The impact of emergency responder musculoskeletal injuries in the State of Ohio

Prevalence of work-related musculoskeletal disorders and associated factors affecting emergency medical services professionals in Jordan: a cross-sectional study

OBJECTIVES

Emergency medical services (EMSs) personnel are at high risk for developing work-related musculoskeletal disorders (WMSDs). However, no studies have yet investigated the prevalence and effect of these disorders on the Jordanian EMS personnel. Therefore, this study aimed to determine the prevalence of WMSDs among Jordanian EMS personnel and its associated factors.

DESIGN

This study used a cross-sectional design. Participants were asked to complete a self-administrated and validated questionnaire to measure the WMSDs, including a demographic survey and the Nordic Musculoskeletal Questionnaire. Descriptive and multivariable regression analyses were used.

SETTING

The Jordanian Civil Defence stations in the main cities of Jordan.

PARTICIPANTS

The sample consisted of 435 EMS workers which were obtained across the country of Jordan. A total of 79.0% of the participants were male, with a mean age of 27.9 (±4.3 SD) years.

RESULTS

The pain in the lower back (308, 70.8%) and neck (252, 57.9%) were the most reported in the last 12 months. Furthermore, about half of the participants reported having pain in their upper back (234, 53.8%), knee (227, 52.2%) and shoulder (226, 52.0%) pain in the last 12 months. Overall, WMSDs in at least one body part were significantly associated with age, experience, being a male, increased body mass index and lower educational level.

CONCLUSIONS

There is a high prevalence of musculoskeletal complaints among EMS personnel. Multiple variables may be incorporated into a national prevention campaign and professional development programme to educate EMS personnel on avoiding WMSDs.

A systematic review and meta-analysis of musculoskeletal disorders among firefighters

INTRODUCTION

Due to the nature of their job, firefighters face many ergonomic risk factors and are exposed to several musculoskeletal disorders (MSDs). The aim of this systematic review and meta-analysis was to investigate the prevalence of MSDs among firefighters.

MATERIALS AND METHODS

This study was conducted based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The literature search was conducted in the databases of PubMed, Scopus, Web of Science, Science Direct, SID, ISC and Google Scholar without applying a time limitation until the end of July 2022. The random effects model was used for meta-analysis, and the I2 index was used to check heterogeneity among studies. The data were analyzed using STATA version 14 software.

RESULTS

The primary literature searches in the databases identified 1,291 articles, 26 of which were entered the meta-analysis stage after screening, study selection, and quality assessment, including 36,342 firefighters. Based on the results of a meta-analysis, the overall prevalence of MSDs among firefighters was 46.39% (95% CI: 32.45-60.32, I2 = 99.7%, P < 0.001). The prevalence of MSDs was also investigated at neck (18.36%), low back (34.32%), shoulder (18.68%), hands (7.43%), upper back (10.15%), knee (19.97%) and foot (6.66%).

CONCLUSION

Considering the relatively high prevalence of MSDs among firefighters and their higher exposition to specific job-related risk factors of MSDs compared to other professions, it is suggested to provide firefighters with appropriate training, implement ergonomic interventions, and regularly screen them to reduce MSDs.

A biomechanical evaluation of firefighters' musculoskeletal loads when carrying self-contained breathing apparatus in walking and running

INTRODUCTION

Musculoskeletal loading data are needed to design ergonomic intervention for firefighters. This study aimed to quantify the firefighters' musculoskeletal loads during self-contained breathing apparatus (SCBA) carriage and evaluate the effectiveness of shoulder strap length variation for the prevention of SCBA-related injuries.

METHOD

Twelve firefighters (height: 174.6 ± 2.4 cm, mass: 67 ± 3.5 kg, BMI = 22 ± 1 kg/m2) participated the walking and running protocols with no SCBA equipped and three varying-strapped SCBAs conditions. Joint range of motion and surface electromyography (sEMG) were synchronously measured. Subsequently, joint kinematics was inputted for subject-specific musculoskeletal modeling to estimate muscle forces and joint reaction forces, while the sEMG was used to validate the model. Repeated measures analysis of variance was used for the main effects (p < 0.05). Independent samples t-test was performed to determine differences between walking and running.

RESULTS

Walking with SCBA increased the rectus femoris force and hip reaction force by 34.92% [F = 53.629; p < 0.001; η2 = 0.317] and 34.71% [F = 53.653; p < 0.001; η2 = 0.517], the growth rate was 54.2% [F = 76.487; p < 0.001; η2 = 0.418] and 51.19% [F = 69.201; p < 0.001; η2 = 0.652] during running, respectively. Running with SCBA significantly increased the knee reaction force by 63.04% [F = 83.960; p < 0.001; η2 = 0.797], while only 18.49% increase during walking. Adjusting SCBA shoulder strap length significantly altered the rectus abdominis force and L4/L5 reaction force during walking and running.

CONCLUSIONS

Results revealed that rectus femoris activity, hip and knee exertion was sensitive to SCBA carriage. The variation of shoulder strap length has potential to influence the risk of low back pain (LBP).

PRACTICAL APPLICATIONS

The findings suggest that fire services promote targeting physical training at firefighters' hip and knee regions. Test firefighters in this study were not advisable to adjust their shoulder strap at loose-fitting condition. The compatibility design of the trunk morphology and SCBA back-mounted frame was suggested for the management of LBP.

Occupational injuries and illnesses among law enforcement officers, 2001-2019: Findings from the Ohio Bureau of Workers' Compensation

BACKGROUND

Occupational injuries are common among law enforcement officers (LEOs) and can impact an agency's ability to serve communities. Workers' compensation (WC) data are an underutilized source for occupational injury surveillance in the law enforcement field.

METHODS

LEOs WC claims from the Ohio Bureau of Workers' Compensation (OHBWC) from 2001 to 2019 were identified based on manual review of the occupation title and injury description. Worker, employer, incident, and injury characteristics were described by claim type-medical-only (MO) and lost-time (8 or more days away from work). Data are presented using injury claim counts.

RESULTS

From 2001 to 2019, 50,793 WC claims were identified among Ohio LEOs. Of these, 68% were MO claims (n = 34,622). WC claims significantly decreased over the 19-year period (p < 0.001). Seventy-five percent of WC claims were from a LEO with more than one claim and of these, 34% were from a LEO with five or more claims during the study period. Male officers and those aged 25-54 years incurred the highest proportion of total claims (87.8% & 91.8%, respectively). Violence (n = 17,247; 34%), falls/slips/trips (n = 9079; 17.9%), and transportation events (n = 7977; 15.7%) were the leading events. Among the 50,793 claims, there were 79,637 unique clinical diagnosis groups. The most common injury diagnoses were sprains (n = 32,796; 41.2%) followed by contusions (n = 13,529; 17%).

CONCLUSIONS

Results can guide the development or improvement of workplace injury prevention strategies for LEOs. Efforts should be focused on better understanding and preventing violent injury events and sprains among LEOs, as well as preventing multiple injury events.

The Relative Burden of Occupational Injuries and Illnesses in Firefighters: An Analysis of Washington Workers' Compensation Claims, 2006-2020

Firefighters face many hazards on the job and have a high rate of work-related injuries and illnesses (WRII). We analyzed Washington workers' compensation claims from 2006-2020 to characterize WRII in firefighters compared to law enforcement officers and "all other" workers. There were 9187 compensable claims for firefighters, 7801 for law enforcement officers, and 586,939 for "all other" workers. Nearly 40% of claims for firefighters were work-related musculoskeletal disorders (WMSDs). The claim rate per 10,000 full-time equivalent (FTE) firefighters was 716.4, which is significantly higher than that of law enforcement officers (510.0) and "all other" workers (163.2). The rate per 10,000 FTE of WMSD claims was also higher in firefighters (277.0) than in law enforcement officers (76.2) and "all other" workers (57.6). Additional WRII among firefighters commonly included being struck or caught in objects, slipping or tripping, and exposure to caustic or noxious substances; and amongst law enforcement, transportation accidents and violence. Medical costs and time-loss days per claim were lower for firefighters and law enforcement than for "all other" workers. Common tasks associated with WMSDs in firefighters included lifting and transporting patients, using specific tools and equipment, and physical training. WMSDs stand out as an area for prevention and intervention activities.

Workers' compensation injury claims among firefighters in Ohio, 2001-2017

BACKGROUND

Firefighters are at high risk for nonfatal and fatal occupational injuries. While some past research has quantified firefighter injuries using various data sources, Ohio workers' compensation injury claims data largely have not been used.

METHODS

Public and private firefighter claims, including volunteer and career firefighters, from Ohio's workers' compensation data for 2001-2017 were identified based on occupational classification codes and manual review of the occupation title and injury description. The task during injury (firefighting, patient care, training, other/unknown, etc.) was manually coded based on the injury description. Injury claim counts and proportions were described across claim type (medical-only or lost-time), worker demographics, task during injury, injury events, and principal diagnoses.

RESULTS

33,069 firefighter claims were identified and included. Most claims were medical-only (66.28%, <8 days away from work) and involved males (93.81%) aged 25-54 years (86.54%). While the task during injury could not be categorized for many narratives (45.96%), the largest percentage that could be categorized occurred during firefighting (20.48%) and patient care (17.60%). The most common injury events were overexertion involving outside sources (31.33%) and struck by objects or equipment (12.68%). The most frequent principal diagnoses were back, lower extremity, and upper extremity sprains (16.02%, 14.46%, and 11.98%, respectively).

CONCLUSIONS

This study provides a preliminary basis for the development of focused firefighter injury prevention programming and training. Obtaining denominator data, enabling rate calculation, would strengthen the risk characterization. Based on the current data, prevention efforts focusing on the most frequent injury events and diagnoses may be warranted.

Effects of multiple risk factors on upper limb musculoskeletal disorders among workers in inner Brazil

BACKGROUND: The literature discussing musculoskeletal diseases of inner northeastern workers is scarce, although 67,559 cases were reported in Brazil between 2007 and 2016. OBJECTIVE: This study aimed to evaluate the effect of multiple risk factors that influence the symptoms of work-related musculoskeletal disorders (WMSDs) in wrists, elbows, and shoulders in workers from four different economic sectors. METHODS: A sample included 420 workers from the inner regions of the Brazilian states of Alagoas and Bahia. The Nordic Musculoskeletal Questionnaire was used to capture pain symptoms on both sides of the body (left and right). Sociodemographic variables, items from the biomechanical exposure and organizational conditional, in addition to other questionnaires (JCQ, COPSOQ II, ERI) were used to assess the characteristics and occupational risks of the respondents. Ordinal logistic regression model was using to identify the relationship between symptoms and factors. RESULTS: This study highlights the psychosocial, biomechanical, occupational, and sociodemographic variables contributed to development of WMSDs. Use of hand-vibrating tool increased the likelihood of symptoms manifesting on the body. On the other hand, high job control and high job insecurity reduced the likelihood of developing symptoms. On the other hand, high job control and job satisfaction reduced the likelihood of developing symptoms. Factors such as age, curved spine, high job insecurity and excessive commitment contributed to the development of WMSDs only on one side of the body. CONCLUSIONS: The development of WMSDs is multifactorial. Sociodemographic, occupational, biomechanical, and psychosocial factors may commonly contribute to WMSD manifesting only on one side of the body more than on both sides.

A Methodological Framework to Capture Neuromuscular Fatigue Mechanisms Under Stress

Neuromuscular fatigue is exacerbated under stress and is characterized by shorter endurance time, greater perceived effort, lower force steadiness, and higher electromyographic activity. However, the underlying mechanisms of fatigue under stress are not well-understood. This review investigated existing methods of identifying central mechanisms of neuromuscular fatigue and the potential mechanisms of the influence of stress on neuromuscular fatigue. We found that the influence of stress on the activity of the prefrontal cortex, which are also involved in exercise regulation, may contribute to exacerbated fatigue under stress. We also found that the traditional methods involve the synchronized use of transcranial magnetic stimulation, peripheral nerve stimulation, and electromyography to identify the contribution of supraspinal fatigue, through measures such as voluntary activation, motor evoked potential, and silent period. However, these popular techniques are unable to provide information about neural alterations upstream of the descending drive that may contribute to supraspinal fatigue development. To address this gap, we propose that functional brain imaging techniques, which provide insights on activation and information flow between brain regions, need to be combined with the traditional measures of measuring central fatigue to fully understand the mechanisms behind the influence of stress on fatigue.