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(A) Weighted estimates of nonfatal injuries to fire fighters treated in emergency departments, 2003-2014. (B) Rates of nonfatal injuries per 10,000 fire fighters a treated in emergency departments, 2003-2014. a Denominator data are from the NFPA fire department profile (NFPA 2016b). NFPA, National Fire Protection Association.
Source publication
Introduction:
Several studies of nonfatal firefighter injuries have been conducted but are limited by the inclusion criteria used and coverage. The aim of this study was to enhance current knowledge by providing national estimates of nonfatal injuries to firefighters treated in U.S. emergency departments.
Methods:
Nonfatal injuries from 2003 thr...
Contexts in source publication
Context 1
... 2003 through 2014, an estimated 351,800 FF injuries were treated in EDs (Table 1). The highest annual estimate (32,900 injuries, 95% CI¼16,100, 49,700) occurred in 2003 while the lowest (22,800 injuries, 95% CI¼14,400, 37,200) occurred in 2013 ( Figure 1A). Male FFs sustained most of the injuries (95%; Table 1). ...
Context 2
... FF rate was 1.2 times higher than the nonfatal ED-treated injury rate of 214 injuries per 10,000 workers (95% CI¼172, 256) for all other U.S. workers (except FFs). The highest rate (300 injuries per 10,000 workers, 95% CI¼150, 450) was in 2003; the lowest rate (200 injuries per 10,000 workers, 95% CI¼128, 272) was in 2013 ( Figure 1B). FFs aged 20 to 29 years had the highest rate of 332 injuries per 10,000 FFs whereas FFs Z60 years had the lowest rate (86). ...
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Citations
... Fatal and nonfatal casualties represent a significant "burden" to those involved in fire and rescue. The mechanical and physiological stress placed on the body, due to the extreme occupational demands of firefighting, is likely one key contributor to stress or overexertion being the leading cause of fireground casualties [1,2]. In 2021, there were 141 reported firefighter fatalities in the United States, with 39 resulting from stress or overexertion [3]. ...
Cardiac deaths account for the largest share of on-duty firefighter deaths. To help ensure duty fitness and minimize injury risk, many fire departments require the passing of an annual physical ability test, consisting of a battery of simulated fire suppression activities (sFSAs). The purpose of the study was to determine the relationship of sFSA performance to acute cardiac and respiratory events (ACREs) and the effect that estimated VO2max has on sFSA performance. The study was retrospective. As part of an annual physical ability test, five timed sFSAs were performed, summed for a composite time, and categorized into three performance levels (fast, moderate, and slow). Estimated VO2max was determined using the Forestry Step Test. A significant (p = 0.023) linear trend was observed with higher sFSA performance times being associated with a higher proportion of firefighters going on to suffer an ACRE. The estimated VO2max was significantly (p < 0.001) higher in the fast group compared to the slow group. There was not a significant (p = 0.70) difference in estimated VO2max between the moderate and slow groups. Estimated VO2max performance and sFSA performance were significantly correlated, with rs(488) = −0.272 and p < 0.001. Poorer sFSA performance was found to be associated with a higher proportion of ACREs. The results suggest that sFSA performance may be a valid indicator of ACRE injury risk and aerobic capacity.
... In 2020, it was estimated that 62.3 per 1000 firefighters were injured on the job (Campbell and Evarts 2020), underscoring the burden of injuries among this occupational group. Colloquial understanding of firefighter injuries may assume that most of their occupational injuries are related to fighting fires (i.e., on the fireground (Marsh, et al. 2018)), but prior research has demonstrated many injuries occur during training/physical activity exercises (Hollerbach et al. 2020;Poplin et al. 2012) or on non-fire calls (Poplin et al. 2012;Phelps et al. 2018). Emergency medical services (EMS) response constitutes 65% of all 9-1-1 calls to fire departments (Available from 2019) and there is some evidence to support that paramedics stationed in fire departments have higher all-injury rates than firefighters within the same department (Widman et al. 2018). ...
... Traditional firefighter and EMS provider injury research has primarily focused on the outcome of injuries (Marsh et al. 2018;Hollerbach et al. 2020;Poplin et al. 2012;Phelps et al. 2018; Available from 2019; Widman et al. 2018;Taylor et al. 2016;Maguire et al. 2018;Reichard et al. 2017), thus more needs to be known about its upstream predictors of safety climate, which is a well-established predictor of occupational injury (Christian et al. 2009;Huang et al. 2016). Safety climate reflects the perceptions of individuals regarding their organization's regard for their occupational safety as expressed through their policies, procedures, and practices (Zohar 1980). ...
Background
The Fire service Organizational Culture of Safety (FOCUS) survey is an assessment tool comprised of psychometrically validated metrics of safety climate, safety behavior, and downstream outcomes (organizational and injury) that are specific to the U.S. fire and rescue service.
Methods
This analysis consists of a descriptive summary of two independent survey waves (FOCUS 1.0 and 2.0). The fire departments included in these survey waves were from convenience sampling ( n 1.0 = 275; n 2.0 = 170). In addition to department level characteristics, we examined individual level characteristics for firefighters and EMS providers in participating departments ( n 1.0 = 22,719; n 2.0 = 16,882). We conducted regression analyses to examine the associations between safety climate and safety behaviors, organizational outcomes, and safety outcomes. All analyses were stratified by organization type (career, volunteer).
Results
Our analysis indicated that a majority of respondents were males (90.7% FOCUS 1.0 ; 90.4% FOCUS 2.0 ), non-officers (68.4% FOCUS 1.0 ; 66.4% FOCUS 2.0 ), and non-Hispanic Whites (70.8% FOCUS 1.0 ; 69.5% FOCUS 2.0 ). For both samples there was a higher prevalence of injuries among individuals in career departments ( n FOCUS 1.0 = 3778 [17.5%]; n FOCUS 2.0 = 3072 [18.7%]) than volunteer departments ( n FOCUS 1.0 = 103 [8.8%]; n FOCUS 2.0 = 34 [7.4%]). We observed an approximate 10-point difference between the mean scores of Management Commitment to Safety for career and volunteer departments in both samples. We observed associations for two organizational outcomes, Safety Behavior and Job Satisfaction, with Management Commitment to Safety and Supervisor Support for Safety overall and when stratified by organization type. We observed a decrease in the odds of injuries associated with a one-unit increase in Management Commitment to Safety (OR 1.0 overall : 0.98, 95% CI 0.97–0.99; OR 2.0 volunteer : 0.90, 95% CI 0.85–0.95) and Supervisor Support for Safety (OR 1.0 overall : 0.95, 95% CI 0.93–0.97; OR 1.0 career : 0.95, 95% CI 0.92–0.98).
Conclusions
From our current study, and a prior analysis of a geographically stratified random sample of U.S. fire departments, we identified that from all the organizational outcomes, job satisfaction was most consistently associated with FOCUS safety climate. Further, firefighters in our samples consistently rated Supervisor Support for Safety higher than Management Commitment to Safety. Future interventions should support fire departments in improving their departmental Management Commitment to Safety and maintaining their Supervisor for Safety.
... In this study, dayroom was categorized as the common room/space where firefighters interact, relax, or perform other activities while waiting for an emergency. As first responders, the nature of firefighters' work often puts them in situations where they respond to emergency calls with incomplete information [1,2]. The response situations are often complicated because response activities are provided in heterogeneous and uncontrolled circumstances. ...
... Cont.Before performing wound care, if your hands are not visibly dirty, which method of hand cleaning would you prefer?[1] Using an alcohol-based hand rub 1 2 [2] = Washing hands with soap and water, followed immediately by use of alcohol-based hand rub 1[3] = None. ...
Due to the emerging threat conditions in the work environment, firefighters are at a high risk of exposure to not only toxic substances but also biological agents in the dayroom and during emergency runs. The aim of this study is to evaluate firefighter (career and volunteer) knowledge and practice behaviors on infection control. This study surveyed 444 firefighters (210 career, 234 volunteer) in rural Northwestern Kentucky. The self-reported survey focused on individual characteristics, knowledge on exposure incident control, precautionary actions, and personal protections. We evaluated the descriptive characteristics of knowledge and practice scores stratified by firefighter groups (career and volunteers). The associations between infection control training received (yes/no) and firefighter knowledge and practice scores were also examined. Firefighters who were trained on infection control prevention had significantly higher knowledge scores (M = 63.7, SD = 13.4 vs. M = 59.7, SD = 15.9; p = 0.012). Volunteer firefighters exhibited better infection control practice behaviors than career firefighters (M = 70.6, SD = 13.0 vs. M = 67.4, SD = 11.1; p = 0.05). Firefighters who followed infection control guidelines (M = 69.5, SD = 11.9 vs. M = 58.1, SD = 9.9; p = 0.012) and expressed need for a comprehensive training on personal protective equipment (PPE) selection (β = 3.41, SE = 1.54, aOR = 30.22, 95% CI: 1.47–620.87; p = 0.028) had significantly higher practice scores compared to those who did not. The study results have policy implications for infection prevention and control (IPC) in rural fire departments, both career and volunteer. A review of infection control policies is needed, especially as it relates to training and practice behaviors during emergency calls and in the dayroom. Results also suggest the need to develop strategies to improve the culture of PPE use and training on the selection of PPEs appropriate to the emergency response type.
... The identification of published data was dependent on the accessibility and discretization of the number of injuries and their nature, the part of the body affected, and related activities. For this, the collection of data was carried out using national reports led by organizations responsible for the collection and analysis of information related to injuries and illnesses for workers in the U.S., i.e., the NFPA [20][21][22][23][24][25][26], the BLS [27] and the NEISS [9,28]. All these organizations provide annual injury reports in the U.S., and the characteristics of each database are described in Table 1 [29]. ...
... It is important to note that the NEISS data for this comparative analysis was provided by two studies from the literature review. The first study was conducted by Marsh et al. [28], who analyzed and reported non-fatal firefighter injuries treated in emergency rooms from 2003 to 2014 using the National Electronic Injury Surveillance System occupational supplement (NEISS-Work). The second study was conducted by Reichard et al. [9], who performed a study of the occupational injuries and illnesses among EMS personnel, FFs, and police treated in U.S. hospital emergency departments from 2000 to 2001. ...
... This FF injury data addressed by the authors in [9] included injuries for career and volunteer FFs during fireground operations and training activities. It is important to note that for easier identification of the data through this manuscript, the data reported by Reichard et al. [9] would be identified as "NEISS 2000-2001", and the data reported by Marsh et al. [28] would be identified as "NEISS 2003-2014". Figure 2 depicts how the search process of the open literature was conducted. ...
Safety and prevention of injuries should always be considered in a firefighting environment due to the hazardous conditions experienced on the fireground. These hazardous environmental conditions lead to an increased risk of contracting job-related injuries and illnesses. This review article focuses on evaluating from a statistical perspective the potential solutions found in the literature and how they decrease the likelihood and impact of occupational firefighting injuries. Investigating, identifying, and prioritizing the most common activities leading to injury, the nature of injury, and the body parts affected is a vital step in the implementation of preventive solutions. The scientific community has conducted various studies to evaluate the main injuries and injury profiles commonly suffered by firefighters. Researchers have conducted many independent studies on firefighter communities in the United States, while others have referenced national databases from sources such as the National Fire Protection Association, the Bureau of Labor Statistics, and the National Electronic Injury Surveillance System. Unfortunately, the results of these independent studies lacked standardization in survey categories and terminology, impairing the ability to obtain a clear consensus among studies on the primary nature of injuries, the body parts injured, and the activities contributing to these injuries. Consequently, this review article performed a comparative statistical analysis of published data between 1992 and 2020 to define and rank the most common work scenarios where firefighters were likely to be injured, the most common types of injuries, the parts of the body affected, and the activities that most contribute to United States firefighter injuries as documented in both national databases and independent research surveys. The statistical analysis consisted of determining the mean, standard deviation, confidence intervals (95%), and coefficients of variation for the reported data. The present study identified that despite the preventative measures taken by many organizations in the firefighting community, strains and sprains were still the leading type of injury reported from all the databases under this analysis.
... About 1.5% of all annual deaths in the world are caused by work. The amount reported in developed countries is about 40% higher than the amount in developing countries [1]. The elimination of labor force, disability and medical expenses is one of the obvious damages caused by occupational and work-related illnesses, but they also cause significant damage to economic and social development. ...
Background
Hospitals are considered to be one of the most hazardous environments to work in, and their service workers are exposed to many serious risks. So The purpose of this study was to investigate the effect of educational intervention based on the Health Action Model to promote the safe behavior of hospital service workers.
Methods
In this quasi-experimental study, 45 workers in each of the control and experimental groups participated. Demographic information and data related to Health Action Model constructs were collected through a questionnaire and a checklist, immediately and three months after the intervention. Cronbach’s alpha coefficients were used to confirm the properties of the tools. Educational intervention accompanied was applied in the form of four training classes. The data were analyzed using SPSS 20 software.
Results
Before the intervention, there was no significant difference between the two groups in terms of demographics and the study’s main variables. results showed significant changes in mean scores of safe behavior, Attitude, norms, belief, intention, knowledge in the experimental group three months after the intervention (P < 0.001).
Conclusions
The research results show that Health Action Model educational intervention can change workers’ awareness, attitudes, norms, beliefs, and intentions toward unsafe behavior and improve their safety performance.
Trial registration
IRCTID: IRCT20160619028529N7.
... The National Fire Protection Association (NFPA) publishes an annual report of national estimates for firefighter injuries among public fire departments within the United States and reported that 64,875 injuries occurred in 2020. While used widely by fire departments around the country, these data are limited in application due to the exclusion of state, federal, and private fire departments, which represent (Marsh, Gwilliam, Konda, Tiesman, & Fahy, 2018). Although informative, this analysis relied on emergency department (ED) data and therefore excluded injuries that were not severe enough to warrant emergency care and injuries that were cared for via other medical interventions (self-care, non-emergency medical facilities, etc.). ...
... A task code similar to the code assigned to cases in the current study was assigned to the data in the emergency department study. Similar to our results, the study of emergency department-treated injuries found that by far the largest number of injuries occurred during firefighting (Marsh et al., 2018). However, previous literature has indicated that firefighting makes up Footnotes: a All percentages are presented as column percentages. ...
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.
... One study reported the total number of participants in the study but did not provide the total number of injuries recorded (Jahnke et al. 2013), 3 studies reported both the number of firefighters who participated in the data collection and the number of injuries recorded (Wynn and Hawdon 2012;Phelps et al. 2018;Hollerbach et al. 2020), and 18 studies only reported the number of injuries recorded. The 21 studies that reported the total number of injuries recorded had considerable variation in the total number of injuries reported, as the maximum number of injuries was 351,800 (Marsh et al. 2018) ...
... Of the 23 studies, 16 articles did not report the career status (career or volunteer) of the firefighter participants, although inferences could be made based on details provided in the studies. Ten studies appeared to collect data for career and volunteer firefighters (Karter andMolis 2007, 2010;LaTourrette et al. 2008;Karter andMolis 2012, 2013;Haynes and Molis 2016;Pawlak et al. 2016;Evarts and Molis 2018;Campbell and Evarts 2020;Hollerbach et al. 2020) and 6 studies appeared to collect data from career firefighters (Szubert and Sobala 2002;Poplin et al. 2012;Tyakoff et al. 2015;Frost et al. 2016;Marsh et al. 2018;Kim et al. 2018). Two studies reported only collecting data from career firefighters (Frost et al. 2015b;Phelps et al. 2018), two studies reported only collecting data from volunteer firefighters (Karter , 2013, three studies reported collecting data from both career and volunteer firefighters (Jahnke et al. 2013;Burgess et al. 2014;Marsh et al. 2018), and one study reported collected data from new firefighter recruits (Wynn and Hawdon 2012). ...
... Ten studies appeared to collect data for career and volunteer firefighters (Karter andMolis 2007, 2010;LaTourrette et al. 2008;Karter andMolis 2012, 2013;Haynes and Molis 2016;Pawlak et al. 2016;Evarts and Molis 2018;Campbell and Evarts 2020;Hollerbach et al. 2020) and 6 studies appeared to collect data from career firefighters (Szubert and Sobala 2002;Poplin et al. 2012;Tyakoff et al. 2015;Frost et al. 2016;Marsh et al. 2018;Kim et al. 2018). Two studies reported only collecting data from career firefighters (Frost et al. 2015b;Phelps et al. 2018), two studies reported only collecting data from volunteer firefighters (Karter , 2013, three studies reported collecting data from both career and volunteer firefighters (Jahnke et al. 2013;Burgess et al. 2014;Marsh et al. 2018), and one study reported collected data from new firefighter recruits (Wynn and Hawdon 2012). Three articles outlined the firefighters' position held within the fire department (Poplin et al. 2012;Jahnke et al. 2013;Phelps et al. 2018). ...
Objectives
To summarize the current research on the occurrence of firefighter exercise and training injuries and to describe the nature of these injuries.
Methods
Scoping review methods were used to identify articles and extract information relevant to firefighter exercise and training injuries. Relevant articles were identified from MEDLINE, Web of Science, CINAHL, Embase, PubMed, and through hand-searching.
Results
A total of 1053 articles were identified, and 23 met the inclusion criteria. Nine studies were retrospective analyses of injury data, 13 studies used surveys to identify injuries in the past year, and 1 study reviewed U.S. firefighter injury reports. Three studies included both career and volunteer firefighters, 2 studies included career firefighters, 2 studies include volunteer firefighters, 1 study include recruits and 16 studies did not specify the career status. The occurrence of exercise and training injuries from 22 of the 23 studies ranged from 8.1 to 55.3% of reported injuries. One study found that 3 out of 15 fire departments identified exercise and training as the most common cause of their firefighter injuries. The 13 articles that reported the type of injuries identified musculoskeletal disorders as the most common type of injury (32% to 79% of reported injuries). The ankle, knee and leg were identified as the most commonly injured areas of the body.
Conclusions
Training injuries are common in firefighters and must be prevented. Future research is needed to identify root causes of training injuries to guide prevention strategies.
... Yet many employees often fail to evacuate when fire alarms are activated, despite its obvious benefits and evacuation being practiced since early childhood (Pillemer et al., 1994). Evacuating during fires not only prevents injuries and fatalities but also enables emergency personnel to focus on fire containment rather than search and rescue operations (Marsh et al., 2018). Individuals may fail to evacuate when they deem the alarm as false, experience alarm fatigue due to perceptions of frequent drills or "false alarms," or believe others (e.g., firefighter, safety manager) are responsible for initiating evacuation (Caponecchia, 2010;Gwynne et al., 2016;Jelenewicz, 2008;Kobes et al., 2010;Proulx, 1995;Proulx & Reid, 2006). ...
Background
Nonresidential fires and resultant injuries and deaths have been on the rise the last decade in the United States. Although evacuation is a primary prevention method, people in the workplace still fail to evacuate when they hear a fire alarm. The current formative study applied the Reasoned Action Approach (RAA) to identify belief factors associated with university employees’ intention evacuate.
Methods
Data were collected from employees at a large public university ( N = 490) through an online survey. Multiple linear regression quantified the relative contribution of six RAA constructs that represent belief factors underlying employees’ intention to leave the office building immediately the next time they hear a fire alarm.
Findings
Nearly 60% of the variation in employees’ intention to leave was predicted from the belief factors, adjusted R ² = 0.598, F(17, 472) = 43.80, p < .001. Controlling for demographic characteristics, five of the six RAA global constructs showed statistically significant independent associations with intention: instrumental attitude ( B = .272, SE = .026, p < .001), experiential attitude ( B = −.073, SE = .026, p = .024), injunctive norm ( B = .210, SE = .075, p < .001), descriptive norm ( B = .347, SE = .070, p < .001), and capacity ( B = .178, SE = .077, p < .001).
Conclusions/Applications to Practice
These findings show the RAA can be successfully applied to provide employees’ perspective on safety decisions like evacuation. The belief factors’ relative contributions can help safety professionals prioritize interventions to facilitate leaving immediately. Here the high weights for the two normative factors suggest addressing employees’ descriptive beliefs that others like them leave and their injunctive beliefs that significant others, like supervisors and safety personnel, approve of their leaving.
... Firefighters often suffer from different degrees of sports injuries, both during daily physical training and in specific work environments [15] . Due to the special nature of firefighters' occupations, it is particularly important to reduce sports injuries and the complications they bring. ...
The physical fitness level of firefighters is the basic element of the comprehensive combat effectiveness of the national fire fighting force, and the highly stressful working condition of firefighters determines that they need to have a higher level of physical function. This paper compares the development and standards of firefighter fitness evaluation system in the United States in recent years, combines the actual situation of firefighter fitness level and evaluation system in China, integrates China's national conditions, puts forward some suggestions to help improve the physical fitness level of firefighters in China, and provides theoretical support for the construction of firefighter fitness evaluation system.
... In the United States (US), firefighters experienced an estimated >30,000 fire ground injuries per year from 2010 to 2014, with similar rates of 61.6 per 1,000 male and 61.2 per 1,000 female firefighters (3). US emergency departments treated ∼351,800 injured firefighters from 2003 to 2014, 95% of whom were males (4). ...
... While many firefighter injury studies do not exclude females, females typically make up such a small proportion of samples that it is difficult to draw any specific conclusions regarding their health outcomes (9,10). Furthermore, these studies often do not analyze data by sex or gender (4,11). In an international survey of 840 female firefighters in 14 countries, those in North America were more likely to have been injured than those in the UK and Ireland, Australasia, and Europe (12). ...
... In both countries, career firefighters and those assigned to an engine made up the largest proportion of injuries. Similarly, studies have found that career firefighters in the US were injured on the job more than volunteers, although these samples were predominantly males (3,4). In the US and Canada, injuries occurred most often on the fire ground, adding to the conflicting literature describing firefighter injuries, some of which report training as the most common activity at the time of injury (11,13,18), and some of which report firefighting, fire ground duties, or fire station duties as the most common activities at the time of injury (4,18,25). ...
Objectives
This study explored how demographic characteristics, life experiences, and firefighting experiences have an impact on work-related injuries among female firefighters, and described events surrounding such work-related injuries.
Methods
This online survey was available from June 2019 to July 2020. Questions related to demographic characteristics, life experiences, firefighting experiences, and work-related injuries. Descriptive analyses characterized variables by the presence or absence of work-related injury, injury severity, job assignment, and country of residence.
Results
There were 1,160 active female firefighter survey respondents from the US and Canada, 64% of whom reported having at least one work-related injury. US respondents made up 67% of the total but 75% of the injured sample. Injured respondents were older, had been in the fire service longer, and had a greater number of fires and toxic exposures than non-injured respondents. Heavier weight, tobacco use, and alcohol consumption were more common among injured respondents. The two most common contributing factors to work-related injuries were human error and firefighter fatigue. Among respondents who reported an injury-related time loss claim, 69% were wearing protective equipment when injured, and 9% of the injuries directly resulted in new policy implementation.
Conclusions
These findings can help inform resource allocation, and development of new policies and safety protocols, to reduce the number of work-related injuries among female firefighters.
