Original articleSymptoms of PTSD according to individual and work environment characteristics of Korean railroad drivers with experience of person-under-train accidents
Introduction
Generally, railroad drivers have a potential for exposure to many traumatic events when driving a train. The on-the-track accidents often experienced by railroad drivers include person-under-train by accident or suicide attempt and cars or other vehicles being hit at road junctions, derailments, and train collisions [1]. After exposure to these accidents, most of them suffer from psychological health hazards like panic disorder, depression, anxiety, and particularly posttraumatic stress disorder (PTSD). PTSD, which is generally diagnosed when a minimum of these symptoms has continued for more than 1 month, consists of persistent reexperiencing of the event, avoidance of reminders and numbing, and increased arousal [2].
According to the Korea Railroad Cooperation's statistics in 2004, 575 on-the-track accidents occurred, and approximately 1000 persons were killed or injured by them. Over 40% of the victims are mainly a result of person-under-train accidents other than train derailments and collisions between trains. Furthermore, a currently worse economic condition in Korea abets the general public in railway suicides and, as a result, causes to slightly increase the person-under-train accidents despite preventive endeavors of diverse sources. Thus, the Korean railroad drivers exposed to person-under-train accidents more than once appear to be faced with acute and chronic PTSD symptoms. In addition, outbreak rate of these accidents and number of persons damaged by them in Korea is of considerable magnitude, compared to other developed countries [3], [4], [5], [6], [7], [8], [9], [10], [11], [12].
There are many articles on studies performed in foreign countries in relation to prevalence of PTSD or other psychological symptoms in train drivers who experienced person-under-train accident. Vatshelle and Moen [1] reported that it was postulated to casually associate traumatic on-the-track experiences and long-term health problems in train drivers. Cothereau et al [5] demonstrated that most of the psychobehavioural disorders were observed in the immediate outbreak of the accident and disappeared within a year. According to results of a study conducted with train drivers in Sweden and Norway [9], experiences of more than two previous railway suicide accidents provoked a feeling of vulnerability and caused stronger acute responses. Theorell et al [13] found that subway drivers witnessing seriously injured victims by railway accident were absent from work for longer periods than drivers with mildly injured or dead victims. Also, there are studies reporting an association between experience of person-under-train accident and driver's stress caused by poor working environment [14], [15].
Contrary to much of the research conducted in these countries, there is no epidemiological study related to not only an evaluation of PTSD, but also fundamental diagnosis of psychological state in Korean railroad drivers with experience of person-under-train accidents.
The purpose of this study is to collect a basic data on the prevalence degree of PTSD in Korean railroad drivers exposed to person-under-train accidents according to the individual characteristics and working environmental characteristics, to compare them with the previously foreign studies, and to apply them to develop the preventive measures and psychiatric health programs with respect to Korean railroad drivers.
Section snippets
Methods
The study was performed during March and June in 2004. The five major stations (Kuro, Ansan, Shindorim, Suseo, and Daehwa) in Seoul metropolitan subway line and the nine major stations (Seoul, Busan, Daegu, Mokpo, Kwangju, Iksan, Jechun, Donghae, and Chunan) in Korean National Railway line were targeted during former and latter periods, respectively. Questionnaires were sent to all the railroad drivers engaged in each station and now accompanying active service by company post. Focusing on
Results
All the respondents except for one person were male railroad drivers, as a result of the data analysis. This is why most of women in Korea would not prefer the railroad service as a job due to their recognition of it as a difficult and dangerous duty. Because a small group of female respondents is judged to be insignificant, statistical analysis with gender difference was therefore not performed in this study.
Discussion
Based on the results from this study, the following conclusions were obtained compared to the previous reports.
First, young railroad drivers expressed higher prevalence of the posttraumatic stress diagnosis than the old. This is assumed by the fact that most young railroad drivers have a first experience of person-under-train accident after having engaged in this job and are more susceptible to such a terrible scene than the old railroad drivers who have worked relatively for a long time.
Acknowledgments
This article is based on a doctoral dissertation progressed at the Institute for Occupational Health, College of Medicine, Yonsei University, Seoul, Korea, by Byeong S. Yum. We wish to thank the Korea Railroad Cooperation and respondents who made this study possible.
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