Abstract
OBJECTIVE: This study aimed to comprehensively evaluate changes in lifestyle behaviors and mental health status among rescue workers before and after a major public health emergency, and to identify key modifiable risk factors associated with psychological distress in this critical population. METHODS: A cross-sectional online survey was conducted between February 23 and March 9, 2020, among rescue workers from a designated unit in China. Using a retrospective design, 1,052 valid responses were collected. Participants reported lifestyle behaviors (smoking, alcohol use, mobile phone use, physical activity, work hours, sleep quality) for both pre- and post-outbreak periods. Mental health was assessed using the PHQ-9 and GAD-7 scales. Statistical analyses included paired comparisons, correlation analysis, stratification by living status and age group, and multivariable regression models. RESULTS: Significant adverse lifestyle changes occurred post-outbreak: increases in smoking (13.98% of smokers), alcohol consumption (6.02% of drinkers), mobile phone use (median rise from 2 to 3 h/day), and nocturnal awakenings, alongside declines in physical activity (inactivity rose from 6.56 to 17.68%) and work hours. Mild-to-severe anxiety and depression prevalence were 9.98% and 10.17%. CONCLUSION: Public health emergencies trigger unhealthy lifestyle shifts and significant mental health deterioration among rescue workers, with restrictive environments amplifying these risks. These findings highlight the urgent need for integrated biosecurity strategies combining psychological support, health behavior promotion, and organizational modifications to protect frontline responders and sustain operational readiness during prolonged crises.