APHA 2024

Occupational risks for women in the emergency medical services (EMS) profession

Dr. Brian J. Maguire

Introduction

Emergency medical technicians and paramedics in emergency medical services (EMS) respond to 40 million calls for assistance each year in the U.S. These professionals have an occupational injury rate that is more than four times higher than the national average, and an occupational fatality rate that is 60% higher than the rate for all workers in the U.S. These high risks may be a factor in the 25% turnover of EMS personnel per year.

Although the high risks for EMS personnel have been known for some time, little is known about the risks for women in this profession. The objectives of this research are to describe current occupational injuries and illnesses involving days away from work among women and men in EMS by event type, and to calculate the differences in relative risks between women and men.

Methods

Data supplied by the U.S. Department of Labor (DOL) for 2011 to 2020, were used to compare the risks of non-fatal injuries by event type for women and men in EMS. Person-years is the sum of all workers per year for the study period. Rate is the number of cases per 100 person years. Relative risk (RR) and 95% confidence intervals (CI) were computed using standard formulae.

Results

The total person-years for EMS personnel employed by private, local, and state government agencies was 2,083,000. Of them, 685,787 (33%) were women. The average number of personnel per year was 208,300. During the study period there were 77,030 occupational injuries and illnesses involving days away from work; the overall injury rate was 3.70. The event type with the highest rate, 2.03, was overexertion and bodily reaction.

The highest RRs for women were for: falls- slips- trips (RR = 1.63. CI = 1.57, 1.69); transportation incidents (RR = 1.58. CI = 1.50, 1.66); contact with objects (RR = 1.33. RR = 1.27, 1.40); overexertion and bodily reaction (RR = 1.27. CI = 1.25, 1.30); and violence (RR = 1.25. CI = 1.17, 1.33). Overall, the RR for women for all cases was 1.30 (CI = 1.28, 1.32). In each event category with data, the RR was higher for women compared to men.

Conclusions

Women in the EMS profession have injury rates that are higher than for men in the profession across all event types, with the highest relative risks for falls- slips- trips, and for transportation related events (including ambulance crashes, air ambulance crashes, and workers struck by vehicles).

The overall injury rate of 3.7 for EMS is more than four times higher than the national average for all private industry workers in the U.S. in 2018.

These findings indicate the immediate need for research to determine both the reasons for these high rates, and the reasons for the differences by sex, as well as to develop and evaluate interventions to reduce these high rates of occupational injuries. Reducing these risks will save lives, reduce turnover, and ultimately improve care for the millions of people who call EMS professionals for assistance every year.