Injury patterns and fatigue-related health outcomes among Bangladeshi firefighters: a cross-sectional survey of 553 personnel

Purpose This study estimated the 12-month prevalence of occupational injury among Bangladeshi firefighters and examined its independent occupational predictors, alongside concurrent musculoskeletal, sleep, psychological, and respiratory health outcomes. Design/methodology/approach A cross-sectional survey of 553 operational personnel across 55 fire stations in Dhaka and Chattogram divisions used the Nordic Musculoskeletal Questionnaire, Insomnia Severity Index-7, PC-PTSD-5, and STOP-Bang. Multivariable logistic regression, adjusted for age group, rank, division, night-call frequency, and sleep duration, identified independent injury predictors. Findings In total, 243 respondents (43.9%; 95% CI 39.9–48.1%) reported at least one occupational injury in the preceding 12 months. Portable pump carrying (manual transport of pump assemblies exceeding 90 kg) was the sole independent predictor (adjusted odds ratio 1.68; 95% CI 1.22–2.49; p = 0.002), although the model explained only 6% of outcome variance. Musculoskeletal symptoms affected 49.0% of respondents, moderate-to-severe insomnia 31.0%, probable post-traumatic stress disorder 17.0%, and high-risk obstructive sleep apnea 11.0%. Full protective-equipment access (33.8%) and post-incident psychological support (9.0%) were limited. Research limitations/implications The cross-sectional, self-reported design and purposive sampling of high-incident stations limit causal inference and broader generalizability. Practical implications Findings support prospective evaluation of ergonomic alternatives to manual pump transport and expansion of protective-equipment and psychological-support infrastructure. Social implications Addressing these deficits could reduce firefighter injury and support workforce sustainability and community emergency-response capacity. Originality/value This provides a foundational epidemiological baseline of physical and psychological health outcomes among Bangladeshi firefighters, establishing a baseline for future research.