New Findings from Paramedic Services Risk Assessment & Root Cause Analysis Project to Inform Future Prevention Efforts for the Paramedic Sector
calendar icon May 24th, 2022
New Findings from Paramedic Services Risk Assessment & Root Cause Analysis Project to Inform Future Prevention Efforts for the Paramedic Sector

The two-part, industry-led project supports the sector in preventing workplace injury and illness by identifying the high-risk hazards workers are most exposed to and developing solutions to mitigate risk.


TORONTO – Public Services Health & Safety Association (PSHSA) is pleased to release the findings of the Paramedic Services Risk Assessment and Root Cause Analysis project. The purpose of the project was to support the sector in preventing injury and illness by identifying the occupational health and safety hazards that paramedics and ambulance communication officers are most exposed to, understanding the associated risks and root causes, and developing solutions to mitigate, control or eliminate risk.


The two-part project involved a risk assessment which was completed in Fall 2021 and a root cause analysis which was completed in Winter 2022. The project utilized a “by the industry, for the industry” approach, securing a balance of perspectives across Ontario’s land and air ambulance services including sector representatives serving urban, rural and remote communities (labour and employer), individuals with lived experience, clinicians, health and safety professional and representatives from academia and provincial government.


For the risk assessment, stakeholders came together to identify a comprehensive list of hazards they perceived paramedics faced in the workplace. In the end, a total of 105 hazards were identified. The stakeholders rated each hazard according to its likelihood and consequence to determine overall risk rating for all hazards: 48 were found to be high-risk, 54 medium-risk and 3 low-risk.


Post-traumatic stress disorder (PTSD) injuries were identified as the top hazard. Risks involving ambulance design, equipment concerns, workplace violence, traffic protection and fatigue rounded out the top ten.


Ontario’s EMS Section 21 Sub-Committee reviewed the top ten hazards which resulted from the first project phase and selected the top identified hazard – PTSD injuries – to be explored in the second phase of the project.


For the second phase, another group of stakeholders identified root causes fundamental to the elimination and control of exposures to events that can lead to psychological harm which can seriously impact the paramedic services worker, their families, the public and the service. The focus was on the occupations of paramedics providing patient care and ambulance communication officers. The stakeholders documented 36 primary causal factors and rated their relative importance to determine the top 12. A total of 150 unique solutions and controls for the top 12 primary causal factors were then identified as possible interventions that can be taken to reduce the risk of psychological harm to workers.


Updating training for workplace violence, psychological health and safety, resiliency, stay at work and return to work, providing trauma-informed and paramedic-specific mental health supports, and increasing collaboration between educational institutions, base hospital programs and service providers on training, mentorship and program development were found to be among the top themes that emerged from the list of possible solutions and controls. Stakeholders including paramedic services and Central Ambulance Communication Centres, unions, the Ontario Association of Paramedic Chiefs, Ministry of Health, Ministry of the Solicitor General, colleges, municipalities, clinicians and WSIB are identified as potential partners to help action each of the identified solutions.


Comprehensive reports for both project phases detailing additional background, methodology, findings and recommendations for next steps can be accessed at


Ontario has over 11,000 Paramedics, 1200 Communications Officers and more than 2000 Support Staff who handle 1.75 million emergency calls every year (Ontario Paramedic Association). “From a WSIB premium perspective, paramedic services jobs are one of the highest risk occupations among the sectors PSHSA represents. The paramedic sector also has high rates and risk of work-related mental health injury as evidenced by WSIB data and research,” said Tanya Morose, Director of Prevention, Retention and Engagement for Public Safety at PSHSA. “Results of this project will help to inform future prevention efforts and workplace health and safety programming for the paramedic sector.”


The release of these two reports coincides with the annual National Paramedic Services Week which takes place May 22-28, 2022. This year, the week recognizes the many “Faces of Paramedicine”, acknowledging the many people and various specialties that make the paramedic profession successful in delivering out-of-hospital care in both acute and non-acute environments.


PSHSA thanks all project participants for their involvement and invaluable contributions.


For additional information about this project, please contact:


Tanya Morose

Director, Prevention, Retention and Engagement, Healthcare and Public Safety

Public Services Health & Safety Association