Category Archives: Emergency Services

Violence against emergency medical services personnel: A systematic review of the literature

Source: Brian J. Maguire, Peter O’Meara, Barbara. O’Neill, and Richard Brightwell, American Journal of Industrial Medicine, Early View, November 27, 2017
(subscription required)

From the abstract:
Background
Violence against emergency medical services (EMS) personnel is a growing concern. The aim of this systematic review is to synthesize the current literature on violence against EMS personnel.

Methods
We examined literature from 2000 to 2016. Eligibility criteria included English-language, peer-reviewed studies of EMS personnel that described violence or assaults. Sixteen searches identified 2655 studies; 25 studies from nine countries met the inclusion criteria.

Results
The evidence from this review demonstrates that violence is a common risk for EMS personnel. We identified three critical topic areas: changes in risk over time, economic impact of violence and, outcomes of risk-reduction interventions. There is a lack of peer reviewed research of interventions, with the result that current intervention programs have no reliable evidence base.

Conclusions
EMS leaders and personnel should work together with researchers to design, implement, evaluate and publish intervention studies designed to mitigate risks of violence to EMS personnel.

New onset of asthma and job status change among world trade center responders and workers

Source: Hyun Kim, Sherry Baron, Navneet K. Baidwan, Adam Schwartz and Jacqueline Moline, American Journal of Industrial Medicine, Early View, First published: September 14, 2017
(subscription required)

From the abstract:
Background:
Despite the high rates, the consequences of new onset asthma among the World Trade Center (WTC) responders in terms of the change in job status have not been studied.

Methods:
This study consists of a cohort of 8132 WTC responders out of the total 25 787 responders who held a full-time job at the baseline visit, and participated in at least one follow-up visit.

Results:
Overall, 34% of the study cohort changed their job status from full-time at a follow-up visit. Multivariable models showed that asthmatics were respectively 27% and 47% more likely to have any job status change and get retired, and twice as likely to become disabled as compared to non-asthmatics.

Conclusions:
With asthma incidence from WTC exposure, negative job status change should be considered as a potential long-term consequence of WTC exposure.

Congressional Primer on Responding to Major Disasters and Emergencies

Source: Jared T. Brown, Bruce R. Lindsay, Jaclyn Petruzzell, Congressional Research Service, CRS Report, R41981, September 8, 2017

While the disaster response and recovery process is fundamentally a relationship between the federal government and the requesting state or tribal government, there are roles for congressional offices. For instance, congressional offices may help provide information to survivors on available federal and nonfederal assistance, oversee the coordination of federal efforts in their respective states and districts, and consider legislation to supplemental disaster assistance or authorities. Congressional offices also serve as a valuable source of accurate and timely information to their constituents on response and relief efforts….

….Before and after a disaster strikes, it is useful to understand the basic national emergency management structure and where authority rests at various stages of the process. This report provides information to aid policymakers as they navigate the many levels of responsibility, and numerous policy pressure points; it describes the laws and administrative policies governing the disaster response and recovery process. The report also reviews the legislative framework that exists for providing federal financial assistance following disasters, as well as the policies the executive branch employs to provide supplemental help to state, tribal, and local governments during time of disasters…..

Related:
Congressional Considerations Related to Hurricanes Harvey and Irma
Source: Jared T. Brown, Congressional Research Service, CRS Insight, IN10763, September 8, 2017

This Insight provides a short overview of issues Congress may consider in relation to Hurricanes Harvey and Irma. It is not intended to provide up-to-date information on unfolding events. For storm-related updates and the current status of response efforts, see official government sources (e.g., Federal Emergency Management Agency (FEMA) and National Weather Service), congressional advisories from government sources, and/or news media. For additional support, please contact available CRS experts in disaster-related issue areas….

The mental health impact of major disasters like Harvey and Irma
Source: J. Brian Houston, Jennifer First, The Conversation, September 11, 2017

What do hospitals do in a hurricane? Use their own emergency plans
Source: Daniel B. Hess, The Conversation, September 11, 2017

‘Giving Help and Not Asking for It’: Inside the Mental Health of First Responders

Source: Katherine Barrett & Richard Greene, Governing, July 7, 2017

Teaching cops, firefighters and prison workers to recognize and know how to handle people with mental illness is a big part of the efforts to reduce suffering and death at the hands of law enforcement. Less talked about is the mental health of the cops, firefighters and prison workers themselves. ….

Emergency Medical Services in California: Wages, Working Conditions, and Industry Profile

Source: Ken Jacobs, Nereida Heller, Saba Waheed and Sam Appel, UC Berkeley Center for Labor Research and Education – UCLA Labor Center, February 2017

From the press release:
More than 16,000 emergency medical service workers are employed in California, with the vast majority working for private providers. Wages in the industry are low, employees work long hours often without rest and meal breaks, and injury rates are high, according to a joint study by UC Berkeley’s Center for Labor Research and Education and the UCLA Labor Center. The study looks at working conditions addressed in the Emergency Medical Services Workers’ (EMS) Bill of Rights, or Assembly Bill 263, proposed today by Assemblymember Freddie Rodriguez (D-Pomona/Chino).

Emergency medical technicians (EMTs) and paramedics provide critical pre-hospital emergency care often in life or death situations. Unfortunately, the stress of the job and long work shifts can take a toll on their health. Previous research has found that EMS workers suffer disproportionately from post-traumatic stress disorder, depression, and suicidal ideation. ….
Related:
Summary

Firefighters protect us. Who protects them?

Source: Mike Hendricks and Matt Campbell, Kansas City Star, 2016

….Tough luck sums it up well on both the regulatory and legal fronts, The Star found in an investigation of shortcomings in firefighter safety. In most occupations, there are rules to follow and legal consequences for flouting them.

Not necessarily with firefighters.

Because local fire departments are subject to no federal workplace safety rules and scant state regulation in much of the country, firefighters cannot count on government to help correct unsafe practices.

“OSHA cannot come in and do nothing for us, because we are not under OSHA,” Waycross, Ga., firefighter Bill Jordan said.

And because the survivors of fallen firefighters generally cannot file wrongful-death lawsuits against fire departments in Missouri, Kansas and most other states, the fear of shelling out big damage awards won’t spur departments to exercise more caution.

That lack of accountability, especially on the regulatory front, officials inside and outside government say, hampers efforts to prevent injuries and line-of-duty deaths…..
Related:
Fatal Echoes

About this series:
The Star set out to examine how and why U.S. firefighters die on the job after Kansas City firefighters John Mesh and Larry Leggio were killed in October 2015.

Reporters Mike Hendricks and Matt Campbell interviewed scores of experts on fire behavior and firefighter safety. Hendricks and photographer/videographer Joe Ledford visited Texas, Georgia, New York, Maryland and Washington, D.C., to speak with firefighters and survivors, visit the National Fire Fighters Memorial and observe a federal rule-writing committee in action.

The reporters analyzed hundreds of federal and state fatality investigative reports, five years’ worth of federal workplace safety inspection records and reams of meeting transcripts of an advisory board that recently proposed the first new federal safety regulations governing the fire service in decades.

Fifteen years after 9/11, illnesses compound for first responders

Source: Sam Weber and Laura Fong, PBS NewsHour, September 11, 2016

Tens of thousands of people who worked at ground zero are still coping with the long-term health effects from the worst terrorist attack in U.S. history. 15 years after the attack, doctors and researchers continue to study the connection between the toxins at the site and physical ailments, along with complications from mental health issues like post-traumatic stress disorder. NewsHour Weekend Special Correspondent Karla Murthy reports.

Special Issue: Health Effects of 9/11: Fifteen Year Reports

Source: American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

Articles include:
FDNY and 9/11: Clinical services and health outcomes in World Trade Center-exposed firefighters and EMS workers from 2001 to 2016
Source: Jennifer Yip, Mayris P. Webber, Rachel Zeig-Owens, Madeline Vossbrinck, Ankura Singh, Kerry Kelly and David J. Prezant, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

Ten-year cancer incidence in rescue/recovery workers and civilians exposed to the September 11, 2001 terrorist attacks on the World Trade Center
Source: Jiehui Li, Robert M. Brackbill, Tim S. Liao, Baozhen Qiao, James E. Cone, Mark R. Farfel, James L. Hadler, Amy R. Kahn, Kevin J. Konty, Leslie T. Stayner and Steven D. Stellman, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

Post-9/11 cancer incidence in World Trade Center-exposed New York City firefighters as compared to a pooled cohort of firefighters from San Francisco, Chicago and Philadelphia (9/11/2001-2009)
Source: William Moir, Rachel Zeig-Owens, Robert D. Daniels, Charles B. Hall, Mayris P. Webber, Nadia Jaber, James H. Yiin, Theresa Schwartz, Xiaoxue Liu, Madeline Vossbrinck, Kerry Kelly and David J. Prezant, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

Impact of 9/11-related chronic conditions and PTSD comorbidity on early retirement and job loss among World Trade Center disaster rescue and recovery workers
Source: Shengchao Yu, Robert M. Brackbill, Sean Locke, Steven D. Stellman and Lisa M. Gargano, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

Mental health status of World Trade Center tower survivors compared to other survivors a decade after the September 11, 2001 terrorist attacks
Source: Lisa M. Gargano, Angela Nguyen, Laura DiGrande and Robert M. Brackbill, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

The prevalence of metabolic syndrome among law enforcement officers who responded to the 9/11 World Trade Center attacks
Source: Jacqueline M. Moline, Mary Ann McLaughlin, Simonette T. Sawit, Cynara Maceda, Lori B. Croft, Martin E. Goldman, Mario J. Garcia, Rupa L. Iyengar and Mark Woodward, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

The association between body mass index and gastroesophageal reflux disease in the World Trade Center Health Program General Responder Cohort
Source: Nikolina Icitovic, Lynn C. Onyebeke, Sylvan Wallenstein, Christopher R. Dasaro, Denise Harrison, Jieying Jiang, Julia R. Kaplan, Roberto G. Lucchini, Benjamin J. Luft, Jacqueline M. Moline, Lakshmi Pendem, Moshe Shapiro, Iris G. Udasin, Andrew C. Todd and Susan L. Teitelbaum, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

Isolated small airway reactivity during bronchoprovocation as a mechanism for respiratory symptoms in WTC dust-exposed community members
Source: Kenneth I. Berger, Samantha Kalish, Yongzhao Shao, Michael Marmor, Angeliki Kazeros, Beno W. Oppenheimer, Yinny Chan, Joan Reibman and Roberta M. Goldring, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

Improvement in severe lower respiratory symptoms and small airway function in World Trade Center dust exposed community members
Source: Caralee Caplan-Shaw, Angeliki Kazeros, Deepak Pradhan, Kenneth Berger, Roberta Goldring, Sibo Zhao, Mengling Liu, Yongzhao Shao, Maria Elena Fernandez-Beros, Michael Marmor, Nomi Levy-Carrick, Rebecca Rosen, Lucia Ferri and Joan Reibman, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

Biomarkers of patient intrinsic risk for upper and lower airway injury after exposure to the World Trade Center atrocity
Source: Rachel Zeig-Owens, Anna Nolan, Barbara Putman, Ankura Singh, David J. Prezant and Michael D. Weiden, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)
Asthma among Staten Island fresh kills landfill and barge workers following the September 11, 2001 World Trade Center terrorist attacks
Source: James E. Cone, Sukhminder Osahan, Christine C. Ekenga, Sara A. Miller-Archie, Steven D. Stellman, Monique Fairclough, Stephen M. Friedman and Mark R. Farfel, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

Effect of asthma and PTSD on persistence and onset of gastroesophageal reflux symptoms among adults exposed to the September 11, 2001, terrorist attacks
Source: Jiehui Li, Robert M. Brackbill, Hannah T. Jordan, James E. Cone, Mark R. Farfel and Steven D. Stellman, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

Sex differences in asthma and gastroesophageal reflux disease incidence among the World Trade Center Health Program General Responder Cohort
Source: Jieying Jiang, Nikolina Icitovic, Michael A. Crane, Christopher R. Dasaro, Julia R. Kaplan, Roberto G. Lucchini, Benjamin J. Luft, Jacqueline M. Moline, Lakshmi Pendem, Moshe Shapiro, Iris G. Udasin, Andrew C. Todd and Susan L. Teitelbaum, American Journal of Industrial Medicine, Volume 59 no. 9, September 2016
(subscription required)

24-hour work shifts, sedentary work, and obesity in male firefighters

Source: BongKyoo Choi, Marnie Dobson, Peter Schnall, and Javier Garcia-Rivas, American Journal of Industrial Medicine, Volume 59 Issue 6, June 2016
(subscription required)

From the abstract:
Background: Little is known about the occupational risk factors for obesity in US firefighters.
Methods: 308 male California firefighters, who participated in a work and obesity project, were chosen. Working conditions were measured with a firefighter-specific occupational health questionnaire. Adiposity was clinically assessed using body mass index (BMI), waist circumference (WC), and body fat percent.
Results: In a multivariate analysis, the prevalence of obesity by all measures was significantly higher in the firefighters who reported seventeen to twenty-one shifts than those who reported eight to eleven shifts in the past month. Prolonged sedentary work was also a risk factor for obesity by BMI. Furthermore, there was a linear dose-response relationship of obesity by BMI and WC with the number of 24-hr shifts and sedentary work.
Conclusions: Many additional 24-hr shifts and prolonged sedentary work substantially increased the risk for obesity in male firefighters.