Long Work Hours, Majority of Time Working With COVID-19 Associated With PTSD

PTSD
sad woman alone with surgical mask
Public health workers were evaluated for traumatic events or stressors experienced since March 2021, mental health symptoms, employer-provided resources, and workplace factors.

According to a study published in the Morbidity and Mortality Weekly Report, higher prevalence of post-traumatic stress disorder (PTSD) among public health workers during the second year of the COVID-19 pandemic was associated with more work hours and a greater proportion of time spent working on COVID-19 response activities.

In March 2022, state, tribal, local, and territorial (STLT) public health workers were invited to self-administer an anonymous, web-based survey. The participants were evaluated for traumatic events or stressors experienced since March 2021, mental health symptoms, employer-provided resources, and workplace factors.

Nearly half of respondents (N=26,069; 48.0%) said they had symptoms consistent with a mental health condition. The most common conditions were PTSD (28.4%), anxiety (27.9%), depression (27.7%), and suicidal ideation (8.1%).

Stratified by demographic characteristics, risk for PTSD was associated with spending ≥76% of working time on COVID-19 activities (prevalence ratio [PR], 2.43), working >60 hours per week (PR, 2.07), being transgender or nonbinary (PR, 1.98), and ≤29 years of age (PR, 1.80).

Stratified by the number of hours worked and the time spent on the COVID-19 response, the highest risk for PTSD was observed among those who worked >60 hours weekly and spent ≥76% of their time on COVID-19 (PR, 2.48), followed by those working 41-60 hours and spending ≥76% of their time on COVID-19 (PR, 2.63), >60 hours and spending 51%-75% of their time on COVID-19 (PR, 2.19), and working 41-60 hours and spending 51%-75% of their time on COVID-19 (PR, 2.16).

Individuals who were overwhelmed by workload or family and work balance (PR, 2.98); were disconnected from family and friends due to work (PR, 2.74); experienced stigma or discrimination because of work (PR, 2.12); received job-related threats (PR, 2.12); were bullied, threatened, or harassed because of work (PR, 2.12); inadequately compensated for their work (PR, 2.02); and unappreciated at work (PR, 2.01) were associated with a higher prevalence of PTSD.

Compared with a similar survey conducted the previous year, the 2022 sample reported a reduction (P <.001) in PTSD (-8.4%), depression (-3.1%), and anxiety (-2.4%). Despite these trends, PRs for PTSD increased among subgroups of participants stratified by hours of work and proportion of time spent working with the COVID-19 response.

This study may have included recall bias, as participants relied on recollection.

Study authors concluded, “Public health workers who spent more time on COVID-19 response activities were more likely to report mental health symptoms, including PTSD. Compared with results of the 2021 survey of STLT public health workers, in 2022, prevalence of PTSD was 15.7% lower among public health workers who worked >60 hours per week and spent ≥76% on COVID-19. However, the PRs increased, and the prevalence of PTSD (49.5%) was higher for this group than the overall prevalence of PTSD (28.4%).”

Reference

Koné A, Horter L, Thomas I, et al. Symptoms of mental health conditions and suicidal ideation among state, tribal, local, and territorial public health workers — United States, March 14-25, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(29):925-930. doi:10.15585/mmwr.mm7129a4