Abstract
BACKGROUND: Working in emergency medical services involves a high level of physical and psychological stress. The proportion of female professionals in the German emergency medical services has been steadily increasing in recent years. This gender-comparative study therefore aims to identify potential differences and similarities in the stress profiles of men and women across different age groups regarding physical and psychosocial complaints. METHODS: A total of 201 employees (132 male, 69 female) from the emergency medical services in one German federal state (Hesse) voluntarily participated in this survey, which included the Nordic Musculoskeletal Questionnaire (NMQ), the Copenhagen Psychosocial Questionnaire (COPSOQ) and the Sources of Occupational Stress in Firefighters and Paramedics (SOOS-14) questionnaire. In addition to comparing all variables between genders and different age groups, a total score was calculated based on a Rasch model for the items of the COPSOQ and SOOS-14. Correlations were performed with sociodemographic data as well as well-being (total COPSOQ score) and individual stress levels (total SOOS-14 score). RESULTS: The prevalence of physical complaints was highest in the cervical spine at 72.6%, with women affected significantly longer (p ≤ 0.01; female: 42% > 30 days/12 months vs. male: 16.7% > 30 days/12 months). This corresponded with the subjective perception of 74.1% of respondents who regularly had to perform heavy physical work. Overtime was worked regularly by 94.6%, and 51.2% perceived emotional stress to be above average. No significant differences were found in occupational stressors and psychosocial factors across all age and gender groups, except for the diversity evaluation between genders, with women reporting higher levels of variety in their work (p < 0.01). Sleep interruptions and poor nutrition were the most important job-related stress factors for both genders. An above-average level of pride (74.6%) and meaningfulness (73.2%) compensated for this high workload. Correlations were particularly evident among female participants between higher weight (p < 0.01; rho = -0.39), and higher body mass index (p < 0.01; rho = -0.37) and health status. Men’s well-being and occupational stress was more severely impaired by higher weekly working hours and larger amount of active service (p < 0.01; rho = 0.3) in older men and high body mass index (p < 0.01; rho = 0.4) in younger men. CONCLUSION: Women in particular rate their health as similar to that of their male colleagues despite higher physical stress - especially in younger women - with obesity negatively influencing their self-assessment. For older male employees, higher mental stress and strain at work is associated with long working hours. Psychosocial factors such as professional pride and meaningfulness appear to serve as important resilience resources for both genders. Future analyses should therefore be multidimensional. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12995-025-00495-0.