In brief
A serious occupational accident affects not only the injured employee but everyone who saw it, ran to give first aid and managed that shift. Sleep disturbance, reliving the accident in the mind and avoiding the machine in the first days are normal reactions for most people and fade over time; symptoms lasting longer than a month or impairing functioning call for specialist assessment. The employer's task is not compulsory "talking meetings" but safety, accurate information, voluntary support, follow-up by the workplace physician and a planned return to work.
Trauma after an occupational accident: what lies behind "I'm fine"?
An employee's hand gets caught on the press line. Two colleagues beside them stop the machine, the first aider tries to stop the bleeding and the foreman meets the ambulance. The next day they are all at work; when asked, they say "I'm fine". A week later one of them asks for leave to avoid going near the press line, and the other only tells the physician at the third consultation that they cannot sleep at night. Trauma after an occupational accident is the invisible second consequence of the accident, and it is often overlooked in people other than the injured person.
The people who may be affected are not only those who were there at the moment of the incident:
- Those who directly witnessed the accident and stopped the machine,
- Those who ran to give first aid and carried the casualty,
- The foreman who managed the shift and colleagues thinking "I should have warned them",
- The maintenance team who cleaned the scene or put the machine back into service,
- In fatal accidents, the whole workplace and close colleagues.
Normal reactions and warning signs in employees who witness an accident
Most of the reactions seen among employees who witness an accident are normal reactions to an abnormal event. Post-traumatic stress in the workplace often appears not as a diagnosis but as absenteeism, attention errors or avoidance of a particular machine. What matters is being able to distinguish a normal reaction from a situation that needs help.
| Time | Common reactions that usually pass | Signs requiring specialist assessment |
|---|---|---|
| First hours and days | Shock, numbness, trembling, crying, anger, guilt, disturbed sleep and appetite, the event flashing before the eyes | Seeming detached from reality, disorientation, thoughts of self-harm |
| First weeks | Avoiding the scene and the machine, being startled by sudden noises, poor concentration, nightmares | Symptoms increasing, being unable to come to work, increased use of alcohol or medication |
| After one month | Symptoms decreasing markedly | Symptoms persisting or impairing daily functioning |
In psychiatric classification, intense symptoms lasting between three days and one month after the event are assessed as acute stress disorder, and symptoms lasting longer than a month as post-traumatic stress disorder (PTSD). Making these diagnoses is not the job of the employer or the foreman; but knowing the one-month threshold makes it easier to understand who should be referred and when.
Psychological support after an accident: the first 72 hours
In the first hours, psychological support after an accident is not therapy but providing order and safety. Plan the following steps for the first three days after the accident:
- Safety and basic needs: The scene is made safe; witnesses are taken away from the area to a quiet place where they can sit down, and their need for water and food is met. Nobody is sent back to the machine where the accident happened on the same shift.
- Accurate and timely information: The team is given brief, accurate information about the casualty's condition and what has been done. An information gap fills with rumour, and rumour increases anxiety. The casualty's privacy is protected.
- Communication with families: Who will inform the families of the witnesses and the casualty, and how, should be decided in advance.
- Voluntary conversations: The workplace physician or nurse holds short, one-to-one, voluntary conversations with the people affected. The aim is to find out how the person is, explain normal reactions and tell them where to go if necessary.
- Going home: An employee who is badly shaken is prevented from driving home alone that day.
This approach is based on the principles of the World Health Organization's psychological first aid guide: prepare, look, listen, link. Listening to what the person wants to say, not forcing them to talk, meeting practical needs and connecting them with sources of support.
For the legal notification of the accident, protection of the scene and records, see our article on what to do after an occupational accident, and for the process in fatal accidents, see the process after a fatal occupational accident.
When taking witness statements
Witness statements are needed for the accident investigation and are too important to postpone. However, a statement can be taken without deepening the trauma: a quiet room, short and clear questions, non-blaming language and, if the person wishes, someone they trust beside them. We explained the method for statements in our article on the accident report and witness statements.
The workplace physician's role: follow-up and referral
Art. 9 of the Regulation on the Duties, Authority, Responsibilities and Training of Workplace Physicians and Other Health Personnel gives the workplace physician duties covering work to protect employees from psychosocial risks and stress factors in the working environment, health surveillance and return-to-work assessment. After an accident, the physician's work takes concrete form in these steps:
- List of those affected: Witnesses, those who took part in first aid and close colleagues are recorded.
- Active follow-up: Short check-in conversations are held in the first week, in weeks two to four and at the end of the first month. Nothing further is needed for a person whose symptoms are fading; increasing or persistent symptoms are noticed.
- Referral: In cases lasting longer than a month, impairing functioning or showing urgent signs, the person is referred for psychiatric or clinical psychology support. Trauma-focused psychotherapy methods are treatments with proven effectiveness in this area.
- Confidentiality: What is discussed in conversations is personal health information. Art. 15 of Law No. 6331 on Occupational Health and Safety requires health information to be kept confidential; only fitness for work and recommended adjustments are reported to the employer, not the diagnosis. For the data protection side of the subject, see our article on employee health information and KVKK (the Personal Data Protection Law).
Return to work: being psychologically ready
Psychological return to work needs preparation, both for the injured employee and for witnesses who will return to the machine where the accident happened. Art. 15 of Law No. 6331 provides for a return-to-work examination at the employee's request after absences from work due to an occupational accident, occupational disease or repeated absences for health reasons. We explained how the examination and recommendations are written in our article on the return-to-work examination. Build the plan with these elements:
- Gradual return: If necessary, start with a different task for a short time or a shorter shift.
- Approaching the machine again: The return to the machine where the accident happened is made by showing the new measures that have been taken and, in the first days, with a trusted colleague alongside. If avoidance continues, this is planned with the physician or therapist.
- Additional training: Under Art. 17 of Law 6331, additional training is given after an occupational accident. Because this training shows the team the causes of the accident and the new measures, it also strengthens their sense of control; for details see our article on refresher and additional training.
- Anniversaries and triggers: The anniversary of the accident, a similar sound or a new near miss can revive reactions; the foreman should be attentive during these periods.
If a restriction has been recommended in the report, our article on restricted or unfit reports explains how to apply it.
Organisational preparedness: who does what, and when?
If post-accident support is only thought about after the accident, it runs in a disorganised way. Add a short section to your emergency plan:
| Time | Responsible | Task |
|---|---|---|
| First hour | Shift supervisor | Take witnesses away from the area, bring them to a quiet place, draw up the list |
| First day | Employer or human resources | Give the team accurate information, manage communication with families |
| First 72 hours | Workplace physician or nurse | Voluntary one-to-one conversations, information about normal reactions |
| First month | Workplace physician | Active follow-up, referral if necessary |
| On return | Physician, supervisor and OHS specialist | Gradual return plan, additional training, showing the new measures |
Subcontractor employees and interns are also included in this plan. Psychosocial effects should also be addressed in the risk assessment renewed after the accident; root cause analysis should focus on fixing the system rather than looking for someone to blame. For methods see our article on root cause analysis methods, and for the general framework, psychosocial risk factors.
Carrying out post-accident follow-up and return-to-work planning in businesses in Bursa and the surrounding provinces is part of our workplace physician service.
Frequently Asked Questions
Should everyone who witnessed the accident receive psychological support?
Not everyone needs therapy, and nobody should be pressured. Everyone affected is informed, offered a voluntary conversation and followed up during the first month. People whose symptoms persist or increase are referred to a specialist.
Should we hold a team meeting after the accident?
A short team meeting is useful for giving information and explaining what has been done and the measures to be taken. However, single-session meetings that press participants to describe the event and their feelings in detail are not routinely recommended; emotional support should be one to one and voluntary.
When does an employee who has experienced trauma return to work?
There is no fixed period. Most witnesses without physical injury return to work quickly; what matters is that the return is planned. For employees who were injured or whose symptoms persist, the workplace physician recommends a suitable task and a gradual return through the return-to-work examination.
Is what is discussed in psychological conversations shared with the employer?
No. Conversations are personal health information and are confidential. Only the employee's fitness for work and recommended adjustments are reported to the employer; the diagnosis and the content of conversations are not shared.
A physician assigned for the time your hazard class requires: pre-employment and periodic examinations, fitness-for-work reports and health surveillance.
Bursa SİSTEMER OSGB Technical Team — written from the field experience of our OHS specialists and workplace physicians. Legal information is valid as of the publication/update date; contact us for an assessment specific to your business.