# Driving in emergency medical service settings: a cross-sectional study of clinical psychological factors and perceived stress in a sample of ambulance drivers

## TL;DR

This study explores stress levels and influencing factors among ambulance drivers, finding that women report higher stress and that lifestyle and health factors play a role.

## Contribution

The study provides new insights into stress predictors and lifestyle profiles among ambulance drivers, emphasizing gender differences and the role of physical activity and alcohol consumption.

## Key findings

- Female ambulance drivers reported significantly higher perceived stress compared to males.
- Physical activity was found to have a protective effect against stress, while alcohol consumption increased stress levels.
- Cluster analysis identified two distinct lifestyle profiles among drivers based on physical activity and alcohol consumption patterns.

## Abstract

Ambulance drivers represent a critical yet understudied component of emergency healthcare systems, exposed to high levels of occupational stress. Despite their essential role in patient transport and emergency response, this population has received limited attention compared to other healthcare professionals. This cross-sectional study aimed to investigate perceived stress levels and associated factors among professional ambulance drivers, examining gender differences, predictive factors, and behavioral profiles.

A sample of 1.436 ambulance drivers (76.7% male, mean age 52.77 years) underwent occupational health surveillance between October 2024–2025 at the Polyclinic University Hospital in Catania, Sicily. Perceived stress was assessed using the Perceived Stress Scale (PSS-10), which demonstrated excellent reliability (Cronbach’s α = 0.995). Data on sociodemographic characteristics, health status, and lifestyle habits were collected. Statistical analyses included independent t-tests, multiple linear regression, and cluster analysis.

Female drivers reported significantly higher perceived stress (M = 11.77, SD = 9.01) compared to males (M = 8.84, SD = 7.53), with a small-to-moderate effect size (Cohen’s d = −0.37). Multiple regression analysis identified several significant predictors of stress: female gender (B = 3.07, p < 0.001), longer work experience (B = 0.11, p = 0.006), presence of medical conditions (B = 1.22, p = 0.006), and higher alcohol consumption (B = 0.90, p = 0.017), while physical activity showed a protective effect (B = −0.28, p = 0.037). The model explained 4.5% of variance (R2 = 0.045). Cluster analysis revealed two distinct lifestyle profiles: one characterized by high physical activity but elevated alcohol consumption, and another by sedentary behavior with lower alcohol intake.

Ambulance drivers experience significant occupational stress influenced by multiple factors including gender, work seniority, health status, and lifestyle behaviors. Physical activity emerges as a protective factor, while alcohol consumption represents a risk factor. These findings highlight the need for multidimensional prevention strategies integrating both organizational interventions and individual support programs, with particular attention to gender-specific needs and promotion of healthy lifestyles.