Health Effects of Person-Under-Train Incidents on Train Drivers-A Systematic Review.

Background/

Objectives

A person-under-train (PUT) incident is a traumatic event for train drivers that can result in serious health consequences. This systematic review aimed to identify and synthesize evidence on these health effects, including post-traumatic stress disorder (PTSD), sickness absence (SA), and other related mental health outcomes.

Methods

Following the PECO scheme, we searched the PubMed, Web of Science, and Embase databases for studies published between 1980 and 2021. We included cross-sectional, case-control, prospective, and interventional studies focusing on train drivers exposed to PUT incidents. Data synthesis followed PRISMA guidelines, with quality appraisal using the Downs and Black checklist.

Results

The search was conducted on 22 September 2022, resulting in 3673 records. Nine studies were included, involving a total of 3425 participants. PTSD prevalence ranged from 0% to 55.3%, depending on study design and timing of data collection. Risk factors included repeated exposure, lack of social support, and proximity to the victim. SA varied widely, with durations ranging from 1 day to over 6 months. Drivers frequently reported depression, somatoform disorders, and other long-term psychological impacts.

Conclusions

PUT incidents significantly affect the mental health of train drivers and their ability to return to work, frequently leading to extended sickness absence. The timely identification of at-risk individuals and the implementation of best-practice interventions could mitigate long-term effects. Future research should explore standardized follow-up periods to improve comparability.