"Missing Mobility": Perspectives of North American Firefighters on the Risks and Causes of Work-Related Shoulder Disorders: A Qualitative Study.

Background: Firefighters are routinely exposed to significant work-related musculoskeletal disorders (WRMSDs) which can sometimes be career-ending due to the workplace stressors and the physical demands of the job. Shoulder disorders are the third most frequent WRMSDs that cause pain, disability, and morbidity in the general working population. However, little is known about the task-specific causes and risk factors for work-related shoulder disorders (WSDs) among firefighters (FFs).

Objectives: To explore the perspectives of FFs who experienced WSDs with respect to the following: (a) risk factors of WSDs; and (b) causative factors for WSDs.

Methods: Using an interpretive descriptive methodology, we purposefully sampled for age and occupational diversity. Twelve FFs (males, 8 and females, 4) between 26 and 63 years, who experienced WSDs during their career ranging from 3 to 33 years were recruited. One-on-one interviews based on a semi-structured interview guide were conducted via an online Zoom platform and transcribed verbatim. Transcripts were analyzed using reflexive thematic analysis.

Results: The WSDs reported by FFs included rotator cuff tears, labral tears and muscle sprains or strains. Three themes were identified as risk factors for WSDs: (1) too much or too little shoulder exercises is a risk for shoulder injuries; (2) internal contextual factors can increase the risk of shoulder injurie; and (3) personal factors such as age and sex mediate the risk of shoulder injuries. Three themes were reported by FFs as the causative factors of WSDs: (1) unpredictable hazards in harsh environmental conditions can lead to traumatic shoulder injuries; (2) maneuvering heavy equipment in non-ergonomic positions can lead to shoulder strains; and (3) routine firefighting tasks can lead to gradual onset of shoulder injuries.

Implications: Our results emphasized the inter-related and multifaceted nature of the risks and causative factors that increase the risk of traumatic or gradual onset WSDs among FFs. There is a need for a comprehensive prevention and self-management program that addresses fire-specific prevention and treatment program that addresses modifiable environmental, behavioral and personal risks factors.