Emergency service ergonomic hazards
A number of emergency service work requirements can be easily targeted for analysis of ergonomic hazards. The following is a list of the most prevalent causes of sprains, strains and muscular pain encountered by emergency service personnel.
- Lifting/carrying: Emergency responders are frequently injured while lifting or carrying (Figure 1.6). This includes lifting or carrying patients and equipment (hoses, ladders, medical boxes, gurneys, etc.). These physical demands can occur during an emergency situation, requiring speed of movement for a successful rescue. However, some of these activities occur outside of an emergency situation, allowing for greater care to be taken with technique and physical efficiency. Lifting injuries also occur in the weight room. Strength training is a necessity for job performance; however, flawed technique or fatigue can lead to injury.
- Awkward positions: Emergency care often requires awkward positions. Any time the body is asked to perform outside of its neutral, anatomical position, greater demands are placed on the body and the risk for injury increases. Wearing PPE such as turnouts and an SCBA limit a firefighter's mobility and agility. Crouching, crawling, twisting and bending are often required for firefighting, technical rescue and patient care. To add insult to the awkward position, all too often a forceful exertion is required while in such a position, increasing the risk of injury.
- Sustained positions: The very nature of providing patient care in the field requires sustained positions by bending or leaning over a patient to provide care. Fire suppression also requires numerous sustained positions, including manipulation of hoses, kneeling or crawling, and overhaul. Technical rescues in swift water, on mountainsides and during extrication are often performed in awkward and sustained positions.
- Vibration: Repeated or prolonged exposure to vibrating saws and drills can lead to injury.
- Extreme environmental conditions: Exposure of workers to extreme heat and cold can lead to injury and illness (Figure 1.7).
Figure 1.7. Courtesy of Ron Jeffers, Union City, New Jersey. - Repetitive/prolonged activity: Any activity that is performed repeatedly can leave workers vulnerable to injury. Bending, crouching, pushing, pulling and lifting are the most prevalent forms of repetitive activities that can lead to injury. Additionally, repetitive fitness activities such as weight lifting, running, jumping, etc., can lead to injury.
- PPE: Protective clothing and equipment reduces mobility, agility, dexterity and coordination while performing work tasks. Strength, endurance and power are also compromised as this equipment adds weight and bulk to all movements. Additionally, PPE adds another element of thermal stress to the body. This includes wearing turnouts, SCBA, and even protective gowns, masks and gloves. Vision, hearing and tactile sensations are also reduced while in protective equipment.
- Use of heavy equipment: The use of fire apparatus and patient rescue vehicles pose positional and maneuverability limitations. Emergency responders are often riding backwards or sideways in compromising postures while performing patient care or preparing en route to an emergency. Step height and depth are often not optimal, requiring special attention to correct technique in order to avoid an injury. Traversing an apparatus such as a fire engine, ladder truck or rescue ambulance leaves the worker walking on uneven and often slippery surfaces.