Emergency Medical Services/Original ResearchOccupational fatalities in emergency medical services: A hidden crisis*
Introduction
Emergency medical services (EMS) personnel are exposed to a wide variety of occupational hazards, including ambulance crashes, assaults, infectious disease, hearing loss, lower back injury, hazardous materials exposure, stress, extended work hours, and exposure to temperature extremes. These emergency medical technicians (EMTs) and paramedics respond to automobile crashes, shootings, medical emergencies, hazardous material incidents, and large-scale disasters. However, little is known regarding the risks associated with this occupation.
Because EMS personnel were not defined by a unique industry or occupational code, published data from the Bureau of Labor Statistics (BLS) cannot be routinely used to describe the risk of occupational illness or injury to these personnel. Therefore, the only information available were obtained from record reviews or surveys of EMS populations. It is also difficult to get a comprehensive injury profile from the published studies because the authors use different definitions of “injury” and use different denominators for their calculation of rates.
To date, few data are available to quantify the injury risk to EMS workers, in part because of a lack of specific codes to identify more workers in standard databases. This research was conducted to quantify the risk of fatality among providers of out-of-hospital care in the United States by combining data from 3 independent existing sources of data.
Section snippets
Materials and methods
The Census of Fatal Occupational Injuries (CFOI) is the central repository for information on fatal occupational injuries in the United States; occupational fatalities for particular groups can be identified by specific occupational codes. However, there is no specific occupational code used for EMS workers. Rather, EMS workers are mixed in with other occupational groups. We used CFOI to identify probable EMS injury fatalities from within 5 other occupational groups by using the methods
Results
For CFOI, 67 (74%) of the 91 probable EMS fatalities resulted from crashes. Ten (11%) fatalities were caused by assaults. In 7 of the 10 assault cases, the decedent was shot. The majority of these 10 victims were women. The 14 cases listed as “other” included cardiovascular incidents, air ambulance crashes, smoke inhalation, electrocution, falls, suicide, needle sticks, drowning, and injuries from other causes. These 14 cases are classified for this analysis as “other” because CFOI regulations
Discussion
Little is known to date about the injury risks of EMS personnel. Only 4 studies have evaluated a broad spectrum of injuries. Gershon et al10 evaluated injuries among EMS workers in Baltimore, MD, and found 226 occupational injuries per 197 employees per year. At face value, this equals a rate of 115 injuries per 100 full-time employees per year. However, the authors specified neither the definition of “injury” nor whether the denominator was based on full-time equivalent employment. By
Acknowledgements
We thank Tee Guidotti, MD, MPH, and Jim Weeks, PhD, for their critical review of the manuscript, Dante Verme, PhD, and Earl Pollack, PhD, for statistical advice, and Jim Weeks, PhD, for his assistance with the CFOI data. We extend our thanks to Peter McIntyre, Nabil Ali, and Aaron Patterson for their help with the initial data collection. We also appreciate the assistance and support from representatives of the Bureau of Labor Statistics, particularly Eric Sygnatur.
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Address for reprints: Brian J. Maguire, MSA, EMT-P, Department of Emergency Health Services, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250; 410-455-3778,fax 410-455-3045; E-mail [email protected]