'Person under train' incidents from the subway driver's point of view--A prospective 1-year follow-up study: The design, and medical and psychiatric data

From the subway driver's point of view, a 'person under train' (PUT) incident is a serious life event. This study focuses on the 1-yr consequences of such events. Follow-up was made 3 wk, 3 months and 1 yr after the event. 40 consecutive PUT subway drivers were followed. For each PUT driver, a control driver matched with regard to gender, age and country of birth was followed at identical intervals. Main results: the PUT group had significantly more sick days during the interval from the event to 3 wk later. During the period 3 wk to 3 months after the event no difference between the groups was observed. From 3 months to 1 yr after the PUT significantly more days were again reported by the PUT group. 38% in the PUT groups vs 14% in the control group had at least 1 month of sickness absence during this period. A mild acute psychophysiological reaction was observed 3 wk after the event, with elevated prolactin and increased sleep disturbance in the PUT group. Such acute reactions were transitory and not correlated with long-term sick leave, which was predicted independently, however, by a high plasma cortisol level (analysed in men) and a high depression score. Drivers in the group with seriously injured victims were absent from work for longer periods than drivers in the groups with mildly injured or dead victims. PUT victims described a successively worsened psychosocial work situation during the 12 months of follow-up whereas the drivers in the control group described an unchanged situation.