title: A qualitative study of health problems, risk factors, and prevention among Emergency Medical Service workers.
abstract: BACKGROUND
  Risk factors among Emergency Medical Service (EMS) workers are difficult to characterize and inconsistencies remain about their main health problems.
  
  
  OBJECTIVE
  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, but EMS workers also wanted more organizational support.
authors.affiliation: Occupational and Environmental Medicine of Long Island, North Shore-LIJ Health System, Occupational Medicine, Epidemiology, and Prevention, Hofstra North Shore-LIJ School of Medicine, Great Neck, NY, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dropkin
authors.affiliation: Occupational Medicine, Epidemiology, and Prevention, VP, Population Health, North Shore-LIJ Health System, Great Neck, NY, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Moline
authors.affiliation: North Shore-LIJ Health System, Center for Emergency Medical Services, Great Neck, NY, USA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Power
authors.affiliation: Occupational Medicine, Epidemiology, and Prevention, North Shore-LIJ Health System, Hofstra North Shore-LIJ School of Medicine, Great Neck, NY, USA.
authors.forename: Hyun
authors.initials: H
authors.lastname: Kim
mesh_terms: D000328:Adult; D004632:Emergency Medical Services / Q000458:organization & administration; D005260:Female; D006801:Humans; D007857:Leadership; D008297:Male; D055805:Moving and Lifting Patients; D009141:Musculoskeletal System / Q000293:injuries*; D060051:Occupational Injuries / Q000209:etiology* / Q000517:prevention & control; D010561:Personnel Staffing and Scheduling; D010809:Physical Fitness; D036301:Qualitative Research; D012307:Risk Factors; D012456:Salaries and Fringe Benefits; D035502:Trust; D014481:United States; D017132:Workplace / Q000458:organization & administration / Q000523:psychology
keywords: Interviews; exposures; focus groups; low back pain; organizational factors; primary prevention