Occupational Safety and Health Issue Addressed. Musculoskeletal injuries consistently account for about half of all injuries to firefighter/paramedics engaged in emergency medical services (EMS) operations as well as to EMS workers in the private sector. These injuries result in lost work time, permanent disability, and high worker compensation costs. The tasks performed during EMS runs that place these workers at risk for serious sprain and strain injuries include lifting and carrying patients for transport to the hospital. This problem becomes more serious as the population becomes more obese and the weight of the load increases. In previous research conducted by us with funding from NIOSH, we identified and quantified the most high-risk EMS job tasks in need of ergonomic intervention. These tasks involved transporting patients down stairs and lateral patient transfers. Purpose of the Study. The purpose of this NIOSH-funded study was to design, build, and evaluate EMS ergonomic interventions that reduce biomechanical loads on the back and are considered worthy of adoption for use by firefighter/paramedics who transport patients during EMS operations. We used a participatory ergonomic process, engaging fire chiefs and firefighter/paramedics throughout the study. The goal of our work is to translate the product of this research into practice. Methods and Findings by Phase of Study. In Phase 1 of this four-phase study, we conducted focus groups with firefighter/paramedics to generate concept ideas for EMS patient handling devices and task method changes to address the problematic job tasks identified in our earlier research. The focus group participants specified the criteria for what would be considered a useable product and brainstormed concepts while an industrial designer sketched their ideas. Of the 20 concepts generated, the voted top 10 were considered in the following phase. In Phase 2 of the study, prototype EMS devices were produced by us, acquired from inventors, or purchased and modified. Lab testing of simulated stair-descent and lateral transfer tasks was conducted in Phase 3 with 11 two person teams of firefighter/paramedics. Measures included levels of muscle use (EMG for 8 trunk muscles), heart rate, spine postures and movements, and ratings of perceived exertion. In this phase, we used a repeated measures experimental design to examine the relative effectiveness of new EMS devices compared to the existing approaches in reducing biomechanical loads. The sequencing of the experiments was randomized for each team, as was the sequencing of the experimental versus control condition. Five EMS devices that we designed showed positive EMG results, as did 2 prototype devices acquired from other inventors. One device and a task method change showed either non-significant changes or increases in muscle activity. Results for other outcome measures showed similar patterns to the EMG results. In Phase 4 we pursued commercialization opportunities for those EMS devices that we designed and that showed a biomechanical advantage in our lab tests. We gathered stakeholder input during feedback meetings at the engineering facility as production-ready devices were being developed. Finally, we obtained continuing stakeholder input during this phase as we conducted focus groups to gather information on how to facilitate dissemination and adoption of new EMS devices into practice. How the Findings Advance the Research. Other than the work we have conducted, little research exists documenting the specific job tasks that pose risk for serious musculoskeletal injury associated with EMS transport of patients. Our research suggests ergonomic interventions that may help reduce the risk of injury to this worker population and offers ideas and suggestions for further research. How the Results can be Utilized in the Workplace. By sharing our results with the end-users and pursuing the commercialization of the promising EMS devices that we designed, we hope to have a direct impact on reducing the risk for musculoskeletal injury in our target population. Unlike health care workers in an institutional setting, firefighter/paramedics and other EMS workers work in an uncontrolled environment where engineering controls are less feasible. Finding simple, ergonomically designed EMS devices that can be stowed in a small space on an ambulance, are affordable, are quick to assemble, and easy to carry and clean are features identified as essential by this public safety services group. Our EMS devices were developed with these criteria in mind. Recently, the university entered into a licensing agreement with an engineering firm to produce four of the five devices developed during this research project (Backboard Footstrap, Bridgeboard, Transfer Rod, and Transfer Sling).