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Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
Systematic Review and Meta-Analysis of Traumatic Brain Injury in First Responders
Katherine J Hunzinger1, Kayla Riel, Carly Smith
1Author Affiliations: Department of Exercise Science, Thomas Jefferson University, Philadelphia, Pennsylvania (Dr Hunzinger); Division of Epidemiology, The Ohio State University, Columbus, Ohio (Riel and Dr Wing); School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio (Dr Smith, Beach, Dr Oñate, and Dr Caccese); Center for Brain Injury Recovery & Discovery, The Ohio State University, Columbus, Ohio (Dr Smith, Beach, Dr Oñate, Wing, and Caccese); Department of Behavioral Science and Leadership, United States Air Force Academy, USAF Academy, Colorado (Dr D'Lauro); Matthew Gfeller Center and STAR Heel Performance Laboratory, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (Dr Register-Mihalik); Injury Prevention Research Center, University of North Carolina at Chapel Hill (Dr Register-Mihalik); Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio (Dr Panchal); Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (Dr Schneider); and Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (Dr Schneider).
Traumatic brain injury (TBI) is prevalent among first responders, with law enforcement reporting 58.8% lifetime TBI. Standardized definitions and monitoring are crucial for addressing injury risks in these essential workers.
Area of Science:
- Occupational Health
- Neuroscience
- Public Health
Background:
- First responders face significant occupational risks, including potential for traumatic brain injury (TBI).
- Existing research on TBI prevalence among first responders is fragmented and lacks standardized definitions.
- Understanding the scope of TBI in these populations is critical for developing targeted interventions.
Purpose of the Study:
- To systematically review and meta-analyze the proportion of first responders with traumatic brain injury (TBI).
- To synthesize existing data on TBI prevalence across different first responder groups (law enforcement, firefighters, EMS).
Main Methods:
- Systematic review and meta-analysis of observational and interventional studies.
- Searches conducted across five major databases (PubMed, Embase, Scopus, CINAHL, Web of Science).
- Data abstraction by two independent reviewers, with random-effects meta-analyses and risk of bias assessment.
Main Results:
- Twenty-three studies met inclusion criteria; five contributed to meta-analyses.
- Pooled lifetime TBI prevalence for law enforcement and corrections officers was 58.8%.
- High self-reported lifetime TBI prevalence (62%-77%) noted for firefighters, with limited data for EMS personnel.
Conclusions:
- Traumatic brain injury is a common condition among first responders, highlighting a significant occupational health concern.
- Heterogeneity in study methodologies and TBI definitions necessitates standardized approaches.
- Recommendations include standardized TBI definitions, surveillance, routine screening, and longitudinal monitoring for injury prevention and policy development.
