Grant: Partnerships for Health System Improvement (PHSI)

Firefighters are exposed to significant personal risk while providing essential services. Musculoskeletal (MSK) injuries, poor fitness & cardiovascular health are common problems. Firefighters, their union and employer approached researchers to develop, implement and evaluate an evidence-based "wellness" program to prevent injuries, optimize safe return to work and reduce rising health care costs. The research program has 2 phases. The goal is to evaluate the impact of community-based medical, fitness and MSK injury screening. Phase 1 will examine and characterize health problems identified by a doctor specialized in occupational medicine in a series of 300 firefighters and monitor the health services they require. In preparation for Phase 2, we will define job demands using motion analysis of firefighting tasks. Then we will conduct a screen of MSK injury and fitness of 150 firefighters with identified signs of emerging MSK problems. From these, 75 will be assigned to a personal education intervention within their fire station about how to perform their work in a manner that reduces risk of injury. We will evaluate our success by measuring health and work indicators at the start, and 6 & 12 months later. Outcomes include; number/type and cost of injuries, lost work, self-reported overall health status, change in fitness and at-work limitations. They will be measured by trustworthy methods. Mathematical models will help us know if this approach reduces the illness and disability burden experienced by firefighters. Cost savings will be put back into the wellness program to enable program expansion and long-term sustainability. Firefighters intend to lead the project and share it with other groups.