title: A National Assessment of the Health and Safety of Emergency Medical Services Professionals.
abstract: OBJECTIVE
  The objectives were to assess changes in (1) health and physical fitness, (2) the prevalence of selected health problems, (3) risk behaviors, (4) ambulance safety issues, and (5) the preparedness of Emergency Medical Services (EMS) professionals. In addition, the incidence of patient-initiated violence directed toward EMS personnel and associated factors were assessed.
  
  
  METHODS
  Data were obtained from a sample of nationally certified EMS professionals via annual questionnaires between 1999 and 2008. Stratification was based upon national certification level, self-reported race, and experience level. Weighted percentages, averages for continuous variables, and 95% confidence intervals (CIs) were calculated. Significant changes over time were noted by lack of CI overlap.
  
  
  RESULTS
  The proportion reporting "excellent" health declined significantly from 1999 (38.5%) to 2008 (32.2%). High rates of sleeping problems (20%-27%), back problems (20%-24%), and hearing problems (7%-10%) were reported as having occurred in the past year. These rates remained constant over time. As a result of sleepiness, 8.0% of nationally certified EMS professionals reported difficulty in driving an emergency vehicle for short distances and 17.5% reported difficulty in driving long distances. The proportion of daily tobacco smokers significantly declined from over one-third (35.3%) to about one-fifth (20.3%). The proportion of providers who had ever been involved in an ambulance crash increased slightly from 2004 (14.5%) to 2008 (15.8%). In 2000, the majority of EMS professionals reported that they and/or their partner had been assaulted by a patient. Finally, there was a significant decrease in the amount of training time devoted to the recognition of biological, chemical, and nuclear (BCN) threats, use of personal protective equipment (PPE), and treatment and management of patients exposed to BCN from an average from 8.4 hours in 2003 to 6.2 hours in 2008.
  
  
  CONCLUSIONS
  The overall health and physical fitness of EMS professionals as well as their health problems, risk behaviors, ambulance safety, and patient-initiated violence in the prehospital emergency setting are areas of concern for the nation's emergency medical system. The prevalence of these problems and overall health and physical fitness has shown little or no improvement from 1999 to 2008. Bentley MA , Levine R . A national assessment of the health and safety of Emergency Medical Services professionals. Prehosp Disaster Med. 2016;31(Suppl. 1):s96-s104.
authors.affiliation: 1Division of Epidemiology,College of Public Health,The Ohio State University,Columbus,Ohio,USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Bentley
authors.affiliation: 2Consultant,Redwood City,California,USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Levine
mesh_terms: D000328:Adult; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016272:Occupational Health; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce
keywords:  BCN biological;  BRFSS Behavioral Risk Factor Surveillance System;  CI confidence interval;  EMS Emergency Medical Services;  EMT Emergency Medical Technician;  LEADS Longitudinal EMT Attributes and Demographic Study;  PPE personal protective equipment;  and nuclear;  chemical; Emergency Medical Services; paramedic; prehospital; safety; wellness