Biopsychosocial and Occupational Health of Emergency Healthcare Professionals: A Systematic Review and Meta-Analysis.

Background/

Objectives

Emergency healthcare professionals are continually exposed to high clinical and organizational demands that compromise their mental, physical, and occupational health. This systematic review and meta-analysis examined the prevalence and interrelations of biopsychosocial and work-related health outcomes among emergency personnel, providing an integrated synthesis of recent empirical evidence.

Methods

A systematic search of PubMed, Scopus, Web of Science, and CINAHL identified 6214 records, of which 50 studies met inclusion criteria and were analyzed (total n = 278,000 emergency professionals). Eligible studies (2020-2025) evaluated biopsychosocial outcomes (burnout, depression, stress, resilience, sleep quality) and occupational indicators (workplace violence, job satisfaction, effort-reward imbalance, engagement, turnover intention). Meta-analyses were conducted using random-effects models (DerSimonian-Laird method), producing pooled prevalence estimates for each outcome based on the number of studies that reported the corresponding variable. Risk of bias was assessed using the Joanna Briggs Institute tools, with most studies rated as moderate-to-high quality.

Results

Pooled estimates showed fair self-perceived health in 44.0%, severe burnout in 10.7%, depressive symptoms in 35.1%, moderate-to-severe stress in 74.6%, and poor sleep quality in 40.1% of staff. Workplace violence affected 76.9% of professionals. Job satisfaction averaged 68.1%, turnover intention 62.1%, and effort-reward imbalance 61.9%. Resilience was predominantly moderate (33.9%). Considerable heterogeneity was observed; however, patterns were consistent across regions and professional roles.

Conclusions

Emergency healthcare personnel face substantial biopsychosocial strain and occupational risks, driven by persistent structural pressures. Health systems should implement integrated organizational strategies to reduce violence, enhance psychological support, ensure safe staffing, and protect rest and recovery. Improving staff well-being is essential for maintaining a resilient and effective emergency care workforce.