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Occupational injury among paramedics: a systematic review
  1. Jason Kearney1,
  2. Carlyn Muir1,
  3. Karen Smith2
  1. 1 Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia
  2. 2 Research and Evaluation, Ambulance Victoria, Melbourne, Victoria, Australia
  1. Correspondence to Jason Kearney, Monash University Accident Research Centre, Monash University, Clayton, VIC 3800, Australia; jason.kearney{at}


Introduction Paramedics are frequently exposed to acute and/or chronic environmental, operational and patient-related factors that increase their risk of physical and psychological injury. However, there has been wide variation in reported paramedic injury rates. This systematic review aims to synthesise the evidence to examine the incidence and nature of occupational injury among paramedics.

Methods This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO 2020: CRD42020164556). A systematic search of four electronic databases was conducted for the years 2004–2019. Peer-reviewed studies examining the incidence and proportions of paramedic occupational injury within civilian emergency medical services (EMS) were included. Injury types, mechanisms, contributing factors and incidence of injury were synthesised narratively.

Results Twelve studies met the inclusion criteria. The incidence of injury ranged from 29.7 to 345.6 injuries per 1000 workers per year. Sprains and strains were the most reported injury types, and the trunk and upper limbs were the main sites. Body motion was the most frequently reported mechanism of injury, accounting for 35%–55% of all injuries. Female paramedics had a proportionally higher rate of injury compared with male paramedics. Paramedics aged 25–34 years accounted for the majority of fatal (mean 34.0%) and non-fatal (mean 51.7%) injuries.

Conclusion This review highlights the increased risk of occupational injury among paramedics and provides further insight into their overall injury profile.

  • occupational injury
  • prehospital
  • workplace
  • systematic review

Data availability statement

Data are available upon request.

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Data availability statement

Data are available upon request.

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  • Contributors All authors were involved in the planning of the study. JK conducted the search and CM reviewed it. Data extraction was initially performed by JK and discussed with CM in order to reach consensus. The quality of each study was assessed by JK. The qualitative data synthesis was completed by JK and discussed and validated by CM and KS. JK drafted the manuscript, and all authors contributed to its revisions. JK is the guarantor of this review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.