Background Although firefighting and emergency medical services are high-risk professions, few studies have identified the aetiology of injury in the fire service beyond the fireground. Methods Data were collected for work-related injuries in a medium-sized metropolitan fire department. In a descriptive study, the factors explored included the nature of injury, agent, mechanism, body location, environment, abbreviated injury scale (AIS), functional capacity index (FCI) and lost time status. Results From 2004 to 2009, the annual injury incidence rate averaged 17.7 per 100 employees. One-third of all injuries (32.9%) resulted from physical exercise activities, while patient transport, training drills and fireground operations resulted in 16.9%, 11.1% and 10.2% of injuries, respectively. For all job operations, sprains and strains were the most prevalent type of injury (40.2-85.2%), followed by contusions and lacerations (7.7-26.1%). The third most common injury was related to the conventional hazards of the individual job operation. Most injuries (n=862, 95.6%) were minor in severity, while 4.3% of injuries were classified as having some impedance of normal function (FCI 3). Moderate injuries (AIS 2) were infrequent, but comprised a greater proportion of fireground injuries (8.7%) than the other activities (1.0-4.1%); however, lost time injuries were more frequent for patient transport (46.1%) than other operations (22.0-29.1%). Conclusions Physical exercise, patient transport and training activities were responsible for a greater percentage of injuries than fireground operations. Focused efforts to improve the characterisation of risks during these more diverse set of work processes should help guide the development of salient strategies for injury prevention.

The aim of the present study was to understand the risk of injury in relation to fitness in a retrospective occupational cohort of firefighters in Tucson, Arizona, from 2005 to 2009. Annual medical evaluations and injury surveillance data were linked to compare levels of aerobic fitness in injured employees with those in noninjured employees. The individual outcomes evaluated included all injuries, exercise-related injuries, and sprains and strains. Time-to-event analyses were conducted to determine the association between levels of fitness and injury likelihood. Fitness, defined by relative aerobic capacity (Vo2max), was associated with injury risk. Persons in the lowest fitness level category (Vo2max <43 mL/kg/minute) were 2.2 times more likely (95% confidence interval: 1.72, 2.88) to sustain injury than were those in the highest fitness level category (Vo2max >48 mL/kg/minute). Those with a Vo2max between 43 and 48 mL/kg/minute were 1.38 times (95% confidence interval: 1.06, 1.78) more likely to incur injury. Hazard ratios were found to be greater for sprains and strains. Our results suggest that improving relative aerobic capacity by 1 metabolic equivalent of task (approximately 3.5 mL/kg/minute) reduces the risk of any injury by 14%. These findings illustrate the importance of fitness in reducing the risk of injury in physically demanding occupations, such as the fire service, and support the need to provide dedicated resources for structured fitness programming and the promotion of injury prevention strategies to people in those fields.

This 5-year analysis of clinical occupational health assessments enabled the development of a relevant metric for relating comprehensive fitness with the risk of injury. Results were consistent with previous studies focused on cardiorespiratory fitness, but also less susceptible to inter-individual variability of discrete measurements.

ObjectiveEnvironmental exposure to arsenic results in multiple adverse effects in the lung. Our objective was to identify potential pulmonary protein biomarkers in the lung-lining fluid of mice chronically exposed to low-dose As and to validate these protein changes in human populations exposed to As.MethodsMice were administered 10 or 50 ppb As (sodium arsenite) in their drinking water for 4 weeks. Proteins in the lung-lining fluid were identified using two-dimensional gel electrophoresis (n = 3) or multidimensional protein identification technology (MUDPIT) (n = 2) coupled with mass spectrometry. Lung-induced sputum samples were collected from 57 individuals (tap water As ranged from ~ 5 to 20 ppb). Protein levels in sputum were determined by ELISA, and As species were analyzed in first morning void urine.ResultsProteins in mouse lung-lining fluid whose expression was consistently altered by As included glutathione-S-transferase (GST)-omega-1, contraspin, apolipoprotein A-I and A-IV, enolase-1, peroxiredoxin-6, and receptor for advanced glycation end products (RAGE). Validation of the putative biomarkers was carried out by evaluating As-induced alterations in RAGE in humans. Regression analysis demonstrated a significant negative correlation (p = 0.016) between sputum levels of RAGE and total urinary inorganic As, similar to results seen in our animal model.ConclusionCombinations of proteomic analyses of animal models followed by specific analysis of human samples provide an unbiased determination of important, previously unidentified putative biomarkers that may be related to human disease.