Affiliation:
1. Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia
Abstract
Relevance: According to global studies, the prevalence of back pain in firefighters ranges from 30 to 71.1 %. Harsh working conditions lead to acute and chronic pain syndromes and limited range of motion in the spine, which can become critical in an emergency.The objective is to analyze the influence of age, length of service, professional workload, successful performance at work on the presence of pain and reduction of movements, as well as neurological vertebrogenic manifestations, taking into account the musculoskeletal system (MS) pathology (C13 IDC-10) in among fire service employees in general.Materials and methods: 117 subjects, aged 20 to 47 years, employed by the Federal Border Service of the State Fire Fighter Service of the EMERCOM of Russia, underwent traditional neurological examination, spine biomechanical testing, and pain syndrome assessment by the VAS scale. The results were split into groups and structured by age, length of service, professional workload, success at work, and pathology of the musculoskeletal system.Results: Occasional pain in the spine was observed in 59.2 % of firefighters, mostly in the subgroup with over 15 years of professional experience than in subgroups with 6 to 14 years and under 5 years (p < 0.05) of professional record. Musculartonic syndrome was detected in 34 % and was more pronounced in the subgroup with high professional workload, than in those with light and moderate (p < 0.05) workload and in workers aged 40 to 50 years, rather than in younger subgroups (p < 0.05). Static and static/dynamic disorders in the spine were detected in 45 % of employees and were prevalent mostly in the subgroup with a service record of over 15 years (p < 0.001), as well as in the subgroup with high professional load (p < 0.05). A decrease in reflexes was mostly observed in the subgroup aged 31 to 39 years old (p < 0.05) and in the ODS impairment subgroup (p < 0.001), while root tension symptoms dominated in the subgroup aged 40 to 50 years (p < 0.05). Sensitivity disorders (p < 0.005; p < 0.05) and root tension symptoms (p < 0.01; p < 0.005) were more often detected in subgroups with low and average professional success compared to the subgroup of successful performers. According to the regression analysis model that considered age, length of service, professional workload, successful performance at work, and ODS pathology, work experience was an only parameter showing a significant cause-and-effect correlation with static/ dynamic spine disorders: OR = 3.66; 95 % CI = 1.25–10.7 (p < 0.05).Conclusion: In firefighters, the major factors influencing pain and reduction of movements in the spine include work experience in extreme conditions and professional workload; transformed perception of painful stimuli and radicular sensory disturbances are more pronounced in employees with limited professional success. Ergonomic interventions and a biopsychosocial approach are key in the treatment and prevention of dorsopathy in fire service personnel.
Subject
Psychiatry and Mental health,Public Health, Environmental and Occupational Health,Clinical Psychology,Emergency Medicine,Emergency Medical Services
Reference52 articles.
1. Zhivolupov S.A., Samarcev I.N., Shul’man R.B. Dorsopatii: klinika, differencial’naja diagnostika i lechenie [Dorsopathies: clinical picture, differential diagnosis and treatment]. St. Petersburg. 2021. 61 p. (In Russ.).
2. Tsykunov M. Ocenka narushenij pri patologii oporno-dvigatel’noj sistemy s ispol’zovaniem kategorij Mezhdunarodnoj klassifikacii funkcionirovanija [Evaluation of Disorders of the Musculoskeletal System Pathology Using Categories of the International Classification of Functioning]. Fizicheskaja i reabilitacionnaja medicina [Physical and Rehabilitation Medicine]. 2019; 1(2):37–59 DOI: 10.26211/2658-4522-2019-1-2-37-59. (In Russ.).
3. Kobzev I.Ju., Zolotenko V.A. Vlijanie stressoustojchivosti na vremennuju netrudosposobnost’ sotrudnikov organov vnutrennih del [The influence of stress resistance on temporary disability of employees of internal affairs bodies]. Vestnik psikhoterapii [Bulletin of Psychotherapy]. 2021; (80):47–53. (In Russ.).
4. Myshechno-tonicheskij sindrom – lechenie, prichiny, simptomy, diagnostika [Muscular-tonic syndrome – treatment, causes, symptoms, diagnosis. Dikul Center [Electronic resource]. 2020. URL: www.dikul.net/wiki/myshechno-tonicheskijsindrom/.(In Russ.).
5. Abrard S., Bertrand M., De Valence T., Schaupp T. Physiological, cognitive and neuromuscular effects of heat exposure on firefighters after a live training scenario. Int J. Occup. Saf. Ergon. 2021; 27(1):185–193. DOI: 10.1080/10803548.2018.1550899.