A qualitative study of health problems, risk factors, and prevention among Emergency Medical Service workers

BACKGROUND:Risk factors among Emergency Medical Service (EMS)workers are difficult to characterize and inconsistencies remain about their main health problems. OBJECTIVES: To identify main work-related health problems among EMS workers in the United States; identify risk factors at the organizational, task, and exposure level; identify prevention strategies; examine these issues between participants (EMS workers and supervisors). METHODS: Two types of qualitative research methods based on grounded theory were used: in-depth interviews with emergency medical technicians/paramedics (EMS workers) and focus groups (EMS workers and supervisors). RESULTS: Most participants reported similar health problems (musculoskeletal injuries) and the task related to these injuries, patient handling. Participants also reported similar physical exposures (ascending stairs with patients and patient weight). For organization/psychosocial factors, participants agreed that fitness, wages, breaks, and shift scheduling were linked with injuries, but overall, perceptions about these issues differed more than physical exposures. Lack of trust between EMS workers and supervisors were recurrent concerns among workers. However, not all organizational/psychosocial factors differed. EMS workers and supervisors agreed pre-employment screening could reduce injuries. Participants identified micro- and macro-level prevention opportunities. CONCLUSIONS: The grounded theory approach identified workers' main health problems, and the organizational factors and exposures linked with them. Perceptions about work organization/psychosocial exposures appeared more diverse than physical exposures. Prevention among all participants focused on mechanized equipment, butEMSworkers alsowanted more organizational support.