Photo by Flash90
An Israeli firefighter calls for backup after a car bomb in Jerusalem.

Israeli firefighters, like their peers elsewhere, suffer powerful emotional consequences of their dangerous work, according to a study by Marc Lougassi, a health sciences doctoral student at Ben-Gurion University of the Negev.

Lougassi, an Israeli firefighter himself, is the first to research the prevalence of post-traumatic stress disorder (PTSD) in this high-risk profession, and how firefighters cope with ongoing symptoms such as nightmares, difficulty sleeping, severe anxiety, sweating and flashbacks.

Echoing similar studies in other countries, Lougassi found that out of 300 participants in his survey, 90 percent exhibited the typical stress symptoms of PTSD in the month following exposure to serious injury or death to themselves or the victims they aided.

“This applies to firefighters anywhere,” he tells ISRAEL21c. “Similar results have been found in many countries: 24% of firefighters in Israel say they suffer from full PTSD, 67% showed partial PTSD, and only 9% showed no signs of PTSD. It is important to note that as far as Israeli firefighters are concerned there has been no documented evidence of PTSD prevalence [prior to this], despite the fact that they are exposed to additional traumas such as war and terror strikes that add to the traumas they experience in the course of their daily shifts.”

Marc Lougassi.

He found that a good predictor of PTSD is how the firefighters cope with trauma. The study revealed that psychosocial support most often comes from the firefighter’s family members rather than from trained professionals.

“If we expand social support available through the firefighting unit, we can reduce the chances of PTSD,” Lougassi says. He also recommends that during the recruitment process, potential firefighters should be screened psychologically to determine their susceptibility to developing PTSD.

Working under the auspices of Ben-Gurion’s psychiatry department, Lougassi shared his research results with Yoav Gadasi, head of the Israeli Firefighters Union.

Recurring traumas contribute to PTSD

About 1,160 active firefighters in Israel, as elsewhere, are frequently exposed to extreme stress on the job. In addition to the physical challenges involved in their work, they often deal with burned and injured victims or dead bodies.

Those who agreed to participate in the study come from a range of age groups and educational levels. They include single, married and divorced firefighters with varying years of service as regular firefighters, crew leaders, officers and commanders. Lougassi excluded anyone in psychological treatment, as well as those on regular medications or who’d sustained head injuries.

He selected 300 respondents who had been exposed to a relatively large number of multi-year traumatic events since 1997. An additional 42 subjects, chosen from a crew of 72 flight firefighters based at Ben-Gurion International Airport, constituted the control group because they experience an insignificant amount of traumatic events. Indeed, just 5% of the flight firefighters were discovered to suffer from PTSD, and half of them showed no PTSD or only partial PTSD symptoms.

“These results support the hypothesis that increased exposure to recurring traumatizing events is a significant factor contributing to PTSD development,” according to Lougassi.

He recommends that firefighting units develop updated training programs to prepare new firefighters for functioning in stressful situations, and that they establish professional units for treating emotionally injured firefighters.

Lougassi also says it would be helpful to provide workshops and seminars where early problems may be detected and case studies of successful outcomes could be presented. Finally, he suggests that officers strengthen communication between the firefighting services and the firefighters’ families so that they better understand how to deal with expected stress.

Fire Service Commander Shahar Ayalon told Lougassi he intends to incorporate these recommendations into standard operating procedure in Israel.