OCCUPATIONAL IMPACT OF MUSCULOSKELETAL OR MENTAL DISORDERS ON HEALTH-RELATED QUALITY OF LIFE OF PUBLIC SAFETY PERSONNEL: SYSTEMATIC REVIEW AND META-ANALYSIS

T. Osifeso¹, J. MacDermid¹, P. Bobos¹, K. Sinden², P. Parikh¹

¹Western University, Health and Rehabilitation Science, London, Ontario, Canada, ²Lakehead University, Kinesiology, Thunder Bay, Ontario, Canada

Background: Public safety personnel (PSP) including firefighters, police offices, and paramedics are exposed to daily traumatic and stressful situations including physical, emotional, and mental stress because of their job. Despite this occupational burden, there is currently no synthesized information on the occupational impact of musculoskeletal or mental health disorders on the Health-Related Quality of Life (HRQoL).

Purpose: a) To determine if there is a difference in HRQoL scores of PSP with or without musculoskeletal or mental health disorders, b) To compare the HRQoL scores of PSP and the general population using age-matched normative data of Short Form (SF-12, SF-36) and European Quality of Life Five-Dimension (EQ-5D) outcome measures.

Methods: This systematic review and meta-analysis was done in accordance with the PRISMA guidelines. Six databases were searched including PubMed, Embase, Web of Science, PsycINFO, CINHAL, and Scopus. A grey literature search was also completed through hand searching of google scholar and the reference lists of included studies. Two reviewers (TO and PB) independently screened the studies and conducted quality assessment. Mean and standard deviation for each domain of the SF-12 and SF-36 were reported. A random effect model using Dar Simonian and Laird was utilized for the meta-analysis and subgroup analysis comparing the PSP without health disorders (full cohort), PSP with mental health disorders and PSP with alcohol abuse. The normative datasets of Brazil and the USA was utilized for comparison because both countries had the most and equal number of studies in the review.

Results: The search yielded a total of 537 studies, 15 met inclusion/exclusion criteria for the systematic review, while 12 fair to high quality studies were eligible for meta-analysis including 10,099 participants aged between 31 to 51 years. Meta-analysis of the SF-12 pooled mean scores indicated that the PSP with mental health disorders had the lowest physical component summary (PCS) scores, 45.8 (44.3 - 47.4) and mental component summary (MCS) scores, 39.3 (34.9-43.7) compared to PSP full cohort, PCS scores 50.7 (49.3-52.1) MCS scores 48.2(46.2-50.2) and PSP with alcohol abuse, PCS scores 47.1(44.1-50.1) MCS scores 44.3(35.1-53.5). A subgroup analysis showed that there is a statistically significant difference (p < .001) between the PSP groups with mental health disorders, PCS scores, 45.8 (44.3 - 47.4) and MCS scores, 39.3 (34.9-43.7) and PSP without any health disorders, PCS scores, 50.7 (49.3-52.1) and MCS scores 48.2 (46.2-50.2). For PSP subgroups full cohort, the HRQoL of police, 50 (48- 51.9) and paramedics, 49.9 (48.2- 51.7) showed equal PCS scores while the MCS scores of the police, 46.1 (42.5- 49.7) was lower compared to paramedics, 47.8 (45.1- 49.4) and firefighters, 51 (45.5 - 56.6). Lastly, the HRQoL scores of PSP full cohort was lower in comparison to the normative datasets from Brazil, with PCS scores, 55 (54 - 55) and MCS scores, 52 (52 - 53).

Conclusions: PSP with mental health disorders had the lowest HRQoL scores when compared to other PSP groups without any health disorders and the Brazilian normative datasets.

Implications: This study indicates PSP have compromised mental and physical health that may benefit from physiotherapy.

Funding acknowledgements: There was no financial or non-financial support for the review

Keywords:
Mental health disorders
Public safety personnel
Health-Related Quality of Life

Topics:
Occupational health & ergonomics
Musculoskeletal
Mental health

Did this work require ethics approval? No

Reason: An ethical approval was not required because the study was a systematic review and meta-analysis which required the synthesis of previous studies from literature.