A systematic review and meta-analysis of musculoskeletal disorders among firefighters

Introduction: Due to the nature of their job, firefighters face many ergonomic risk factors and are exposed to several musculoskeletal disorders (MSDs). The aim of this systematic review and meta-analysis was to investigate the prevalence of MSDs among firefighters.

Materials and methods: This study was conducted based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The literature search was conducted in the databases of PubMed, Scopus, Web of Science, Science Direct, SID, ISC and Google Scholar without applying a time limitation until the end of July 2022. The random effects model was used for meta-analysis, and the I² index was used to check heterogeneity among studies. The data were analyzed using STATA version 14 software.

Results: The primary literature searches in the databases identified 1,291 articles, 26 of which were entered the meta-analysis stage after screening, study selection, and quality assessment, including 36,342 firefighters. Based on the results of a meta-analysis, the overall prevalence of MSDs among firefighters was 46.39% (95% CI: 32.45-60.32, I² = 99.7%, P < 0.001). The prevalence of MSDs was also investigated at neck (18.36%), low back (34.32%), shoulder (18.68%), hands (7.43%), upper back (10.15%), knee (19.97%) and foot (6.66%).

Conclusion: Considering the relatively high prevalence of MSDs among firefighters and their higher exposition to specific job-related risk factors of MSDs compared to other professions, it is suggested to provide firefighters with appropriate training, implement ergonomic interventions, and regularly screen them to reduce MSDs.