Analysis of nosologies diagnosed at regular medical examinations in the personnel of fire rescue units of the Federal Fire Service of the EMERCOM of Russia

Relevance. Firefighters rank among the ten most dangerous professions in the world. According to the working conditions criterion, firefighting belongs to dangerous occupations, impregnated the risk of acute diseases or even death.

The objective is to analyze the medical and statistical indicators for major nosologies among the fire and rescue units based on the International Classification of Diseases and Health Related Problems, 10th revision (ICD–10) and respective disease chapters, with a focus on prevention measures.

Methods. From 2020 through 2024, the outpatient department of the Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia, performed regular medical examinations in 3,037 firefighters, including 77 % of officers with specialized ranks and 22.6 % of employees serving in fire and rescue units of the Federal Fire Service of the EMERCOM of Russia. The firefighters’ age ranged from 19 to 54 years (mean age of 34.3 ± 0.14 years), with their professional experience spanning from 6 months to 36 years (mean value of 10.5 ± 0.13 years). All subjects were split in two subgroups by age (19–34 years vs. ³ 35 years) and in three subgroups by professional experience (0–5 years; 6–14 years; ³ 15 years). The results were calculated in ppm per 1,000 firefighters. A statistically significant extra morbidity rate was calculated for the subgroup aged ³ 35 years and the subgroup with ³15 years of work experience. The normality of data distribution was tested using the KolmogorovSmirnov test. Long–term average rates were calculated as the sum of absolute indicators over 5 years of observation. Average annual rates were calculated as arithmetic mean values and standard errors (M ± m) derived from annual rates. The similarity (or difference) in nosology indicators across disease chapters was determined using the Kruskal–Wallis test.

Results and analysis. Based on the regular medical examination results obtained from 2020 through 2024, the average long–term morbidity rate among firefighters was 2700.4 ‰, with an average annual rate of 2946.4 ± 315.2 ‰. A decrease in overall morbidity and somatic burden was observed over time depending on age and work experience. For example, the morbidity rate among firefighters aged ³ 35 years was 2.5 times higher than among the 19–34 (p < 0.001) years subgroup; in the subgroup with ³ 15 years of work experience, the morbidity rate was almost 3.3 times higher than in the subgroup with 0–5 years of experience (p < 0.001). Although the firefighter morbidity rate was calculated by age and work experience, negative occupational factors exercised a more significant impact, e.g. the extra occupational contribution to the average long–term morbidity rate was 426.7 ‰ with statistically significant differences, if calculated by disease chapters, vs. 327 ‰ calculated by blocks. Among the general cohort of firefighters, 6 nosologies were identified responsible for ³ 5% of morbidity rate (listed top to bottom by prevalence): Dorsopathies (M40–M54) with an average long–term rate of 282.2 ‰ and 11 % of the total incidence; Disorders of ocular muscles, binocular movement, accommodation and refraction (H49–H52) 276.9 ‰ and 10.8 %; Diseases of oesophagus, stomach and duodenum (K20–K31) 252.6 ‰ and 9.8 %; Metabolic disorders (E70–E90) 172.2 ‰ and 6.7 %; Other diseases of upper respiratory tract (J30–J39) 157.7 ‰ and 6.1 %; Obesity and other hyperalimentation (E65–E68) 153.8 ‰ and 6.0 %, respectively. The total contribution of these disease blocks was 50 % of the total morbidity rate.

Conclusion. Efficient medical care and preventive measures contributed to a decrease in the age–related morbidity among firefighters. Unfortunately, greater exposure to adverse occupational factors has been registered as well noted. Early disease diagnosis, treatment and rehabilitation can significantly improve the morbidity rates among firefighters.

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