Firefighter Severe Injury Incidence: An Analysis of National Fire Incidence Reporting System (NFIRS) Data from 2010 to 2019

Abstract We aimed to identify variables associated with increased risk of severe injuries leading to lost work time among U.S. firefighters. We analyzed deidentified data from the National Fire Incident Reporting System (NFIRS) from 2010 to 2019 to evaluate associations between injury-related variables and severe injury occurrence. Chi-square tests and multiple logistic regression analyses were used to assess relationships between specified variables and severe injuries. Cause of injury, firefighter career status, and activity at the time of injury were consistently associated with severe injuries across the ten-year period. In 2010, career firefighters were 1.85 times more likely to sustain a severe injury than volunteer firefighters after adjustment (95% CI: 1.51–2.26, p < 0.0001). Injuries caused by falls or trips were 1.57 times more likely to be severe than those caused by being struck by an object (95% CI: 1.26–1.96, p < 0.0001). The magnitude of these associations remained similar over the study period. Firefighter career status, injury cause, and activity at the time of incident emerged as consistent predictors of severe injury. Increasing awareness of these risk factors may inform targeted protective measures and reduce severe injuries among firefighters.