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16 NOVEMBER 2017 | EMSWORLD.com T his month's research review fea- tures a paper devoted to occu- pational injuries and exposures among EMS workers. This inter- esting study was conducted in response to an NHTSA consensus report that called for an injury and illness surveillance system for EMS providers. NHTSA's report noted there was limited literature detailing the extent to which inju- ries and illnesses are experienced by EMS providers. This is how a lot of really impor- tant research starts: A significant study or a group of subject matter experts identifies a topic that is not well researched and calls for scientists and researchers to publish studies that add to the topic's body of lit- erature. This study does an impressive job describing the challenges of remaining safe while working in EMS. It does this by survey- ing EMS providers who sought treatment in an ED for an injury, illness or exposure that occurred on duty. The study collected data by having interviewers call EMS providers who were injured while working. These individuals were identified by the National Electronic Injury Surveillance System, which is used by NIOSH to estimate nonfatal occupational injuries and illnesses treated in EDs around the country. This study was a collaborative effort by NIOSH and the NHTSA Office of EMS. On each call the interviewers admin- istered a 20-minute survey with questions ranging from characteristics of the event to the injury outcome. The study period was from July 2010 to June 2014. National esti- mates of EMS providers treated in EDs for occupational injuries and exposures were calculated based on the results of the tele- phone interviews. In total, 572 interviews were completed. It is worth pausing here for a moment to emphasize that national estimates of EMS providers' injuries were calculated based on results of interviews with 572 injured EMS providers. There were 196 individuals who declined to participate. Yes, getting 74% of those called to complete the survey was impressive; however, the more individuals who reply, the more accurate the estimates. There may be folks reading this who decline to participate in phone surveys. In reality, 20 minutes is a long time to spend on the phone answering questions, but the next time you get a call asking you to participate in a survey, at least listen to the purpose before declining. It could be an opportunity to have a meaningful impact in improving EMS research. To calculate national estimates based on a limited number of individuals, responses are weighted. Essentially what this means is that one individual's answers are treated as responses from many individuals. In this study, the 572 interviews represented 89,100 EMS providers injured or exposed during the study period. Yes, that sounds like a pretty large jump; however, there are validated sta- tistical methods that support the calculation of such estimates. It is beyond the scope of this review to dive into these methods, but this paper does a fantastic job describing the assumptions and adjustments used. I hope everyone who reads these columns follows up and reads the actual manuscripts behind them. This is especially true for those interested in the statistical methods behind the study results. Findings Let's discuss what the authors found out. The most common injuries were described as body motion injuries. Forty-one percent of respondents indicated their injury was a sprain or strain, totaling an estimated 37,000 sprains/strains among EMS pro- viders during the study period. The over- whelming majority (90%) of these injuries occurred when lifting patients. About half of those injured while lifting indicated the patient being lifted was heavy, overweight or obese. Harmful exposures were next, represent- ing 20% of the total diagnoses (17,400 estimated exposures nationally). Of these, Look for PCRF research podcasts based on the topics featured in this column at www.pcrfpodcast.org. On-Duty Injuries and Exposures REVIEWED THIS MONTH Occupational Injuries and Exposures Among Emergency Medical Services Workers Authors: Reichard A A, Marsh SM, Tonozzi TR, Konda S, Gormley MA. Published in: Prehosp Emerg Care, 2017 Jul–Aug; 21(4): 420–31. What sends EMS providers to emergency departments? A new study delves into causes By Antonio R. Fernandez, PhD, NRP, FAHA THE TRIP REPORT: TURNING RESEARCH INTO PRACTICE Photo: Binder Lift