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However, given that poor mental health is common in acute medical staff, we aimed to estimate the additional burden of work involving high exposure to infected patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We report a rapid review, meta-analysis, and living meta-analysis of studies using validated measures from outbreaks of COVID-19, Ebola, H1N1 influenza, Middle East respiratory syndrome (MERS), and severe acute respiratory syndrome (SARS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A random effects meta-analysis found that high-exposure work is not associated with an increased prevalence of above cut-off scoring (anxiety: RR\u2009=\u20091.30, 95% CI 0.87\u20131.93, Total\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200912,473; PTSD symptoms: RR\u2009=\u20091.16, 95% CI 0.75\u20131.78, Total\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20096604; depression: RR\u2009=\u20091.50, 95% CI 0.57\u20133.95, Total\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200912,224). For continuous scoring, high-exposure work was associated with only a small additional burden of acute mental health problems compared to low-exposure work (anxiety: SMD\u2009=\u20090.16, 95% CI 0.02\u20130.31, Total\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20096493; PTSD symptoms: SMD\u2009=\u20090.20, 95% CI 0.01\u20130.40, Total\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20095122; depression: SMD\u2009=\u20090.13, 95% CI -0.04\u20130.31, Total\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20094022). There was no evidence of publication bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Although epidemic and pandemic response work may add only a small additional burden, improving mental health through service management and provision of mental health services should be a priority given that baseline rates of poor mental health are already very high. As new studies emerge, they are being added to a living meta-analysis where all analysis code and data have been made freely available:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/osf.io\/zs7ne\/\">https:\/\/osf.io\/zs7ne\/<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00127-020-01990-x","type":"journal-article","created":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T03:02:42Z","timestamp":1606446162000},"page":"1-11","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Mental health of clinical staff working in high-risk epidemic and pandemic health emergencies a rapid review of the evidence and living meta-analysis"],"prefix":"10.1007","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8616-4847","authenticated-orcid":false,"given":"Vaughan","family":"Bell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy","family":"Wade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,27]]},"reference":[{"key":"1990_CR1","doi-asserted-by":"publisher","first-page":"e15","DOI":"10.1016\/s2215-0366(20)30078-x","volume":"7","author":"Q Chen","year":"2020","unstructured":"Chen Q, Liang M, Li Y et al (2020) Mental health care for medical staff in China during the COVID-19 outbreak. 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