University of Montana ScholarWorks at University of Montana Graduate Student Theses, Dissertations, & Professional Papers Graduate School 2017 Descriptive Analysis of Injuries Sustained by Wildland Firefighters Taylor Purchio University of Montana, Missoula Follow this and additional works at: https://scholarworks.umt.edu/etd Let us know how access to this document benefits ou.y Recommended Citation Purchio, Taylor, "Descriptive Analysis of Injuries Sustained by Wildland Firefighters" (2017). Graduate Student Theses, Dissertations, & Professional Papers. 11059. https://scholarworks.umt.edu/etd/11059 This Thesis is brought to you for free and open access by the Graduate School at ScholarWorks at University of Montana. It has been accepted for inclusion in Graduate Student Theses, Dissertations, & Professional Papers by an authorized administrator of ScholarWorks at University of Montana. For more information, please contact [email protected]. DESCRIPTIVE ANALYSIS OF INJURIES SUSTAINED BY WILDLAND FIREFIGHTERS By TAYLOR JAMES PURCHIO Bachelor of Science, University of Montana, Missoula, Montana, 2014 Thesis presented in partial fulfillment of the requirements for the degree of Master of Athletic Training in Health and Human Performance The University of Montana Missoula, MT Official Graduation Date July 2017 Approved by: Scott Whittenburg, Dean of The Graduate School, Graduate School Dr. Valerie Moody, Chair Health and Human Performance Dr. Charles Palmer. Committee Member Health and Human Performance Dr. Joseph Domitrovich, Committee Member Exercise Physiologist, Missoula Technology and Development Center Purchio, Taylor, M.S., July 2017 Athletic Training Descriptive Analysis of Injuries Sustained by Wildland Firefighters Chairperson: Dr. Valerie Moody Objective: To develop a better understanding of the types of injuries Wildland Firefighters (WLFFs) sustain during Physical Training (PT) and while out on the fire line, and if there are any discernible trends or patterns that can be addressed through the implementation of a more focused PT program. Methods: This study is a web-based cross-sectional questionnaire titled Injury Surveillance of Wildland Firefighters (ISWLFF). We utilized a snowball sampling technique to reach seasonal and fulltime WLFFs of the US Forest Service. 360 WLFFs responded to the questionnaire, but were not required to answer every question. While 112 of the respondents did not report an injury in the past 5 years, 248 WLFFs did. Of the 248 participants whose injury data was utilized, there were 218 males, 29 females and 1 identified as other. Quantitative data from the questionnaire was analyzed using Microsoft Excel to determine WLFFs demographics, types of injuries sustained and the potential influence environmental factors have on injuries sustained. Thematic analysis was conducted on open-ended questions where WLFFs could offer further explanation to a closed ended question. Results: Most WLFFs (n=248) sustained at least one injury in the past 5 fire seasons with 91% (n=226) of those injuries occurring on the fireline on rocky mountainside terrain. Nearly half (n=209) of the injuries reported were sprains and strains occurring to the lower back, knee and ankle. 76% of injuries reported by WLFFs (n=343/453) directly impacted their ability to continue with normal duty. Conclusions: Most of the injuries reported by WLFFs were to the lower extremity and occurred while working on the fireline. Therefore, a more targeted, job-specific injury prevention program that focuses on the lower extremity should be considered. ii Table of Contents 1. Chapter 1: Introduction 1 a. Statement of the Problem 1 b. Theoretical Framework 1 i. Figure 1 2 c. Purpose of Study 2 d. Quantitative Research Questions 3 e. Quantitative Hypotheses 3 f. Significance of Study 3 g. Definition of Terms 4 h. Delimitations 5 i. Limitations 5 j. Threats to Internal Validity 6 k. Threats to External Validity 6 2. Chapter 2: Literature Review 8 a. Overview 8 b. The Tactical Athlete 8 c. Military Injuries 9 d. Injury Prevention Programs 11 e. Organization and Personnel Associated with Wildland Fire 13 f. Wildland Firefighters 15 g. WLFF Injuries 17 h. WLFF Injury Reporting 19 iii i. Injury Prevention Strategies 20 3. Chapter 3: Methods 22 a. Overview 22 b. Population/Size Characteristics 22 c. Selection-Eligibility Characteristics 23 d. Sampling Scheme/Size/Characteristics 23 e. Quantitative Instruments 23 f. Developers/Administrators/Administration of Instrument 24 g. Development Procedures for Injury Surveillance of WLFFs 24 h. Validation Procedures for Injury Surveillance of WLFFs 25 i. Quantitative Procedures 26 i. Ethical Nature of Data Collection 26 ii. Time Line for Data Collection 26 iii. Research Paradigm 27 iv. Research Design (with justification) 27 v. Data Analysis 28 4. References 29 5. Appendix A: Survey 36 6. Chapter 4: Manuscript 44 a. Abstract 45 b. Introduction 46 c. Methods 47 i. Study Design 47 iv ii. Subjects 48 1. Table 1 48 iii. Study Data 48 iv. Data Analysis 49 d. Results 50 i. Demographic Data 50 1. Table 2 51 ii. Injuries Sustained 51 1. Table 3 52 2. Table 4 52 3. Table 5 53 4. Table 6 53 5. Table 7 54 6. Table 8 55 7. Table 9 55 iii. Environmental Factors 56 1. Table 10 56 2. Table 11 57 iv. Discussion 57 v. Demographic Data 58 vi. Injuries Sustained 60 vii. Environmental Factors 61 e. Study Limitations 63 v f. Conclusions 64 g. References 65 vi Chapter 1 Introduction Statement of the Problem: As the number and severity of wildfires increases every year, more is asked of today’s Wildland Firefighters (WLFFs) than ever before.1 The task of wildfire suppression is incredibly arduous, and as the physical demands of the job continue to rise, so too will the risk of injury.2 As the environment for WLFF becomes increasingly more dynamic, it is imperative to look towards optimizing physical performance through injury prevention.3,4 The most important component of injury prevention is first identifying the types of injuries sustained by WLFFs through prior research. In order to accurately assess the types of injuries suffered by WLFFs, an in-depth evaluation of external factors, such as terrain, equipment availability, and duration of work shifts is necessary to address the most prominent threats to the safety of all WLFFs during physical training (PT) and out on the fireline. Unfortunately, the amount of data on WLFF injuries is underwhelming, and research shows that injuries by WLFFs are often underreported.5 The reality of the present situation is that today’s Wildland Firefighters, regardless of crew type or physical fitness, are suffering injuries at an alarming rate. Whether assigned to an incident or during PT, the time lost from these injuries and the subsequent financial burden that the United States Forest Service (USFS) faces as a result of these injuries is an issue that needs to be addressed.3 Theoretical Framework Wildland Firefighters, by nature, are incredibly tough when dealing with injuries. While this may be seen on an individual basis, there are multiple levels of influence that ultimately 1 shape the behaviors of the entire community, as noted by Glanz et al.6 The Social Ecological Model (see Figure 1),6 helps us better understand what factors affect WLFFs behavior patterns by laying out the framework necessary to design programs that benefit the group as a whole. These levels of influence include individual, interpersonal, organizational, community, and public policy. In the WLFF environment, this model thrives because it allows for change and growth on an individual level with the potential for change and growth throughout the WLFF community through beneficial changes in public policy.6 Figure 1. Social Ecological Model Diagram as illustrated in Health Behavior and Health Education: Theory, Research, and Practice6 Purpose of Study In the Wildland Firefighting community, there is a growing realization of the need to develop a better understanding of the types of injuries WLFFs sustain during PT and while out on the line. After collecting and analyzing this injury data, we hope to identify possible patterns 2 or discernible traits that may present a problem for certain demographics of WLFFs. The aim of this study is to identify the types of injuries WLFFs sustain on the job, the factors leading up to the injury, and how best to address these areas of concern. With a solid understanding of injury rates and how they pertain to WLFFs, the next logical step in addressing these injuries is through simple injury prevention strategies, or through the implementation of a more job-specific PT program. Quantitative Research Question(s) 1. What type of injuries do WLFFs sustain while completing physical training? 2. What type of injuries do WLFFs sustain while working on the fireline? 3. Are there specific factors that influence types of injuries sustained by Wildland Firefighters? Quantitative Hypothesis 1. The majority of injuries sustained by WLFFs while completing physical training will consist of injuries to the knees and ankles. 2. The injuries sustained on the fireline by WLFFs will manifest primarily in the low back, knees, and ankles. 3. Specific factors that influence types of WLFF injuries will be time of day, amount of days into work shift, and the type of terrain. Significance of the Study While efforts have been made to research injury rates among structural firefighters, policemen, and military personnel, the unfortunate truth is that these studies do not translate to WLFFs because the physical demands and varying terrain experienced by WLFFs cannot be 3 replicated outside of Wildland Firefighting. To further exacerbate the problem of limited research, the data on WLFF injuries that does exist is outdated, and does not accurately portray today’s WLFF. Therefore, the aim of this study is to identify what parts of the body are most commonly injured during PT and when assigned to an incident, what demographics or specific factors place WLFFs at the greatest risk for injury, and how to take all of this information and apply it towards a more job-specific PT program in order to reduce injury rates amongst Wildland Firefighters.