Systematic Review and Meta-Analysis of Traumatic Brain Injury in First Responders.

In 30 seconds

This systematic review and meta-analysis assessed traumatic brain injury (TBI) prevalence among law enforcement and corrections officers, firefighters, and emergency medical services personnel. Twenty-three observational and interventional studies were included, with five contributing to meta-analyses. Among law enforcement and corrections officers, pooled lifetime TBI prevalence was 58.8% (95% confidence interval [CI]: 48.0%-69.6%; I 2 = 91.5%), while the pooled proportion with job/career-related TBI was 17.2% (95% CI: 5.8%-28.6%; I 2 = 97.2%). Evidence for firefighters and emergency medical services personnel was limited, and TBI definitions and ascertainment varied substantially across studies.

Key findings

• Pooled lifetime TBI prevalence among law enforcement and corrections officers was 58.8% (95% confidence interval [CI]: 48.0%-69.6%; I 2 = 91.5%).
• The pooled proportion of law enforcement and corrections officers with job/career-related TBI was 17.2% (95% CI: 5.8%-28.6%; I 2 = 97.2%).
• Firefighters had self-reported lifetime TBI prevalence of 62%-77%, but available data were limited.
• Emergency medical services evidence was sparse and largely based on administrative or event-related reports.

Why it matters

The findings indicate a substantial reported burden of TBI in some first-responder groups, while marked variation in definitions and ascertainment limits comparisons and confidence in pooled estimates. More consistent surveillance and occupational health monitoring could help clarify cumulative injury risk and support prevention and policy efforts, as the review concludes.

What to keep in mind

Studies varied in TBI definitions and ascertainment, and between-study heterogeneity was high for both pooled law enforcement estimates. Only five of 23 included studies contributed to meta-analyses; evidence for firefighters and emergency medical services personnel was limited.