Research into paramedic health and wellbeing is beginning to gain some traction. This pilot study has shed light on the health behaviours of paramedics: its focus being examination of the eating habits of a small group of paramedics. The aim was to compare energy intake and expenditure of paramedics on work and rest days to understand what impact it could be having on the health of these participants.
Twenty one paramedics completed the full protocol. They were either permanent day shift workers (n=10) or night shift workers (n=11). Participants were required to use self-reporting food journals that covered two days off duty and one day on duty. Estimated energy intake was calculated based on the information provided in the food journals. To calculate energy expenditure, participants' heart rate was monitored during 24 hours on duty and 24 hours off duty. A laboratory exercise test was used so that heart rate could calculate calorie consumption.
The results supported previous findings regarding eating behaviours at work. Energy intake was reported as being inadequate to meet the energy demands of the shift. Day shift paramedics were either preparing small meals or snacks for their shift in anticipation of a busy shift and a lack of time to eat, and night shift workers were more likely to buy fast foods during their shift.
It appeared that energy requirements were not being met. Frequently the meals and snacks being prepared were too small; or the fast food alternatives were inadequate due to being typically high fat and low in nutritional content.
Interestingly, it was noted that on rest days energy intake was higher in both day and night workers than when on duty. On rest days participants had more control over their meal times; however, they would tend to eat more than was required.
The limited or non-existent exercise reported by the participants further demonstrated the unhealthy nature of their health behaviours. The authors suggested that stress could be a factor in determining food consumption: in the presence of acute stress appetite is suppressed; however, chronic stress may lead to over eating. These behaviours may suggest paramedics were suffering the effects of acute and chronic stress; however, the data in this study cannot support that link.
This is a pilot study, and although the results are interesting, more work is required to validate them. The authors suggested that paramedic health behaviours need to be addressed, and further education is required. However, the participants in this study did not appear to be questioned on their understanding of their energy intake and expenditure. Objective stress tests (neuroendocrine) and subjective (questionnaires/interviews) were not reported, so it is unclear how much stress the participants were under and whether this influenced their eating habits. Another limitation identified by the authors is the relatively small sample size.
The authors report that imbalances between energy intake and expenditure with a lack of regular exercise have been linked to unhealthy weight gain. The results of this study have provided further insight into the health behaviours of paramedics. It emphasises the potential risks that paramedics are exposing themselves to, as well as highlighting the duties and responsibilities for emergency medical service employers who need to ensure that their staff have improved working conditions, including adequate rest breaks, to provide healthier working environments for their personnel.