Firefighters and police search dog handlers' experiences working closely with paramedics in urban search and rescue incidents: a qualitative focus group study from Oslo.

BACKGROUND: Rescue operations are in Norway defined as situations where patients are difficult to access or that more resources are needed than the health services alone possess and can put in operation (Bull A, Redningshåndboken er endelig her! [Internet]. Hovedredningssentralen. 2018 [cited 2023 May 15]. Available from: https://www.hovedredningssentralen.no/redningshandboken-er-endelig-her/ ). Rescue operations after large incidents may include civil protection, military forces, non-governmental organizations and other resources, but the initial rescue effort must be performed by the emergency services as time often is of essence. The central area of an accident where special training and personal protection equipment is necessary or mandatory is called the Hot Zone. This study examines Urban Search And Rescue (USAR) firefighters and police officers reported experiences from ambulance personnel's contribution in the Hot Zone. METHODS: We conducted five focus group interviews with USAR-trained firefighters and police officers. The interviewees were those on duty on the agreed dates. The interviews were taped, transcribed, and analysed using thematic analysis as described by Braun & Clarke. RESULTS: Three themes were identified; Feeling safe during missions, Building USAR capacity, and Trust-building within USAR-teams. The firefighters and police officers reported their and the patients' safety are best managed by EMS-personnel, whose presence strongly contributes to their own feeling of safety in a dangerous area. When EMS handles victims and injured emergency workers, firefighters and police officers can focus on their own primary tasks. Indeed, interviewees reported that building a USAR capacity depends on having USAR-trained EMS-personnel in the Hot Zone. The interviewees have clear and consistent opinions on how to establish an interagency USAR capacity effectively. Trust is paramount to the interviewees, and they express a high degree of trust within USAR Oslo. CONCLUSIONS: Firefighters and police officers regard USAR-trained EMS-personnel as a natural and integrated part in urban search and rescue teams. EMS-personnel in the dangerous area deliver safety and medical professional assistance to both rescue workers and patients. Informants in this study had clear opinions on how to establish and maintain such a service.

A 15-year longitudinal study of search-and-rescue dogs identifies the musculoskeletal, integumentary, and gastrointestinal systems as commonly affected.

OBJECTIVE: A longitudinal study followed search-and-rescue (SAR) dogs for 15 years to determine the incidence of health events and whether factors of deployment during 9/11, breed, or sex altered the risk of specific events. ANIMALS: 150 SAR dogs: 95 dogs deployed to the September 11 terrorist attack sites and 55 SAR dogs not deployed. METHODS: Each year, a survey was sent to the handler to collect health information until the dog died or the handler withdrew from the study. The reported health events were then categorized according to the body system affected and etiology. Incidence risk rates, with 95% CIs, were calculated for the most common types of health events. Incidence rate ratios were calculated stratified by deployment status, sex, and breed and significance assessed. RESULTS: 1 or more health event was recorded in 96 of the 150 enrolled dogs. The most affected systems were the musculoskeletal (31%; CI, 24 to 39), integumentary (22%; CI, 15 to 29), and gastrointestinal (20%; CI, 14 to 26). The health events were most commonly reported as inflammatory (45%; CI, 37 to 53) and degenerative (28%; CI, 21 to 35) in nature. There were no significant differences in incidence of health events based on deployment status to the September 11, 2001, terrorist attacks. Additionally, there was no significant effect of breed or sex on incidence of health events. CLINICAL RELEVANCE: To improve the health and longevity of SAR dogs, disease prevention and management programs should focus on reducing the health problems involving the musculoskeletal system as well as the integumentary and gastrointestinal systems.

Shoulder reduction on the scene: current practice and outcome of the Bavarian Mountain Rescue Service-a prospective observational study.

Out-of-hospital reduction of shoulder dislocations using the Campell method is recommended by the International Commission for Alpine Rescue and applied in the Bavarian Mountain Rescue Service (Bergwacht Bayern, BWB) protocols. This prospective observational study includes patients out-of-hospital with suspected shoulder dislocation and treated and evacuated by the BWB. Data were systematically collected using three questionnaires: one completed on-site by the rescuer, the second in hospital by the physician and the third within 28 (8-143) days after the accident by the patient. The suspected diagnosis of shoulder dislocation was confirmed in hospital in 37 (84%) of 44 cases. Concomitant injuries in other body regions were found in eight (16%) of 49 cases and were associated with incorrect diagnosis (p = 0.002). Younger age (p = 0.043) and first shoulder dislocation event (p = 0.038) were associated with a higher success rate for reduction attempts. Out-of-hospital reduction of shoulder dislocations leads to significant pain relief and no poorer long-term outcome. Signs that are associated with successful out-of-hospital reduction (younger age and first event), but also those that are associated with incorrect diagnosis (concomitant injuries) should be considered before trying to reduce shoulder dislocation on site. The considerable rate of incorrect first diagnosis on site should give rise to an intensive discussion around teaching and training for this intervention.Trial registration: This study is registered with the German Registry for Clinical Trials (DRKS00023377).

Use of Unmanned Aerial Vehicles in Wilderness Search and Rescue Operations: A Scoping Review.

Wilderness Search and Rescue (WSAR) focuses on locating and extricating missing persons in remote settings. As unmanned aerial vehicle (UAV) or "drone" technology has evolved, so has the literature describing its application in WSAR operations. We conducted a scoping review of literature that describes the use of UAVs in WSAR contexts. The Joanna Briggs Institute Framework for scoping reviews was followed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews method. Additional individual databases, article reference lists, and relevant grey literature were also included in the search to provide an impartial scope. Seven hundred forty-seven articles were identified. Of these, 56 were found to be duplicates. The remaining 691 were further screened and checked for eligibility. Ultimately, 21 studies were found that met our inclusion criteria. This literature supports the use of UAVs to increase the safety and efficiency of a WSAR operation for locating victims, assessing risks, carrying equipment, and restoring communication systems. Unmanned aerial vehicles are a potentially useful adjunct in the management of WSAR operations. Their limitations include objects obscuring victims, weather changes, uneven terrain, battery-limited flight time, and susceptibility to environmental damage.

Occupational Aspects of Alpine Helicopter Rescue Operations: Recommendation of the Medical Commission of the Union Internationale des Associations d'Alpinisme.

Helicopter rescue operations in the mountains or at high altitude are well-known as strenuous tasks often associated with some risk. However, there is no standardized procedure for preventive checkups of rescue personnel by occupational care professionals. Therefore, the Medical Commission of the International Climbing and Mountaineering Federation (UIAA MedCom) suggests the procedure presented in this study. This comprehensive recommendation is based on more than 2 decades of research of MedCom members and extensive literature search. A total of 248 references were selected by the committee as relevant for the topic. To keep the recommendation handy, the complete list is available as supplemental material (see online Supplemental Material). This article recommends standardized procedures for occupational screening and better health of search and rescue personnel.

Cancer incidence in World Trade Center rescue and recovery workers by race and ethnicity.

INTRODUCTION: It is unclear whether differences in health outcomes by racial and ethnic groups among World Trade Center (WTC) rescue and recovery workers reflect those of the population of New York State (NYS) or show distinct patterns. We assessed cancer incidence in WTC workers by self-reported race and ethnicity, and compared it to population figures for NYS. METHODS: A total of 61,031 WTC workers enrolled between September 11, 2001 and January 10, 2012 were followed to December 31, 2015. To evaluate the association between race/ethnicity and cancer risk, Poisson regression analysis was used to estimate hazard ratios (HR) adjusted for WTC exposure, age, calendar year, sex and, for lung cancer, cigarette smoking. RESULTS: In comparison to Whites, Black workers had a higher incidence of prostate cancer (HR = 1.99, 95% CI = 1.69-2.34) and multiple myeloma (HR = 3.57, 95% CI = 1.97-6.45), and a lower incidence of thyroid (HR = 0.41, 95% CI = 0.22-0.78) and colorectal cancer (HR = 0.57; 95% CI = 0.33-0.98). Hispanic workers had a higher incidence of liver cancer (HR = 4.03, 95% CI = 2.23-7.28). Compared with NYS population, White workers had significantly higher incidence of prostate cancer (HR = 1.26, 95% CI = 1.18-1.35) and thyroid cancer (HR = 1.80, 95% CI = 1.55-2.08), while Black workers had significantly higher incidence of prostate cancer (HR = 1.22, 95% CI = 1.05-1.40). CONCLUSION: Cancer incidence in WTC workers generally reflects data from the NYS population, but some differences were identified that merit further investigation.

Termination of Cardiopulmonary Resuscitation in Mountain Rescue: A Scoping Review and ICAR MedCom 2023 Recommendations.

Lugnet, Viktor, Miles McDonough, Les Gordon, Mercedes Galindez, Nicolas Mena Reyes, Alison Sheets, Ken Zafren, and Peter Paal. Termination of cardiopulmonary resuscitation in mountain rescue: a scoping review and ICAR MedCom 2023 recommendations. High Alt Med Biol. 24:274-286, 2023. Background: In 2012, the International Commission for Mountain Emergency Medicine (ICAR MedCom) published recommendations for termination of cardiopulmonary resuscitation (CPR) in mountain rescue. New developments have necessitated an update. This is the 2023 update for termination of CPR in mountain rescue. Methods: For this scoping review, we searched the PubMed and Cochrane libraries, updated the recommendations, and obtained consensus approval within the writing group and the ICAR MedCom. Results: We screened a total of 9,102 articles, of which 120 articles met the inclusion criteria. We developed 17 recommendations graded according to the strength of recommendation and level of evidence. Conclusions: Most of the recommendations from 2012 are still valid. We made minor changes regarding the safety of rescuers and responses to primary or traumatic cardiac arrest. The criteria for termination of CPR remain unchanged. The principal changes include updated recommendations for mechanical chest compression, point of care ultrasound (POCUS), extracorporeal life support (ECLS) for hypothermia, the effects of water temperature in drowning, and the use of burial times in avalanche rescue.

Performance of a Chemical Heat Blanket in Dry, Damp, and Wet Conditions Inside a Mountain Rescue Hypothermia Wrap.

INTRODUCTION: Casualties with accidental hypothermia are evacuated using multilayer wraps, typically including a chemical heat blanket (CHB), a vapor barrier, and an insulating outer bag. We investigated CHB performance against dry, damp, and wet fabric, in a multilayer wrap, in response to a case report indicating diminished performance when wet. METHODS: We wrapped a torso manikin in a base layer, CHB, vapor barrier, casualty bag, and vacuum mattress, recording CHB panel temperatures at intervals of up to 7 h. Experimental conditions were dry, damp, and wet clothing, with 2 blankets tested in each condition. We subsequently used a forward-looking infrared camera to assess whether the panels heated evenly and heat flux sensors to quantify heat transfer across 2 dry, 1 damp, and 1 wet fleece under CHB panels. RESULTS: Chemical heat blankets maintained heat output for >7 h inside the wraps. Median (IQR) panel steady state temperatures were 52°C (39-56°C) against dry fleece, 41°C (36-45°C) against damp fleece, and 30°C (29-33°C) against wet fleece. Peak panel temperature was 67°C. The heat flux results indicated that CHBs generated similar quantities of heat in dry and damp conditions, as the lower temperatures were compensated by more efficient transfer of heat across the moist clothing layer. Chemical heat blanket heat output was diminished in wet conditions. CONCLUSIONS: Rescuers should cut off saturated clothing in a protected environment before wrapping casualties, but damp clothing need not be removed. Because of the high peak temperatures recorded on the surfaces of CHBs, they should not be placed directly against skin, and compression straps should not be placed directly over CHBs.

Search-and-rescue in the Central Mediterranean Route does not induce migration: Predictive modeling to answer causal queries in migration research.

State- and private-led search-and-rescue are hypothesized to foster irregular migration (and thereby migrant fatalities) by altering the decision calculus associated with the journey. We here investigate this 'pull factor' claim by focusing on the Central Mediterranean route, the most frequented and deadly irregular migration route towards Europe during the past decade. Based on three intervention periods-(1) state-led Mare Nostrum, (2) private-led search-and-rescue, and (3) coordinated pushbacks by the Libyan Coast Guard-which correspond to substantial changes in laws, policies, and practices of search-and-rescue in the Mediterranean, we are able to test the 'pull factor' claim by employing an innovative machine learning method in combination with causal inference. We employ a Bayesian structural time-series model to estimate the effects of these three intervention periods on the migration flow as measured by crossing attempts (i.e., time-series aggregate counts of arrivals, pushbacks, and deaths), adjusting for various known drivers of irregular migration. We combine multiple sources of traditional and non-traditional data to build a synthetic, predicted counterfactual flow. Results show that our predictive modeling approach accurately captures the behavior of the target time-series during the various pre-intervention periods of interest. A comparison of the observed and predicted counterfactual time-series in the post-intervention periods suggest that pushback policies did affect the migration flow, but that the search-and-rescue periods did not yield a discernible difference between the observed and the predicted counterfactual number of crossing attempts. Hence we do not find support for search-and-rescue as a driver of irregular migration. In general, this modeling approach lends itself to forecasting migration flows with the goal of answering causal queries in migration research.

Equipos de búsqueda y rescate urbano (USAR) en estructuras colapsadas en el terremoto de Turquía de 2023 / Urban search and rescue operations (USAR) in collapsed buildings after the 2023 earthquake in Türkiye

Los terremotos ocurridos en Turquía en febrero de 2023 han sido unos de los de mayor impacto en los últimos años. Las autoridades del país, tras activar sus recursos locales y nacionales, hicieron una solicitud de ayuda internacional. Dentro de la Organización de Naciones Unidas (ONU) se encuentra el Grupo Asesor Internacional de Búsqueda y Rescate (INSARAG), cuyos objetivos son establecer las normas internacionales mínimas para los equipos de rescate e implementar una metodología para la coordinación internacional ante terremotos, maremotos y otros desastres naturales, especialmente la coordinación operativa sobre el terreno. El objetivo de este trabajo es ofrecer una visión sobre la epidemiología de los terremotos, la gestión de los equipos de emergencias, la Asociación de Ayuda a Desastres y Emergencias (AFAD) de Turquía, y abordar cómo es el rescate en estructuras colapsadas. Además, se expone la experiencia de Bomberos Unidos Sin Fronteras (BUSF) en dicho terremoto y se describe un rescate que duró 14 horas. (AU)

The earthquakes that occurred in February 2023 in Türkiye had some of the worst consequences of recent years. The Turkish authorities first deployed local resources and then appealed for international help. The International Search and Rescue Group of the United Nations aims to establish minimum international standards for search and rescue teams and a methodology for coordinating responses to earthquakes, tsunamis, and other natural disasters. A main concern of the group is to coordinate operations on the ground. This article offers perspectives on the epidemiology of earthquakes, the management of emergency response teams and Türkiye’s disaster management agency (AFAD); it also explains how rescues are carried out in collapsed buildings. The experience of Firefighters Without Borders after the recent earthquakes and a rescue that took 14 hours are also described. (AU)

Urban search and rescue operations (USAR) in collapsed buildings after the 2023 earthquake in Türkiye. / Equipos de búsqueda y rescate urbano (USAR) en estructuras colapsadas en el terremoto de Turquía de 2023.

TEXT: The earthquakes that occurred in February 2023 in Türkiye had some of the worst consequences of recent years. The Turkish authorities first deployed local resources and then appealed for international help. The International Search and Rescue Group of the United Nations aims to establish minimum international standards for search and rescue teams and a methodology for coordinating responses to earthquakes, tsunamis, and other natural disasters. A main concern of the group is to coordinate operations on the ground. This article offers perspectives on the epidemiology of earthquakes, the management of emergency response teams and Türkiye's disaster management agency (AFAD); it also explains how rescues are carried out in collapsed buildings. The experience of Firefighters Without Borders after the recent earthquakes and a rescue that took 14 hours are also described.

TEXTO: Los terremotos ocurridos en Turquía en febrero de 2023 han sido unos de los de mayor impacto en los últimos años. Las autoridades del país, tras activar sus recursos locales y nacionales, hicieron una solicitud de ayuda internacional. Dentro de la Organización de Naciones Unidas (ONU) se encuentra el Grupo Asesor Internacional de Búsqueda y Rescate (INSARAG), cuyos objetivos son establecer las normas internacionales mínimas para los equipos de rescate e implementar una metodología para la coordinación internacional ante terremotos, maremotos y otros desastres naturales, especialmente la coordinación operativa sobre el terreno. El objetivo de este trabajo es ofrecer una visión sobre la epidemiología de los terremotos, la gestión de los equipos de emergencias, la Asociación de Ayuda a Desastres y Emergencias (AFAD) de Turquía, y abordar cómo es el rescate en estructuras colapsadas. Además, se expone la experiencia de Bomberos Unidos Sin Fronteras (BUSF) en dicho terremoto y se describe un rescate que duró 14 horas.

Personal Protective Equipment Protocols Lead to a Delayed Initiation of Patient Assessment in Mountain Rescue Operations.

van Veelen, Michiel J., Giulia Roveri, Ivo B. Regli, Tomas Dal Cappello, Anna Vögele, Michela Masè, Marika Falla, and Giacomo Strapazzon. Personal protective equipment protocols lead to a delayed initiation of patient assessment in mountain rescue operations. High Alt Med Biol. 24:127-131, 2023. Introduction: Mountain rescue operations can be challenging in austere environmental conditions and remote settings. Airborne infection prevention measures include donning of personal protective equipment (PPE), potentially delaying the approach to a patient. We aimed to investigate the time delay caused by these prevention measures. Methods: This randomized crossover trial consisted of 24 rescue simulation trials intended to be as realistic as possible, performed by mountain rescue teams in difficult terrain. We analyzed the time needed to perform an airborne infection prevention protocol during the approach to a patient. Time delays in scenarios involving patients already wearing versus not wearing face masks and gloves were compared using a linear mixed model Results: The airborne infection prevention measures (i.e., screening questionnaire, hand antisepsis, and donning of PPE) resulted in a time delay of 98 ± 48 (26-214) seconds on initiation of patient assessment. There was a trend to a shorter time to perform infection prevention measures if the simulated patient was already wearing PPE consisting of face mask and gloves (p = 0.052). Conclusion: Airborne infection prevention measures may delay initiation of patient assessment in mountain rescue operations and could impair clinical outcomes in time-sensitive conditions. Trial registration number 0105095-BZ Ethics Committee review board of Bolzano.

The role of modifiable risk factors in incident cancer in transport, rescue, and security industries.

PURPOSE: Examine the risk for site-specific incident cancer across representative transport, rescue, and security industries. METHODS: This Danish nationwide register-based study included all 302,789 workers from transport, rescue and security industries in 2001-2015 and 2,230,877 individuals aged 18-64 years from a total sample of the economically active population for comparison. We used Cox models to estimate the hazard ratios (HRs) of incident cancers. We categorized site-specific cancers by using population-attributable fraction (PAF) estimates from the previous literature. RESULTS: During an average follow-up of 13.4 years, 22,116 incident cancer cases were recorded in these industries. Compared with the reference population, the age-adjusted cancer incidence with a high PAF was higher among men in seafaring (HR 1.28; 95% CI 1.14-1.43), and land transport (HR 1.32; 95% CI: 1.26-1.37), and among women in seafaring (HR 1.26; 95% CI: 1.01-1.57), land transport (HR 1.21; 95% CI: 1.12-1.32), aviation (HR 1.22; 95% CI: 1.05-1.41), and police force (HR 1.21; 95% CI: 1.04-1.40). Overall, tobacco and physical inactivity were the most significant risk factors of cancer. CONCLUSIONS: Regardless of considerable disparities in incident cancer attributable to modifiable risk factors across industries, the total incident cancer rate was elevated in all industries in both sexes.

Psychological First Aid for Wilderness Trauma: Interventions for Expedition or Search and Rescue Team Members.

When exposed to actual or threatened death or serious injury in austere settings, expedition members are at risk of acute stress reactions, as are search and rescue members involved with extricating the patient. Acute stress reactions are a normal response to significant trauma and commonly resolve on their own. If they do not, they can lead to post-traumatic stress disorder (PTSD), a set of persistent symptoms that cause significant effects on the person's life. Medication has a limited preventive role in the field for treatment of stress partly because so few are trained to administer it. Contrastingly, psychological first aid can be performed by lay team members with minimal training. Psychological first aid consists of interventions attempting to encourage feelings of safety, calm, self-efficacy, connection, and hope. These are interventions that provide guidance to not make the situation emotionally worse and might have a preventive effect on later development of PTSD. They are valuable in the field not only for the patient but also for affected team members as well as for search and rescue team members who may be indirectly affected by the trauma and experience repercussions later.

Search and Rescue in California: The Need for a Centralized Reporting System.

INTRODUCTION: There is no published information on the epidemiology of wilderness rescues in California outside of national parks. The objective of this study was to investigate the epidemiology of wilderness search and rescue (SAR) missions in California and identify risk factors for individuals requiring rescue due to accidental injury, illness, or navigation errors in the California wilderness. METHODS: A retrospective review of SAR missions in California from 2018 to 2020 was conducted. This was done from a database of information collected by the California Office of Emergency Services and the Mountain Rescue Association from SAR teams, who submitted voluntarily. The subject demographics, activity, location, and outcomes of each mission were analyzed. RESULTS: Eighty percent of the initial data were excluded because of incomplete or inaccurate data. Seven hundred forty-eight SAR missions involving 952 subjects were included in the study. The demographics, activities, and injuries of our population were consistent with those reported from other epidemiological SAR studies, and there were significant differences in outcomes based on the subject's activity. For example, water activities were highly correlated with a fatal outcome. CONCLUSIONS: The final data show interesting trends, but it is difficult to draw firm conclusions because so much of the initial data had to be excluded. A uniform system for reporting SAR missions in California may be helpful for further research, which may aid both SAR teams and the recreational public in understanding risk factors. A proposed SAR form for easy entry is included in the discussion section.

A search and rescue robot search method based on flower pollination algorithm and Q-learning fusion algorithm.

Search algorithm plays an important role in the motion planning of the robot, it determines whether the mobile robot complete the task. To solve the search task in complex environments, a fusion algorithm based on the Flower Pollination algorithm and Q-learning is proposed. To improve the accuracy, an improved grid map is used in the section of environment modeling to change the original static grid to a combination of static and dynamic grids. Secondly, a combination of Q-learning and Flower Pollination algorithm is used to complete the initialization of the Q-table and accelerate the efficiency of the search and rescue robot path search. A combination of static and dynamic reward function is proposed for the different situations encountered by the search and rescue robot during the search process, as a way to allow the search and rescue robot to get better different feedback results in each specific situation. The experiments are divided into two parts: typical and improved grid map path planning. Experiments show that the improved grid map can increase the success rate and the FIQL can be used by the search and rescue robot to accomplish the task in a complex environment. Compared with other algorithms, FIQL can reduce the number of iterations, improve the adaptability of the search and rescue robot to complex environments, and have the advantages of short convergence time and small computational effort.

All-cause and cause-specific mortality in a cohort of WTC-exposed and non-WTC-exposed firefighters.

OBJECTIVE: To compare mortality rates in World Trade Center (WTC)-exposed Fire Department of the City of New York (FDNY) firefighters with rates in similarly healthy, non-WTC-exposed/non-FDNY firefighters, and compare mortality in each firefighter cohort with the general population. METHODS: 10 786 male WTC-exposed FDNY firefighters and 8813 male non-WTC-exposed firefighters from other urban fire departments who were employed on 11 September 2001 were included in the analyses. Only WTC-exposed firefighters received health monitoring via the WTC Health Programme (WTCHP). Follow-up began 11 September 2001 and ended at the earlier of death date or 31 December 2016. Death data were obtained from the National Death Index and demographics from the fire departments. We estimated standardised mortality ratios (SMRs) in each firefighter cohort versus US males using demographic-specific US mortality rates. Poisson regression models estimated relative rates (RRs) of all-cause and cause-specific mortality in WTC-exposed versus non-WTC-exposed firefighters, controlling for age and race. RESULTS: Between 11 September 2001 and 31 December 2016, there were 261 deaths among WTC-exposed firefighters and 605 among non-WTC-exposed. Both cohorts had reduced all-cause mortality compared with US males (SMR (95% CI)=0.30 (0.26 to 0.34) and 0.60 (0.55 to 0.65) in WTC-exposed and non-WTC-exposed, respectively). WTC-exposed firefighters also had lower rates of all-cause mortality (RR=0.54, 95% CI=0.49 to 0.59) and cancer-specific, cardiovascular-specific and respiratory disease-specific mortality compared with non-WTC-exposed firefighters. CONCLUSION: Both firefighter cohorts had lower than expected all-cause mortality. Fifteen years post 11 September 2001, mortality was lower in WTC-exposed versus non-WTC-exposed firefighters. Lower mortality in the WTC-exposed suggests not just a healthy worker effect, but additional factors such as greater access to free health monitoring and treatment that they receive via the WTCHP.

Occupational Accidents Among Search and Rescue Providers During Mountain Rescue Operations and Training Events.

STUDY OBJECTIVE: We analyzed occupational accidents reported among Corpo Nazionale Soccorso Alpino e Speleologico (CNSAS) providers during mountain search and rescue operations and training events in Italy (1999 to 2019). METHODS: We extracted anonymized data from the CNSAS accident database for all cases of injured mountain search and rescue providers that activated CNSAS insurance (1999 to 2019). We report epidemiological characteristics, mechanisms, type, and severity of injury or illness, clinical outcome, and recovery time. RESULTS: A total of 784 cases of injuries in CNSAS mountain search and rescue providers were recorded. Forty-one percent of the cases occurred during rescue operations and 59% during training events. Overall, trauma was the main cause of injury (96%), whereas only 4% of the cases were classified as medical or environmental illnesses. Moderate injury (National Advisory Committee for Aeronautics II to III) occurred in 80% of the reported accidents. Recovery time differed based on the degree of accident severity. Fatalities occurred in 2% of the cases reported and occurred during rescue operations only. CONCLUSION: In this long-term retrospective analysis, we showed that accidents occurred among mountain search and rescue providers both during rescue operations and training events. Given the high prevalence and associated costs, it is of pivotal importance to understand the epidemiology and characteristics of occupational injury and illness among this out-of-hospital workforce to better inform future prevention strategies.