Injury stats among female firefighters are strikingly similar to male counterparts
Health-related factors – obesity, fitness level, depression and others – impact injury risk for men and women alike
Although women have been a part of the fire service since at least the 1800s, women continue to represent a small fraction of today’s fire service.
As a woman and a former firefighter, I look at firefighter statistics a bit differently now that I research firefighter health and safety issues. While fires certainly don’t discriminate by gender, sex, age or race, there are important differences within the firefighter ranks – take injury for example.
Qualitative feedback highlights unique challenges
The Center for Fire, Rescue & EMS Health Research conducted a study in which we interviewed 73 female firefighters and women in leadership positions in the fire service. We examined their perceptions, attitudes and experiences with injury. This research resulted in some really interesting themes – or commonly occurring topics (Hollerbach et al., 2017).
First, and not surprising, women noted that injuries sustained on the fireground are similar between men and women: “Fires don’t discriminate, it’ll kill you either way.” And while it is true that fires don’t discriminate, women identified numerous differences between them and their male counterparts, such as anatomy and musculature, training needs, PPE, lifting techniques, fitting in, and experiences with harassment.
With regard to anatomy and musculature, firefighters shared comments like the following: “You want to be strong enough to keep up with the rest of the boys.” Women even noted putting themselves at risk to try to accomplish a task without asking for help for fear of appearing weak: “You put your body at risk of a back injury or something else because you go that little extra bit to try to show that you can still do the job.”
And they noted these differences impacted training needs “… generally women are stronger lower body and men are stronger upper body … I believe we need to catch up to the men in the upper body strength ….”
Women also identified gaps in fitness training: “I think there’s a huge gap in fitness training. Even for the men, it’s very traditional. Like the CPAT and the Cooper’s test and pushups, sit ups, and military press … women’s bodies are different.” This impacts not only fitness training but also the way firefighters are taught to accomplish certain fireground tasks. Women in our study noted there are numerous ways to complete a task, and it is worthwhile discussing differing techniques. One participant noted, “… guys will force equipment, women have to use finesse, right?” Another said, “… you lean into a different position and use different body mechanics.”
One of the things I found the most frustrating was that women still struggle with ill-fitting PPE, which serves as firefighters’ baseline level of defense. Women have struggled for decades with PPE that was designed for men – a sentiment echoed by firefighters in the study: “Across the board, I would have to say gear [is an issue]. A lot of women are getting leftover gear, and when they buy things, they buy them in bulk and we spend the extra money on new equipment.”
We heard from numerous participants that harassment was an issue that was not only inappropriate, but left female firefighters at risk of injury. Women may be less likely to report an injury: “A girl gets injured on the job and it’s like, ‘well, she’s a girl … she’s not cut out for it then ….’” One participant said she was told: “You’re just here looking for a husband.”
Jahnke and colleagues recently found that female firefighters reported experiencing verbal (37.5%) and written (12.9%) harassment, hazing (16.9%), sexual advances (37.4%) and assaults (5.1%) in the fire service (Jahnke et al., 2019). This is unacceptable and leaves firefighters at increased risk of injury.
Data underscores nature, prevalence of firefighter injuries
We surveyed over 3,000 career female firefighters from across the United States, representing nearly 25% of the 15,200 estimated career female firefighters nationally (Evarts & Stein, 2020).
Overall, women reported experiencing similar rates and types of injuries as their male colleagues. For example, most reported injuries affected the back (22.5%), hands (17.1%), knees (16.0%) and shoulders (13.1%). Reported injuries were primarily a result of dislocation, sprain or strain (61.3%), superficial injury (21.0%) or fractures (5.5%). Most injuries occurred during training (24.9%), on the fireground (22.0%) or during other non-fire emergencies (16.6%).
According to the most recent NFPA injury report (Campbell & Evarts, NFPA, 2020), firefighters were more likely to be injured during fireground operations than during any other duties. The leading cause of injury was overexertion or strain (29%). Strains, sprains or muscular pain injuries accounted for approximately 41% of fireground injuries, followed by wounds, cuts, bleeding or bruising (13%), smoke or gas inhalation (10%), and thermal stress, including frostbite or heat exhaustion (9%).
We also examined rates of injury in our sample compared with several factors and found numerous predictors of injury, including weight status, physical activity habits, substance use, mental health, and job satisfaction (Hollerbach et al., 2020).
Those firefighters who were overweight or obese were more likely (54% for overweight, 73% for obese) to sustain an injury. Those who reported not engaging in heavy exercise were less likely to sustain an injury than their heavy-exercising peers, which makes sense. If you work out, you’re more likely to sustain minor exercise injuries than if you don’t work out at all. However, research has found that those who exercise experience much more minor injuries than those who do not exercise, and overweight and obesity are predictors of increased incidence of musculoskeletal injuries (Jahnke et al., 2013).
We also found that substance use was related to injury rate. Women who reported being either former or current smokers were more likely (former: 69%; current: 65%) to have sustained an injury.
Further, those who were in the range of concern on the depression scale (CES-D-10) were 69% more likely to have sustained an injury, and those in the range of concern on the PTSD scale (PCL-C) were 96% more likely to have sustained an injury. It is important to note here that these relationships are non-directional, meaning it was not possible to tell whether the participant was more likely to sustain an injury due to a factor such as depression, or if the factor (i.e., depression) was related to having sustained the injury.
Finally, those firefighters who reported not being satisfied with their job as a firefighter were 45% more likely to have sustained an injury.
Our research shows there are still barriers facing women in the fire service, even on the most basic level – ill-fitting gear, continued harassment.
In general, women firefighters experience similar rates and types of injuries as their male colleagues, showing that they are just as capable of doing the job and deserve the same level of support, training and properly fitting gear to protect them.
Further, similar to previous research with men firefighters (Jahnke et al., 2013), there is evidence of a relationship between a number of health-related behaviors and injury risk. Being overweight or obese increases the risk of injury in the fire service. Also, fitness level impacts your risk of injury. While those who exercise are more likely to sustain minor exercise injuries like sprains and strains, they are less likely to suffer from major musculoskeletal injuries. Smoking and alcohol use present an increased risk of injury, as do increased levels of depression and PTSD. Finally, job satisfaction may be a protective factor associated with injury risk suggesting the added benefit of the camaraderie so often touted by those in the fire service.
Hollerbach, B. S., Heinrich, K. M., Poston, W. S., Haddock, C. K., Kehler, A. K., & Jahnke, S. A. (2017). Current Female Firefighters’ Perceptions, Attitudes, and Experiences with Injury. International fire service journal of leadership and management, 11, 41.
Jahnke, S. A., Haddock, C. K., Jitnarin, N., Kaipust, C. M., Hollerbach, B. S., & Poston, W. S. (2019). The prevalence and health impacts of frequent work discrimination and harassment among women firefighters in the US Fire Service. BioMed research international, 2019.
Evarts, B., & Stein, G. P. (2020). US fire department profile 2018. Quincy, MA: National Fire Protection Association.
Campbell, R., & Evarts, B. (2020). U.S. Firefighter Injuries in 2019. NFPA.
Hollerbach, B. S., Kaipust, C. M., Poston, W. S., Haddock, C. K., Heinrich, K. M., & Jahnke, S. A. (2020). Injury correlates among a national sample of women in the US fire service. Journal of Occupational and Environmental Medicine, 62(8), 634-640.
Jahnke, S. A., Poston, W. S. C., Haddock, C. K., & Jitnarin, N. (2013). Injury among a population based sample of career firefighters in the central USA. Injury prevention, 19(6), 393-398.