Disaster occupations are stressful due to the type of work that is generally required. There are
heavy work loads, long hours, and pressures to accomplish difficult tasks quickly. Additionally,
there may be periods of low activity and little pressures which could be suddenly interrupted
by a situation requiring intense concentration and physical exertion. The excitement and
stimulation of large-scale disasters also leads to stress. Major stressors usually present on
disaster jobs include: the working environment; time pressures; and the work load.
Extreme environments are common in disaster work. Physical discomfort for workers is also
common. Noise can be a major stressor (Glass & Singer, 1972). There are times when the
physical conditions make equipment operation difficult or impossible, leading to major
frustrations. The presence of bystanders may be unwelcome. For example, well-meaning, but
ill-equipped and/or untrained persons may try to help workers and end up becoming victims
themselves.
Rescue workers face time-related stressors. Emergency medical protocols may specify strict
time limits between an injury and the start of surgery. This usually includes the time to extract
the victim, stabilize onsite, and transport to a hospital through the emergency room and into
surgery. These present a major source of stress for rescue workers.
Another form of time-related stress occurs in large-scale disasters. These result from changes
in daily or weekly work routines for extended periods of time. Even though non-standard working
hours are expected by workers, they can become seriously upsetting. For example, Holt (1982)
has shown that evening or night work can cause disturbances in daily body rhythms affecting
sleep, body temperature, gastrointestinal function, and others. Disturbances can also occur in
daily patterns of social living. These may lead to undesirable mood changes and interpersonal
conflicts within the family.
Finally, work overload is a familiar thing to disaster workers. There are two types of work load:
quantative and qualitative (Kahn, 1980). Quantitative work load is defined as the amount of work
to be completed within the available time. Qualitative work load is the ease or difficulty of
accomplishing the task. Due to urgency of task completion, both types of work overload are
likely.
Responsibility overload is another form of stress which may be experienced by supervisory
workers. They may feel overwhelmed because they may have several tasks which require
simultaneous accomplishment. Some examples include: assessing damages and victim needs;
mobilizing adequate resources; establishing a command post; coordinating the work of several
types of units; assessing new hazards as they occur; and giving information to the media for
communication to the public. Incident commanders report that setting up a command post
nearby but removed a bit from the immediate disaster scene helps establish priorities among
responsibilities and helps avoid excessive overload (Falder, 1982; Naysmith, 1982).
Most disaster workers realize that the potential emotional impact on them usually depends on
the type of event (Brown, 1983). There are at least three event stressors that are relevant.
They include: personal loss or injury, traumatic stimuli, and human error or mission failure.
When people lose loved ones or meaningful things, they generally experience grief reactions.
These may include depression or extreme sadness and despair. The extent of the reaction is
related to the significance of the loss. Though disaster workers are not usually the primary
victims, those who do lose family members, friends, or property are at high risk for stress
reactions.
Injuries that lead to loss of function may generate psychological reactions similar to the loss
of possessions. Workers injured during recovery work may be vulnerable to stress reactions,
especially when the injury occurs in conjunction with other stressors (Dohrenwend, 1981).
Severe fatigue can also lead to temporary loss of function, and physical exhaustion seems to
"come with the territory" in disaster work. Emergency situations often require high levels of
sustained and strenuous physical activity. Sometimes these occur after long periods of inactivity,
making preparation for them difficult. Long hours are characteristic of disaster work, and even
workers who function effectively for extended periods on the job may suffer extreme exhaustion
when the task is finished.
Severe threats to basic beliefs about the meaning of life can generate stress. Painful deaths,
gross violations of physical integrity, or the apparent injustice and capriciousness of life are
examples of such traumatic stimuli. Others include contact with bodies, especially those in
mutilated or unnatural conditions, and particularly tragic situations such as the deaths of
children.
If workers are in extremely dangerous surroundings, especially for long periods, they risk
later emotional reactions. In general, situations that are life threatening, or demonstrate
the potential vulnerability of the worker, are likely to be traumatic.
Workers in prolonged and emotional contact with survivors who have been severely traumatized
by disaster may experience the trauma vicariously. This is especially true when the worker
identifies the survivor with a loved one, such as a son or daughter. Workers responsible
for life-and-death decisions, for example in triage situations, are also subject to this
type of pain. When workers must deny extensive medical care to nearly dead patients in favor
of victims with a better prognosis, emotional problems can be anticipated.
Not all people react to traumatic events in the same way. Workers who deal with "guts and
gore" on a daily basis are likely to have developed protective strategies through training
and experience (Palmer, 1983). Reactions to traumatic stimuli are always individualized.
That is they are interpreted through the worker's frame of mind and feelings at the time
of the event. Even the most experienced worker will likely find some events difficult to
deal with.
Disaster workers are highly motivated to perform competently and complete their missions
successfully. These high expectations, when they cannot be met, may lead to beliefs and
feelings about the disaster or the worker's role in the relief effort that cause emotional distress.
One of the attractions of disaster work is the personal satisfaction derived from saving lives,
and many workers have a strong need for this type of reinforcement (Graham, 1981a, 1981b).
When they become highly involved in a rescue effort that ends badly, workers may experience
not only disappointment but major personal failure as well. Including feelings of unworthiness,
even though no rational basis exists for this belief.
Frustrated expectations for success are also illustrated by the mission that requires prolonged
expenditures of energy and attention, appears to be going well, but ends in disappointment.
Related to this are deaths that occur inadvertently due to some action of the rescue personnel.
While long-time disaster workers know that incidents of this nature may occur, they represent
the antithesis of worker motivations and efforts.
Another major stressor is the rescue or relief effort that receives intense media coverage, as
when a rescue is broadcast live over television. Workers may feel that only a perfect
performance is acceptable and that no mistakes will be tolerated.
Finally, in manmade disasters, both victims and workers are often outraged that the event was
allowed to occur, and this high degree of anger may interfere with the emotional recovery
process. Mission failure or human error may generate a strong sense of powerlessness and
helplessness.
Certain types of event characteristics, either together or separately, have the potential for
creating emotional distress in disaster workers: personal loss or injury, traumatic stimuli, and
mission failure or human error. When all three of these characteristics are present, the potential
exists for particularly intense stress reactions. Such effects, while debilitating, represent very
normal reactions to quite abnormal situations.
Personal Loss or Injury
Traumatic Stimuli
Mission Failure or Human Error
Summary
Brown, L. (April 13-18 1983). Personal Communication.
Dohrenwend, B.P. (October 15, 1981). Personal communication.
Falder, M. (December 9-11 1982). Report on the Kansas City Hyatt Regency Hotel Disaster. Emergency Management Conference, Indiana Civil Defense Council, Indianapolis.
Glass, C.C. and Singer, J.E. (1972). Urban Stress. New York: Academic Press.
Graham, N.K. (January 1981a). Done in, fed up, burned out: Too much attrition in EMS. Journal of Emergency Services 6: 219-239.
Graham,N.K. (February 1981b). Part 2: How to avoid a short career. Journal of Emergency Medical Services 6:42-48.
Holt, R.H. (1982). Occupational stress. In Goldberger, L. and Brenitz, S., eds. Handbook of Stress: Theoretical and Clinical Aspects. New York: The Free Press.
Naysmith, R. (December 9-11, 1982). Report on the Missassauga Hazardous Materials Emergency Emergency Management Conference, Indiana Civil Defense Council, Indianapolis.
Palmer, C.E. (1983). A note about a paramedic's strategies for dealing with death and dying. Journal of Occupational Psychology 56: 83-86.
