Epidemiological attribution of knee and ankle injuries in firefighters

This study aimed to evaluate the main factors of knee and ankle injuries among Chinese firefighters, focusing on the role of training arrangements, training conditions, and knowledge of training injuries. A questionnaire survey was conducted among 963 firefighters to collect data on training content, duration, load, protective equipment, rehabilitation measures and fatigue after training. Multiple regression analysis was used to explore the relationship between each factor and knee and ankle injuries. Logistic regression analysis revealed that training load parameter (A2) significantly reduced knee injury risk (OR = 0.784,95% CI = 0.642-0.958, p < 0.05), while personal protective equipment (B4) also showed a significant negative association (OR = 0.816,95% CI = 0.679-0.982, p < 0.05). Rehabilitation measures (C4) demonstrated marked protective effects against both knee (OR = 0.846,95% CI = 0.723-0.990, p < 0.05) and ankle injuries (OR = 0.697,95% CI = 0.606-0.802, p < 0.01). Conversely, post-training fatigue or discomfort (A6) was associated with increased ankle injury risk (OR = 1.251,95% CI = 1.119-1.398, p < 0.01). Likelihood ratio tests confirmed statistically significant models for knee (χ²=65.580, df = 15, p < 0.001) and ankle injuries (χ²=79.663, df = 15, p < 0.001), with ROC curves showing AUC values of 0.71 (95% CI = 0.67-0.75) and 0.75 (95% CI = 0.71-0.79) respectively, indicating excellent predictive performance.This study shows that training load parameters, personal protective equipment, rehabilitation measures and fatigue or discomfort factors after training play a significant role in the occurrence of knee and ankle injuries. Based on this, the study proposed a two-stage injury occurrence analysis and three-level intervention method to reduce training injuries based on data analysis of firefighters'knee and ankle joint injuries, including "training load monitoring-dynamic protection adaptation-accurate rehabilitation intervention".