The Effect of Repeated Exposure Trauma on Firefighters


Many research studies have focused on firefighter mental health challenges due to a single traumatic event. But what about repeated exposure to such events? This article details findings from a research project1 that studied the impact of repeated exposure trauma (RET) on firefighters.


Across the country, firefighters are responding to fewer fires but are increasingly called upon to provide Emergency Medical Services (EMS), perform search and rescue, and react to hazardous materials incidents and natural disasters. They come across a wide variety of tragic situations that play out in or around their homes, along highways, and in every other conceivable part of their communities.

RET — the cumulative effect of regularly caring for the broken bodies and wounded minds of victims and their families — is thought to have a negative psychological impact on firefighters’ own mental health. Previous studies have looked at firefighter mental health challenges in the context of post-traumatic stress syndrome (PTSD), which relies on assessment instruments attuned to one particular traumatic event.

Takeaways from previous studies

  • Evidence shows that rates of depression among fire and EMS personnel are higher than in the general population.

  • Firefighters have higher rates of alcohol use and binge drinking compared to the general population. There is a possible connection between risky drinking behaviors and PTSD.

  • Firefighters experience “secondary trauma” or “compassion fatigue” from repeated exposure to trauma. They may not be diagnosed with PTSD, but clearly suffer from symptoms such as sleep disorders, avoidance behaviors, and feelings of helplessness that are associated with PTSD.

Takeaways from this study


  • It is more common for firefighters to experience a negative mental health impact from a series of traumatic events rather than from one single event.

  • Symptoms of RET for most firefighters include desensitization, irritability, cynicism and intrusive flashbacks.

  • Many firefighters appear to effectively manage their emotional response to trauma. Future research should explore their protective coping methods and resiliency.

Published by U.S. Fire Administration | Read the article

Chea DavisResearch, Firefighters