V. Simas1,2, R. Orr1,2, E. Canetti1,2, B. Schram1,2
1Bond University, Tactical Research Unit, Gold Coast, Australia, 2Bond University, Bond Institute of Health and Sport, Gold Coast, Australia

Background: Due to the unpredictable, varied and physical nature of firefighting duties, firefighters are at a high risk of work-related physical injury, suffering over three times the rates of those reported in the private sector. Tasks performed by firefighters can include fire suppression, victim rescue, advancing a charged hose and climbing in and out of fire vehicles. As a result of these occupational factors, firefighters can be at risk of not only fire-related injuries, but also musculoskeletal injuries. In addition, firefighters are required to carry external loads whilst performing key tasks. Injuries to firefighters incur costs to the individual and the firefighting organisation, in the form of resource, personnel and capability costs. Furthermore, in terms of workforce loss, reduced workforce strength and absenteeism, firefighters were found to take twice as long to return to work following a musculoskeletal injury than workers in a private sector. As such, reducing musculoskeletal injuries to firefighters can not only reduce fiscal costs but, just as importantly, maintain the integrity of the firefighter workforce. By profiling firefighter injuries by bodily sites, mechanisms and types of injuries sustained, informed prevention and rehabilitation practices can be developed.

Purpose: The aim of this critical narrative review was to identify, critically appraise and synthesise key findings from recent literature investigating firefighting musculoskeletal injuries, in order to develop a profile of the injuries experienced by this unique population.

Methods: The methodological approach was registered with PROSPERO and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using the Downs and Black checklist with scores graded according to the Kennelly grading system. Levels of evidence were ranked according to the Australian National Health and Medical Research Council.

Results: Of the 8231 studies identified, 17 met the criteria for inclusion. The methodological quality of the studies was ‘fair’ with a level of evidence of III-2. Reported injury rates ranged from 9% to 74% with the lower extremities and back the leading aggregated bodily sites of injury. Sprains and strains were the leading nature of musculoskeletal injury, often caused by slips, trips and falls, although muscle bending, lifting and squatting or muscle stressing were also prevalent.

Conclusion(s): There was considerable variability in injury definition and categorisation, which impacts the ability to build a volume of evidence regarding firefighter injuries and highlights the need for future research to be conducted with better methodological quality. However, there do appear to be some similarities between the injuries presenting in firefighters and those of other tactical populations, and as such, means of mitigating and rehabilitating these injuries may be of benefit across the tactical spectrum. Larger, prospective cohort studies using consistent injury definitions so as to allow for results that can be applied across the firefighter population should be the focus of future research.

Implications: This review may inform injury reduction strategies, and, given that injuries reported in firefighters are similar to those of other tactical populations, safety processes to mitigate injuries may be of benefit across the tactical spectrum.

Funding, acknowledgements: This research received no external funding.

Keywords: Firefighter, Injury, Occupational health

Topic: Musculoskeletal

Did this work require ethics approval? No
Institution: N/A
Committee: N/A
Reason: This research was conducted as a critical review of the literature.

All authors, affiliations and abstracts have been published as submitted.

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