Post-Traumatic Stress

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Construction Safety Association of Ontario

Summary Statement

Article describing how to identify and address Post Traumatic Stress Disorder in witnesses of a traumatic construction accident.

When a death or critical injury occurs on a construction site, it's not only the victims and their families who suffer.

Coworkers witnessing the accident or helping with first aid may suffer severe emotional stress that can result in injury or illness later. The syndrome affecting workers following a traumatic event on the job is known as post-traumatic stress disorder (PTSD).

Workers experiencing PTSD may show one or more of the following symptoms:

  • physical ­ inability to sleep properly, recurrent nightmares
  • emotional ­ feelings of anger, guilt, grief, or bitterness
  • psychological ­ inability to process information, to make decisions, or to remember common words
  • behavioral ­ withdrawal, excessive use of drugs and/or alcohol.

These symptoms may occur immediately after a traumatic event or may be a delayed reaction to the stress. They may last a few days or persist for weeks or even months, unless professional help is provided.

Construction employers, supervisors, and workers must recognize that PTSD can be a problem after a serious accident. As part of site emergency planning, construction companies should have measures in place to control the effects of PTSD.

Policy and Procedure

The employer's policy and procedures regarding a jobsite fatality or critical injury should include guidelines for controlling the effects of PTSD.


Supervisors should be trained in the immediate on-site response to a serious accident and should have basic knowledge of PTSD symptoms. Trained coworkers, called peer supporters, have been beneficial in dealing with PTSD because they understand the workplace. Peer support members are trained 1) to provide education before a traumatic event takes place, and 2) to assist workers in coping with emotional stress after the event.

Supervisors should always be included in peer support awareness training, as they are often the first on the scene of the accident and deal with its initial impact. Remember, however, that peer supporters are not trained therapists and should always operate under the guidance of a certified trauma specialist.

Crisis Intervention

In response to a fatality or critical injury, professional trauma assistance should be on the jobsite within 24 to 72 hours after the event. Early intervention is critical in helping to prevent PTSD.

Professional assistance in managing PTSD is offered by various organizations. When selecting one, make sure that trained trauma counselors are available 24 hours a day, 365 days a year, and can be on site within one to three days after the incident.


Defusing. This is crisis intervention in a group format. Within hours of the traumatic event, counselors teach workers how they can reduce their reaction to stress.

Debriefing. This is done on the day after the incident and helps workers understand the factual and emotional aspects of PTSD.

One-on-one Discussion. At the defusing or debriefing, counselors identify individuals with severe reactions to the event. Referral to a health care professional may be appropriate at this point.

Group Follow-up. Within five days of the debriefing, the trauma counselor calls the workplace contact to determine whether there is need for further intervention.

Family Information Sessions. Usually, this is a session explaining how to support family members suffering from PTSD.

Follow-up Evaluation. The trauma team manager follows up with the employer to assess the effectiveness of the policy and procedures in place for managing PTSD. Necessary changes can be implemented in a revised plan.


Post-traumatic stress disorder must be controlled to avoid further injury or illness after a serious accident. Preventive procedures can help to ensure that people touched by trauma recover to lead healthy lives.