Exercise called leading factor in firefighter strains, sprains
TUCSON FIRE DEPT. INJURIES SCRUTINIZED

Exercise called leading factor in firefighter strains, sprains

Fire Capt. Mike Castoro, front, performs some ab crunches during a morning workout. Crew members are required to exercise for at least 90 minutes per 24-hour shift. Castoro says crew fitness is especially important given the unexpected nature of fire calls.

Being in top shape is a priority for firefighters, but exercise is also the main reason for on-the-job injuries within the Tucson Fire Department, a recently published report found.

The report by University of Arizona researchers, part of the Strategies to Prevent Injuries Among Firefighters, found that one-third of injuries were exercise-related - 85 percent from strains and sprains.

"We think that's from a lack of training and a lack of instruction," Capt. Jeff Langejans, a Tucson fire spokesman said.

To lower those numbers, the department plans to make better use of its 12 peer fitness trainers, firefighters who are certified to give fitness instruction. The department has not certified new trainers since 2008 because there's no money in the budget to send more firefighters to training, Langejans said.

Stations with peer fitness trainers have reported improvements in staff members who use them, and the department is writing a job description for a designated peer fitness trainer so that position can be filled when the budget allows, Langejans said.

Firefighters are required to exercise for at least 90 minutes during a 24-hour shift, he said.

"As a citizen of Tucson, I expect that the first responders that come and assist me in my time of need are going to be able to do their job. ... Someone who is not up to task or physically fit may not be able to do that," Langejans said.

Capt. Mike Castoro has been with the department for 12 years and said it's important that firefighters stay fit because of the unexpected nature of calls.

"In the middle of the night you have to wake up, and there's no warm-up period," he said. "You're often in awkward angles trying to do certain medical procedures. At times you're not lifting with very good form."

With those working conditions, firefighters are at risk for sprains and strains, Castoro said.

"By staying fit and active you kind of reduce the odds," he said.

Researchers looked at injury reports from TFD between the years 2004 and 2009, and the results showed that, additionally, transporting patients accounted for nearly 17 percent, followed by training drills with 11.1 percent, and injuries caused while fighting fires at 10.2 percent.

TFD not only reports injuries required by Occupational Safety and Health Administration standards, but also any injury to the eye, back, knee, ankle and shoulder.

The next phase of the study is to reduce the number of injuries.

Several stations have been equipped with slide boards, hard plastic boards that can be used to transfer patients to a gurney, so that firefighters don't have to bear all the weight on their backs. Ideally, all stations will have these boards readily available, Langejans said.

"We're finding that a lot of our strains and sprains and back injuries are coming from having a load on your spine and then twisting to move the patient," he said.

At some point, the department may be able to purchase new gurneys with hydraulic lifts to further reduce injury, said Gerald Poplin, an injury epidemiologist from the UA's Mel and Enid Zuckerman College of Public Health leading the study.

"They have to lift these patients a number of times per patient and per work shift, so anything you can do to reduce that repetitive motion and that load you're helping to reduce the amount of fatigue," said Poplin, who rode along with several crews as part of his research.

Another strategy is to create a training plan to deal with patient assaults, said Poplin, who nearly missed being struck by a chair hurled toward him by a patient on drugs during one of the calls he observed.

The department has taught a street-survival-skills class in the past that addressed what to do when firefighters encounter a combative patient. The goal is to hold that class more frequently and create specific action plans for different crews, Poplin said.

The study groups suggested implementing new CPR protocols so firefighters can rotate after performing 200 compressions on a patient, which would both increase the effectiveness of the compressions as well as reduce the amount of time one person spends in an awkward position, Poplin said.

At the end of the study, the researchers will determine which strategies were effective.

Contact reporter Veronica Cruz at vcruz@azstarnet.com or 573-4224.

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