The rise in obesity among Americans is taking its toll on rescue workers who must load patients onto stretchers and get them into and out of ambulances.
Fire and rescue officials say workers are incurring serious, in some cases career-ending, injuries from the strain of transporting obese patients. An increasing number of agencies are buying special stretchers and other equipment that can accommodate adults weighing as much as 1,600 pounds.
In a survey last year of 1,300 workers conducted by the National Association of Emergency Medical Technicians, 47 percent reported suffering back injuries while performing their duties. Officials said it was the first such survey, but that a rising number of calls involving obese patients is a clear factor in the high injury rate.
"It's a huge problem for emergency medical services and is just now coming into national prominence with the super-sizing of America," said Jerry Johnston of Mount Pleasant, Iowa, the association's president-elect.
In Lufkin, Texas, north of Houston, Fire Chief Pete Prewitt said one of his paramedics suffered debilitating back and neck injuries lifting an obese patient during a rescue last year and probably will be forced to retire. Others recently suffered hernias as well as arm and shoulder injuries, one requiring surgery.
"What's happening in America is that obesity is becoming a problem, and it's a problem for paramedics," Prewitt said.
More than 60 percent of Americans aged 20 years and older are overweight, and one-quarter of American adults also are obese, which is generally defined as men whose body fat exceeds 25 percent and women whose body fat exceeds 30 percent.
According to the American Heart Association, the obesity rate among American men nearly tripled to 28 percent between 1960 and 2002, and more than doubled to 34 percent among women.
Obesity also is forcing agencies to send out more workers per rescue.
Akron, Ohio, Fire Department Battalion Capt. Marc Greenwood has studied obesity and emergency response. He cited an August 2003 case in Cleveland in which 22 firefighters and emergency workers spent 21/2 hours removing a 772-pound woman from her townhouse because its doorway wasn't wide enough.
"What I've found is that more crews are required to transport these patients," Greenwood said.
Mike Smith, director of emergency medical services in Durham County, N.C., recalled needing three medical units, four fire units and several other workers to treat an unconscious 1,080-pound man staying at a motel. The rescue took several hours and involved moving the man from his bed to a tarp to a smaller moveable bed only to have its wheels break twice.
"We moved him out of that motel with some ingenuity and creative thinking and a lot of work," Smith said.
Fire and rescue agencies are investing in equipment geared for extremely heavy patients.
Worldwide sales of stretchers designed for obese, or "bariatric," patients are expected to rise from $29.6 million in 2004 to $50.5 million in 2012, according to a recent forecast by MarketStrat, a Fremont, Calif., consulting firm. Sales of special lift systems are expected to rise from nearly $75 million to $193 million.
Some large cities, such as New Orleans and Baltimore, have added such equipment in recent years, and the trend also appears to be spreading to smaller communities.
Prewitt, the Lufkin fire chief, said his agency recently invested in a $10,000 hydraulic stretcher made by Stryker Corp. of Portage, Mich., that has extensions to accommodate extra girth and extra handles to make lifting easier. He said he would like to acquire several more.
"We've had no injuries with it," he said.
Other agencies are modifying existing equipment.
In 2002, private Phoenix-based transport firm Southwest Ambulance became one of a handful of companies to create a special bariatric transport fleet by outfitting some vehicles with a winch-and-pulley system. The ambulances have a retractable ramp that can be used with a gurney latched to a steel chain.