Annals of Occupational and Environmental Medicine

  • 제23권2호
  • /
  • Pages.139-148
  • /
  • 2011
  • /
  • 1225-3618(pISSN)
  • /
  • 2052-4374(eISSN)
대한직업환경의학회 (The Korean Society of Occupational & Environmental Medicine)
권호 표지

버스 운전사의 근무 중 사고경험과 외상 후 스트레스 장애

The Relationship between the Experience of an Accident and Post Traumatic Stress Disorder in Bus Drivers

  • 최원선 (가톨릭대학교 성모병원 산업의학과) ;
  • 조성애 (전국운수산업노동조합) ;
  • 김경연 (가톨릭대학교 성모병원 산업의학과) ;
  • 조영승 (가톨릭대학교 성모병원 산업의학과) ;
  • 구정완 (가톨릭대학교 의과대학 예방의학교실 및 산업의학센터) ;
  • 김형렬 (가톨릭대학교 의과대학 예방의학교실 및 산업의학센터)
  • Choi, Won-Seon (Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital) ;
  • Cho, Sung-Ae (Korean Transport Workers' Union) ;
  • Kim, Kyeong-Yeon (Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital) ;
  • Cho, Young-Seung (Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital) ;
  • Koo, Jung-Wan (Department of Preventive Medicine, Catholic Industrial Medical Center, The Catholic University of Korea) ;
  • Kim, Hyoung-Ryoul (Department of Preventive Medicine, Catholic Industrial Medical Center, The Catholic University of Korea)
  • 발행 : 2011.06.30
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 버스 운전사들을 대상으로 근무 중 사고경험에 따른 외상 후 스트레스 장애의 유병률 및 관련요인을 알아보고, 외상 후 스트레스 장애가 우울증상 및 근무에 미치는 영향을 알아보고자 하였다. 방법: 운수노동조합에 소속되어 있는 버스 운전사 491명을 대상으로 일반적 특성, 승객과의 갈등을 포함하여 근무 중 사고경험 유무, 외상 후 스트레스 장애와 우울증상 등을 포함한 설문조사를 하였으며, 사고 경험과 외상후 스트레스 장애의 관련성, 외상 후 스트레스 장애와 우울증상, 작업손실과의 관련성에 대해 분석하였다. 결과: 사고 경험 종류에 상관없이 근무 중 사고 경험이 있는 군에서 외상 후 스트레스 장애가 의심되는 운전자가 많았으며, 타인이 사망한 사고 경험과 승객과의 갈등이 외상 후 스트레스 장애에 있어 중요한 요인인 것으로 나타났다. 외상 후 스트레스 장애군에서 우울증상을 호소하는 비율이 높았고, 작업손실 및 작업장애일수도 평균적으로 많았다. 결론: 버스 운전사들의 근무 중 사고 경험은 외상 후스트레스 장애와 관련이 있었으며, 이는 우울증상이나 업무에도 영향을 줄 가능성이 있는 것으로 나타났다. 버스는 많은 시민의 안전과 연결되어 있는 만큼 운전사들의 정신건강을 보호할 수 있는 방안이 마련되어야 하며, 실태 조사와 사고 후 관리 프로그램의 개발 및 제공에 대한 관심이 필요하다.

Objectives: Mental fitness issues have recently become a point of dispute in the field of health. Drivers are occupationally in danger of a possible accident, and are also exposed to other factors aside from accidents that threaten their mental health. The purpose of this research is to examine the level and state of post traumatic stress disorder (PTSD) and overall mental fitness in bus drivers. In addition, we wish to understand the various causes that can influence PTSD. Methods: From April 1 to June 30, 2009, taking the region and number of workers into consideration, survey sheets were distributed to selected bus drivers who belonged to the public transportation union. The questionnaire included questions on experiences, details of accidents, the characteristics of the working environment, and the status of mental health. We used the Davidson Trauma Scale to investigate PTSD symptoms and the Center for Epidemiological Studies Depression Scale to evaluate depression. Results: Regardless of the type of accident, the group of bus drivers with accident experience showed stronger signs of suffering from PTSD. It seemed that the experience of an accident that caused the death of passengers or conflict with passengers were important factors for PTSD. Within the PTSD group, we found more symptoms of depression, and also this group is more likely to take time off work. Conclusions: The experience of an accident threatens the mental health of bus drivers. Since bus drivers are responsible for the safety of many citizens, we must work towards finding ways to protect their mental health.

키워드

참고문헌

  1. Road Traffic Authority. Traffic Accident Analysis Center. Road Traffic Accidents in Korea 2010. Available from: http://www.rota.or.kr/Work/Code/RotaSafety/RotaSafety18_view_list.jsp?no=12¤tPage=1&tbl_name=BB_analysis01&category_id=0.
  2. Lim SJ, Kim WC, Jung SM, Chang MS. Bus traffic accident analysis: before and after transportation reform in Seoul. research of Seoul & other cities 2006;7(2):1-12. (Korean)
  3. Brunet A, Boyer R, Brillon P, Ehrensaft E, Stephenson R. Lifetime exposure to traumatic events among a sample of city bus drivers. Psychol Rep 1998;83:1155-60.
  4. Dickov A, Martinovic-Mitrovic S, Vuckovic N, Siladji-Mladenovic D, Mitrovic D, Jovicevic M, Misic-Pavkov G. Psychiatric consequences of stress after a vehicle accident. Psychiatr Danub 2009;21(4):483-9.
  5. Mayou R, Bryant B, Duthie R. Psychiatric consequences of road traffic accidents. BMJ 1993;307(6905):647-51. https://doi.org/10.1136/bmj.307.6905.647
  6. Vedantham K, Brunet A, Boyer R, Weiss DS, Metzler TJ, Marmar CR. Posttraumatic stress disorder, trauma exposure, and the current health of Canadian bus drivers. Can J Psychiatry 2001;46(2):149-55.
  7. Textbook Of Psychiatry. Korean Neuropsychiatric Association. Jungang Moonwha. Seoul. 2005. pp 222-6. (Korean)
  8. Seethalakshmi R, Dhavale HS, Gawande S, Dewan M. Psychiatric morbidity following motor vehicle crashes: a pilot study from India. J Psychiatr Pract 2006;12(6):415-8. https://doi.org/10.1097/00131746-200611000-00012
  9. Matsuoka Y, Nishi D, Nakajima S, Kim Y, Homma M, Otomo Y. Incidence and prediction of psychiatric morbidity after a motor vehicle accident in Japan: the Tachikawa Cohort of Motor Vehicle Accident Study. Crit Care Med 2008;36(1):74-80. https://doi.org/10.1097/01.CCM.0000291650.70816.D6
  10. Lee SM, Kim CH. Precipitating factors of posttraumatic stress disorder and psychological characteristics in bus accident victims. The Korean Journal of Clinial Psychology 2002;21(3):547-63. (Korean)
  11. Yi SM, Kim DI. A study of chronic posttraumatic stress disorder in physically injured patients by motor vehicle accidents : a prospective study on incidence, pattern of symptom changes and predictors. Journal of the Korean Neuropsychiatric Association 2000;39(5):797-808. (Korean)
  12. Tranah T, Farmer RD. Psychological reactions of drivers to railway suicide. Soc Sci Med 1994;38(3):459-69. https://doi.org/10.1016/0277-9536(94)90448-0
  13. Karlehagen S, Malt UF, Hoff H, Tibell E, Herrstromer U, Hildingson K, Leymann H. The effect of major railway accidents on the psychological health of train drivers--II. A longitudinal study of the one-year outcome after the accident. J Psychosom Res 1993;37(8):807-17. https://doi.org/10.1016/0022-3999(93)90170-K
  14. Cothereau C, de Beaurepaire C, Payan C, Cambou JP, Rouillon F, Conso F. Professional and medical outcomes for French train drivers after "person under train" accidents: three year follow up study. Occup Environ Med 2004;61(6):488-94. https://doi.org/10.1136/oem.2003.007922
  15. Vatshelle A, Moen BE. Serious on-the-track accidents experienced by train drivers: psychological reactions and long-term health effects. J Psychosom Res 1997;42(1):43-52. https://doi.org/10.1016/S0022-3999(96)00214-0
  16. Woo JM, Kang TY, Lee JE. Increasing risk of mental health problems among subway drivers experiencing accidents on the track. The Korean Society of Occupational Medicine 2005;17(1):36-43. (Korean)
  17. Choi JH, Chung IJ, Chung MY. The risk factors for posttraumatic stress disorder in Veterans. J Korean Neuropsychiatr Assoc 1997;36(6):997-1003. (Korean)
  18. Choi KS. Posttraumatic stress disorder among occupational accident patients. Department of Medical Science Graduate School, Korea University. Seoul. 2001. pp 7-10. (Korean)
  19. Breslau N, Davis GC, Peterson EL, Schultz L. Psychiatric sequelae of posttraumatic stress disorder in women. Arch Gen Psychiatry 1997;54(1):81-7.
  20. Lerner D, Adler DA, Chang H, Berndt ER, Irish JT, Lapitsky L, Hood MY, Reed J, Rogers WH. The clinical and occupational correlates of work productivity loss among employed patients with depression. J Occup Environ Med 2004;46(6 Suppl):S46-55.
  21. Sanderson K, Tilse E, Nicholson J, Oldenburg B, Graves N. Which presenteeism measures are more sensitive to depression and anxiety? J Affect Disord 2007;101(1-3):65-74. https://doi.org/10.1016/j.jad.2006.10.024
  22. Seo HJ, Chung SK, Lim HK, Chee IS, Lee KU, Paik KC, Kim D, Lee SY, Ryu SH, Kim JB, Kim TS, Kim W, Chong J, Chae JH. Reliability and validity of the Korean version of the Davidson Trauma Scale. Compr Psychiatry 2008;49(3):313-8. https://doi.org/10.1016/j.comppsych.2007.10.007
  23. Davidson JR, Book SW, Colket JT, Tupler LA, Roth S, David D, Hertzberg M, Mellman T, Beckham JC, Smith RD, Davison RM, Katz R, Feldman ME. Assessment of a new self-rating scale for post-traumatic stress disorder. Psychol Med 1997;27(1):153-60. https://doi.org/10.1017/S0033291796004229
  24. Chae JH. Evidence based medicine guideline for posttraumatic stress disorder. Korean Academy of Anxiety Disorder. Seoul. 2009. pp 31-2. (Korean)
  25. Cho MJ, Kim KH. Diagnostic validity of the CESD( Korean version) in the assessment of the DSM-III-R major depression. J Korean Neuropsychiatr Assoc 1993;32(3):381-99. (Korean)
  26. Radoloff. The CES-D Scale: A self report depression scale for research in the general population. Apple Psychol Measurement 1977;1:385-401. https://doi.org/10.1177/014662167700100306
  27. Eun HJ, Lee SM, Kim TH. The epidemiological study of posttraumatic stress disorder in an urban area. The Korean Neuropsychiatric association 2001;40(4):581-91. (Korean)
  28. Stein MB, Walker JR, Hazen AL, Forde DR. Full and partial posttraumatic stress disorder: findings from a community survey. Am J Psychiatry 1997;154(8):1114-9.
  29. Woo JM, Kang TY, Lee JE. Increasing risk of mental health problems among subway drivers experiencing accidents on the track. The Korean Society of Occupational Medicine 2005;17(1):36-43.(Korean)
  30. Mayou R, Tyndel S, Bryant B. Long-term outcome of motor vehicle accident injury. Psychosom Med 1997;59(6):578-84.
  31. Breslau N, Davis GC. Posttraumatic stress disorder in an urban population of young adults: risk factors for chronicity. Am J Psychiatry 1992;149(5):671-5.
  32. Yum BS, Roh JH, Ryu JC, Won JU, Kim CN, Lee JE, Kim KY. Symptoms of PTSD according to individual and work environment characteristics of Korean railroad drivers with experience of person-under-train accidents. J Psychosom Res 2006;61(5):691-7. https://doi.org/10.1016/j.jpsychores.2006.07.005
  33. Limosin F, Loze JY, Cothereau C, De Beaurepaire C, Payan C, Conso F, Hautecouverture S, Rouillon F. A prospective study of the psychological effects of "person under train" incidents on drivers. J Psychiatr Res 2006;40(8):755-61. https://doi.org/10.1016/j.jpsychires.2005.04.007
  34. Koren D, Arnon I, Klein E. Acute stress response and posttraumatic stress disorder in traffic accident victims: a one-year prospective, follow-up study. Am J Psychiatry 1999;156(3):367-73.
  35. Ursano RJ, Fullerton CS, Epstein RS, Crowley B, Kao TC, Vance K, Craig KJ, Dougall AL, Baum A. Acute and chronic posttraumatic stress disorder in motor vehicle accident victims. Am J Psychiatry 1999;156(4):589-95.
  36. Jo SJ, Yim HW, Kim HR, Lee KS, Park JI, Chang SM. Association of subway driver's depressive symptoms and experience of work-related problems. Epidemiol Health 2010;32:e2010010.
  37. Brady KT, Killeen TK, Brewerton T, Lucerini S. Comorbidity of psychiatric disorders and posttraumatic stress disorder. J Clin Psychiatry 2000;61 Suppl 7:22-32.
  38. O'Donnell ML, Creamer M, Pattison P. Posttraumatic stress disorder and depression following trauma: understanding comorbidity. Am J Psychiatry 2004;161(8):1390-6.
  39. Breslau N, Davis GC, Schultz LR. Posttraumatic stress disorder and the incidence of nicotine, alcohol, and other drug disorders in persons who have experienced trauma. Arch Gen Psychiatry 2003;60(3):289-94.
  40. Campbell DG, Felker BL, Liu CF, Yano EM, Kirchner JE, Chan D, Rubenstein LV, Chaney EF. Prevalence of depression-PTSD comorbidity: implications for clinical practice guidelines and primary care-based interventions. J Gen Intern Med 2007;22(6):711-8.
  41. Wald J. Work limitations in employed persons seeking treatment for chronic posttraumatic stress disorder. J Trauma Stress 2009;22(4):312-5.
  42. Breslau N, Lucia VC, Davis GC. Partial PTSD versus full PTSD: an empirical examination of associated impairment. Psychol Med 2004;34(7):1205-14.
  43. Lee CK, Park KK, Cho MJ, Jung EK, Kim JK, Kim SW. The epidemilogical survey of psychiatric illnesses in Korea. Ministry of Health & Welfare. Seoul. 2001. pp 271 .(Korean)
  44. Theorell T, Leymann H, Jodko M, Konarski K, Norbeck HE. 'Person under train' incidents from the subway driver's point of view- a prospective 1-year follfollow-up study: the design, and medical and psychiatric data. Soc Sci Med 1994;38(3):471-5.
  45. Guo YJ, Chen CH, Lu ML, Tan HK, Lee HW, Wang TN. Posttraumatic stress disorder among professional and non-professional rescuers involved in an earthquake in Taiwan. Psychiatry Res 2004;127(1-2):35-41.
  46. Wagner D, Heinrichs M, Ehlert U. Prevalence of symptoms of posttraumatic stress disorder in German professional firefighters. Am J Psychiatry 1998;155(12):1727-32.
  47. North CS, Tivis L, McMillen JC, Pfefferbaum B, Spitznagel EL, Cox J, Nixon S, Bunch KP, Smith EM. Psychiatric disorders in rescue workers after the Oklahoma City bombing. Am J Psychiatry 2002;159(5):857-9.
  48. Kim HR, Choi WS, Cho SA, Lee YS. Mental health research of bus and taxi drivers (Translated by Choi WS). Korean Transport Workers Union, The Catholic University of Korea. 2009. pp 39. (Korean)
  49. Lee JY, Yoo JM, Hyun MH. The effects of emotional intelligence, active coping and social support on PTSD symptoms of firefighters. The Korean Journal of Health Psychology 2007;13(2):373-89. (Korean)
  50. Kucukalic A, Dzubur-Kulenovic A. Quality of life in veterans suffering from chronic posttraumatic stress disorder. Med Arh 2009;63(6):339-41.
  51. Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry 1995;52(12):1048-60.
  52. Freedman SA, Brandes D, Peri T, Shalev A. Predictors of chronic post-traumatic stress disorder. A prospective study. Br J Psychiatry 1999;174:353-9.
  53. Kuhn M, Ehlert U, Rumpf HJ, Backhaus J, Hohagen F, Broocks A. Onset and maintenance of psychiatric disorders after serious accidents. Eur Arch Psychiatry Clin Neurosci 2006;256(8):497-503.