Emergency responders at high risk to miss work because of injuries

New research suggests that at any given time, almost 10 percent of the emergency medical technicians (EMTs) and paramedics in the United States miss work because of injuries and illnesses they suffered on the job.

A study examining how common these injuries are and tracking new cases of work-related injuries and illnesses in these professionals also suggests that in one year, an estimated 8.1 of every 100 emergency responders will suffer an injury or illness forcing them to miss work. Compared to data compiled by the U.S. Bureau of Labor Statistics, the rate of injuries requiring work absence among these first responders far exceeds the national average of 1.3 per 100 lost-work injury cases reported in 2006.

The study also identified work-related and health conditions most likely to lead to injuries, which included responding to a high volume of emergency calls, working in bigger cities and having a history of back problems. Researchers conducting the study say that knowing how common severe injuries are in this population will help guide interventions designed to reduce the risks of injury.

“There is a relatively high incidence of lost-work injuries among emergency medical services professionals, and those injuries are related to the work they do. We may be able to target specific risks and make changes to see if we can affect those injuries,” said first author Jonathan Studnek, a Ph.D. candidate in epidemiology at Ohio State University. “The ultimate goal is to find a way to reduce injuries. But first we have to understand how big a problem it is.”

The study is published in the December issue of the American Journal of Industrial Medicine.

Studnek and colleagues selected data from the Longitudinal Emergency Medical Technician Attributes and Demographics Study, an annual survey created in 1998 by the National Registry of Emergency Medical Technicians and the National Highway Traffic Safety Administration to describe the characteristics of emergency medical services workers in the United States . Within that survey, the Ohio State researchers looked specifically at self-reported absence from work caused by work-related injury or illness, and work-life characteristics associated with those absences.

They looked at a cross-sectional snapshot of injury and illness among emergency workers and also watched for trends over time, between 1999 and 2005. Both types of analyses connected a high call volume and a history of recent back problems to a higher likelihood of injury among EMTs and paramedics.

About 900,000 certified emergency medical services professionals responded to more than 17 million calls in 2005. The most common injuries these professionals suffer are exposure to blood-borne pathogens from needle sticks, musculoskeletal injuries associated with lifting and moving patients, various wounds inflicted by violent patients, and injuries caused by traffic accidents involving ambulances.

“There's no doubt many of these types of injuries occur among people who often have to rely on their backs to do something that's not in their best interest. They need to make something happen fast and can't wait for help, so they put themselves into positions they shouldn't,” said John “Mac” Crawford, assistant professor of environmental health sciences in Ohio State 's College of Public Health and a co-author of the study.

“The public health implications go beyond these circumscribed professional groups. Patient safety is at stake, and there are liability issues, as well.”

Along with the average 9.4 percent of injured or ill EMTs at any one time among all participants examined, the researchers found the prevalence of lost-work injuries was highest among those with a very high call volume (22.3 percent) and back problems (21.0 percent). Very high call volume was defined as 40 or more calls per week.

The analysis of several years of data produced similar results. While an estimated 8.1 per 100 of these professionals experienced an on-the-job injury or illness per year, the rates were much higher for those with very high call volume (18.9 per 100) and self-reported back problems (12.5 per 100).

In addition, those working in an urban environment – a community with a population exceeding 25,000 – were three times more likely to report an injury with missed work time than their counterparts in rural communities.

This research is part of a larger effort to study the effectiveness and attitudes about the use of new devices that have potential to reduce back injury, such as stretchers equipped with hydraulic lift mechanisms and specialized chairs that ease the movement of patients on stairs. The equipment designed for this purpose “has a high cost, but it saves backs,” said Crawford, a registered nurse and a former EMT who lost six weeks of work to a back injury when he was working full time as a nurse.

Both Crawford and Studnek know the hazards that go along with this profession. Studnek, now a fellow at the National Registry of Emergency Medical Technicians in Columbus, was a paramedic for five years before beginning graduate work in public health at Ohio State .

“I hurt my back once or twice and have seen good friends who got hurt and had to leave the field. I feel this is important work that needs to be done to help my colleagues lengthen their careers.

“Injury prevention pertains more to retention than to recruitment of EMTs and paramedics. Once they've devoted time to the profession, we don't want them to leave because they became injured.”