The price of doing business: severe injuries in wildland firefighters in the United States by activity performed and hazard encountered

Background Wildland firefighters are exposed to hazards when working which can, and do, result in serious injury or death. Understanding the activities in which firefighters are engaged when they are injured, the hazards to which they were exposed during that activity and the resulting injury severity is critical to manage the risk of serious injury to firefighters. Aims This study aims to provide an assessment of wildland firefighter injuries. Methods A set of 435 severe injuries in wildland firefighters in the United States from 2019 to 2023 was classified by activity being performed, hazard encountered and injury severity. Statistical summaries were used to contextualize the data and to examine the frequency and severity of these injuries. Proportional odds models tested the impact of activity, region and fire complexity on injury severity. Key results Aviation activities are associated with higher injury severity; there is no statistically significant difference in injury severity among other activities. Region and fire type do not impact injury severity. Injury frequency and severity vary among hazards and associated activities. Conclusions and Implications Given the hazard mitigations in place, reducing injury frequency and severity may be challenging without clearly defined agency level risk tolerances.