The Frequency and Economic Impact of Musculoskeletal Disorders for California Firefighters: Trends and Outcomes over the Past Decade.

Musculoskeletal disorders (MSDs) are the most common type of occupational injury or illness suffered by firefighters, so there is considerable interest among policymakers and stakeholders about how best to monitor, prevent, and treat firefighter MSDs. In this study, the authors update analyses from a 2010 RAND study on firefighters in California and consider the impacts of the 2013 workers' compensation reforms and the economic shocks of the late 2000s on outcomes for firefighters with MSDs. The California Department of Industrial Relations requested that the authors address a wide range of specific research questions on various aspects of firefighters' injury risk and outcomes in the workers' compensation system, from case mix and economic consequences to permanent disability rating and medical treatment patterns. The authors analyzed administrative data from the California workers' compensation system linked to data on earnings for workers injured between 2005 and 2015, with additional analyses to tailor the results to the new reforms. They compare firefighters with three groups of workers in broadly comparable occupations-police, other public-sector workers, and private-sector workers with job demands that resemble firefighting-and supplement the analysis using outside data. The authors found, among other things, that firefighters continue to face elevated risk of work-related MSDs and that earnings losses for firefighters worsened after the Great Recession of 2008-2009. Their findings will be of interest to policymakers in California and other states and to other audiences concerned with the occupational health and safety of firefighters.