Service-Related Musculoskeletal Injuries in Polish Firefighters: A 2021–2023 Accidents Analysis
Abstract
:1. Introduction
2. Material and Methods
2.1. Research Design
2.2. Research Setting
- Type of activity: sports, rescue and firefighting, drills/training, technical and maintenance (TM) work and other (moving between buildings and falling on stairs);
- Type of injury: sprain, fracture, laceration and other type;
- Body area: lower limb, upper limb, chest, torso and head.
2.3. Ethical Considerations
2.4. Exclusion Criteria
- Population under observation: firefighters of Volunteer Fire Departments (VFDs) and civilian employees of SFS (these groups do not perform national service);
- Time of observation: events occurring outside the date range of 1 January 2021–31 December 2023 were rejected. The date of injury (health hazard) was important, not the time of treatment and preparation of post-injury documentation;
- The cause and circumstances of the injury—causing temporary indisposition of firefighters arising during off-duty time—were not included. Importantly, according to the rules of the course of duty, while on the way to and from activities, it is treated as an accident at work. In the analysis, there were several events (skeletal injuries during the way “to activities” and “return from activities”, classified in category 1—subcategory “other”);
- Analysis does not include soft tissue injuries, visual injuries, thermal injuries, or hearing (acoustic) injuries.
2.5. Statistical Analysis
3. Results
4. Discussion
5. Limitations
- The lack of access to the firefighters’ medical records after the resulting injury (treatment procedures, diagnostic imaging, surgical treatment and medical diagnoses);
- The lack of the age of the injured firefighters, allowing statistical calculations: the correlation of injury with age;
- No information on the firefighters’ positions, which would allow us to determine the statistical probability of injury in correlation with the occupation: office work, driver and commander;
- No information on possible permanent injury and impact on the course of further service;
- In some of the post-injury reports collected, clinical data on the code according to the International Statistical Classification of Diseases and Related Health (ICD-10) were available, but the OOSH reports are not medical records and codes on the location and type of injury are rare, so the authors deviated from statistical summaries using ICD-10 codes. The most frequent codes were as follows:
- S93—Dislocation, sprain and tear of joints and ligaments at the ankle joint;
- S83—Dislocation, sprain and tear of the joints and ligaments of the knee [45].
- Only a part of reports described in detail the official role of the firefighter whose injury was included in the study; therefore, the authors refrained from statistical analysis of this variable. However, available data show that firefighters–rescuers were more likely to have accidents than drivers and commanders;
- Longitudinal studies to assess long-term injury effects and recovery patterns are impossible because of the anonymous nature of the population, the large number of people included in the study and the lack of possibility to observe the same people whether there is a repeatability of injuries;
- The analysis may underestimate minor injuries that were not reported by firefighters.
6. Conclusions
7. Future Research Directions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Regulation of the Minister of Internal Affairs and Administration of 17 September 2021 on the Detailed Organization of the National Rescue and Firefighting System. (Dz.U. 2021 poz. 1737). Available online: https://isap.sejm.gov.pl/isap.nsf/download.xsp/WDU20170001319/O/D20171319.pdf (accessed on 12 December 2024).
- Głąb, N. State Fire Service in the civil rescue and security system—Effectiveness of operations or execution of obligations? Sci. Rep. Pro Publico Bono. 2021, 1, 273–288. [Google Scholar] [CrossRef]
- Kozłowski, P.; Tomaszewski, W. Analysis and comparision of injury rate state fire brigade workers and volunteer fire brigade workers. Pol. J. Sports Med. 2022, 2, 91–100. [Google Scholar]
- Central Institute for Labor Protection. International Occupational Hazard Safety Data Sheet, Warszawa 2020. Available online: https://www.ciop.pl/CIOPPortalWAR/appmanager/ciop/pl (accessed on 25 July 2024).
- Anderson, N.; Marcum, J.; Bonauto, D.; Siegel, M.; LaSee, C. The Relative Burden of Occupational Injuries and Illnesses in Firefighters: An Analysis of Washington Workers’ Compensation Claims, 2006–2020. Int. J. Environ. Res. Public Health 2023, 20, 7077. [Google Scholar] [CrossRef]
- Regulation of the Minister of Internal Affairs and Administration of 11 October 2018 on the List of Diseases and Disabilities, along with the Categories of Ability to Serve in the Police, Border Guard, Marshal’s Guard, State Fire Service and State Protection Service. (Dz. U. 2018 poz. 2035). Available online: https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20180002035 (accessed on 25 October 2024).
- Act of 24 August 1991 on Fire Protection (Dz.U. 1991 Nr 81, poz. 351). Available online: https://isap.sejm.gov.pl/isap.nsf/download.xsp/WDU19910810351/U/D19910351Lj.pdf (accessed on 2 August 2024).
- Regulation of the Council of Ministers of 30 June 2009 on Occupational Diseases (Dz. U. z 2013 r. poz. 1367). Available online: https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20130001367 (accessed on 2 August 2024).
- Dworsky, M.; Seabury, S.A.; Broten, N. The Frequency and Economic Impact of Musculoskeletal Disorders for California Firefighters. Rand Health Q. 2021, 9, 4. [Google Scholar]
- Hanson, B.; Steele Cooper, S.; Tegarden, T.; Tipton, L.; Freeman, A.M.; Davis, K.G.; Gillespie, G.L.; Huston, T. The impact of emergency responder musculoskeletal injuries in the State of Ohio. Work 2021, 68, 1001–1008. [Google Scholar] [CrossRef]
- Kołcz, A. Obciążenie Układu Mięśniowo-Szkieletowego Osób Pracujących w Sektorze Ochrony Zdrowia-Wybrane Zagadnienia z Zakresu Ergonomii i Fizjoprofilaktyki; Wroclaw Medical University: Wrocław, Poland, 2020. [Google Scholar]
- Idczak, P. Ergonomia sprzętu przeznaczonego do działań ratowniczych podczas zdarzeń drogowych. Sci. Rep. Pro Publico Bono 2023, 1, 369–392. [Google Scholar] [CrossRef]
- Murphy, M.C.; George, H.; Naqi, M.; Owen, P.J.; Chivers, P.; Hart, N.H. Musculoskeletal injury epidemiology in law enforcement and firefighter recruits during physical training: A systematic review. BMJ Open Sport Exerc. Med. 2022, 8, e001289. [Google Scholar] [CrossRef] [PubMed]
- Dudziński, Ł.; Panczyk, M.; Kubiak, T.; Milczarczyk, T. Sports-related injuries sustained by officers of the State Fire Service on duty—Nationwide 7-year follow-up. Front. Public Helath 2023, 11, 1204841. [Google Scholar] [CrossRef]
- Dudziński, Ł.; Kubiak, T.; Bihałowicz, J.S.; Kasperczyk, R.; Gujska, J. Injury Incidence Among Polish Firefighters Related to Firefighting Sports Activities from 2014 to 2022. Scient. Rep. Natl. Res. Inst. Minist. Inter. Adm. 2023, 3, 1–7. [Google Scholar] [CrossRef]
- Calendar of SFS Sports Events Co-Organized by the SFS Headquarters. Available online: www.gov.pl/web/kgpsp/kalendarz-imprez-sportowych-psp-wspolorga-nizowanych-przez-komende-glowna-psp (accessed on 2 August 2024).
- Killip, S.C.; MacDermid, J.C.; Thayalan, N.; Lomotan, M.; Gewurtz, R.E.; Sinden, K.E. Exploring Canadian Career Firefighters’ Understanding of the Return-to-Work Process After Musculoskeletal Injuries. J. Occup. Rehabil. 2024, 34, 582–593. [Google Scholar] [CrossRef]
- Carr-Pries, N.J.; Killip, S.C.; MacDermid, J.C. Scoping review of the occurrence and characteristics of firefighter exercise and training injuries. Int. Arch. Occup. Environ. Health 2022, 95, 909–925. [Google Scholar] [CrossRef] [PubMed]
- Ziaei, M.; Esmaeili, H.; Zolaktaf, V. A systematic model to identify and reduce work-related musculoskeletal disorders in firefighters, and improve their function. J. Bodyw. Mov. Ther. 2023, 36, 125–132. [Google Scholar] [CrossRef] [PubMed]
- Friedenberg, R.; Kalichman, L.; Ezra, D.; Wacht, O.; Alperovitch-Najenson, D. Work-related musculoskeletal disorders and injuries among emergency medical technicians and paramedics: A comprehensive narrative review. Arch. Environ. Occup. Health 2020, 77, 9–17. [Google Scholar] [CrossRef]
- Albanesi, B.; Piredda, M.; Bravi, M.; Bressi, F.; Gualandi, R.; Marchetti, A.; Facchinetiti, G.; Ianni, A.; Cordella, F.; Zollo, L.; et al. Interventions to prevent and reduce work-related musculoskeletal injuries and pain among healthcare professionals. A comprehensive systematic review of the literature. J. Saf. Res. 2022, 82, 124–143. [Google Scholar] [CrossRef]
- Sousa, A.D.; Baixinho, C.L.; Presado, M.H.; Henriques, M.A. The Effect of Interventions on Preventing Musculoskeletal Injuries Related to Nurses Work: Systematic Review. J. Pers. Med. 2023, 13, 185. [Google Scholar] [CrossRef] [PubMed]
- Headquarters of the State Fire Service. Information Bulletin of the State Fire Service for Multi-Author Study; Headquarters of the State Fire Service: Warsaw, Poland, 2023. [Google Scholar]
- Headquarters of the State Fire Service. In Organizational Structure of the State Fire Service, Warszawa; 2021. Available online: www.gov.pl/web/kgpsp/nowy-statut-i-nowa-struktura-organizacyjna-komendy-glownej-pspod-1-pazdziernika-2021-r (accessed on 22 July 2024).
- Act of 5 December 1996 on the Professions of Doctor and Dentist; Dz.U. 1997 nr 28 poz. 152; The Ministry of Health and Social Care: Warsaw, Poland, 1997; as Amended. Available online: https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=wdu19970280152 (accessed on 22 July 2024).
- Nowak, A.M.; Molik, B.; Wójcik, A.; Rutkowska, I.; Nowacka-Dobosz, S.; Kowalczyk, M.; Marszałek, J. Physical Activity and Injuries Relating to Physical Fitness of Professional Firefighters. Adv. Rehabil. 2018, 2, 13–22. [Google Scholar] [CrossRef]
- Dudziński, Ł.; Czyżewski, Ł.; Panczyk, M. Assessment of parameters reflecting the reactivity of the autonomic nervous system of Polish firefighters on the basis of a test in a smoke chamber. Front. Public Health 2024, 12, 1426174. [Google Scholar] [CrossRef]
- Nazari, G.; Osifeso, T.A.; MacDermid, J.C. Distribution of Number, Location of Pain and Comorbidities, and Determinants of Work Limitations among Firefighters. Rehab. Res. Pract. 2020, 9, 1942513. [Google Scholar] [CrossRef]
- Games, K.E.; Winkelmann, Z.K.; McGinnis, K.D.; McAdam, J.S.; Pascoe, D.D.; Sefton, J.E. Functional Performance of Firefighters After Exposure to Environmental Conditions and Exercise. J. Athl. Train. 2020, 55, 71–79. [Google Scholar] [CrossRef]
- Ras, J.; Pellei, I.; Niehaus, G.; Leach, L. Musculoskeletal Discomfort and Musculoskeletal Injuries in Firefighters of the City of Cape Town Fire and Rescue Service. Open Public Health J. 2024, 17, 18749445290291. [Google Scholar] [CrossRef]
- Lanham, S.N.; Thruston, J.L.; Miller, J.B.; Abel, M.G.; Briney, E.R.; Langford, E.L.; Eastman, A.Q.; Monteiro, L.F.; Santos, V.; Massuça, L.M.; et al. Perceptions of exercise injury mechanisms among injured firefighters. In Proceedings of the National Meeting of the National Strength and Conditioning Association, Las Vegas, NV, USA, 12 July 2023. [Google Scholar] [CrossRef]
- Evdokimov, V.I.; Bobrinev, E.V.; Kondashov, A.A.; Vetoshkin, A.A. The method to predict damage of body areas due to occupational injury among firefighters. Med.-Biol. Soc.-Psychol. Issues Saf. Emerg. Situat. 2023, 4, 5–17. [Google Scholar] [CrossRef]
- Eastman, A.Q.; Rous, B.; Langford, E.L.; Tatro, A.L.; Heebner, N.R.; Gribble, P.A.; Lanphere, R.; Abel, M.G. Etiology of Exercise Injuries in Firefighters: A Healthcare Practitioners’ Perspective. Healthcare 2023, 11, 2989. [Google Scholar] [CrossRef]
- Aksu, N.; Akgonul, B.; Aksu, T.; Atansay, V.; Kara, A.N. Traumatic knee injury patterns in Anatolian folk dancers: A case series and literature review. Int. J. Occup. Med. Environ. Health 2019, 32, 585–593. [Google Scholar] [CrossRef] [PubMed]
- Zhang, G.; Tao, P.; Chen, J.; Wang, Z.; Xu, R. The Injury Risk Prediction of Firefighters with Biomechanical Parameters during Single- and Double-Leg Jumps. Appl. Sci. 2024, 14, 4636. [Google Scholar] [CrossRef]
- Wang, S.; Wang, Y. Musculoskeletal Model for Assessing Firefighters’ Internal Forces and Occupational Musculoskeletal Disorders During Self-Contained Breathing Apparatus Carriage. Saf. Health Work 2022, 13, 315–325. [Google Scholar] [CrossRef]
- Lesniak, A.Y.; Bergstrom, H.C.; Clasey, J.L.; Stromberg, A.J.; Abel, M.G. The effect of personal protective equipment on firefighter occupational performance. J. Strength Condition. Res. 2020, 34, 2165–2172. [Google Scholar] [CrossRef]
- Walker, A.; Pope, R.; Schram, B.; Gorey, R.; Orr, R. The impact of occupational tasks on firefighter hydration during a live structural fire. Safety 2019, 5, 36. [Google Scholar] [CrossRef]
- Dudziński, Ł.; Czyżewski, Ł. Qualified first aid procedures for injuries in the activities of the State Fire Service in Lublin in 2016–2018. Dis. Emerg. Med. J. 2019, 4, 142–146. [Google Scholar] [CrossRef]
- Nadolny, K.; Ładny, J.R.; Ślęzak, D.; Komza, M.; Gałazkowski, R. Analysis of medical rescue operations performer by medical rescue teamt from all over Poland in patients with burn wounds. Wiad. Lek. 2019, 72, 26–30. [Google Scholar] [CrossRef]
- Principles of Organization of Emergency Medical Services in the National Rescue and Firefighting System. Headquarters of the State Fire Service, Warszaw, Poland. 2021. Available online: www.gov.pl/web/kgpsp/wykaz-wazniejszych-zasad-obowiazujacych-w-ksrg (accessed on 7 July 2024).
- International Trauma Life Support Guidelines. 2021. Available online: www.prc.krakow.pl/wytyczne_2021.html (accessed on 7 July 2024).
- Stephenson, S.D.; Kocan, J.W.; Vinod, A.V.; Kluczynski, M.A.; Bisson, L.J. A Comprehensive Summary of Systematic Reviews on Sports Injury Prevention Strategies. Orthop. J. Sports Med. 2021, 9, 23259671211035776. [Google Scholar] [CrossRef] [PubMed]
- Plummer, A.; Mugele, H.; Steffen, K.; Stoll, J.; Mayer, F.; Müller, J. General versus sports-specific injury prevention programs in athletes: A systematic review on the effects on performance. PLoS ONE 2019, 14, e0221346. [Google Scholar] [CrossRef]
- World Health Organization. International Statistical Classification of Diseases and Related Health Problems (ICD-10); World Health Organization: Geneva, Switzerland, 2020; Volume X. [Google Scholar]
Year | 2021 | 2022 | 2023 | p |
---|---|---|---|---|
Injuries, N | 707 | 589 | 648 | |
Employed, N (whole country) | 30,249 | 30,550 | 30,408 | |
Injuries (‰) from all employed | 0.23 | 0.19 | 0.21 | 0.302 |
All interventions in country, N | 534,500 | 560,900 | 486,400 | |
Injuries (‰) from all interventions | 1.32 | 1.05 | 1.33 | 0.079 |
Cause, n (%) | <0.001 | |||
χ2 = 54.8, df = 8 | ||||
Injury in interventions-total | 187 (26) | 158 (27) | 110 (17) | <0.001 |
Fire | 98 (52) | 66 (42) | 46 (42) | |
LT | 62 (33) | 57 (36) | 45 (41) | |
Not specified * | 27 (14) | 35 (22) | 19 (17) | |
Sport | 319 (45) | 287 (49) | 408 (63) | <0.001 |
Training | 32 (5) | 30 (5) | 32 (5) | 0.883 |
TM work | 60 (8) | 34 (6) | 29 (5) | 0.008 |
Other | 109 (15) | 80 (14) | 69 (11) | 0.034 |
Injury type, n (%) | 0.012 | |||
χ2 = 19.5, df = 8 | ||||
Sprain | 423 (60) | 365 (62) | 379 (59) | 0.454 |
Fracture | 134 (19) | 103 (17) | 105 (16) | 0.413 |
Tear | 23 (3) | 15 (2) | 37 (6) | 0.090 |
Dislocation | 50 (7) | 51 (9) | 72 (11) | 0.032 |
Other | 77 (11) | 55 (9) | 55 (9) | 0.313 |
Injury location, n (%) | <0.001 | |||
χ2 = 28.7, df = 8 | ||||
Lower limb | 532 (75) | 441 (75) | 527 (81) | 0.008 |
Upper limb | 118 (17) | 91 (15) | 90 (14) | 0.360 |
Head | 3 (0.4) | 12 (2) | 11 (2) | 0.026 |
Body-back | 41 (6) | 28 (5) | 15 (2) | 0.003 |
Body-front | 13 (2) | 17 (3) | 5 (1) | 0.020 |
Intervention | Sport | Other | Training | TM Work | p | |
---|---|---|---|---|---|---|
Injury type | N = 455 | N = 1014 | N = 258 | N = 94 | N = 123 | 0.002 |
χ2 = 36.8, df = 16 | ||||||
Sprain | 281 (62) | 622 (61) | 142 (55) | 49 (52) | 73 (59) | 0.168 |
Fracture | 77 (17) | 163 (16) | 52 (20) | 21 (22) | 29 (24) | 0.115 |
Tear | 9 (2) | 57 (6) | 6 (2) | 0 | 3 (2) | <0.001 |
Dislocation | 42 (9) | 88 (9) | 23 (9) | 12 (13) | 8 (7) | 0.604 |
Other | 46 (10) | 84 (8) | 35 (14) | 12 (13) | 10 (8) | 0.084 |
Season | N = 455 | N = 1014 | N = 258 | N = 94 | N = 123 | <0.001 |
χ2 = 45.5, df = 12 | ||||||
Spring | 124 (27) | 298 (29) | 63 (24) | 34 (36) | 22 (18) | 0.017 |
Summer | 102 (22) | 339 (33) | 70 (27) | 29 (31) | 37 (30) | <0.001 |
Autumn | 110 (24) | 206 (20) | 63 (24) | 18 (19) | 33 (27) | 0.208 |
Winter | 119 (26) | 171 (17) | 62 (24) | 13 (14) | 31 (25) | <0.001 |
Injury location | N = 455 | N = 1014 | N = 258 | N = 94 | N = 123 | <0.001 |
χ2 = 76.6, df = 16 | ||||||
Lower limb | 334 (73) | 838 (83) | 184 (71) | 61 (65) | 83 (67) | <0.001 |
Upper limb | 68 (15) | 135 (13) | 46 (18) | 22 (23) | 28 (23) | 0.006 |
Head | 3 (1) | 17 (2) | 4 (2) | 2 (2) | 0 | 0.323 |
Body back | 36 (8) | 15 (1) | 17 (7) | 7 (7) | 9 (7) | <0.001 |
Body front | 14 (3) | 9 (1) | 7 (3) | 2 (2) | 3 (2) | 0.032 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Dudziński, Ł.; Czyżewski, Ł.; Wyzgał, J. Service-Related Musculoskeletal Injuries in Polish Firefighters: A 2021–2023 Accidents Analysis. Healthcare 2025, 13, 684. https://doi.org/10.3390/healthcare13060684
Dudziński Ł, Czyżewski Ł, Wyzgał J. Service-Related Musculoskeletal Injuries in Polish Firefighters: A 2021–2023 Accidents Analysis. Healthcare. 2025; 13(6):684. https://doi.org/10.3390/healthcare13060684
Chicago/Turabian StyleDudziński, Łukasz, Łukasz Czyżewski, and Janusz Wyzgał. 2025. "Service-Related Musculoskeletal Injuries in Polish Firefighters: A 2021–2023 Accidents Analysis" Healthcare 13, no. 6: 684. https://doi.org/10.3390/healthcare13060684
APA StyleDudziński, Ł., Czyżewski, Ł., & Wyzgał, J. (2025). Service-Related Musculoskeletal Injuries in Polish Firefighters: A 2021–2023 Accidents Analysis. Healthcare, 13(6), 684. https://doi.org/10.3390/healthcare13060684