{"paper_id":"03f2c7bd-1040-4f8a-b2df-d0c930f01dae","body_text":"Impact of Occupational Injuries on Psychological Functioning of Firefighters in Northern Ghana | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Impact of Occupational Injuries on Psychological Functioning of Firefighters in Northern Ghana John N-yelbi, Columban Kwesi Hughes This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8819741/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 15 You are reading this latest preprint version Abstract The purpose of the study was to examine the influence of occupational injuries on psychological functioning of firefighters in Northern Ghana. It looked at types of occupational injuries and the extent to which occupational injuries influence psychological functioning. The study employed a quantitative approach underpinned by cross-sectional survey design. The target population comprised firefighters in Ghana. A total of 642 firefighters were sampled using stratified and simple random sampling. Inventory of Psychosocial Functioning and Work Injury Questionnaire was adapted and used for data collection. Data was analysed using means and standard deviation and multiple regression. The study found that firefighters experience occupational injuries such as sprain and strain, exhaustion, thermal burns, fainting and smoke inhalation. Also, the study reported a significant negative association between occupational injuries and psychological functioning. It is recommended that firefighters be given modern personal protective equipment that reduces the danger of burns and exposure to hazardous materials. Firefighters should be provided with mental health options such as individual and group counselling and peer support to assist them cope with psychological pain. It is also recommended that rehabilitation should include both mental health and physical therapies to ensure that firefighters receive comprehensive healthcare. Occupational injuries psychological functioning firefighters INTRODUCTION Firefighters face exposure to poisonous gases, smoke, and extreme temperatures during their operations. They also encounter chemical and biological agents, risks from collapsed buildings, and engage in high-intensity physical activities. All these factors elevate the risk of occupational injuries, which can be both fatal and non-fatal (Garcia et al., 2024 ). Firefighters’ physical and emotional health are still seriously endangered by the nature and circumstances of their employment. Occupational injuries involve physical harm linked to an employee’s job responsibilities or environment, including injuries from unforeseen events, harmful substances, repetitive movements, and psychosocial stress from adverse conditions (Worade et al., 2025). Firefighters, facing heightened workloads due to additional chemical and technological incidents, experience increased vulnerability to these injuries (Szubert & Sobala, 2002 ). Mental health conditions, including PTSD, anxiety, depression, and burnout, are prevalent among firefighters due to Occupational injuries and the high-stress nature of their profession (Lee et al., 2017 ). Firefighters, as professional rescue workers, regularly face traumatic situations and are subjected to significant physical and psychological stress, which increases their vulnerability to psychological distress (Psarros et al., 2018). Campbell and Hall ( 2023 ) highlight the various threats faced by firefighters both on and off the fireground. In Ghana, over 100 firefighters are injured annually, with many suffering permanent incapacitation due to their work, including fighting fires and responding to crises (Carlis-Paittoo, 2016 ). The job entails significant health and safety risks from exposure to physical and thermal stresses, as well as harmful chemicals, leading to high stress levels during emergencies. Psychological well-being is the expression of pleasant feelings and general happiness with one’s life in various domains such as family, education, and employment, and it includes both emotional and cognitive components (Ramdas, 2019 ). However, when occupational injuries are intense or prolonged and interfere with daily functioning, psychological health suffers (Marc et al., 2021 ). Globally, emergency professionals, such as firefighters, are among the most physically demanding and dangerous professions. Although there is increasing pressures on firefighters due to the nature of their work, but the demands on firefighters in developing nations such as Ghana appear to be unusually high when compared to those in industrialised countries. A report by the International Labour Organization ( 2016 ) estimated that the firefighter-to-citizen ratio in developed countries such as European nations was 1:1,000–1,200, whereas developing countries such as Mali, with Ghana not an exception, had a ratio of 1:33,435, which is extremely high. Furthermore, growing fire outbreaks in developing nations such as Ghana are projected to boost the demand for firefighters (Ghana National Fire Service, 2016 ). According to Kodom-Wiredu ( 2018 ), the firefighting profession is characterised by uncertainty, exposure to human loss, shift work, and traumatic incidents, among other factors. In America, an estimated 65,650 firefighters’ injuries occurred in the line of duty in 2022, an increase of 8% from the 60,750 injuries reported in 2021 (Campbell & Hall, 2023 ). Firefighters were more likely to be injured at fireground operations than during any other duty. In 2022, an estimated 21,325 injuries, representing 33% of all reported firefighter injuries, occurred on the fireground. While responding to or returning from an accident, as well as those that occurred while performing other operational activities. Overexertion injuries accounted for three in ten fireground injuries (31%), followed by falls, jumps, slips, or trips (22%). Sprains, strains, and muscular discomfort injuries accounted for nearly two out of every five (36%) firefighters’ injuries. Additionally, Campbell and Hall ( 2023 ) added that prominent fireground injuries included wounds, cuts, bleeding, or bruising (15%), fire or chemical burns (9%), thermal stress (frostbite or heat exhaustion) (7%), and smoke or gas inhalation. There were 96 on-duty firefighter fatalities in the United States last year, according to a report on fatal firefighter injuries in the country published by the National Fire Protection Association ( 2023 ). Out of this number, one was a full-time federal land management employee, six were contractors for federal or state land management organizations, 51 were volunteer firemen, and 38 were professional firefighters. Another report indicates that approximately 43% of these injuries occurred on the fireground, primarily due to falls, slips, and jumps (27.2%), alongside overexertion and strain. Injuries vary in severity, from minor to fatal, with evidence indicating that a firefighter is injured every eight minutes (Haynes & Molis, 2015b ; Hylton & Molis, 2016 ). Firefighters encounter numerous hazards, including medical emergencies and hazardous materials, which can lead to serious injuries and fatalities impacting families and communities. As first responders, they are crucial during disasters like residential fires and gas explosions that also threaten schools. Jahnke et al. ( 2016 ) outline that firefighters’ responsibilities have expanded beyond fire suppression to include various emergencies, which, alongside exposure to trauma and irregular sleep patterns from shift work, severely endangers their mental health (Stanley et al., 2017 ). Firefighters are at a higher risk for psychological issues, such as mood and substance use disorders, compared to the general population, a notion reinforced by Pepper ( 2021 ), who links these challenges to elevated stress and trauma in the profession. In Ghana, firefighters face significant risks, including exposure to heat, smoke, long working hours, and biological hazards, as they respond to over 1,000 fires annually Cafiadas-De la et al., 2015). Despite the evident dangers, research on their psychological well-being remains limited. However, studies indicate that firefighters experience higher rates of psychological issues, including mood disorders, stress-related conditions, and substance use disorders compared to the general population (Del Ben et al., 2006; Jahnke et al., 2016 ). Firefighters experience significant work-related stress and trauma daily, as highlighted by Pepper ( 2021 ). The risks associated with their job, including injuries and mortality, adversely affect both productivity and the socioeconomic status of their families (Appiah, 2019 ). Additionally, there are serious psychosocial hazards like workplace stress and fatigue, as well as ergonomic risks resulting in injuries such as sprains and fractures (Aguma-Acon, 2012 ; Mbulingwe, 2014 ; Theuri, 2012 ). Mock et al. ( 2005 ) found that occupational injuries lead to greater mortality, prolonged disability, and increased treatment costs compared to non-occupational injuries. They highlighted the significant impact of industrial injuries on work sickness, particularly in developing countries like Ghana. The authors emphasise the importance of enhanced workplace safety, supported by both voluntary initiatives and government regulation, for promoting health and preventing injuries at work. Injuries are increasingly recognised as a rising health problem in low- and middle-income countries such as Ghana. They are also the leading source of disability and health-related economic losses, with a considerable number of these injuries ascribed to work-related (Mock et al., 2005 ). Research on occupational injuries and psychological functioning of firefighters in Ghana includes Paittoo (2016), who examined injuries and disabilities using mixed methods, and Pepper ( 2021 ), who studied the psychological functioning of retired firefighters through a cross-sectional design. Despite inherent resilience linked to their personality traits, many firefighters experience negative psychological effects from their stressful and traumatic work experiences, as highlighted by Jahnke et al. ( 2016 ). Further study on this population from an occupational therapy perspective is supported by a wealth of information from the literature (Gulliver et al., 2021; Torchalla & Strehlau, 2018 ). There is also significant evidence for occupational therapist-delivered holistic education for those facing mental health challenges to increase and maintain occupational engagement (D’Amico et al., 2018 ). Additionally, while previous studies offer an insightful perspective on the traumatic experiences associated with firefighters’ work, it appears that their psychological functioning post-traumatic is dearth. This gap limits the understanding of how well policies can introduce psychological interventions to cater for the professional needs of firefighters, which is crucial for their overall well-being. The focus of this study, therefore was to examine occupational injuries and its effects on psychological functioning of firefighters in Northern Ghana using quantitative research approach underpinned by cross-sectional survey design. Assessing the potential health consequences of occupational injuries and their impact on mental health is essential. This understanding will lead to the formulation and implementation of targeted policies and interventions, which will enhance the psychological functioning of firefighters, leading to a guaranteed overall psychological well-being. More significantly, firefighters in Northern Ghana are frequently exposed to injuries due to sociocultural norms that restrict the expression of psychological anguish, institutional limitations, and a lack of psychosocial support. The lack of empirical information on the impact of injury-related stress on psychological functioning in this setting limits the development of theories and evidence-based interventions. To apply stress-health models to underrepresented occupational and cultural settings and to create integrated occupational health policies that include psychological care in addition to physical injury treatment, it is imperative that this gap be filled. Besides, the study will offer evidence-based information for incorporating post-injury mental health care and psychological risk assessment into emergency workers’ occupational health systems. To reduce long-term psychological burden and improve occupational functioning, the results of this study also promote the creation of context-sensitive stress management, peer support, and rehabilitation therapies. Theoretical Framework The study draws on the Conservation of Resources (COR) Theory—Hobfoll and the Job Demands-Resources (JD-R) Model. Job Demands-Resources (JD-R) Model The Job Demand-Resources (JD-R) Model, a well-known framework in work health psychology, was developed by Demerouti et al. ( 2001 ) to describe how job demands and resources impact employee performance and well-being. According to the model, if work demands such as a high workload or emotional pressure are not adequately managed, they might lead to stress and burnout. Employment resources like support, autonomy, and feedback can help alleviate the negative effects of job demands and foster positive outcomes, including engagement and job satisfaction (Bunjak et al., 2023 ). Firefighting is a high-demand occupation with physical hazards like burns and trauma, as well as emotional strains like exposure to death and disaster, as can be seen by applying the JD-R Model to this study. The JD-R model takes into consideration how these job demands and the resources at their disposal are balanced or out of balance. As a result, there is a higher chance of harm from the depletion of resources, including mental and physical, and psychological functioning deteriorates when demands consistently surpass coping ability, resulting in burnout, anxiety, and depression. Conservation of Resources (COR) Theory–Hobfoll The core tenant of this theory is that a person experiences stress when they actually lose resources (Casper et al., 2018 ). However, acquiring additional resources and safeguarding existing ones will result in behavior that promotes well-being. An individual must safeguard his resources and work to acquire new ones in order to prevent stress. According to Schmidt and Zank ( 2005 ), the hypothesis is based on the loss aversion phenomenon, which holds that people often choose avoiding losses above gaining benefits. Firefighters must invest their resources in order to safeguard them against losses and obtain new ones. Drawing from the core tenants of Conservation of Resources (COR) Theory-Hobfoll, it is ideal for explaining the psychological impact of occupational injuries. After an injury, firefighters frequently lose important resources. These include social standing, confidence, work identity or purpose, and physical harm. Resource loss spirals are a contributing factor to poor mental health outcomes, as explained by COR. It also promotes the idea of resilience, which holds that those who have more resources, such as coping mechanisms and social support, are more likely to experience psychological recovery after an injury. Research Questions 1. What are the occupational injuries experienced by firefighters in Northern Ghana? 2. To what extent does occupational injuries predict psychological functioning of firefighters in Northern Ghana? METHODOLOGY Research Design The study employed a quantitative research approach underpinned by cross-sectional survey design. This design was seen as appropriate because statistical inferences were made on the data collected from the respondents. Thus, the respondents were not manipulated, but the researcher only sought their views on the type of injuries they experienced during their firefighting operations and the extent to which it affected their psychological functioning. The choice of this design is in line with the argument advanced by Allen ( 2017 ) and Ihudiebude-Splendor and Chikeme ( 2020 ) that cross-sectional survey designs are employed to describe a population of interest at a specific point in time. Additionally, cross-sectional survey design was appropriate for the study because it gathered data from a large number of firefighters at a moment in time in order to describe how their injuries influence psychological functioning in terms of thinking, feeling, sensing, and intuition. Sampling Size and Sampling Technique The sample size for this study comprised 642 firefighters in Northern Ghana. The regions include: Northern, Savannah, North East, Upper East, and Upper West. These regions were zone into five strata and simple random sampling technique was employed to sample the participants for the study. This was done to give each member a fair chance of participating in the study. To ensure equal representation, each stratum was further stratified into males and females. Within each stratum, the lottery method was used to sample the participants for the study, where there was inscription “yes” and “no” were written on slips of paper, and put into a container. The contents were thoroughly mixed, and one slip of paper was drawn at a time from the container without looking into it. Whenever a slip was selected and recorded, it was thrown back into the container before the next one was picked. However, if an already drawn number was selected for a second or third term, it was thrown back into the container before the next one was drawn. The process continued until the required sample size was obtained. This was meant to ensure a broad representation of geographical, ethnic, and cultural diversity across the northern region’s landscape. They collectively span the Northern, Savannah, North East, Upper East and Upper West Regions and offer a wide array of deprived fire stations in Ghana. This diversity provided a rich backdrop for analysing the variables of interest in various socio-cultural contexts. In order to ensure proportional representation across the fire stations, a stratified sampling technique was first employed. Fire service fighters were stratified by regions, which helped reduce sampling bias and improved the generalisability of the findings across the five regions. Table 1 presents descriptive statistics for the regional distribution of respondents in the table. A total of 642 out of the accessible population of 3,500 participated in the study. Of this number, 395 representing 61.5% were males, while 247 representing 38.4% were females. Out of this number, 162 (25.2%) were sampled from Northern Region, 109 (16.9%) were chosen from Savannah, 104 (16.2%) were selected from North East, 123 representing 19.2% were sampled from Upper East, while 144 representing 22.4 were selected from Upper West. Measures Data for the study was gathered using two adapted questionnaires: the Inventory of Psychosocial Functioning (IPF), developed by Marx et al. ( 2020 ), and the Work Injury Questionnaire, developed by Kenny ( 2017 ). The items were adapted to reflect types of work injuries mostly experienced by Ghanaian firefighters. The questionnaires were structured into three sections, each of which collected specific data relating to the research questions. The first section collected demographic data of the respondents, which included gender. The second section focused on the type of work-related injury, which included sprain and strain, exhaustion, thermal burns, fainting, and smoke inhalation using the Work Injury Questionnaire. Finally, psychological functioning was measured using the Inventory of Psychosocial Functioning. The questionnaires were administered by the corresponding researcher. The two questionnaires were measured on a 4-point Likert scale type: “1 = Not at all”, “2 = Occasionally”, “3 = Frequently”, “4 = Continuously”. After the construction of the questionnaire, it was piloted on 40 firefighters in the Nkwanta North District of the Oti Region which shares boundaries with Northern Region. Reliability and Validity The reliabilities of the questionnaire were tested according to the two segments which sought to assess the type of occupational injuries experienced by firefighters in the line of duty and the psychological function of firefighters after being exposed to occupational injuries while carrying out their professional duty. All the two questionnaires demonstrated acceptable levels of internal consistency based on pretesting with 150 firefighters form Oti Region which shared similar characteristics with those in Northern, Savanna, North East, Upper East and Upper West in terms of type of work, occupational injuries experienced and psychological experiences after being exposed to injuries of some kind in the line of duty. The Cronbach alpha value of occupational injuries was 0.89, while psychological functioning was 0.78, indicating good reliabilities. In determining the validity, the adapted version of the questionnaires was given to research statisticians and measurement and evaluation experts, who examined it, made corrections, and provided suggestions and recommendations, which were appropriately included in the final version of the instrument prior to its administration. Data Analysis Responses were downloaded, cleaned, and coded for analysis when data collection was finished. For statistical analysis, IBM SPSS version 26.0 was employed. The demographic characteristics of the respondents were summarised using frequencies and percentages. Means and standard deviations were employed to analyse research one which sought to provide insights into the occupational injuries experienced by firefighters in line of their duties. In order to demonstrate how consistent or varied these encounters were, as well as to present concise and easily comprehensible summaries of the data, the researchers used means and standard deviations to identify the trends and areas of concern. The second research question, which aimed to ascertain the degree to which firefighters’ psychological functioning is predicted by occupational injuries, was examined inferentially using multiple regression. To identify the most impactful injuries, control for significant factors such as age, years of service, trauma exposure, and available support networks, and ultimately promote evidence-based interventions and mental health strategies for firefighters, multiple regression analysis was employed to quantify the predictive power of injuries on psychological functioning. Ethical Consideration of the Study To ensure that informed consent and anonymity, voluntary participation, and withdrawal were adhered to, letters of introduction were submitted to the commanders of the three fire service stations requesting permission to collect data for this study. Both the respondents and the authorities of the fire stations were duly informed of the study’s purpose in these letters. The respondents were guaranteed that their identities would be kept confidential. To achieve this goal, fire service personnel were given numbers to write on their questionnaires instead of their real names, making it harder to identify them. Individual participants were informed that they might withdraw from the study at any time as the study progresses. RESULTS Research Question One What are the occupational injuries experienced by firefighters in Northern Ghana? The research question sought to investigate occupational injuries experienced by firefighters using work health indicators that measure occupational injuries associated with work health, such as workplace exposures, hazards, or interventions in a workplace population. The injuries were identified as sprains, smoke inhalation, thermal burns, exhaustion, laceration, contusion, fainting, and overexertion. The responses were rated based on means and standard deviations. The scoring was based on agreed-upon and disagreed-with dimensions on a 1 to 4 Likert-type scale. The threshold of 2.50 was determined using the formula 1 + 2+3 + 4 = 10/4 = 2.50. Thus, mean values of 2.50 or greater than 2.50 were found for the agreed-upon dimension and mean values less than 2.50 for the disagreed-upon dimension. The results are presented in Table 2 as follows: Table 2 shows the consistency of the mean estimates and the robustness of the large sample size were demonstrated by the low standard errors (ranging from 0.03 to 0.06) across all injury categories. While smoke inhalation was consistently classified as the least serious injury, sprains and strains, along with exhaustion, were thought to be the most severe among the injuries assessed. Given that smoke inhalation is known to be potentially fatal, the latter finding is especially significant and raises the possibility of perceptual bias on the side of the respondents. Response variability was highest for exhaustion and thermal burns (SD = 1.5), suggesting that participants’ assessments of these situations varied. On the other hand, smoke inhalation showed the least amount of variation (SD = 0.64), indicating a more robust consensus, but one that understated its clinical significance. Additionally, distributional analyses showed that low-severity injuries showed positive skewness, with ratings concentrated at the lower end of the scale, whereas high-severity injuries showed negative skewness, with ratings clustering at the upper end. In line with non-flat response patterns, kurtosis values (≈ 2–3) for all categories indicate substantially peaked distributions. When combined, the results reveal a gap between perceived and actual medical severity, underscoring the need for targeted educational initiatives. There is a tendency to underestimate serious conditions like smoke inhalation while overestimating mild ones like sprains. Training and awareness programmes are essential to recalibrate these perceptions, thereby enhancing readiness and response in emergency and occupational contexts through more accurate risk assessments. Research Question Two To what extent does occupational injuries predict psychological functioning of firefighters in Northern Ghana? The research question sought to determine the extent to which occupational injuries predict the psychological of firefighters in Northern Ghana. Regression was used to analyse this research question, and the results are shown in Table 3 below. Table 3 presents the results of a multiple regression analysis predicting psychological functioning from a range of predictors related to sprain and strain, exhaustion, thermal burns, fainting and smoke inhalation. The model reveals several significant predictors, all consistent with the study’s theoretical framework. It is significant to note that all the predictors contribute negatively to the psychological functioning. Smoke inhalation explains a substantial negative effect (B = -0.767; β = -0.406, P < .000), indicating that higher smoke inhalation is strongly associated with lower psychological functioning. Similarly, sprain and strain (B = -0.094; β = -0.137, P < .000), exhaustion (B = -0.230; β = -0.291, P < .000), thermal burns (B = -0.219; β = -0.305, P < .000), and fainting (B = -0.592; β = -0.220, P < .000). Smoke inhalation exerts the strongest negative influence on psychological functioning, suggesting that firefighters who are more expose to smoke inhalation experience diminished psychological functioning. This effect surpasses that of sprain and strain, exhaustion, thermal burns and fainting confirming that firefighters who experience higher smoke inhalation report markedly poorly psychological health. DISCUSSION According to the study’s findings, firefighters suffer various forms of occupational injuries while on duty. This explains why firefighter are inevitably exposed to occupational injuries while carrying out their professional duties. Firefighters sustain injuries ranging from first aid to death. This finding is consistent with the arguments presented by Haynes and Molis (2015) and Hylton and Molis ( 2016 ), who claim that a fireman is injured every 8 minutes. The findings are consistent with those of Campbell and Hall ( 2023 ), which reported that some of the occupational injuries experienced by firefighters include overexertion, falls, jumps, slips, or trips; sprains, strains, or muscular pain; wounds, cuts, bleeding, or bruising; fire or chemical burns; thermal stress (frostbite or heat exhaustion); and smoke or gas inhalation. Similarly, the findings of this study support Cafiadas-De la et al. (2015), who hypothesised that in Ghana, firefighters work under conditions of high speed, uncertainty, repetitive bending, exposure to extreme heat and smoke, long hours of standing, stress, and exposure to biological hazards such as victim’s blood. It is worth noting that due to the nature of the work done by firefighters and the hazards of the incident scene environment, it is doubtful that all firefighter injuries would be eradicated. However, the implementation of proactive safety programs by fire departments can help reduce the frequency of injuries among firefighters and other emergency responders. Besides, the study’s findings imply that work-related injury has a negative impact on the psychological functioning of firefighters. The findings revealed that an increase in occupational injuries among firefighters will have a negative impact on their psychological functioning. Consistent with this conclusion, Appiah ( 2019 ) showed that exposure to work hazards, including injuries, disease, and mortality, has a significant impact on both work productivity and the socioeconomic well-being of employees and their families. In a related view, Aguma-Acon ( 2012 ), Mbulingwe ( 2014 ), and Theuri ( 2012 ) noted that there is also a risk of psychosocial hazards such as work-related stress and exhaustion, in addition to ergonomic hazards such as sprains, muscle pain, dislocations, and fractures. Additionally, this finding is consistent with Stanley et al. ( 2017 ), who found that the current nature of the firefighter profession, such as repeated exposure to painful and traumatic events, combined with the erratic sleep schedules inherent in shift work, pose a significant risk to firefighters’ mental health. Furthermore, this finding is consistent with Jahnke et al. ( 2016 ), who revealed in their study that there is persuasive evidence that firefighters had greater rates of psychological problems, such as mood, stress-related, and substance use disorders, than the general population. Limitations of the Study The following limitations provide context for understanding the study's findings. First, because of operational limitations and confidentiality concerns, it was extremely challenging to obtain a representative sample of active firefighters, particularly those who have been injured. It's also important to note that because the study used a cross-sectional design, it's possible that the results will indicate correlation rather than causation, making it difficult to say whether psychological problems were pre-existing or brought on by injuries. Furthermore, injuries may be small, severe, or of a variety of forms, and each may have a unique psychological consequence. Lastly, firefighters may underestimate the psychological impact if they choose not to disclose psychological symptoms out of fear of stigma or being relieved of their duties. CONCLUSION The study highlights the prevalence of occupational injuries among firefighters in Bimbilla, Salaga, and Saboba in Ghana’s Northern Region. It underscores the necessity for targeted interventions to improve firefighters' job effectiveness and efficiency. Furthermore, it stresses the importance of regularly assessing these injuries and providing adequate support from counsellors and psychologists to mitigate their negative impact on mental health. Firefighting is a high-risk profession characterised by frequent and severe injuries due to hazardous working conditions. Moreover, it can be inferred that occupational injuries have a major detrimental impact on the psychological functioning of firefighters, as an injury not only affects the body but also causes psychological suffering such as mood, stress-related symptoms, and burnout. Repeated exposure to distressing experiences, combined with physical traumas, might raise the likelihood of mental health issues, resulting in decreased psychological functioning. RECOMMENDATIONS The study recommends firefighters to have modern protective equipment (PPE) to mitigate risks such as burns and exposure to hazardous materials. Additionally, mental health support, including counselling and peer support, is recommended to help firefighters cope with the psychological impacts of their injuries. Also, it was further recommended that rehabilitation should include mental health therapies in addition to physical therapy to ensure that firefighters receive comprehensive care. Furthermore, the study suggests that confidential counselling services be provided for employees to discuss their on-site experiences and concerns. Implications for Policy and Practice The study highlights the importance of integrating mental health services into post-injury care. Workers recovering from industrial injuries often experience depression, anxiety, Post- Traumatic Symptoms Disorder (PTSD), and reduced cognitive functioning, which can negatively affect their overall well-being and hinder their ability to return to work. As part of work injury regulations, employers and legislators should establish targeted support programs, including peer support, counseling, and psychological testing. Additionally, laws or regulations mandating psychological testing after significant job-related injuries should be considered. To increase efficiency and timeliness, work health personnel should also be taught to identify early indicators of psychological suffering after physical accidents. Furthermore, while assessing options about returning to work, psychological preparedness ought to be a major consideration. Employers should therefore implement adaptable, phased return-to-work plans that take into account both physical and emotional recuperation. Finally, being aware of the psychological effects of injuries emphasizes how crucial preventative safety measures are. Improving workplace safety might lessen long-term psychological effects in addition to physical injury. Implications for Counselling The results of this study demonstrate how urgently counselling psychology is needed to address firefighters’ dual burden of psychological and physical injury. Burns, smoke inhalation, and tiredness are examples of occupational traumas that impair psychological resilience in addition to physical competence. To normalise suffering, promote resilience, and reduce the stigma surrounding mental health care in emergency response professions, counselling psychologists must adopt trauma-informed practices. These practices should recognize the cumulative effects of repeated injuries. Additionally, preventive counselling services are especially important. The psychological effects of workplace dangers can be alleviated by integrating stress management training, resilience-building programmes, and psychoeducation into fire service organisations. The Job Demands–Resources concept highlights the necessity of replenishing personal resources to balance high occupational demands, which aligns with these proactive measures. Counselling psychology can lessen firefighters’ susceptibility to long-term psychological impairment by providing them with adaptive coping mechanisms. Moreover, counselling services provided in the workplace also stand out as a crucial consequence. The establishment of counselling facilities at fire stations would provide prompt access to psychological assistance after occurrences involving injuries, promoting early intervention and lowering the likelihood of long-term dysfunction. Additionally, rehabilitation-focused counselling can help injured firefighters return to active duty by addressing issues such as identity reconstruction, diminished self-efficacy, and fears of re-injury, thereby fostering a smoother transition back to work. The study concludes by highlighting the advocacy function of counselling psychology in creating occupational health policy. Counselling psychologists can advocate for the inclusion of psychological services in injury management procedures, establishing the field as a vital player in the sustainability of the workforce. This expands the role of counselling psychology beyond traditional clinical environments in Ghana and other settings, strengthening its contribution to institutional resilience and public health. Declarations Ethics Approval and Consent to Participate This study was approved by the Institutional Review Board (IRB) at the University of Education, Winneba. The research was conducted in accordance with the guidelines and ethical standards of the University of Education, Winneba. All procedures involving human participants were performed in compliance with the ethical standards of the institutional and/or national research committee and with the 2024 Helsinki declaration on research involving human participants. Informed consent was obtained from all participants before data collection. Participants were informed of the study’s purpose, procedures, and their right to withdraw at any time without penalty. Confidentiality of participants’ data was strictly maintained throughout the study. Consent for Publication Not applicable. The study did not include any identifiable personal data, multimedia content, or sensitive materials requiring individual publication consent. Availability of Data and Materials The datasets generated and analysed during the current study on Impact of Occupational Injuries on Psychological Functioning of Firefighters in Northern Ghana are available from the corresponding author, John N-yelbi, upon reasonable request. To safeguard participant anonymity and in line with ethical guidelines, raw data will not be made publicly available but can be accessed under appropriate institutional oversight. Competing Interests The authors declare that he has no known competing interests of financial, personal, or otherwise that could have influenced the outcomes or interpretations of this study. Funding This research was completely self-funded by the authors. No external grants, sponsorships, or institutional financial contributions were obtained. The independence and objectivity of the study were fully upheld throughout the research process. Acknowledgments The authors express sincere appreciation to all the firefighters who participated in this study. We are also grateful to my team of research assistants for their invaluable support in data collection and data analysis. Author’s Contribution JN Conceived and designed the study; led the development of the research instrument; supervised data collection; performed statistical analyses; and prepared the initial draft of the manuscript. He also served as the corresponding author and coordinated the overall research process. CKH Contributed to the introduction and methodological framework; supported questionnaire validation and data interpretation; and reviewed and revised the manuscript critically for important intellectual content. References Aguma-Acon, J. (2012). Occupational health and safety in small scale industries in Uganda. African Newsletter on Occupational Health and Safety, 9 (1), 46-48. Allen, M. (2017). The SAGE encyclopedia of communication research methods . SAGE. https://doi.org/10.4135/9781483381411 Appiah, S. O. (2019). Working conditions and exposure to work related injuries and accidents at Kokompe-Accra Ghana. Ghana Journal of Geography, 11 (2), 52-76. Bunjak, A., Černe, M., Nagy, N., & Bruch, H. (2023). Job demands and burnout: The multilevel boundary conditions of collective trust and competitive pressure. Human Relations , 76 (5), 657-688. Cafiadas-De la., F. G., Vargas, C., Lius, S. C., Garcia, I., Cafiadas, G., & De la, F. E. (2015). Risk factors and prevalence of burnout syndrome in the nursing profession. Int J Nur Stud, 52 , 240-9. Campbell, R., & Hall, S. (2023). United States firefighter injuries in 2022. National Fire Protection Association. Carlis-Paittoo, B. O. (2016). Occupational related injuries and disabilities among operational fire fighters in Ghana (Master’s thesis). 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Fire 7 (2), 46. https://doi.org/10.3390/fire7020046 Ghana National Fire Service. (2016). National fire statistics for the year 2015 as of December . The Republic of Ghana. Gulliver, S. B., Zimering, R. T., Knight, J., Morissete, S. B., Kamholz, B. W., Pennington, M. L., Dobani, F., Carpenter, T. P., Kimbrel, N. A., Keane, T. M., & Meyer, E. C. (2021). A prospective study of firefighters’ PTSD and depressive symptoms: The first 3 years of service. Psychological Trauma: Theory, Research, Practice, and Policy, 13 (1), 44-55. https://doi.org/10.1037/tra0000980 International Labour Organization. (2016). Public emergency services: Social dialogue in a changing environment . https: www.ilo.org/public/English/dialogue/sector/techmeet/impes-r-pdf Ihudiebude-Splendor, C. N., & Chikeme, P. C. (2020). A descriptive cross-sectional study: Practical and feasible design in investigating health care-seeking behaviors of undergraduates . SAGE. Https://doi.org/10.4135/9781529742962 Jahnke, S. A., Poston, W. S. C., Haddock, C. K., & Murphy, B. (2016). Firefighting and mental health: Experiences of repeated exposure to trauma. Journal of Prevention, Assessment and Rehabilitation, 53 (4), 737-744. Kenny, D. T. (2017). Questionnaire: Injury workers’ perception of injured management . ResearchGate. Kodom-Wiredu, J. K. (2018). The relationship between firefighters’ work demand and work-related musculoskeletal disorders: The moderating role of task characteristics. Safety and Health at Work, 10 , 61-66. Lee, J. H., Lee, D., Kim, J., Jeon, K., & Sim, M. (2017). Duty related trauma exposure and posttraumatic stress symptoms in professional firefighters. Journal of Traumatic Stress, 30 , 133-141. Haynes, H. J. G., & Molis, J. L. (2015b). U.S. Firefighter injuries – 2014 . National Fire Protection Association. Hylton, J. G., & Molis, J. L (2016). Firefighter injuries in the United States . National Fire Protection Association. Marc, E. S. Reyes, P. A., Bueno, D., Kyle, F. R., Fernandze, G. J., Lopez, A., & Ryan, F. O. C. (2021). Psychological well-being and retirement anxiety of selected Filippino middle-aged adults: A brief research report. Philippine Journal of Psychology . https://www.researchgate.net/publication/35968538410.31710/pjp/0054.02 Marx, B. P., Schnurr, P. P., Lunney, C., Weathers, F. W., Bovin, M. J., & Keane, T. M. (2020). The Inventory of Psychosocial Functioning (IPF). https://www.ptsd.va.gov. Mbulingwe, E. S. (2014). Levels and influencing factors of noise pollution from small scale industries in a developing country. Journal of Environmental Management, 33 (6), 830-839. Mock, C., Adjei, S., Acheampong, F., Deroo, L., & Simpson, K. (2005). Occupational injuries in Ghana. International Journal of Occupational and Environmental Health, 11 , 238-245. National Fire Protection Association. (2023). New NFPA report available on fatal firefighter injuries in the U.S. in 2022 . National Fire Service Counci. Pepper, J. S. (2021). Assessment of psychological functioning in retired firefighters (Doctoral dissertation). Nova Southeastern University. https://nsuworks.nova.edu/cps_stuetd/148 Ramdas, K. R. (2019). Psychological well-being and stress among college teachers. The International Journal of Indian Psychology, 7 (4), 680-684. Schmidt, U., & Zank, H. (2005). What is loss aversion? Journal of Risk and Uncertainty, 30 , 157-167. Stanley, I. H., Boffa, J. W., Hom, M. A., Kimbrel, N. A., & Joiner, T. E. (2017). Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters. The Journal of Psychiatric Research, 247 , 236-242. http://dx.doi.org.ezproxylocal.library.nova.edu/10.1016/j.psychres.2016.11.037 Szubert, Z., & Sobala, W. (2002). Work-related injuries among firefighters: Sites and circumstances of their occurrence. International Journal of Occupational Medicine and Environmental Health . https://www.researchgate.net/publication/11333955 Theuri, C. K. (2012). Small-scale enterprises and the informal sector in Kenya. African Newsletter on Occupational Health and Safety, 23 (2), 32-34. Torchalla, I., & Strehlau, V. (2018). The evidence base for interventions targeting individuals with work-related PTSD: A systematic review and recommendations. Behavior Modification, 42 (2), 273-303. https://doi.org/10.1177/0145445517725048 Worede, E.A., Yesuf, K., Demoze, L . Yitageasu, G., & Bitew, B.D. (2025). Work-related injury characterization and factors among fire brigade workers in Ethiopia. Sci Rep 15 , 12401. https://doi.org/10.1038/s41598-025-96776-z Tables Tables 1 to 3 are available in the Supplementary Files section. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-8819741\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":605139523,\"identity\":\"e29c0332-bb5c-4a43-bc9e-44078ca64b6b\",\"order_by\":0,\"name\":\"John N-yelbi\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA20lEQVRIiWNgGAWjYBACxgYg8bBBQg7CZQNiCWK0JDZIGBOvBQwSG0CIWC3Ms3sMHyTusEjfcLzHgOFD2WEG+egGAg6bc8bYIPGMRO6GM2cMGGecO8xgeOcAAS0zcswkEtuAWm7kbmDmbQNqmZFAUIv5D6CWdIP7bzcw/yVSixkDUEuCwQ3eDcyMQC3yEgS1pBVLAP1iOPNM/oeDPefSeQwIaTGckbzxw8cddfJ8x48lPvhRZi0nT8hhhg0cBnDOASDmMTiAXweDPAP7AzSRBgJaRsEoGAWjYMQBANE6SQoYaCdoAAAAAElFTkSuQmCC\",\"orcid\":\"\",\"institution\":\"University of Education, Winneba\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"John\",\"middleName\":\"\",\"lastName\":\"N-yelbi\",\"suffix\":\"\"},{\"id\":605139524,\"identity\":\"0eb66834-aa70-4ec1-9589-68d66d9d2268\",\"order_by\":1,\"name\":\"Columban Kwesi Hughes\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University of Education, Winneba\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Columban\",\"middleName\":\"Kwesi\",\"lastName\":\"Hughes\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2026-02-08 07:23:44\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-8819741/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-8819741/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":104835403,\"identity\":\"159318f6-b422-4885-a3ec-9235f26f3302\",\"added_by\":\"auto\",\"created_at\":\"2026-03-17 17:44:36\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":604544,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8819741/v1/31615f6c-8924-4425-9912-7142f55f3f4b.pdf\"},{\"id\":104583259,\"identity\":\"e316e1db-1246-4b24-af3a-ae68e45bc7d9\",\"added_by\":\"auto\",\"created_at\":\"2026-03-13 15:18:20\",\"extension\":\"docx\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":28064,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"Tables.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8819741/v1/60f36941440398020b7b2405.docx\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Impact of Occupational Injuries on Psychological Functioning of Firefighters in Northern Ghana\",\"fulltext\":[{\"header\":\"INTRODUCTION\",\"content\":\"\\u003cp\\u003eFirefighters face exposure to poisonous gases, smoke, and extreme temperatures during their operations. They also encounter chemical and biological agents, risks from collapsed buildings, and engage in high-intensity physical activities. All these factors elevate the risk of occupational injuries, which can be both fatal and non-fatal (Garcia et al., \\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e). Firefighters\\u0026rsquo; physical and emotional health are still seriously endangered by the nature and circumstances of their employment.\\u003c/p\\u003e \\u003cp\\u003eOccupational injuries involve physical harm linked to an employee\\u0026rsquo;s job responsibilities or environment, including injuries from unforeseen events, harmful substances, repetitive movements, and psychosocial stress from adverse conditions (Worade et al., 2025). Firefighters, facing heightened workloads due to additional chemical and technological incidents, experience increased vulnerability to these injuries (Szubert \\u0026amp; Sobala, \\u003cspan citationid=\\\"CR39\\\" class=\\\"CitationRef\\\"\\u003e2002\\u003c/span\\u003e). Mental health conditions, including PTSD, anxiety, depression, and burnout, are prevalent among firefighters due to Occupational injuries and the high-stress nature of their profession (Lee et al., \\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e2017\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eFirefighters, as professional rescue workers, regularly face traumatic situations and are subjected to significant physical and psychological stress, which increases their vulnerability to psychological distress (Psarros et al., 2018). Campbell and Hall (\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e2023\\u003c/span\\u003e) highlight the various threats faced by firefighters both on and off the fireground. In Ghana, over 100 firefighters are injured annually, with many suffering permanent incapacitation due to their work, including fighting fires and responding to crises (Carlis-Paittoo, \\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e2016\\u003c/span\\u003e). The job entails significant health and safety risks from exposure to physical and thermal stresses, as well as harmful chemicals, leading to high stress levels during emergencies. Psychological well-being is the expression of pleasant feelings and general happiness with one\\u0026rsquo;s life in various domains such as family, education, and employment, and it includes both emotional and cognitive components (Ramdas, \\u003cspan citationid=\\\"CR36\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e). However, when occupational injuries are intense or prolonged and interfere with daily functioning, psychological health suffers (Marc et al., \\u003cspan citationid=\\\"CR30\\\" class=\\\"CitationRef\\\"\\u003e2021\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eGlobally, emergency professionals, such as firefighters, are among the most physically demanding and dangerous professions. Although there is increasing pressures on firefighters due to the nature of their work, but the demands on firefighters in developing nations such as Ghana appear to be unusually high when compared to those in industrialised countries. A report by the International Labour Organization (\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e2016\\u003c/span\\u003e) estimated that the firefighter-to-citizen ratio in developed countries such as European nations was 1:1,000\\u0026ndash;1,200, whereas developing countries such as Mali, with Ghana not an exception, had a ratio of 1:33,435, which is extremely high. Furthermore, growing fire outbreaks in developing nations such as Ghana are projected to boost the demand for firefighters (Ghana National Fire Service, \\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e2016\\u003c/span\\u003e). According to Kodom-Wiredu (\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e2018\\u003c/span\\u003e), the firefighting profession is characterised by uncertainty, exposure to human loss, shift work, and traumatic incidents, among other factors.\\u003c/p\\u003e \\u003cp\\u003eIn America, an estimated 65,650 firefighters\\u0026rsquo; injuries occurred in the line of duty in 2022, an increase of 8% from the 60,750 injuries reported in 2021 (Campbell \\u0026amp; Hall, \\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e2023\\u003c/span\\u003e). Firefighters were more likely to be injured at fireground operations than during any other duty. In 2022, an estimated 21,325 injuries, representing 33% of all reported firefighter injuries, occurred on the fireground. While responding to or returning from an accident, as well as those that occurred while performing other operational activities. Overexertion injuries accounted for three in ten fireground injuries (31%), followed by falls, jumps, slips, or trips (22%). Sprains, strains, and muscular discomfort injuries accounted for nearly two out of every five (36%) firefighters\\u0026rsquo; injuries. Additionally, Campbell and Hall (\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e2023\\u003c/span\\u003e) added that prominent fireground injuries included wounds, cuts, bleeding, or bruising (15%), fire or chemical burns (9%), thermal stress (frostbite or heat exhaustion) (7%), and smoke or gas inhalation. There were 96 on-duty firefighter fatalities in the United States last year, according to a report on fatal firefighter injuries in the country published by the National Fire Protection Association (\\u003cspan citationid=\\\"CR34\\\" class=\\\"CitationRef\\\"\\u003e2023\\u003c/span\\u003e). Out of this number, one was a full-time federal land management employee, six were contractors for federal or state land management organizations, 51 were volunteer firemen, and 38 were professional firefighters.\\u003c/p\\u003e \\u003cp\\u003eAnother report indicates that approximately 43% of these injuries occurred on the fireground, primarily due to falls, slips, and jumps (27.2%), alongside overexertion and strain. Injuries vary in severity, from minor to fatal, with evidence indicating that a firefighter is injured every eight minutes (Haynes \\u0026amp; Molis, \\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e2015b\\u003c/span\\u003e; Hylton \\u0026amp; Molis, \\u003cspan citationid=\\\"CR29\\\" class=\\\"CitationRef\\\"\\u003e2016\\u003c/span\\u003e). Firefighters encounter numerous hazards, including medical emergencies and hazardous materials, which can lead to serious injuries and fatalities impacting families and communities.\\u003c/p\\u003e \\u003cp\\u003eAs first responders, they are crucial during disasters like residential fires and gas explosions that also threaten schools. Jahnke et al. (\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e2016\\u003c/span\\u003e) outline that firefighters\\u0026rsquo; responsibilities have expanded beyond fire suppression to include various emergencies, which, alongside exposure to trauma and irregular sleep patterns from shift work, severely endangers their mental health (Stanley et al., \\u003cspan citationid=\\\"CR38\\\" class=\\\"CitationRef\\\"\\u003e2017\\u003c/span\\u003e). Firefighters are at a higher risk for psychological issues, such as mood and substance use disorders, compared to the general population, a notion reinforced by Pepper (\\u003cspan citationid=\\\"CR35\\\" class=\\\"CitationRef\\\"\\u003e2021\\u003c/span\\u003e), who links these challenges to elevated stress and trauma in the profession.\\u003c/p\\u003e \\u003cp\\u003eIn Ghana, firefighters face significant risks, including exposure to heat, smoke, long working hours, and biological hazards, as they respond to over 1,000 fires annually Cafiadas-De la et al., 2015). Despite the evident dangers, research on their psychological well-being remains limited. However, studies indicate that firefighters experience higher rates of psychological issues, including mood disorders, stress-related conditions, and substance use disorders compared to the general population (Del Ben et al., 2006; Jahnke et al., \\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e2016\\u003c/span\\u003e). Firefighters experience significant work-related stress and trauma daily, as highlighted by Pepper (\\u003cspan citationid=\\\"CR35\\\" class=\\\"CitationRef\\\"\\u003e2021\\u003c/span\\u003e). The risks associated with their job, including injuries and mortality, adversely affect both productivity and the socioeconomic status of their families (Appiah, \\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e). Additionally, there are serious psychosocial hazards like workplace stress and fatigue, as well as ergonomic risks resulting in injuries such as sprains and fractures (Aguma-Acon, \\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e2012\\u003c/span\\u003e; Mbulingwe, \\u003cspan citationid=\\\"CR32\\\" class=\\\"CitationRef\\\"\\u003e2014\\u003c/span\\u003e; Theuri, \\u003cspan citationid=\\\"CR40\\\" class=\\\"CitationRef\\\"\\u003e2012\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eMock et al. (\\u003cspan citationid=\\\"CR33\\\" class=\\\"CitationRef\\\"\\u003e2005\\u003c/span\\u003e) found that occupational injuries lead to greater mortality, prolonged disability, and increased treatment costs compared to non-occupational injuries. They highlighted the significant impact of industrial injuries on work sickness, particularly in developing countries like Ghana. The authors emphasise the importance of enhanced workplace safety, supported by both voluntary initiatives and government regulation, for promoting health and preventing injuries at work. Injuries are increasingly recognised as a rising health problem in low- and middle-income countries such as Ghana. They are also the leading source of disability and health-related economic losses, with a considerable number of these injuries ascribed to work-related (Mock et al., \\u003cspan citationid=\\\"CR33\\\" class=\\\"CitationRef\\\"\\u003e2005\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eResearch on occupational injuries and psychological functioning of firefighters in Ghana includes Paittoo (2016), who examined injuries and disabilities using mixed methods, and Pepper (\\u003cspan citationid=\\\"CR35\\\" class=\\\"CitationRef\\\"\\u003e2021\\u003c/span\\u003e), who studied the psychological functioning of retired firefighters through a cross-sectional design. Despite inherent resilience linked to their personality traits, many firefighters experience negative psychological effects from their stressful and traumatic work experiences, as highlighted by Jahnke et al. (\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e2016\\u003c/span\\u003e). Further study on this population from an occupational therapy perspective is supported by a wealth of information from the literature (Gulliver et al., 2021; Torchalla \\u0026amp; Strehlau, \\u003cspan citationid=\\\"CR41\\\" class=\\\"CitationRef\\\"\\u003e2018\\u003c/span\\u003e). There is also significant evidence for occupational therapist-delivered holistic education for those facing mental health challenges to increase and maintain occupational engagement (D\\u0026rsquo;Amico et al., \\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e2018\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eAdditionally, while previous studies offer an insightful perspective on the traumatic experiences associated with firefighters\\u0026rsquo; work, it appears that their psychological functioning post-traumatic is dearth. This gap limits the understanding of how well policies can introduce psychological interventions to cater for the professional needs of firefighters, which is crucial for their overall well-being. The focus of this study, therefore was to examine occupational injuries and its effects on psychological functioning of firefighters in Northern Ghana using quantitative research approach underpinned by cross-sectional survey design. Assessing the potential health consequences of occupational injuries and their impact on mental health is essential. This understanding will lead to the formulation and implementation of targeted policies and interventions, which will enhance the psychological functioning of firefighters, leading to a guaranteed overall psychological well-being.\\u003c/p\\u003e \\u003cp\\u003eMore significantly, firefighters in Northern Ghana are frequently exposed to injuries due to sociocultural norms that restrict the expression of psychological anguish, institutional limitations, and a lack of psychosocial support. The lack of empirical information on the impact of injury-related stress on psychological functioning in this setting limits the development of theories and evidence-based interventions. To apply stress-health models to underrepresented occupational and cultural settings and to create integrated occupational health policies that include psychological care in addition to physical injury treatment, it is imperative that this gap be filled. Besides, the study will offer evidence-based information for incorporating post-injury mental health care and psychological risk assessment into emergency workers\\u0026rsquo; occupational health systems. To reduce long-term psychological burden and improve occupational functioning, the results of this study also promote the creation of context-sensitive stress management, peer support, and rehabilitation therapies.\\u003c/p\\u003e\\n\\u003ch3\\u003eTheoretical Framework\\u003c/h3\\u003e\\n\\u003cp\\u003eThe study draws on the Conservation of Resources (COR) Theory\\u0026mdash;Hobfoll and the Job Demands-Resources (JD-R) Model.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eJob Demands-Resources (JD-R) Model\\u003c/h2\\u003e \\u003cp\\u003eThe Job Demand-Resources (JD-R) Model, a well-known framework in work health psychology, was developed by Demerouti et al. (\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e2001\\u003c/span\\u003e) to describe how job demands and resources impact employee performance and well-being. According to the model, if work demands such as a high workload or emotional pressure are not adequately managed, they might lead to stress and burnout. Employment resources like support, autonomy, and feedback can help alleviate the negative effects of job demands and foster positive outcomes, including engagement and job satisfaction (Bunjak et al., \\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e2023\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eFirefighting is a high-demand occupation with physical hazards like burns and trauma, as well as emotional strains like exposure to death and disaster, as can be seen by applying the JD-R Model to this study. The JD-R model takes into consideration how these job demands and the resources at their disposal are balanced or out of balance. As a result, there is a higher chance of harm from the depletion of resources, including mental and physical, and psychological functioning deteriorates when demands consistently surpass coping ability, resulting in burnout, anxiety, and depression.\\u003c/p\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eConservation of Resources (COR) Theory–Hobfoll\\u003c/h3\\u003e\\n\\u003cp\\u003eThe core tenant of this theory is that a person experiences stress when they actually lose resources (Casper et al., \\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e2018\\u003c/span\\u003e). However, acquiring additional resources and safeguarding existing ones will result in behavior that promotes well-being. An individual must safeguard his resources and work to acquire new ones in order to prevent stress. According to Schmidt and Zank (\\u003cspan citationid=\\\"CR37\\\" class=\\\"CitationRef\\\"\\u003e2005\\u003c/span\\u003e), the hypothesis is based on the loss aversion phenomenon, which holds that people often choose avoiding losses above gaining benefits. Firefighters must invest their resources in order to safeguard them against losses and obtain new ones.\\u003c/p\\u003e \\u003cp\\u003eDrawing from the core tenants of Conservation of Resources (COR) Theory-Hobfoll, it is ideal for explaining the psychological impact of occupational injuries. After an injury, firefighters frequently lose important resources. These include social standing, confidence, work identity or purpose, and physical harm. Resource loss spirals are a contributing factor to poor mental health outcomes, as explained by COR. It also promotes the idea of resilience, which holds that those who have more resources, such as coping mechanisms and social support, are more likely to experience psychological recovery after an injury.\\u003c/p\\u003e \\u003cp\\u003e \\u003cb\\u003eResearch Questions\\u003c/b\\u003e \\u003c/p\\u003e \\u003cp\\u003e1. What are the occupational injuries experienced by firefighters in Northern Ghana?\\u003c/p\\u003e \\u003cp\\u003e2. To what extent does occupational injuries predict psychological functioning of firefighters in Northern Ghana?\\u003c/p\\u003e \\u003c/p\\u003e\"},{\"header\":\"METHODOLOGY\",\"content\":\"\\u003cdiv id=\\\"Sec6\\\" class=\\\"Section2\\\"\\u003e\\n \\u003ch2\\u003eResearch Design\\u003c/h2\\u003e\\n \\u003cp\\u003eThe study employed a quantitative research approach underpinned by cross-sectional survey design. This design was seen as appropriate because statistical inferences were made on the data collected from the respondents. Thus, the respondents were not manipulated, but the researcher only sought their views on the type of injuries they experienced during their firefighting operations and the extent to which it affected their psychological functioning. The choice of this design is in line with the argument advanced by Allen (\\u003cspan class=\\\"CitationRef\\\"\\u003e2017\\u003c/span\\u003e) and Ihudiebude-Splendor and Chikeme (\\u003cspan class=\\\"CitationRef\\\"\\u003e2020\\u003c/span\\u003e) that cross-sectional survey designs are employed to describe a population of interest at a specific point in time. Additionally, cross-sectional survey design was appropriate for the study because it gathered data from a large number of firefighters at a moment in time in order to describe how their injuries influence psychological functioning in terms of thinking, feeling, sensing, and intuition.\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003ch3\\u003eSampling Size and Sampling Technique\\u003c/h3\\u003e\\n\\u003cp\\u003eThe sample size for this study comprised 642 firefighters in Northern Ghana. The regions include: Northern, Savannah, North East, Upper East, and Upper West. These regions were zone into five strata and simple random sampling technique was employed to sample the participants for the study. This was done to give each member a fair chance of participating in the study. To ensure equal representation, each stratum was further stratified into males and females. Within each stratum, the lottery method was used to sample the participants for the study, where there was inscription \\u0026ldquo;yes\\u0026rdquo; and \\u0026ldquo;no\\u0026rdquo; were written on slips of paper, and put into a container. The contents were thoroughly mixed, and one slip of paper was drawn at a time from the container without looking into it. Whenever a slip was selected and recorded, it was thrown back into the container before the next one was picked.\\u003c/p\\u003e\\n\\u003cp\\u003eHowever, if an already drawn number was selected for a second or third term, it was thrown back into the container before the next one was drawn. The process continued until the required sample size was obtained. This was meant to ensure a broad representation of geographical, ethnic, and cultural diversity across the northern region\\u0026rsquo;s landscape. They collectively span the Northern, Savannah, North East, Upper East and Upper West Regions and offer a wide array of deprived fire stations in Ghana. This diversity provided a rich backdrop for analysing the variables of interest in various socio-cultural contexts. In order to ensure proportional representation across the fire stations, a stratified sampling technique was first employed. Fire service fighters were stratified by regions, which helped reduce sampling bias and improved the generalisability of the findings across the five regions.\\u003c/p\\u003e\\n\\u003cp\\u003eTable 1 presents descriptive statistics for the regional distribution of respondents in the table. \\u0026nbsp;A total of 642 out of the accessible population of 3,500 participated in the study. Of this number, 395 representing 61.5% were males, while 247 representing 38.4% were females. Out of this number, 162 (25.2%) were sampled from Northern Region, 109 (16.9%) were chosen from Savannah, 104 (16.2%) were selected from North East, 123 representing 19.2% were sampled from Upper East, while 144 representing 22.4 were selected from Upper West.\\u003c/p\\u003e\\n\\u003ch3\\u003eMeasures\\u003c/h3\\u003e\\n\\u003cp\\u003eData for the study was gathered using two adapted questionnaires: the Inventory of Psychosocial Functioning (IPF), developed by Marx et al. (\\u003cspan class=\\\"CitationRef\\\"\\u003e2020\\u003c/span\\u003e), and the Work Injury Questionnaire, developed by Kenny (\\u003cspan class=\\\"CitationRef\\\"\\u003e2017\\u003c/span\\u003e). The items were adapted to reflect types of work injuries mostly experienced by Ghanaian firefighters. The questionnaires were structured into three sections, each of which collected specific data relating to the research questions. The first section collected demographic data of the respondents, which included gender. The second section focused on the type of work-related injury, which included sprain and strain, exhaustion, thermal burns, fainting, and smoke inhalation using the Work Injury Questionnaire. Finally, psychological functioning was measured using the Inventory of Psychosocial Functioning. The questionnaires were administered by the corresponding researcher. The two questionnaires were measured on a 4-point Likert scale type: \\u0026ldquo;1\\u0026thinsp;=\\u0026thinsp;Not at all\\u0026rdquo;, \\u0026ldquo;2\\u0026thinsp;=\\u0026thinsp;Occasionally\\u0026rdquo;, \\u0026ldquo;3\\u0026thinsp;=\\u0026thinsp;Frequently\\u0026rdquo;, \\u0026ldquo;4\\u0026thinsp;=\\u0026thinsp;Continuously\\u0026rdquo;. After the construction of the questionnaire, it was piloted on 40 firefighters in the Nkwanta North District of the Oti Region which shares boundaries with Northern Region.\\u003c/p\\u003e\\n\\u003cdiv id=\\\"Sec11\\\" class=\\\"Section2\\\"\\u003e\\n \\u003ch2\\u003eReliability and Validity\\u003c/h2\\u003e\\n \\u003cp\\u003eThe reliabilities of the questionnaire were tested according to the two segments which sought to assess the type of occupational injuries experienced by firefighters in the line of duty and the psychological function of firefighters after being exposed to occupational injuries while carrying out their professional duty. All the two questionnaires demonstrated acceptable levels of internal consistency based on pretesting with 150 firefighters form Oti Region which shared similar characteristics with those in Northern, Savanna, North East, Upper East and Upper West in terms of type of work, occupational injuries experienced and psychological experiences after being exposed to injuries of some kind in the line of duty. The Cronbach alpha value of occupational injuries was 0.89, while psychological functioning was 0.78, indicating good reliabilities. In determining the validity, the adapted version of the questionnaires was given to research statisticians and measurement and evaluation experts, who examined it, made corrections, and provided suggestions and recommendations, which were appropriately included in the final version of the instrument prior to its administration.\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv id=\\\"Sec12\\\" class=\\\"Section2\\\"\\u003e\\n \\u003ch2\\u003eData Analysis\\u003c/h2\\u003e\\n \\u003cp\\u003eResponses were downloaded, cleaned, and coded for analysis when data collection was finished. For statistical analysis, IBM SPSS version 26.0 was employed. The demographic characteristics of the respondents were summarised using frequencies and percentages. Means and standard deviations were employed to analyse research one which sought to provide insights into the occupational injuries experienced by firefighters in line of their duties. In order to demonstrate how consistent or varied these encounters were, as well as to present concise and easily comprehensible summaries of the data, the researchers used means and standard deviations to identify the trends and areas of concern.\\u003c/p\\u003e\\n \\u003cp\\u003eThe second research question, which aimed to ascertain the degree to which firefighters\\u0026rsquo; psychological functioning is predicted by occupational injuries, was examined inferentially using multiple regression. To identify the most impactful injuries, control for significant factors such as age, years of service, trauma exposure, and available support networks, and ultimately promote evidence-based interventions and mental health strategies for firefighters, multiple regression analysis was employed to quantify the predictive power of injuries on psychological functioning.\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003cdiv id=\\\"Sec13\\\" class=\\\"Section2\\\"\\u003e\\n \\u003ch2\\u003eEthical Consideration of the Study\\u003c/h2\\u003e\\n \\u003cp\\u003eTo ensure that informed consent and anonymity, voluntary participation, and withdrawal were adhered to, letters of introduction were submitted to the commanders of the three fire service stations requesting permission to collect data for this study. Both the respondents and the authorities of the fire stations were duly informed of the study\\u0026rsquo;s purpose in these letters. The respondents were guaranteed that their identities would be kept confidential. To achieve this goal, fire service personnel were given numbers to write on their questionnaires instead of their real names, making it harder to identify them. Individual participants were informed that they might withdraw from the study at any time as the study progresses.\\u003c/p\\u003e\\n\\u003c/div\\u003e\"},{\"header\":\"RESULTS\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eResearch Question One\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eWhat are the occupational injuries experienced by firefighters in Northern Ghana?\\u003c/p\\u003e\\n\\u003cp\\u003eThe research question sought to investigate occupational injuries experienced by firefighters using work health indicators that measure occupational injuries associated with work health, such as workplace exposures, hazards, or interventions in a workplace population. The injuries were identified as sprains, smoke inhalation, thermal burns, exhaustion, laceration, contusion, fainting, and overexertion. The responses were rated based on means and standard deviations. The scoring was based on agreed-upon and disagreed-with dimensions on a 1 to 4 Likert-type scale. The threshold of 2.50 was determined using the formula 1\\u0026thinsp;+\\u0026thinsp;2+3\\u0026thinsp;+\\u0026thinsp;4\\u0026thinsp;=\\u0026thinsp;10/4\\u0026thinsp;=\\u0026thinsp;2.50. Thus, mean values of 2.50 or greater than 2.50 were found for the agreed-upon dimension and mean values less than 2.50 for the disagreed-upon dimension. The results are presented in Table \\u003cspan class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e as follows:\\u003c/p\\u003e\\n\\u003cp\\u003eTable 2 shows the consistency of the mean estimates and the robustness of the large sample size were demonstrated by the low standard errors (ranging from 0.03 to 0.06) across all injury categories. While smoke inhalation was consistently classified as the least serious injury, sprains and strains, along with exhaustion, were thought to be the most severe among the injuries assessed. Given that smoke inhalation is known to be potentially fatal, the latter finding is especially significant and raises the possibility of perceptual bias on the side of the respondents.\\u003c/p\\u003e\\n\\u003cp\\u003eResponse variability was highest for exhaustion and thermal burns (SD\\u0026thinsp;=\\u0026thinsp;1.5), suggesting that participants\\u0026rsquo; assessments of these situations varied. On the other hand, smoke inhalation showed the least amount of variation (SD\\u0026thinsp;=\\u0026thinsp;0.64), indicating a more robust consensus, but one that understated its clinical significance. Additionally, distributional analyses showed that low-severity injuries showed positive skewness, with ratings concentrated at the lower end of the scale, whereas high-severity injuries showed negative skewness, with ratings clustering at the upper end. In line with non-flat response patterns, kurtosis values (\\u0026asymp;\\u0026thinsp;2\\u0026ndash;3) for all categories indicate substantially peaked distributions. When combined, the results reveal a gap between perceived and actual medical severity, underscoring the need for targeted educational initiatives. There is a tendency to underestimate serious conditions like smoke inhalation while overestimating mild ones like sprains. Training and awareness programmes are essential to recalibrate these perceptions, thereby enhancing readiness and response in emergency and occupational contexts through more accurate risk assessments.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eResearch Question Two\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eTo what extent does occupational injuries predict psychological functioning of firefighters in Northern Ghana?\\u003c/p\\u003e\\n\\u003cp\\u003eThe research question sought to determine the extent to which occupational injuries predict the psychological of firefighters in Northern Ghana. Regression was used to analyse this research question, and the results are shown in Table 3 below.\\u003c/p\\u003e\\n\\u003cdiv id=\\\"Sec15\\\" class=\\\"Section2\\\"\\u003e\\n \\u003cp\\u003eTable\\u0026nbsp;3 presents the results of a multiple regression analysis predicting psychological functioning from a range of predictors related to sprain and strain, exhaustion, thermal burns, fainting and smoke inhalation. The model reveals several significant predictors, all consistent with the study\\u0026rsquo;s theoretical framework. It is significant to note that all the predictors contribute negatively to the psychological functioning. Smoke inhalation explains a substantial negative effect (B = -0.767; \\u0026beta; = -0.406, P \\u0026lt; .000), indicating that higher smoke inhalation is strongly associated with lower psychological functioning.\\u003c/p\\u003e\\n \\u003cp\\u003eSimilarly, sprain and strain (B = -0.094; \\u0026beta; = -0.137, P \\u0026lt; .000), exhaustion (B = -0.230; \\u0026beta; = -0.291, P \\u0026lt; .000), thermal burns (B = -0.219; \\u0026beta; = -0.305, P \\u0026lt; .000), and fainting (B = -0.592; \\u0026beta; = -0.220, P \\u0026lt; .000). Smoke inhalation exerts the strongest negative influence on psychological functioning, suggesting that firefighters who are more expose to smoke inhalation experience diminished psychological functioning. This effect surpasses that of sprain and strain, exhaustion, thermal burns and fainting confirming that firefighters who experience higher smoke inhalation report markedly poorly psychological health.\\u003c/p\\u003e\\n\\u003c/div\\u003e\"},{\"header\":\"DISCUSSION\",\"content\":\"\\u003cp\\u003eAccording to the study\\u0026rsquo;s findings, firefighters suffer various forms of occupational injuries while on duty. This explains why firefighter are inevitably exposed to occupational injuries while carrying out their professional duties. Firefighters sustain injuries ranging from first aid to death. This finding is consistent with the arguments presented by Haynes and Molis (2015) and Hylton and Molis (\\u003cspan citationid=\\\"CR29\\\" class=\\\"CitationRef\\\"\\u003e2016\\u003c/span\\u003e), who claim that a fireman is injured every 8 minutes. The findings are consistent with those of Campbell and Hall (\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e2023\\u003c/span\\u003e), which reported that some of the occupational injuries experienced by firefighters include overexertion, falls, jumps, slips, or trips; sprains, strains, or muscular pain; wounds, cuts, bleeding, or bruising; fire or chemical burns; thermal stress (frostbite or heat exhaustion); and smoke or gas inhalation.\\u003c/p\\u003e \\u003cp\\u003eSimilarly, the findings of this study support Cafiadas-De la et al. (2015), who hypothesised that in Ghana, firefighters work under conditions of high speed, uncertainty, repetitive bending, exposure to extreme heat and smoke, long hours of standing, stress, and exposure to biological hazards such as victim\\u0026rsquo;s blood. It is worth noting that due to the nature of the work done by firefighters and the hazards of the incident scene environment, it is doubtful that all firefighter injuries would be eradicated. However, the implementation of proactive safety programs by fire departments can help reduce the frequency of injuries among firefighters and other emergency responders.\\u003c/p\\u003e \\u003cp\\u003eBesides, the study\\u0026rsquo;s findings imply that work-related injury has a negative impact on the psychological functioning of firefighters. The findings revealed that an increase in occupational injuries among firefighters will have a negative impact on their psychological functioning. Consistent with this conclusion, Appiah (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e) showed that exposure to work hazards, including injuries, disease, and mortality, has a significant impact on both work productivity and the socioeconomic well-being of employees and their families. In a related view, Aguma-Acon (\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e2012\\u003c/span\\u003e), Mbulingwe (\\u003cspan citationid=\\\"CR32\\\" class=\\\"CitationRef\\\"\\u003e2014\\u003c/span\\u003e), and Theuri (\\u003cspan citationid=\\\"CR40\\\" class=\\\"CitationRef\\\"\\u003e2012\\u003c/span\\u003e) noted that there is also a risk of psychosocial hazards such as work-related stress and exhaustion, in addition to ergonomic hazards such as sprains, muscle pain, dislocations, and fractures.\\u003c/p\\u003e \\u003cp\\u003eAdditionally, this finding is consistent with Stanley et al. (\\u003cspan citationid=\\\"CR38\\\" class=\\\"CitationRef\\\"\\u003e2017\\u003c/span\\u003e), who found that the current nature of the firefighter profession, such as repeated exposure to painful and traumatic events, combined with the erratic sleep schedules inherent in shift work, pose a significant risk to firefighters\\u0026rsquo; mental health. Furthermore, this finding is consistent with Jahnke et al. (\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e2016\\u003c/span\\u003e), who revealed in their study that there is persuasive evidence that firefighters had greater rates of psychological problems, such as mood, stress-related, and substance use disorders, than the general population.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec17\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eLimitations of the Study\\u003c/h2\\u003e \\u003cp\\u003eThe following limitations provide context for understanding the study's findings. First, because of operational limitations and confidentiality concerns, it was extremely challenging to obtain a representative sample of active firefighters, particularly those who have been injured. It's also important to note that because the study used a cross-sectional design, it's possible that the results will indicate correlation rather than causation, making it difficult to say whether psychological problems were pre-existing or brought on by injuries. Furthermore, injuries may be small, severe, or of a variety of forms, and each may have a unique psychological consequence. Lastly, firefighters may underestimate the psychological impact if they choose not to disclose psychological symptoms out of fear of stigma or being relieved of their duties.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"CONCLUSION\",\"content\":\"\\u003cp\\u003eThe study highlights the prevalence of occupational injuries among firefighters in Bimbilla, Salaga, and Saboba in Ghana\\u0026rsquo;s Northern Region. It underscores the necessity for targeted interventions to improve firefighters' job effectiveness and efficiency. Furthermore, it stresses the importance of regularly assessing these injuries and providing adequate support from counsellors and psychologists to mitigate their negative impact on mental health. Firefighting is a high-risk profession characterised by frequent and severe injuries due to hazardous working conditions. Moreover, it can be inferred that occupational injuries have a major detrimental impact on the psychological functioning of firefighters, as an injury not only affects the body but also causes psychological suffering such as mood, stress-related symptoms, and burnout. Repeated exposure to distressing experiences, combined with physical traumas, might raise the likelihood of mental health issues, resulting in decreased psychological functioning.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec19\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eRECOMMENDATIONS\\u003c/h2\\u003e \\u003cp\\u003eThe study recommends firefighters to have modern protective equipment (PPE) to mitigate risks such as burns and exposure to hazardous materials. Additionally, mental health support, including counselling and peer support, is recommended to help firefighters cope with the psychological impacts of their injuries. Also, it was further recommended that rehabilitation should include mental health therapies in addition to physical therapy to ensure that firefighters receive comprehensive care. Furthermore, the study suggests that confidential counselling services be provided for employees to discuss their on-site experiences and concerns.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec20\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eImplications for Policy and Practice\\u003c/h2\\u003e \\u003cp\\u003eThe study highlights the importance of integrating mental health services into post-injury care. Workers recovering from industrial injuries often experience depression, anxiety, Post- Traumatic Symptoms Disorder (PTSD), and reduced cognitive functioning, which can negatively affect their overall well-being and hinder their ability to return to work. As part of work injury regulations, employers and legislators should establish targeted support programs, including peer support, counseling, and psychological testing. Additionally, laws or regulations mandating psychological testing after significant job-related injuries should be considered.\\u003c/p\\u003e \\u003cp\\u003eTo increase efficiency and timeliness, work health personnel should also be taught to identify early indicators of psychological suffering after physical accidents. Furthermore, while assessing options about returning to work, psychological preparedness ought to be a major consideration. Employers should therefore implement adaptable, phased return-to-work plans that take into account both physical and emotional recuperation. Finally, being aware of the psychological effects of injuries emphasizes how crucial preventative safety measures are. Improving workplace safety might lessen long-term psychological effects in addition to physical injury.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec21\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eImplications for Counselling\\u003c/h2\\u003e \\u003cp\\u003eThe results of this study demonstrate how urgently counselling psychology is needed to address firefighters\\u0026rsquo; dual burden of psychological and physical injury. Burns, smoke inhalation, and tiredness are examples of occupational traumas that impair psychological resilience in addition to physical competence. To normalise suffering, promote resilience, and reduce the stigma surrounding mental health care in emergency response professions, counselling psychologists must adopt trauma-informed practices. These practices should recognize the cumulative effects of repeated injuries.\\u003c/p\\u003e \\u003cp\\u003eAdditionally, preventive counselling services are especially important. The psychological effects of workplace dangers can be alleviated by integrating stress management training, resilience-building programmes, and psychoeducation into fire service organisations. The Job Demands\\u0026ndash;Resources concept highlights the necessity of replenishing personal resources to balance high occupational demands, which aligns with these proactive measures. Counselling psychology can lessen firefighters\\u0026rsquo; susceptibility to long-term psychological impairment by providing them with adaptive coping mechanisms.\\u003c/p\\u003e \\u003cp\\u003eMoreover, counselling services provided in the workplace also stand out as a crucial consequence. The establishment of counselling facilities at fire stations would provide prompt access to psychological assistance after occurrences involving injuries, promoting early intervention and lowering the likelihood of long-term dysfunction. Additionally, rehabilitation-focused counselling can help injured firefighters return to active duty by addressing issues such as identity reconstruction, diminished self-efficacy, and fears of re-injury, thereby fostering a smoother transition back to work.\\u003c/p\\u003e \\u003cp\\u003eThe study concludes by highlighting the advocacy function of counselling psychology in creating occupational health policy. Counselling psychologists can advocate for the inclusion of psychological services in injury management procedures, establishing the field as a vital player in the sustainability of the workforce. This expands the role of counselling psychology beyond traditional clinical environments in Ghana and other settings, strengthening its contribution to institutional resilience and public health.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eEthics Approval and Consent to Participate\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThis study was approved by the Institutional Review Board (IRB) at the University of Education, Winneba. The research was conducted in accordance with the guidelines and ethical standards of the University of Education, Winneba. All procedures involving human participants were performed in compliance with the ethical standards of the institutional and/or national research committee and with the 2024 Helsinki declaration on research involving human participants. Informed consent was obtained from all participants before data collection. Participants were informed of the study\\u0026rsquo;s purpose, procedures, and their right to withdraw at any time without penalty. Confidentiality of participants\\u0026rsquo; data was strictly maintained throughout the study.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent for Publication\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable. The study did not include any identifiable personal data, multimedia content, or sensitive materials requiring individual publication consent.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAvailability of Data and Materials\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe datasets generated and analysed during the current study on Impact of Occupational Injuries on Psychological Functioning of Firefighters in Northern Ghana are available from the corresponding author, John N-yelbi, upon reasonable request. To safeguard participant anonymity and in line with ethical guidelines, raw data will not be made publicly available but can be accessed under appropriate institutional oversight.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCompeting Interests\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors declare that he has no known competing interests of financial, personal, or otherwise that could have influenced the outcomes or interpretations of this study.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFunding\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThis research was completely self-funded by the authors. No external grants, sponsorships, or institutional financial contributions were obtained. The independence and objectivity of the study were fully upheld throughout the research process.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAcknowledgments\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors express sincere appreciation to all the firefighters who participated in this study. We are also grateful to my team of research assistants for their invaluable support in data collection and data analysis. \\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthor\\u0026rsquo;s Contribution\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eJN Conceived and designed the study; led the development of the research instrument; supervised data collection; performed statistical analyses; and prepared the initial draft of the manuscript. He also served as the corresponding author and coordinated the overall research process.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eCKH Contributed to the introduction and methodological framework; supported questionnaire validation and data interpretation; and reviewed and revised the manuscript critically for important intellectual content.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\n\\u003cli\\u003eAguma-Acon, J. (2012). Occupational health and safety in small scale industries in Uganda. \\u003cem\\u003eAfrican Newsletter on Occupational Health and Safety, 9\\u003c/em\\u003e(1), 46-48. \\u003c/li\\u003e\\n\\u003cli\\u003eAllen, M. (2017). \\u003cem\\u003eThe SAGE encyclopedia of communication research methods\\u003c/em\\u003e. SAGE. https://doi.org/10.4135/9781483381411\\u003c/li\\u003e\\n\\u003cli\\u003eAppiah, S. O. (2019). Working conditions and exposure to work related injuries and accidents at Kokompe-Accra Ghana. \\u003cem\\u003eGhana Journal of Geography, 11\\u003c/em\\u003e(2), 52-76.\\u003c/li\\u003e\\n\\u003cli\\u003eBunjak, A., Černe, M., Nagy, N., \\u0026amp; Bruch, H. (2023). Job demands and burnout: The multilevel boundary conditions of collective trust and competitive pressure. \\u003cem\\u003eHuman Relations\\u003c/em\\u003e, \\u003cem\\u003e76\\u003c/em\\u003e(5), 657-688.\\u003c/li\\u003e\\n\\u003cli\\u003eCafiadas-De la., F. G., Vargas, C., Lius, S. C., Garcia, I., Cafiadas, G., \\u0026amp; De la, F. E. (2015). Risk factors and prevalence of burnout syndrome in the nursing profession. \\u003cem\\u003eInt J Nur Stud, 52\\u003c/em\\u003e, 240-9. \\u003c/li\\u003e\\n\\u003cli\\u003eCampbell, R., \\u0026amp; Hall, S. (2023). United States firefighter injuries in 2022. National Fire Protection Association.\\u003c/li\\u003e\\n\\u003cli\\u003eCarlis-Paittoo, B. O. (2016). \\u003cem\\u003eOccupational related injuries and disabilities among operational fire fighters in Ghana\\u003c/em\\u003e (Master\\u0026rsquo;s thesis). Kwame Nkrumah University of Science and Technology.\\u003c/li\\u003e\\n\\u003cli\\u003eCasper, W. J., Vaziri, H., Wayne, J., DeHauw, S., \\u0026amp; Greenhaus, J. (2018). The jingle-jangle of work-nonwork balance: A comprehensive and meta-analytic review of its meaning and measurement. \\u003cem\\u003eJournal of Applied Psychology, 103\\u003c/em\\u003e(2),182-214. https: doi.org/10.1037/apl0000259\\u003c/li\\u003e\\n\\u003cli\\u003eD\\u0026rsquo;Amico, M. L., Jaffe, L. E., \\u0026amp; Gardner, J. A. (2018). Evidence for interventions to improve and maintain occupational performance and participation for people with serious mental illness: A systematic review. \\u003cem\\u003eAmerican Journal of Occupational Therapy, 72\\u003c/em\\u003e(5), 7205190020p1\\u0026ndash;7205190020p11. https://doi.org/10.5014/ajot.2018.033332\\u003c/li\\u003e\\n\\u003cli\\u003eDemerouti, E., Bakker, A. B., Nachreiner, F., \\u0026amp; Schaufeli, W. B. (2001). The job demands-resources model of burnout. \\u003cem\\u003eJournal of Applied Psychology\\u003c/em\\u003e, \\u003cem\\u003e86\\u003c/em\\u003e(3), 499.\\u003c/li\\u003e\\n\\u003cli\\u003eGarcia, J., Bazzocchi, M. C., Fite, K., Ocampo, J. D., \\u0026amp; Martinez, M. (2024). Review and statistical analysis of us structural firefighting injuries: Their causes and effects. \\u003cem\\u003eFire\\u003c/em\\u003e \\u003cstrong\\u003e7\\u003c/strong\\u003e(2), 46. https://doi.org/10.3390/fire7020046 \\u003c/li\\u003e\\n\\u003cli\\u003eGhana National Fire Service. 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(2020). \\u003cem\\u003eA descriptive cross-sectional study: Practical and feasible design in investigating health care-seeking behaviors of undergraduates\\u003c/em\\u003e. SAGE. Https://doi.org/10.4135/9781529742962\\u003c/li\\u003e\\n\\u003cli\\u003eJahnke, S. A., Poston, W. S. C., Haddock, C. K., \\u0026amp; Murphy, B. (2016). Firefighting and mental health: Experiences of repeated exposure to trauma. \\u003cem\\u003eJournal of Prevention, Assessment and Rehabilitation, 53\\u003c/em\\u003e(4), 737-744.\\u003c/li\\u003e\\n\\u003cli\\u003eKenny, D. T. (2017). \\u003cem\\u003eQuestionnaire: Injury workers\\u0026rsquo; perception of injured management\\u003c/em\\u003e. ResearchGate.\\u003c/li\\u003e\\n\\u003cli\\u003eKodom-Wiredu, J. K. (2018). 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J., Lopez, A., \\u0026amp; Ryan, F. O. C. (2021). Psychological well-being and retirement anxiety of selected Filippino middle-aged adults: A brief research report. \\u003cem\\u003ePhilippine Journal of Psychology\\u003c/em\\u003e. https://www.researchgate.net/publication/35968538410.31710/pjp/0054.02\\u003c/li\\u003e\\n\\u003cli\\u003eMarx, B. P., Schnurr, P. P., Lunney, C., Weathers, F. W., Bovin, M. J., \\u0026amp; Keane, T. M. (2020). \\u003cem\\u003eThe Inventory of Psychosocial Functioning (IPF).\\u003c/em\\u003e https://www.ptsd.va.gov.\\u003c/li\\u003e\\n\\u003cli\\u003eMbulingwe, E. S. (2014). Levels and influencing factors of noise pollution from small scale industries in a developing country. \\u003cem\\u003eJournal of Environmental Management, 33\\u003c/em\\u003e(6), 830-839.\\u003c/li\\u003e\\n\\u003cli\\u003eMock, C., Adjei, S., Acheampong, F., Deroo, L., \\u0026amp; Simpson, K. (2005). 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What is loss aversion? \\u003cem\\u003eJournal of Risk and Uncertainty, 30\\u003c/em\\u003e, 157-167.\\u003c/li\\u003e\\n\\u003cli\\u003eStanley, I. H., Boffa, J. W., Hom, M. A., Kimbrel, N. A., \\u0026amp; Joiner, T. E. (2017). Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters. \\u003cem\\u003eThe Journal of Psychiatric Research, 247\\u003c/em\\u003e, 236-242. http://dx.doi.org.ezproxylocal.library.nova.edu/10.1016/j.psychres.2016.11.037\\u003c/li\\u003e\\n\\u003cli\\u003eSzubert, Z., \\u0026amp; Sobala, W. (2002). Work-related injuries among firefighters: Sites and circumstances of their occurrence. \\u003cem\\u003eInternational Journal of Occupational Medicine and Environmental Health\\u003c/em\\u003e. https://www.researchgate.net/publication/11333955\\u003c/li\\u003e\\n\\u003cli\\u003eTheuri, C. K. (2012). Small-scale enterprises and the informal sector in Kenya. \\u003cem\\u003eAfrican Newsletter on Occupational Health and Safety, 23\\u003c/em\\u003e(2), 32-34.\\u003c/li\\u003e\\n\\u003cli\\u003eTorchalla, I., \\u0026amp; Strehlau, V. (2018). The evidence base for interventions targeting individuals with work-related PTSD: A systematic review and recommendations. \\u003cem\\u003eBehavior \\u003c/em\\u003e\\u003cem\\u003eModification, 42\\u003c/em\\u003e(2), 273-303. https://doi.org/10.1177/0145445517725048\\u003c/li\\u003e\\n\\u003cli\\u003eWorede, E.A., Yesuf, K., Demoze, L\\u003cem\\u003e.\\u003c/em\\u003e Yitageasu, G., \\u0026amp; Bitew, B.D. (2025). Work-related injury characterization and factors among fire brigade workers in Ethiopia. \\u003cem\\u003eSci Rep\\u003c/em\\u003e \\u003cem\\u003e15\\u003c/em\\u003e, 12401. https://doi.org/10.1038/s41598-025-96776-z\\u003c/li\\u003e\\n\\u003c/ol\\u003e\"},{\"header\":\"Tables\",\"content\":\"\\u003cp\\u003eTables 1 to 3 are available in the Supplementary Files section.\\u003c/p\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-public-health\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"pubh\",\"sideBox\":\"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/pubh/default.aspx\",\"title\":\"BMC Public Health\",\"twitterHandle\":\"@BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Occupational injuries, psychological functioning, firefighters\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-8819741/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-8819741/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003eThe purpose of the study was to examine the influence of occupational injuries on psychological functioning of firefighters in Northern Ghana. It looked at types of occupational injuries and the extent to which occupational injuries influence psychological functioning. The study employed a quantitative approach underpinned by cross-sectional survey design. The target population comprised firefighters in Ghana. A total of 642 firefighters were sampled using stratified and simple random sampling. Inventory of Psychosocial Functioning and Work Injury Questionnaire was adapted and used for data collection. Data was analysed using means and standard deviation and multiple regression. The study found that firefighters experience occupational injuries such as sprain and strain, exhaustion, thermal burns, fainting and smoke inhalation. Also, the study reported a significant negative association between occupational injuries and psychological functioning. It is recommended that firefighters be given modern personal protective equipment that reduces the danger of burns and exposure to hazardous materials. 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