Comprehensive Assessment of EMS Injuries, Illnesses Mapped Out

NHTSA's Office of Emergency Medical Services has published a final report titled "Feasibility for an EMS Workforce Safety and Health Surveillance System." Created with help from stakeholder groups including the National Association of State EMS Officials (, it examines the challenges in conducting national surveillance of EMS workers' injuries and illnesses. Past studies indicate the EMS workforce has high on-the-job injury and death rates, yet occupational illness in this group "is still largely limited to infectious disease report analyses mandated by law and the respiratory illness plaguing World Trade Center rescuers," the agency says.

The size of the EMS workforce is difficult to assess because personnel work for varying organizations (such as career and volunteer fire departments, commercial ambulance services, rescue squads, etc.). The goal of the project is to assess the feasibility of conducting occupational injury and illness surveillance for the EMS workforce by examining the extent of on-the-job injuries and illness among EMS personnel; determining essential characteristics and elements of an EMS workforce illness and injury surveillance system; and assessing the utility of existing data systems.

A literature review done by the office examined occupational injuries and illnesses among EMS personnel related to firefighter fatalities, illness, injury, and infectious disease exposure; coronary artery disease and cardiovascular health; motor vehicle crash injuries and deaths; violence and assault; infectious diseases (needlestick injury, hepatitis B, hepatitis C, HIV/AIDS); stress and mental health; and cccupational illness and injury of rescuers at the World Trade Center in 2001. "One of the literature review findings was that musculoskeletal injuries, as a result of overexertion lifting, are one of the common injuries in the EMS workforce," according to NHTSA's Traffic Tech summary. "The literature review also found that in crash conditions, the rear compartment in an ambulance is a dangerous place to be; rear occupants are significantly more likely to be killed than front occupants. Additionally, seat belt use in the EMS workforce is low according to a survey conducted by the National Registry for EMTs."

A consensus panel of officials of EMS stakeholder organizations in the United States, representatives of data collecting or managing entities, and university experts in EMS and occupational injury developed a conceptual model for EMS workforce illness and injury surveillance. This model describes the pathway of data collection, analysis and dissemination of results, use of data in developing preventive interventions and program evaluation, and surveillance program evaluation. The panel concluded no single U.S. data system satisfies the requirements of a comprehensive surveillance data source for EMS workforce illness and injury, but some existing systems (e.g., CFOI, FARS, and NEISS-Work) contribute to or show potential to increase understanding of EMS workers' illnesses and injuries. Rather than creating a new system, the best approach is an integration of data systems, the panel decided. To order the 55-page report, write to Office of Behavioral Safety Research, NHTSA (NTI-130), Washington, DC 20590, fax 202-366-7096, or download it from

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