Pittsburgh paramedics rejected the latest contract offered by the city on Friday.
Some 134 workers nearly unanimously voted against the latest proposal, according to a press release from the Fraternal Association of Professional Paramedics, Local One. Only nine voted in favor of it.
The vote gives the workers authority to go on strike, but union leaders said there is no timetable for a walkout.
Paramedics have now been working without a contract for two years.