The work ability Index and musculoskeletal disorders in Turkish Firefighters: A cross-sectional study on occupational health determinants

BackgroundFirefighting is a physically demanding and hazardous profession. Work-related musculoskeletal disorders (WMSDs) and declining work ability threaten workforce sustainability and public safety. Despite its critical importance, comprehensive occupational health data on this population remains limited in certain regions.ObjectiveThis study evaluated the Work Ability Index (WAI) and its occupational health correlates among Turkish firefighters.MethodsThis cross-sectional study examined 428 active-duty male firefighters from major Turkish cities using three validated instruments: the Work Ability Index, Nordic Musculoskeletal Questionnaire, and International Physical Activity Questionnaire. Multivariable linear regression modeling identified independent predictors of work ability.ResultsMean WAI score was 42.66 ± 5.08, with 11.2% having poor or moderate work ability. High prevalence of overweight/obesity (76%) and WMSDs particularly lower back (16%) and neck (12%) was observed. Age was the strongest independent predictor (β = -0.277, 95% CI: [-0.221 to -0.087], p < 0.001). WMSDs showed robust negative association with work ability (β = -0.200, 95% CI: [-3.080 to -1.187], p < 0.001) when controlling for age and physical activity. Chronic disease was significantly associated with lower WAI scores (p < 0.001).ConclusionWhile the overall work ability of active-duty Turkish firefighters is high, age-related decline and chronic health conditions are significantly associated with reduced capacity. These associative findings highlight the need for targeted health surveillance, though they must be interpreted cautiously due to potential healthy worker survivor bias inherent in such physically demanding occupational cohorts.