Home›Primary Care & Family Medicine› Earthquake responders with personal exposure show higher secondary traumatic stress than deployed personnel
Earthquake responders with personal exposure show higher secondary traumatic stress than deployed personnelPersonal Exposure to Disasters Increases Risk of Traumatic Stress
Frontiers in MedicinePublished October 11, 2026DOI ↗Editorial oversight: Dr. Sofia Müller, MD · Lifespan & Whole-Person Care
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Key Takeaway
Consider personal disaster exposure, not just professional role, when monitoring responders for traumatic stress.
This meta-analysis synthesized 13 quantitative studies comprising 2,894 responders to the 2023 Kahramanmaraş earthquakes to examine secondary traumatic stress and probable PTSD among disaster response personnel. The scope focused on how personal exposure to the disaster, rather than professional role alone, relates to psychological outcomes.
Pooled Secondary Traumatic Stress Scale total scores were 44.37 (95% CI 32.25 to 56.50). Personnel who were resident in or personally affected by the disaster zone had higher secondary traumatic stress scores than deployed personnel not resident in or affected by the zone (48.80 vs 38.40; 10.40-point difference; 95% CI 1.57 to 19.23). Probable PTSD prevalence was 14.5% (95% CI 8.5 to 21.5).
Secondary traumatic stress varied by type of personal exposure: physical injury (Hedges' g = 0.99), home destruction (Hedges' g = 0.70), and bereavement (Hedges' g = 0.41). These effect sizes were reported without corresponding confidence intervals.
The authors noted that the difference in scores between resident and deployed personnel was imprecisely estimated. No adverse events, follow-up duration, funding, or conflicts of interest were reported. The evidence is associational and does not establish causality.
Practice relevance suggested by the authors is that task allocation and post-deployment monitoring should be organized around personal exposure rather than professional role alone. Clinicians should interpret these findings as hypothesis-generating given the imprecision and observational nature of the included data.
How this fits prior evidence
This meta-analysis extends prior coverage of PTSD by shifting focus from individual-level interventions and biomarkers to disaster responder triage. Prior coverage noted that heart rate variability biofeedback shows mixed results for PTSD and may serve only as a supportive intervention, and that voice and speech biomarkers lack validation for clinical use. This synthesis addresses a gap in identifying which responders are at highest risk based on personal exposure, rather than relying on professional role alone. It does not confirm or contrast with the genetic overlap finding between GERD and PTSD, nor with ketamine or bereavement frameworks, but adds an occupational exposure dimension to the PTSD literature.
A meta-analysis looked at the mental health of 2,894 responders following the 2023 Kahramanmaraş earthquakes. The study compared the stress levels of personnel who lived in or were personally affected by the disaster zone against those who were only deployed to the area for work.
The findings showed that responders with personal exposure to the disaster had higher scores for secondary traumatic stress. Specifically, those in the affected zone scored 48.80 compared to 38.40 for those who were not residents. The study also found that 14.5% of the group showed signs of probable post-traumatic stress disorder.
Because the data on the exact difference caused by personal exposure was not precisely measured, the results should be viewed with caution. However, the data suggests that personal connection to a disaster site may impact a responder's mental health. These findings suggest that mental health monitoring should consider a person's personal ties to a disaster area rather than just their professional role.
What this means for you:
Responders with personal ties to a disaster zone may experience higher levels of traumatic stress.
Common questions
Who was included in this study?
The study included 2,894 responders who were involved in the response to the 2023 Kahramanmaraş earthquakes. This group was analyzed across 13 different quantitative studies to compare those who lived in the disaster zone with those who were only deployed to the area.
What did the study find about stress levels?
The study found that personnel resident in or affected by the disaster zone had higher scores for secondary traumatic stress than those who were not residents. Specifically, the scores were 48.80 for those with personal exposure compared to 38.40 for those without it.
How common was post-traumatic stress disorder?
The study found a 14.5% prevalence of probable post-traumatic stress disorder among the responders studied. These findings suggest that personal exposure to a disaster may be a factor in the mental health of first responders.
BackgroundThe Kahramanmaraş earthquakes on February 6, 2023 prompted one of the largest disaster response operations on record. Responders faced repeated exposure to death and distress, and locally recruited personnel were often disaster-affected themselves. Existing syntheses of this event excluded responders.MethodsFollowing PRISMA 2020 (PROSPERO-registered), seven Turkish and English sources were searched for studies on psychological outcomes among responders to these earthquakes. The primary outcome was secondary traumatic stress. Outcomes were pooled in random-effects models (restricted maximum likelihood, Hartung–Knapp–Sidik–Jonkman adjustment); prevalence after Freeman–Tukey transformation. Personal exposure was a pre-specified moderator.ResultsTwenty-one studies were included; 13 quantitative studies contributed data on 2,894 responders. The pooled Secondary Traumatic Stress Scale total across four studies was 44.37 (95% CI 32.25–56.50; I2 = 99.2%). Heterogeneity appeared partly attributable to personal exposure: personnel resident in or affected by the disaster zone scored 48.80 against 38.40 among deployed personnel, an imprecisely estimated difference of 10.40 points (95% CI 1.57–19.23), with τ2 falling from 46.96 to 8.22 among deployed personnel. Pooled prevalence of probable post-traumatic stress disorder across three studies was 14.5% (8.5–21.5). Within the largest sample, personal exposure predicted secondary traumatic stress in graded fashion: physical injury Hedges’ g = 0.99, home destruction g = 0.70, bereavement g = 0.41.ConclusionWhether the responder was also a victim was the most consistent modifier of outcome. Its direction was consistent, but its magnitude was imprecise and possibly small. Task allocation and post-deployment monitoring should be organized around personal exposure rather than professional role alone.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261289019, identifier CRD420261289019.
