Factors Associated with Lost Time Injury among Paramedics in Victoria, Australia

Figures & data

Table 1. Incidence of injury.

Year	Workforce size (FTE)	Total injuries	Hours worked by 1,000 paramedics per year	Total hours worked by entire workforce	Injury rate per 1,000 FTE workers per year	LTI injury rate 1000 FTE workers per year	NLTI injury rate 1,000 FTE workers per year
2015	3654.8	1378	1,920,000	7,017,216	377.04	99.60	277.44
2016	3756.8	1392	1,920,000	7,213,056	370.53	103.28	267.25
2017	4155.7	1182	1,920,000	7,978,944	284.43	88.79	195.64
2018	4401.9	1433	1,920,000	8,451,648	325.54	89.05	236.49
2019	4518.7	1394	1,920,000	8,675,904	308.50	87.42	221.08
2020*	4822.8	812	1,920,000	4,629,888^#	336.73*	89.58*	247.16*
Total	–	7591	1,920,000	43,966,656	333.80	92.95	240.84

Abbreviations: FTE, full-time equivalent; LTI, lost time injury; NLTI, no lost time injury. Workforce size extracted from Ambulance Victoria annual reports. Workforce size = staffing numbers (FTE) minus other managerial, professional, and administrative staff. ^#Total hours worked by entire workforce over six months; *Injury rate is based on 6 months, not a full year.

Table 2. Mean rate of injury based on injury type.

Injury type	Total injuries over the study period	Mean injury rate per 1000 FTE workers per year
Musculoskeletal	4855	212.02
Psychological	553	24.15
Fractures	41	1.79
Other traumatic injuries	459	20.04
Neurological	221	9.65
Skin, subcutaneous, and soft tissue	607	26.51
Needlestick injuries	108	4.72
Other	731	31.92

Abbreviations: FTE, full-time equivalent.

Table 3. Mean rate of injury based on mechanism.

Mechanism of injury	Total injuries over the study period	Mean injury rate per 1000 FTE workers per year
Manual handling/ body stressing	4544	198.4
Psychological	999	43.6
Gravity	604	26.4
Vehicular	189	8.3
Object damage	311	13.6
Hazardous substance	178	7.8
Environment	175	7.6
Occupational violence and aggression	57	2.5
Other	313	13.7

Abbreviations: FTE, full-time equivalent.

Figure 1. Injury rate trends based on injury type. Abbreviations: FTE, full-time equivalent.

Figure 2. Injury rate trends based on the mechanism of injury. Abbreviations: FTE, full-time equivalent.

Table 4. Proportions and significance of shift and injury-related characteristics on lost time injury.

	All (n = 7591)	LTI (n = 2124)	NLTI (n = 5467)	X^2
Year, n (%)				X^2 (5, N = 7591) = 8.97, p = 0.110
2015	1378 (18)	364 (17)	1014 (19)
2016	1392 (18)	388 (18)	1004 (18)
2017	1182 (16)	369 (17)	813 (15)
2018	1433 (19)	392 (19)	1041 (19)
2019	1394 (18)	395 (19)	999 (18)
2020 (1 Jan-30 June)	812 (11)	216 (10)	596 (11)
Month, n (%)				X^2 (11, N = 7591) = 10.51, p = 0.486
January	679 (9)	177 (8)	502 (9)
February	626 (8)	181 (9)	445 (8)
March	742 (10)	193 (9)	549 (10)
April	701 (9)	191 (9)	510 (9)
May	764 (10)	214 (10)	550 (10)
June	770 (10)	218 (10)	552 (10)
July	583 (8)	153 (7)	430 (8)
August	596 (8)	166 (8)	430 (8)
September	519 (7)	165 (8)	354 (7)
October	527 (7)	156 (7)	371 (7)
November	549 (7)	147 (7)	402 (7)
December	535 (7)	163 (8)	372 (7)
Time occurred, n (%)				X^2 (5, N = 7291) = 39.25, p < 0.001. Φc = 0.073
00:00–04:00	712 (10)	168 (8)	544 (10)
04:01–08:00	814 (11)	259 (13)	555 (11)
08:01–12:00	1575 (22)	438 (21)	1137 (22)
12:01–16:00	1613 (22)	514 (25)	1099 (21)
16:01–20:00	1458 (20)	412 (20)	1046 (20)
20:01–23:59	1119 (15)	256 (13)	863 (17)
Unknown	300	77	223
Shift type, n (%)				X^2 (6, N = 7287) = 85.08, p < 0.001. Φc = 0.108
First day	1487 (20)	429 (21)	1058 (20)
Second day	1216 (17)	348 (17)	868 (17)
Afternoon	1158 (16)	366 (18)	792 (15)
First night	1496 (21)	379 (19)	1117 (21)
Second night	675 (9)	121 (6)	554 (11)
Overtime	367 (5)	79 (4)	288 (6)
Other	888 (12)	322 (16)	566 (11)
Unknown	304	80	224
Location type, n (%)				X^2 (8, N = 7586) = 49.32, p < 0.001. Φc = 0.081
On scene – Public area	535 (7)	160 (8)	375 (7)
On scene – Residential	1534 (20)	396 (19)	1138 (21)
On scene – Unspecified location	2060 (27)	547 (26)	1513 (28)
On scene – Hospital	823 (11)	195 (9)	628 (12)
On scene – Aged care facility	178 (2)	52 (3)	126 (2)
On scene – Other private location	479 (6)	117 (6)	362 (7)
Ambulance station	855 (11)	295 (14)	560 (10)
Enroute	442 (6)	124 (6)	318 (6)
Other	680 (9)	234 (11)	446 (8)
Unknown	5	4	1
Region, n (%)				X^2 (1, N = 7591) = 0.99, p = 0.320
Metropolitan	4838 (64)	1335 (63)	3503 (64)
Rural	2753 (36)	789 (37)	1964 (36)
Agency of injury, n (%)				X^2 (5, N = 7591) = 118.79, p < 0.001. Φc = 0.125
Equipment	2100 (28)	515 (24)	1585 (29)
Human	2851 (38)	760 (36)	2091 (38)
Physical agency	1105 (15)	292 (14)	813 (15)
Vehicle	588 (8)	185 (9)	403 (7)
Biological or chemical agency	388 (5)	107 (5)	273 (5)
Other	567 (8)	265 (13)	302 (6)
Bodily location of injury, n (%)				X^2 (6, N = 7586) = 445.28, p < 0.001. Φc = 0.242
Head and neck	565 (7)	130 (6)	435 (8)
Trunk	3040 (40)	863 (41)	2177 (40)
Upper limbs	1801 (24)	334 (16)	1467 (27)
Lower limbs	1031 (14)	288 (14)	743 (14)
Multiple locations	520 (7)	141 (7)	379 (7)
Psychological	533 (7)	345 (16)	188 (3)
Other	96 (1)	22 (1)	74 (1)
Unknown	5	1	4
Injury type, n (%)				X^2 (7, N = 7575) = 525.86, p < 0.001. Φc = 0.263
Musculoskeletal	4855 (64)	1316 (62)	3539 (65)
Psychological	553 (7)	355 (17)	198 (4)
Fractures	41 (1)	30 (1)	11 (0)
Other traumatic injuries	459 (6)	62 (3)	397 (7)
Neurological	221 (3)	81 (4)	140 (3)
Skin, subcutaneous, and soft tissue	607 (8)	105 (5)	502 (9)
Needlestick injuries	108 (1)	8 (0)	100 (2)
Other	731 (10)	166 (8)	565 (10)
Unknown	16	1	15
Mechanism of injury, n (%)				X^2 (8, N = 7370) = 189.52, p < 0.001. Φc = 0.160
Manual handling/ body stressing	4544 (62)	1209 (59)	3335 (63)
Psychological	999 (14)	421 (20)	578 (11)
Gravity	604 (8)	192 (9)	412 (8)
Vehicular	189 (3)	69 (3)	120 (2)
Object damage	311 (4)	64 (3)	247 (5)
Hazardous substance	178 (2)	36 (2)	142 (3)
Environment	175 (2)	21 (1)	154 (3)
Occupational violence and aggression	57 (1)	12 (1)	45 (1)
Other	313 (4)	39 (2)	274 (5)
Unknown	221	61	160
First aid treatment given, n (%)				X^2 (1, N = 7591) = 4.58, p = 0.032
Yes	2561 (34)	677 (32)	1884 (35)
No	5030 (66)	1447 (68)	3583 (66)
Medical treatment given, n (%)				X^2 (1, N = 7591) = 1114.31, p < 0.001. Φ = 0.383
Yes	2231 (29)	1219 (57)	1012 (19)
No	5360 (71)	905 (43)	4455 (82)
Percentage of shift complete, n (%)				X^2 (5, N = 7591) = 59.75, p < 0.001. Φc = 0.089
25% or less	1985 (26)	530 (25)	1455 (27)
26% to 50%	1584 (21)	389 (18)	1195 (22)
51% to 75%	1459 (19)	359 (17)	1100 (20)
76% to 100%	1688 (22)	531 (25)	1157 (21)
Overtime	275 (4)	89 (4)	186 (3)
Other	600 (8)	226 (11)	374 (7)

Abbreviations: LTI, Lost Time Injury; NLTI, No Lost Time Injury; X², Pearson Chi Square; Φ, Phi; Φc, Cramer’s V. Percentages (%) were rounded up or down to the nearest integer. The percentages in each category may not add up to 100%.

Table

	Adjusted residual
	LTI	NLTI	X^2	Adjusted p-value
Time occurred
00:00–04:00	−2.80	2.80	7.84	0.005
04:01–08:00	2.52	−2.52	6.35	0.012
08:01–12:00	−0.27	0.27	0.07	0.787
12:01–16:00	3.84	−3.84	14.75	<0.001
16:01–20:00	0.17	−0.17	0.03	0.865
20:01–23:59	−4.21	4.21	17.72	<0.001
Shift type
First day	0.77	−0.77	0.59	0.441
Second day	0.48	−0.48	0.23	0.631
Afternoon	2.94	−2.94	8.64	0.003
First night	−2.62	2.62	6.86	0.009
Second night	−6.15	6.15	37.82	<0.001
Overtime	−2.85	2.85	8.12	0.004
Other	5.81	−5.81	33.76	<0.001
Location type
On scene – Public area	1.05	−1.05	1.10	0.294
On scene – Residential	−2.08	2.08	4.33	0.038
On scene – Unspecified location	−1.65	1.65	2.72	0.099
On scene – Aged care facility	0.38	−0.38	0.14	0.704
On scene – Hospital	−2.88	2.88	8.29	0.004
On scene – Other private location	−1.77	1.77	3.13	0.077
Ambulance station	4.54	−4.54	20.61	<0.001
Enroute	0.05	−0.05	0	0.960
Other	3.94	−3.94	15.52	<0.001
Agency of injury
Equipment	−4.15	4.15	17.22	<0.001
Human	−1.99	1.99	3.96	0.047
Physical agency	−1.25	1.25	1.56	0.211
Vehicle	1.96	−1.96	3.84	0.050
Biological or chemical agency	0.08	−0.08	0.01	0.936
Other	10.34	−10.34	106.92	<0.001
Bodily location of injury
Head and neck	−2.74	2.74	7.51	0.006
Trunk	0.64	−0.64	0.41	0.522
Upper limbs	−10.22	10.22	104.45	<0.001
Lower limbs	−0.04	0.04	0	0.968
Multiple locations	−0.46	0.46	0.21	0.646
Psychological	19.60	−19.60	384.16	<0.001
Other	−1.11	1.11	1.23	0.267
Injury type
Musculoskeletal	−2.38	2.38	5.66	0.017
Psychological	19.67	−19.67	386.91	<0.001
Fractures	6.45	−6.45	41.60	<0.001
Other traumatic injuries	−7.15	7.15	51.12	<0.001
Neurological	2.90	−2.90	8.41	0.004
Skin, subcutaneous, and soft tissue	−6.14	6.14	37.70	<0.001
Needlestick injuries	−4.81	4.81	23.14	<0.001
Other	−3.37	3.37	11.36	0.001
Mechanism of injury
Manual handling/ body stressing	−3.36	3.36	11.29	0.001
Psychological	10.71	−10.71	114.70	<0.001
Gravity	2.17	−2.17	4.71	0.030
Vehicular	2.64	−2.64	6.97	0.008
Object damage	−2.98	2.98	8.88	0.003
Hazardous substance	−2.34	2.34	5.48	0.019
Environment	−4.77	4.77	22.75	<0.001
Occupational violence and aggression	−1.17	1.17	1.37	0.242
Other	−6.25	6.25	39.06	<0.001
Medical treatment given
Yes	33.38	−33.88	1114.22	<0.001
No	−33.88	33.88	1114.22	<0.001
Percentage of shift complete
25% or less	−1.48	1.48	2.19	0.139
26% to 50%	−3.41	3.41	11.63	0.001
51% to 75%	−3.19	3.19	10.18	0.001
76% to 100%	3.61	−3.61	13.03	<0.001
Overtime	1.65	−1.65	2.72	0.099
Other	5.51	−5.51	30.36	<0.001

Abbreviations: LTI, lost time injury; NLTI, no lost time injury; X², Pearson chi-square.