Perceived Barriers to Musculoskeletal Injury and Illness Reporting in the Fire Service

Abstract

Purpose: To identify structural and cultural barriers firefighters face when reporting musculoskeletal injuries in the fire service. Methods: Three hundred fourteen active firefighters from across the United States completed a web-based survey. Fire-fighters who completed the survey (mean age: 40 ± 9 years) were predominantly male (283 of 314, 90.1%), with an average of 16.79 ± 9.55 years of experience serving a city community. The online survey tool was adapted from a previous focus group study comparing the perceptions of fire chiefs and fire-fighters on the factors that contribute to musculoskeletal injuries in the fire service. The survey consisted of 32 items containing a list of cultural and structural barriers. The perceived level of challenge was rated for each selected barrier using a 4-point Likert scale ranging from "slightly challenging" to "extremely challenging." The survey was content validated and pilot tested prior to data collection. Results: The most frequent barriers to musculoskeletal injury reporting included accepting pain as a natural part of the job (167 of 314, 53.1%) and change in duty status (144 of 314, 45.8%). Firefighters identified fear of the worst-case scenario (84 of 314, 26.7%), medical services provided as not helpful (46 of 314, 14.6%), lack of benefits (32 of 314, 10.1%), and commitment to their family (44 of 314, 14.0%) as extremely challenging barriers to reporting. Conclusions: Firefighters indicated cultural barriers to be more challenging than structural barriers to reporting musculoskeletal injuries. The most frequent and most challenging barriers were related to potential long-term health consequences from musculoskeletal injury, which may not be apparent to this population. [Athletic Training & Sports Health Care. 2021;13(2):75–84.]