Prevalence and risk factors of occupational injuries among emergency care providers

Abstract

Introduction: Occupational injuries and diseases affect approximately 260 million people worldwide and kill nearly 2.3 million people per year. While paramedics and other healthcare workers (HCWs) are responsible for ensuring the health of others, their working environment is also considered to be one of the most hazardous environments. Purpose: To describe the prevalence and risk factors associated with occupational injuries, as well as perceptions of both the mitigation and prevention of occupational injuries among paramedics working for KwaZulu-Natal (KZN) Emergency Medical Rescue Services (EMRS). Methodology: The study adopted a quantitative, descriptive, cross-sectional approach. The study population comprised operational paramedics working for the KZN EMRS with a sample of 334 paramedics being drawn from a total of 2378 KZN EMRS paramedics. The study was conducted in five of the eleven districts in KZN. The data collection methods used included a closed ended questionnaire and a document review. The data which had been collected was analysed using Stata version 15. The Pearson chi-squared test was used to test for associations between any two categorical variables and, in instances, where Pearson chi-squared test was invalid Fisher’s exact test was used. A p-value of less than 0.05 was considered to be statistically significant. Results: Two of the five districts provided the required information for reviewing the records. A total of 36 injuries were reported in the two districts between 2011 and 2018. The reported injuries included injuries from motor vehicle accidents (61%), musculoskeletal injuries (16.7%), needle-stick injuries (13.9%), accidental surgical blade cuts (5.6%) and assault injuries (2.8%). A total of 152 survey questionnaires were completed and returned – a 45% response rate. The findings from the selfadministered questionnaire revealed 25 (16.5%) unreported injuries which included musculoskeletal injuries (48%, n = 12), needle-stick injuries (48%, n = 12), and one (1) (4%) assault-related injuries. A further 49 (32.2%) injuries which had resulted in medical attention being sought included musculoskeletal injuries (55.1%, n = 27), injuries due to motor vehicle accidents (44.9%, n = 22), needle-stick injuries (26.5%, n = 13) and assault-related injuries (8.2%, n = 4). Overall, 59 (38.8%) paramedics had experienced occupational injuries (both reported and unreported). The paramedics’ perceived risk factors for occupational injuries included high speed driving (87.5%, n = 133), violent members of society (87.5%, n = 133), heavy objects and patient lifting (86.2%, n = 131), physical exhaustion (78.3%, n = 119), hazardous material (77%, n = 117), and temperature extremes (73%, n = 111). In addition, the paramedics’ perceptions regarding occupational injury prevention revealed the following precautions, namely, avoiding high speed driving (79.6%, n = 121), specific positioning during equipment and patient lifting (63.8%, n = 97), avoiding chaotic scenes (61.8%, n = 94) and avoiding working longer hours (49.3%, n = 75). Conclusion: While it may be anticipated that information regarding occupational injuries suffered by paramedics would not be public knowledge, access to this information for purposes of research that aim to establish mitigation and prevention strategies, should be subjected to fewer challenges. From the data that was available, paramedics from KZN EMRS experienced multiple types of occupational injuries from a variety of injury sources. These injuries could be a result of both, the nature of the work and environment in which paramedics operate. However, further research is necessary to identify and validate these findings, as well as presented strategies required to minimise the rates of occupational injury among paramedics working for KZN EMRS.