FEMA Vehicle Crash Study: Firefighter Injury Reduction through Sustainable Risk Management

Objective: To establish and evaluate a sustainable fire department risk management (RM) program. Background: Firefighters are at high risk for injuries and fatalities. Introduction of RM programs has been associated with a marked reduction in injuries in the mining industry, and in previous research we found that a fire department in the United Kingdom (UK) had injury rates 1/4th to 1/60th that of the US fire departments studied. Building on these findings, we introduced a formalized RM process in the Tucson Fire Department (TFD), supported by a recently completed NIOSH grant. Our preliminary results suggest that implementation of RM was associated with a decline in average annual reported injuries, number of workers’ compensation claims and workers’ compensation claim costs. However, our current model is not sustainable, as it requires continued researcher input for facilitating the RM process and for providing data collection and analytics to measure RM outcomes. In addition, a business case documenting the positive economic return for the RM program is needed. These gaps will be addressed through completion of the following aims. Specific aims: 1. Create a sustainable RM system in TFD; 2. Integrate health and safety data systems at TFD to inform and improve the RM system; and 3. Evaluate the economic return on investment of the overall RM program and component interventions. Study design: A RM system modeled after the successful system in place in the UK, using a civilian RM manager will be implemented to increase the sustainability of TFD’s existing program. The civilian risk manager will develop RM training and tools (standard operating procedures, forms, etc.) necessary to build TFD’s capacity, while the department’s Safety and Health Captain will serve as the RM facilitator, responsible for conducting and evaluating risk assessments and planned task observations. The RM system will be evaluated using injury outcomes and costs, and an in-depth process evaluation to measure program implementation. A data system with injury, workers' compensation, exposure risk (Emergency Medical Services (EMS), dispatch, hazardous materials and crash reports), personnel, training and occupational medical data will be developed and used to assess the RM program and identify potential new areas of focus. The data system will also be used to create a ‘dashboard’ of health and safety information and improve the transparency of the data necessary to inform the RM program. The predicted and actual economic return on investment of the TFD RM program and component interventions will be measured in order to demonstrate a positive return on investment and foster more widespread acceptance of RM in the fire service. Relevance to public health: This study will address NIOSH NORA public safety research priority areas, particularly developing safety interventions as directed by injury surveillance and investigative data. If successful, this sustainable RM model will serve as a template for reducing injuries throughout the fire service.