Partner with the Department of Homeland Security, other federal agencies, 

and manufacturers to 

crash-test ambulances 

and major components 

(e.g., patient cot). 

Collaborate with the 

Office of Emergency 

Medical Services in the 

National Highway Traffic 

Safety Administration to 

describe nonfatal injuries 

and exposures to EMS 

providers. 

 Work with industry to 

improve firefighter 

personal protective 

equipment (PPE) and 

fire apparatus design. 

 Investigate fatal firefighter motor vehicle 

incidents. 

Emergency medical services (EMS) workers and firefighters are vital to disaster response. Their duties 

expose them to hazards that increase their risk for on-the-job injuries. 

NIOSH Motor Vehicle Safety Impact Story

EMS Workers 

& Firefighters

1

Bureau of Labor Statistics, Census of Fatal Occupational Injuries, Query System 

2U.S. Fire Administration (2009-2018). Fire Fighter Fatalities in United States in 

2008-2017. Access reports

46% of all EMS provider fatalities between 2013-2017 were related to motor vehicle crashes.1 

100 firefighters died as a result of motor vehicle crashes between 2008-2017.2

Key Actions: 

Key Findings: 

 Ambulances fall outside most federal motor vehicle safety standards and, as a general rule, are not 

regulated by the federal government. Guidelines for ambulance design, purchasing, and licensing are 

the responsibility of individual states. 

 Motor vehicle incidents led to about 2,000 injured EMS workers seeking emergency department treatment each year from July 2010 to June 2014. Most injured workers in the patient compartment were 

not wearing seat belts. 

 Current seat belt designs do not accommodate some firefighters, especially if they wear turnout gear. 

 Technically-sound design of PPE and fire apparatus requires scientific measurement of firefighters’ 

body dimensions, not self-reported information. 
 Prehospital Emergency 

Care article: Occupational 

injuries and exposures 

among emergency 

medical services workers 

 EMS 

employer 

fact sheet

 Anthropometric (body 

measurement) database

of U.S. firefighters 

published on NIOSH 

website 

 Applied Ergonomics 

article: Seat and seatbelt 

accommodation in fire 

apparatus: Anthropometric aspects

Key Outputs: 

Key Impacts: 

 NIOSH and industry partners worked together to develop and validate 10 new test methods, each 

based on crash testing, to improve worker safety in an ambulance. The Society of Automotive Engineers published each test method. 

 These test methods, their adoption into 3 national bumper-to-bumper standards, and the educational campaign driven by the NIOSH video series led to nationwide changes to ambulance design 

and purchasing specifications. 

 The Volunteer Fire Insurance Services Company used NIOSH investigations in risk management 

training and educational material to educate fire departments on the pros and cons of volunteer 

firefighters responding in privately-owned vehicles. 

 Vehicle and equipment designers are using NIOSH firefighter anthropometric data to design safer 

vehicles and turnout gear. 

 Ambulance crash tests

 Award-winning video 

series, Improving EMS 

worker safety through 

ambulance design and 

testing 

Masthead: ©iStock/Thinkstock 

This product is a component of the NIOSH Center for Motor Vehicle Safety 

Evaluation of Strategic Plan for Research and Prevention, 2014-2018: 

DHHS (NIOSH) Publication No. 2019-166 • https://doi.org/10.26616/NIOSHPUB2019166