term. Main risk factors have to do with social aspects of the work environment, in particular lack of support from the supervisor as well as colleagues and poor communication. When implementing workplace interventions these social aspects need to be taken into account.


  • * R J Kleber is also affiliated at Department of Clinical Health Psychology, Tilburg University, The Netherlands and Institute for Psychotrauma, Zaltbommel, The Netherlands.