Fit for duty: The health status of New South Wales Paramedics
Authors: MacQuarrie Alex James , Robertson Caroline , Micalos Peter , Crane James , High Richard , Drinkwater Eric , Wickham James 
Published: December 2018

<p><strong><em>Introduction</em></strong></p><p>Paramedics are mobile health care workers who respond to trauma and medical emergencies. Worldwide, paramedics exhibit disturbingly high rates of injury and illness with increased markers of poor health, such as obesity and hypertension, being common. The primary aim of this study was to explore the self-reported health status of paramedics in New South Wales, Australia, by gender and geographic rostering pattern and to compare it with that of the Australian general population. A secondary aim was to examine paramedics’ attitudes towards exercise.</p><p><strong><em>Methods</em></strong></p><p>In 2015, paramedics employed by NSW Ambulance were invited to complete a web-based survey which composed of the Medical Outcomes Survey Short Form 36 (SF-36), and measures of attitudes towards exercise. Demographic information and participants’ height and weight (for calculating Body Mass Index (BMI)) were also collected. Normative comparator data for the Australian general population (BMI and SF-36 scores) were sourced from the Household Income Labour Dynamics in Australia 2015 survey.</p><p><strong><em>Results</em></strong></p><p>Of the approximately 3,300 paramedics invited to participate, 747 completed the survey (507 male, 240 female).  Mean age and mean years of service were 41.5 ±9.5 (SD) and 13.6 ±9.0 respectively. There were no differences in SF-36 scores except for the Vitality domain where males scored higher than females (p&lt;0.001), and regional paramedics had a higher General Health domain score than metropolitan paramedics (p&lt;0.05). Regional male paramedics had higher BMIs than their metropolitan counterparts (28.04 kg/m<sup>2</sup> ± 3.99 vs. 26.81 kg/m<sup>2</sup> ± 4.67, p = 0.001). Compared to the Australian population, paramedics scored higher in the Physical Function domain (p&lt;0.001) but lower in summary scores for mental and physical health (p&lt;0.001). Paramedics’ BMIs were slightly higher than the general population (27.10 ± 4.30 kg/m<sup>2 </sup>vs.26.47 ±5.42, p&lt;0.001). Paramedics reported lack of time, family, lack of motivation and in regional postings: distance to fitness facilities and shift patterns as barriers to exercise.</p><p><strong><em>Conclusions</em></strong></p><p>Paramedics scored lower on the SF-36 than the general population, which can indicate a lower health-related quality of life.  High BMI and low SF-36 scores may be related to a perceived inability to engage in regular exercise and the effects of shift work, especially in regional areas. Increasing BMI can be associated with the development of markers of poor health. Attention is needed to ensure that these essential health care providers are “fit for duty”.  This survey should be repeated longitudinally to examine trends in the health status of paramedics. Nationally and internationally, ambulance management can and should foster innovative health promotion programs and paramedics themselves need to recognise and value good health.</p>