Etiology of Firefighter Injuries: A Health Care Practitioner Perspective

BACKGROUND: Structural firefighting involves the performance of rigorous occupational tasks in unpredictable, dynamic, and hot environments which increases firefighters’ risk of injury. Specifically, the National Fire Protection Association reported that musculoskeletal injuries account for 56% of non-fireground and 41% of fireground injuries. Furthermore, physical training is the most common cause of injury, accounting for one-third of all injuries and resulting in 41% of post-injury absences from work. There is limited research identifying occupational and exercise injury risk factors among firefighters. However, experienced health care practitioners working with fire departments may provide critical insight into potential mechanisms of these common injuries. Therefore, the purpose of this study was to query health care practitioners who regularly treat structural firefighters to identify potential mechanisms and risk factors associated with musculoskeletal injuries during occupational tasks and during exercise. METHODS: A phenomenological design was utilized to describe the experiences of health care practitioners when treating musculoskeletal injuries in firefighters. Semi-structured interviews were conducted virtually with 14 health care practitioners. Inclusion criteria included licensed health care practitioners (e.g., Athletic Trainer, Physical Therapist), who had at least one year of experience in treating and rehabilitating firefighter injuries. Two interviews were pilot tested with health care practitioners to ensure reliability and validity. Subsequently, 12 practitioners’ (Relevant clinical experience = 11.8 ± 10.4 yr) interviews were used in the data analyses. Interviews were transcribed and uploaded to a qualitative analysis software program. To ensure reliability and validity of codes and categories, two researchers coded to a level of agreement of at least 90%. Member checking was used to ensure the accuracy of findings with health care practitioners’ responses. RESULTS: Health care practitioners indicated that the back and shoulder were the most prevalent anatomical locations for exercise and occupational injuries. Identified risk factors for exercise injuries included age, immobility, movement proficiency, and general fatigue, recovery, and sleep. Identified risk factors for occupational injuries included age, immobility, and general fatigue, sleep, and recovery. Lifting was considered the most prevalent injury mechanism for exercise and occupational injuries. Specifically, for exercise injuries, poor lifting technique was commonly associated with resistance training. For occupational injuries, patient transfers and poor lifting technique were cited as common injury mechanisms. These findings provide key areas of focus for research and programmatic interventions to reduce injury risk among firefighters