A historic baseline study: occupational injuries and COVID-19 preparedness knowledge among emergency medical technicians (EMTs) in Ghana at the onset of the pandemic

Background:The initial phase of the COVID-19 pandemic served as a global stress test for emergency medical systems.This study establishes a historic baseline capturing (1) the burden of occupational injuries among emergency medical technicians (EMTs) in Ghana, and (2) factors associated with their knowledge of COVID-19 patient transport protocols during the initial pandemic response (June-August 2020).Methods: A cross-sectional study was conducted among 413 EMTs from 59 ambulance stations across 7 regions.Data were collected on sociodemographic characteristics, occupational injury history (past 12 months), general occupational health knowledge/ attitudes, and COVID-19-specific knowledge and preparedness.Occupational injury burden was analyzed descriptively.The primary analytical outcome was adequate knowledge of COVID-19 patient transport protocols.Multivariable logistic regression was used to identify associated factors.Results: Of 400 respondents (96.9%), a high burden of self-reported work-related injuries was documented: back pain (82.5%) and sprains/strains (47.5%).While 77.0% had adequate COVID-19 protocol knowledge, only 45.9% reported that recommended personal protective equipment was available.EMTs demonstrated good general occupational health knowledge (71.2%) and positive attitude (77.8%).In adjusted analysis, male sex (adjusted odds ratio [AOR], 3.30; 95% confidence interval [CI], 1.88-5.78),good general OHS knowledge (AOR, 4.20; 95% CI, 2.41-7.29),and positive attitude towards OHS (AOR, 1.90; 95% CI, 1.06-3.42)were significantly associated with adequate COVID-19 knowledge.Secondary and diploma education were associated with lower odds.The model demonstrated acceptable discriminative ability (C-statistic, 0.79; 95% CI, 0.74-0.84).Conclusion: Within the 7 regions studied, this baseline suggests potential systemic challenges in pre-hospital care, including a knowledge-resource gap and high musculoskeletal injury rates.Findings indicate that resilient emergency medical systems depend on strong foundational OHS, equitable training, and reliable supply chains.This baseline offers a reference point for future evaluations of occupational health among EMTs in similar contexts.