Prevalence and distribution of musculoskeletal disorders in firefighters are influenced by age and length of service

Introduction: The objective of this cross-sectional study is to describe the prevalence and severity of self-reported musculoskeletal disorders (MSDs) in firefighters and how these vary by demographics and length of service (LOS). Methods: A cohort of 294 active-duty firefighters completed a body diagram to indicate the location and pain intensity of their MSK complaints. Where painful sites were indicated, they completed the relevant region-specific self-report disability measure – Neck Disability Index (NDI), Roland Morris Disability Questionnaire (RMDQ), Lower Extremity Functional Scale (LEFS), or the Short Form of Disabilities of the Arm, Shoulder and Hand (QuickDASH) – to quantify severity. Prevalence was determined from the body diagrams and severity from the site-specific self-report questionnaires. Differences in MSK severity based on demographics or LOS were determined using ANOVA. Results: The 294 active-duty firefighters had a mean age of 42.6 (SD 9.7) years and mean duration of service of 15.1 (SD 10.1) years. The prevalence of neck, back, upper-limb, and lower-limb complaints was 20%, 33%, 44%, and 45% respectively. Firefighters 42 years or older reported significantly more severe lower-extremity disability (median (IQR) LEFS: 71 (65, 77) vs. 75 (69.5, 78.5), p=0.03) and more severe back disability (median (IQR) RMDQ: 2 (1, 3) vs. 1 (0, 2), p=0.04). Firefighters with 15 years or more of firefighting service reported significantly more severe lower extremity disability (median (IQR) LEFS: 71 (64, 77) vs. 76 (70, 79), p=0.0005). Firefighters reporting >1 MSDs were significantly older than firefighters reporting no MSD ( F (5,285) =3.3, p=0.002). Discussion: The rate of MSDs is high in firefighters, and their severity is elevated with greater age and LOS, suggesting cumulative exposures/injuries and highlighting the need for ongoing assessment of the musculoskeletal system and interventions to reduce injury throughout firefighters' careers.