Linkage of occupational history records and medical screening examinations as a tool for assessing the long-term health impacts of wildland firefighting

Abstract

Background. Wildland firefighters (WFFs) work under intense and demanding conditions in the protection of human health, life, and property. Air pollutant exposures, heat, noise, disrupted sleep, emotional and psychological stress, and extreme physical exertion each may have short-term consequences for WFFs. Although countless population-based studies have established the long-term consequences of these exposures individually, to date little research has been devoted to their chronic effects in WFFs. The health and fitness of WFFs and the duration and intensity of their varied exposures combined with their limited use of personal protective equipment make WFFs a unique population in need of study. Methods. Occupational history as a WFF was assessed using Incident Qualification and Certification System (IQCS) responder records. These records contain information on specific fires to which a WFF was assigned, the duration of the assignment, and jobs for which a WFF is qualified and the number of times those jobs were performed. IQCS records were linked to Department of the Interior Wildland Fire Medical Standards Program medical screening examinations performed between 2014 and 2017. Results. Between 2014 and 2017, over 10,000 prospective and current WFFs completed comprehensive medical screening examinations to determine fitness for arduous duty firefighting. The median age was 33 years, and 85% of participants were male. Measured median systolic and diastolic blood pressures were 122 and 78 mm Hg, respectively, and 13% had an abnormal resting electrocardiogram. Forty-one percent of participants had available IQCS occupational history records.Conclusions. Preliminary analyses emphasized cardiovascular health among WFFs, and future work will investigate other health measures and their association with occupational history. The project establishes a framework for expanded studies of the occupational health risks linked to wildland firefighting, and findings have the potential to guide future screening and surveillance programs.