Probable PTSD and Functional Impairment among High-Risk Workers who Witnessed an Occupational Fatality

Introduction
Steel, oil, and mining are among the most dangerous industries. Although witnessing a fatality is not an uncommon occurrence for workers in these industries, the preponderance of epidemiologic research on work-related posttraumatic stress disorder (PTSD) does not focus on fatalities and often aggregates those with various types of direct and indirect exposure to traumatic accidents. The purpose of this study was to assess probable-PTSD, symptoms of depression, well-being, and life functioning in a unique sample of workers who directly witnessed a fatality.

Methods
Participants were from a larger survey sample of 346 members of the United Steelworkers recruited from work sites in the United States and Canada. The subsample used in this study consisted of 89 workers from the steel, oil, and mining industries who reported witnessing the fatality of a colleague. Participants completed a survey including demographic questions, the Posttraumatic Stress Disorder Checklist, the Zung Self-Rating Depression Scale, and Well-being and LIfe Functioning Scales from the Psychotherapy Outcome Assessment and Monitoring System.

Results
The average age of participants was 55.6 years and the average length of employment was 29 years. Of the sample, 25.8% reported symptoms consistent with probable-PTSD and 21.3% reported symptoms consistent with subthreshold-PTSD. One-way analyses of variance (ANOVA) indicated that these two groups and the non-PTSD group differed significantly on measures of depressive symptoms, well-being, and life functioning.

Discussion
To our knowledge, this is the first study to assess the emotional impact of witnessing a fatality in the steel, oil, and mining industries. The rate of Probable-PTSD in this sample is higher than rates found in combat veterans and first responders. These findings provide further support for the use of psychological assessments of PTSD and depression following workplace trauma, and suggests that workers should be additional assessed for well-being and life functioning.