Introduction Ambulance personnel are exposed to various occupational stressors which predispose to the development of stress reactions such as PTSD. Increased prevalence of PTSD in ambulance personnel has been found compared with the general population and other emergency frontline workers.

Objectives To determine the factors associated with an increased risk for PTSD in ambulance personnel and the barriers faced in accessing support for work related stress (WRS).

Methods A cross-sectional study of voluntary participants comprising 388 ambulance personnel was conducted. Participants completed self-administered questionnaires: Impact of Event Scale-Revised (IES-R), EMS Critical Incident Inventory (CII), EMS Chronic Stress Questionnaire (EMS-CSQ), SF-36 Quality of Life questionnaire (SF-36) and Connor-Davidson Resilience Scale (CD-RISC). There were used to assess PTSD and level of occupational stressors.

Results The prevalence of PTSD in the study population was 30%. Participants were predominantly female (55%), with a median age of 38 (Interquartile Range [IQR] 31–44) years. 83% had a professional qualification. Those with PTSD were more likely to be current smokers (Odds Ratio [OR]=1.76, 95% Confidence Interval [CI]: 1.05 - 2.95), to be current illicit drug users (OR=16.4, 95% CI: 1.87 - 143.86) and to have drinking problems (OR=3.86, 95% CI: 1.80 - 8.23). Self-reported mental health condition (OR=3.76, 1.96 - 7.21), being treated for a medical condition (OR=1.95, 1.22 - 3.11), chronic WRS exposure (OR=1.05, 1.04 - 1.07) and high critical incident stress score (OR=1.03, 1.02 - 1.04) were positively associated with PTSD risk. Barriers to seeking help for WRS included concerns that services were not confidential, and that the participant’s career would be negatively affected.

Conclusion PTSD prevalence in ambulance personnel is considerably higher than those found in previous studies conducted among this occupational group in the Western Cape. Identified risk factors and exposures should inform prevention strategies and interventions designed to support ambulance personnel with a greater focus on addressing barriers to accessing care.