Effect of musculoskeletal training on risk of occupationally-related injuries in firefighters

In 2011, the U.S. Bureau of Labor Statistics documented injury rates of musculoskeletal injuries requiring days away from work in the full-time firefighter work force at approximately 185/10,000 employees. This represents a staggering cost to municipalities in overtime salaries as well as departmental readiness to meet community needs. We propose, in year one of the project, to observationally determine the prospective association between physical performance measures at baseline and risk of future musculoskeletal injury in a cohort of municipal firefighters of the Austin Fire Department (AFD). We will implement an injury registry surveillance system as well as utilize the AFD Wellness Center physical fitness evaluation of all firefighters within AFD. The prospective association between changes in physical performance measures and risk of musculoskeletal injury within a cohort of AFD firefighters will allow determination of risk of occupational injury incidence and injury severity. To study the effect of musculoskeletal training on lowering the risk of occupationally-related injury, we will conduct a randomized cluster cross-over trial. The critical intervention will be a strength training intervention of six months duration, implemented in Year 2. There are a total of 43 fire stations in the AFD. We will randomize 50% of the fire stations in a strength training intervention for six months with the remaining 50% of fire station participating for the second six months. Changes in fitness, strength, and incidence of injury will be monitored for the 12 months of this design. Results from this study will be disseminated to firefighting agencies with strategies for occupationally-related musculoskeletal injury prevention.