Female Firefighters Research Articles

Firefighters' feet: Differences by sex and weight-bearing

Firefighters have reported their protective boots to be bulky and ill-fitting, which they believe restrict the lower body movement on the unpredictable fireground. This study used 3D foot scanning to compare the shape of firefighters' feet to the general population, the shape of female firefighters’ feet to males, and the impact of the heavy fire gear on foot shape. The results found the foot breadth of firefighters was larger than the general population and the feet of female firefighters were slimmer than males. Furthermore, it revealed that the feet of firefighters became longer, wider, and flatter when bearing the weight of fire gear. Protective boots should be designed based on the foot shape and dimensions of the actual population, with consideration of sex differences and the impact of weight-bearing for their safety.

Hemostatic Responses to Multiple Bouts of Firefighting Activity: Female vs. Male Differences in a High Demand, High Performance Occupation.

While the fire service has long been a male-dominated occupation, women’s participation in this strenuous, high risk, high performance activity has increased in recent years. Firefighting induces significant cardiovascular strain, including hemostatic disruption; however, the effect of sex on hemostatic responses has not been investigated despite evidence that there are sex-related differences in hemostatic variables at rest and following exercise. Thus, we investigated hemostatic responses in age- and BMI-matched male and female firefighters who performed 3–4 evolutions of firefighting drills over a 3 h period. Venous blood samples were collected before and after the firefighting training drills and hemostatic variables were assessed. Firefighting significantly increased platelet count and factor VIII, tissue plasminogen activator (t-PA) antigen, and t-PA activity, and decreased activated partial thromboplastin time and plasminogen activator inhibitor (PAI-1) activity. Females had lower values for epinephrine-induced platelet closure time, antithrombin III, PAI-1 activity, and PAI-1 antigen. There were no interactions between sex and time for any variables assessed. In conclusion, multiple bouts of firefighting activity resulted in a procoagulatory state. Although there were sex differences for several hemostatic variables, male and female firefighters did not differ in their hemostatic response to multiple bouts of firefighting.

Heat tolerance during uncompensable heat stress in men and women wearing firefighter personal protective equipment

Firefighters run a risk of heat strain during occupational tasks. The number of female firefighters has been increasing, but research relevant to this group is still scarce. We aimed to investigate whether there are any sex differences in heat tolerance or physiological responses during uncompensable heat stress while wearing firefighter personal protective equipment. Twelve female (28 ± 7 years, 66 ± 5 kg, 51.7 ± 4.7 mL kg−1 min−1) and 12 male (27 ± 7 years, 83 ± 8 kg, 58.8 ± 7.5 mL kg−1 min−1) participants performed walking (maximum of 60 min) at 6W·kg−1, 40 °C, and 14% relative humidity. No differences were observed between groups in heat tolerance, rectal temperature, heart rate, percent body mass loss, thermal sensation, and rate of perceived exertion. Thus, when personnel are selected using gender-neutral physical employment standards, sex is not an independent factor influencing heat tolerance when wearing firefighter personal protective equipment during uncompensable heat stress.

Impact of SARS-CoV-2 on saliva: TNF-⍺, IL-6, IL-10, lactoferrin, lysozyme, IgG, IgA, and IgM

ObjectivesUnderstanding the role of certain salivary components, such as TNF-⍺, IL-6, IL-10, lactoferrin, lysozyme, IgG, IgA, and IgM, in airway defense during the ongoing SARS-CoV-2 pandemic is essential. The salivary immune barrier of patients with COVID-19 may play a role in their prognosis. The present study aims to evaluate the impact of SARS-CoV-2 on saliva composition. MethodsA longitudinal study was carried out with male and female firefighters aged 24–48 years. The study sample (n = 34) was divided into 3 groups: asymptomatic volunteers with a negative polymerase chain reaction (PCR) test for SARS-CoV-2 (group 1, Control, n = 21); patients with symptoms of COVID-19 of less than 7 days’ duration and a diagnosis of SARS-CoV-2 infection by PCR (group 2, COVID-19, n = 13); and recovered patients from group 2 who were free of COVID-19 symptoms for at least 2 months (group 3, post-COVID-19 recovery, n = 13). All groups underwent real-time PCR to detect the presence of SARS-CoV-2, as well as analysis of the salivary concentrations of TNF-⍺, IL-6, IL-10, lactoferrin, lysozyme, IgG, IgA, and IgM by the ELISA method. ResultsLactoferrin concentrations were significantly decreased in the infected group (COVID-19) when compared to those not infected by SARS-CoV-2 (control) (p = 0.032). IgA concentrations were decreased in the COVID-19 and post-COVID-19 groups compared to the control group (p = 0.005 and p = 0.016, respectively). Comparison of the COVID-19 and post-COVID-19 groups also revealed an increase in IgM concentrations during acute SARS-CoV-2 infection (p = 0.010). ConclusionSARS-CoV-2 alters the composition of the salivary immune barrier.

The experience of reproductive planning of female military firefighters

RESUMO Objetivo: Compreender o vivido do planejamento reprodutivo de bombeiras militares profissionais da saúde. Método: Investigação fenomenológica sob o referencial teórico-filosófico e metodológico de Martin Heidegger. Desenvolvida em unidades de Corpo de Bombeiros do Rio de Janeiro no primeiro semestre de 2016 com 21 mulheres militares profissionais da saúde. Resultados: As mulheres expressaram que é necessário trabalhar e conciliar os papéis. Por isso, têm que se programar para ter filho devido à dificuldade de administrar todos os afazeres e conciliar a maternidade com o trabalho. Elas pensam numa situação mais confortável para se dedicar aos filhos, sendo elas as principais responsáveis por eles. Conclusões: Ações de saúde integral das mulheres militares necessitam ser incluídas nas políticas públicas, pois é um grupo que vem participando cada vez mais em um ambiente anteriormente restrito aos homens e com características relacionadas a eles.

The experience of reproductive planning of female military firefighters.

To understand the experience of reproductive planning of female military firefighter health professionals. Phenomenological research under the theoretical-philosophical and methodological framework of Martin Heidegger. Developed in Fire Department units in Rio de Janeiro in the first half of 2016, with 21 female military health professionals. Women expressed that it is necessary to work and manage roles. Therefore, they have to plan to have a child, due to the difficulty of managing all the tasks and reconciling motherhood with work. They think of a more comfortable situation to dedicate themselves to their children, since they are the main responsiblefor them. Comprehensive health actions for military women need to be included in public policies, as it is a group that has been increasingly participating in an environment previously restricted to men and with their characteristics.

Organophosphate and Organohalogen Flame-Retardant Exposure and Thyroid Hormone Disruption in a Cross-Sectional Study of Female Firefighters and Office Workers from San Francisco.

Occupational exposures to flame retardants (FRs), a class of suspected endocrine-disrupting compounds, are of health concern for firefighters. We sought to characterize exposure to FR compounds and evaluate their association with thyroid hormone levels, a biomarker of early effect, in female firefighters and office workers in San Francisco. In a cross-sectional study, we measured replacement organophosphate and organohalogen FRs in spot urine samples from firefighters (N = 86) and office workers (N = 84), as well as total thyroxine (T4) and thyroid-stimulating hormone in plasma for 84 firefighters and 81 office workers. Median bis(1,3-dichloro-2-propyl)phosphate (BDCPP) levels were 5 times higher in firefighters than office workers. Among firefighters, a doubling of BDCPP was associated with a 2.88% decrease (95% confidence interval −5.28, −0.42) in T4. We did not observe significant associations between FRs and T4 among office workers. In the full group, intermediate body mass index and a college education were associated with higher FR levels. The inverse association observed between FRs and T4 coupled with the lack of studies on women workers and evidence of adverse health effects from FR exposure—including endocrine disruption and breast cancer risk—warrant further research on occupational exposures and identification of opportunities for exposure reduction.

Effect of live-fire training on ventricular-vascular coupling

Cardiovascular events are a leading cause of firefighter duty-related death, with the greatest risk occurring during or shortly after fire suppression activity. Increased cardiovascular risk potentially manifests from detrimental changes in ventricular function, vascular load, and their interaction, described as ventricular-vascular coupling. To determine the effect of live-fire training on ventricular-vascular coupling. Sixty-eight male (28 [Formula: see text] 7years, 26.9 [Formula: see text] 3.9kg/m2) and fifteen female (36 [Formula: see text] 8years, 24.3 [Formula: see text] 3.9kg/m2) firefighters completed hemodynamic and cardiac measures before and after 3h of intermittent live-fire training. Left ventricular function was assessed as ejection fraction (EF) and ventricular elastance (ELV: end systolic pressure [ESP]/end systolic volume) via echocardiography and applanation tonometry-estimated ESP. Vascular load was assessed as arterial elastance (EA: ESP/stroke volume [SV]). Ventricular-vascular coupling (VVC) was quantified as the ratio of EA to ELV and indexed to body surface area (EAI, ELVI). Following firefighting EF decreased (p < 0.01) with no change in ELVI (p = 0.34). SV decreased (p < 0.01) with no change in ESP (p = 0.09), driving a significant increase in EAI (p < 0.01). These changes resulted in a significant increase in the VVC ratio (p < 0.01). The findings suggest that firefighting does not alter ventricular elastance but increases arterial elastance in healthy firefighters, resulting in a mismatch between ventricular and vascular systems. This increase in ventricular-vascular coupling ratio and concomitant reduction in ventricular systolic function may contribute to increased cardiovascular risk following live firefighting.

Selected movement and force pattern differences in rail- and rung-climbing of fire apparatus aerial ladders at 52.5° slope

This study compares human climbing performance, including climbing speed and movement and force patterns, between rail- and rung-climbing styles for a moderate aerial ladder slope (52.5°). Hand and foot movements and forces were recorded for 9 male and 10 female firefighters as they ascended and descended a 3.4-m ladder using elevated handrails (rail-climbing) or rungs (rung-climbing) for hand support. The results indicated that climbers used three or more points of contact 54% of the time for rung-climbing and 100% of the time for rail-climbing. Furthermore, rail-climbing was 10% faster than rung-climbing. In rail-climbing, the lateral hand forces were mostly directed away from the body; while during rung-climbing, they were alternated in lateral and medial directions. Overall, the results suggested that rail-climbing provides better control over body positioning and faster climbing speed. Furthermore, the continuous contact of both hands in rail-climbing may reduce the fall risk by facilitating the recovery from a slip or perturbation.

A non-targeted approach to identify potential breast carcinogens in women firefighters after a fire event

BACKGROUND AND AIM: Female firefighters remain understudied in both exposure and epidemiology studies. Furthermore, occupational studies generally focus on toxic chemicals that are well characterized. The objective of this study was to identify potentially novel chemical exposures associated with a fire event among female firefighters. METHODS: We applied non-targeted analysis methods to three longitudinal serum samples collected in the days and weeks after a fire. To assess exposure to potential breast carcinogens among women workers after an urban structural fire event the Women Workers Biomonitoring Collaborative (WWBC), we recruited female firefighters in San Francisco and developed a biospecimen archive. Female firefighters (n=18) were recruited and provided 3 serum samples—within 48 hours, 1 week, and 1 month after fighting a fire. We applied a non-targeted analytical approach with liquid chromatography quadrupole time of flight mass spectrometry (LC-QTOF/MS) in both the positive and negative ionization modes. RESULTS:We detected over 20,000 features, representing potential chemical exposures in study participants. Exact masses of features were matched to a curated in-house library of 7,935 environmental chemicals and potential breast carcinogens, tentatively identifying 1,667 chemicals. MS/MS fragmentation analysis allowed us to further confirm 181 candidate chemicals based on the predicted fragmentation pattern of each chemical. These chemicals included per-/poly-fluoroalkyl substances, endocrine disrupting chemicals and chemicals associated with mammary tumor development. We will confirm the identity of at least 5 of these novel chemicals by re-running the samples with known standards. CONCLUSIONS:Non-targeted analytical approaches in carefully designed exposure studies can help “look beyond the lamp post” to identify novel exposures with health concerns. KEYWORDS: non-targeted analysis, generalized suspect screen, occupational exposures, internal exposome

Organophosphate and organohalogen flame retardant exposure and thyroid hormone disruption in women firefighters and office workers from San Francisco

BACKGROUND AND AIM: Organophosphate flame retardants (OPFR) are suspected endocrine disrupting compounds and have been detected in fire station dust and firefighter gear. Studies have reported that exposure to FRs can disrupt thyroid hormone (TH) function; however, this relationship is not well characterized, especially for halogenated OPFRs. TH is important for thyroid mediated gene expression and may be relevant to adverse health effects such as cardiovascular disease and cancer. We describe OPFR exposure and its association with TH levels in a cohort of women firefighters and office workers from San Francisco. METHODS: Using liquid chromatography-tandem mass spectrometry (LC MS/MS), we measured 8 urinary FR metabolites in female firefighters (N=86) and office workers (N=84) from San Francisco: bis(1,3-dichloro-2-propyl) phosphate (BDCPP), bis(2-chloroethyl) phosphate (BCEP), dibutyl phosphate (DBuP), dibenzyl phosphate (DBzP), di-p-cresyl phosphate (DpCP), di-o-cresyl phosphate (DoCP), 2,3,4,5-tetrabromobenzoic acid (TBBA), tetrabromobisphenol-A (TBBPA). We assessed potential predictors of exposure levels and the association between FR exposures and thyroxine (T4) and thyroid stimulating hormone (TSH) for 84 Firefighters and 81 office workers. RESULTS:BDCPP, BCEP and DBuP had the highest concentrations among all study participants. However, firefighters had higher median exposure levels of BDCPP, BCEP and DBuP compared to office workers. When we assessed the association of each FR with TH we found that a doubling of BDCPP was associated with a 2.88% decrease (95%CI -5.28,-0.42) in T4 among firefighters. We did not observe significant associations between FR and T4 among office workers nor between FR and TSH in either firefighters or office workers. CONCLUSIONS:Firefighters had significantly higher exposures to FR compared to office workers and their exposure to BDCPP was associated with TH disruption. Characterizing exposure to endocrine disrupting chemicals and assessing the association with biomarkers of early effect such as TH can inform prevention efforts without having to wait for adverse health outcomes to occur. KEYWORDS: occupational exposures, women firefighters, endocrine disruption

Cardiometabolic health among United States firefighters by age

Firefighting is strenuous work that results in considerable cardiovascular strain. Sudden cardiac events are the leading cause of duty-related death in the fire service. This cross-sectional study examined cardiometabolic measures and prevalence of risk factors in firefighters by age and sex and compare these data to the general population. Data obtained at medical exams (2015–2018) from 4279 male and 234 female career firefighters at four occupational health clinics in the United States were analyzed. Estimates for the general population were obtained using the 2015–16 National Health and Nutrition Examination Survey fasting subsample. Linear regression models stratified by sex with age modelled as a continuous variable were used to examine general trends. Point estimates across age groups (20–29, 30–39, 40–49, and 50–59 year olds) for cardiometabolic measures were reported. Among the total sample, 36% were obese and 25% had low HDL cholesterol. Females had significantly lower body mass index (BMI), LDL cholesterol, triglycerides and blood glucose than males. A significant quadratic relationship of age with BMI, total cholesterol, LDL cholesterol, and triglycerides was found in males with increasing values peaking between 45 and 50 years. Total cholesterol and LDL cholesterol increased with age among females. Blood glucose increased with age in both sexes. Firefighters had similar or better cardiometabolic health profiles than the US general population; however, both samples had a concerning prevalence of cardiometabolic risk factors among individuals ≥ 40 years of age. Health professionals and fire service members alike should consider prevention efforts among young firefighters and better treatment among older firefighters.

Hypertension in the United States Fire Service.

Hypertension is a major risk factor for atherosclerotic cardiovascular disease and cardiac remodeling and is associated with an increased risk of sudden cardiac events, the leading cause of duty-related death in the fire service. We assessed systemic blood pressures and prevalence of hypertension among US firefighters by decade of life. Medical records of career firefighters (5063 males and 274 females) from four geographically diverse occupational health clinics were assessed. Hypertension was defined as systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg, or taking antihypertensive medication. Results from the firefighter sample were compared to the US general population (2015–2016 and 2017–2018 National Health and Nutrition Examination Surveys). Among the total sample, 69% of firefighters met the criteria for hypertension and 17% were taking antihypertensive medications. Percentages of hypertensive male and female firefighters were 45% and 11% among 20–29 years old, respectively, and increased to 78% and 79% among 50–59 years old, respectively. Compared to the general population, male firefighters had a higher prevalence of hypertension (p < 0.05) across all age groups (11–16% higher). In order to improve firefighter health and protect against sudden incapacitation in this public safety occupational group, increased efforts are necessary to screen for and manage high blood pressure.

Are there sex differences in physiological parameters and reaction time responses to overload in firefighters?

Male and female firefighters work side-by-side in the same in strenuous and risky conditions. Anthropometrics, physiological, and reaction time (mean of reaction time -MRT-, and errors made -E) parameters of 12 Female and 13 Male firefighters were compared. Effect of overload (step test with and without equipment) on the MRT and E were analyzed on 3 trials (T1 = 1-1s, T2 = 0.5-1s, T3 = 0.5-0.5s), compared with a pre-test condition (basal). T-test between males and females was applied to assess differences (p<0.05) in all parameters. ANOVA with repeated measures and Bonferroni on 3 conditions of step test between males and females was applied in reaction time variables. Between MRT and E, in T1, T2 and T3 trials and the 3 test conditions, ANCOVA models with interactions were used. Differences (p<0.05) in anthropometric, physiological and reaction time data emerged across groups, and on the 3rd trials (T3 vs T1 and T2) in reaction time parameters of each group. ANCOVA showed differences (p<0.001) in E among trials. Post hoc showed significant differences in T1vsT3 and T1vsT2. MRT x trial interaction was extremely significant (P<0.001). Implementing fitness and reaction time exercise programs is important to decrease the injury risk and increase work capacity in firefighters with reference to female workers.

Job Satisfaction Differences by Gender Role Identity among Female Firefighters

This study was conducted to prepare fundamental data, improve job satisfaction, and assess the job satisfaction differences by gender role identity among female firefighters. This study was carried out through a structured self-administered questionnaires survey among 193 female firefighters in a fire station in Kyeong-Nam province. The independent variable was gender role identity type (30 items), and the dependent variable was job satisfaction (33 items). The collected data was analyzed using the SPSS (IBM. Ver. 25.0) statistical package program. There was a positive effect of both types in gender role identity on job satisfaction among female firefighters. When controlling the independent variable affecting job satisfaction, the level of job satisfaction was higher in both types of gender role identity than other factors.

Lead contamination among Paris Fire Brigade firefighters who fought the Notre Dame Cathedral fire in Paris.

On 15th April 2019, the fire at Notre Dame Cathedral, Paris, resulted in the melting of 410 tons of lead. Four hundred fourteen Paris firefighters were involved. For the purpose of preventive medicine, the level of lead contamination among the firefighters was assessed. This study objectives' were to describe the blood lead levels (BLLs) in the firefighters, to study the influence of some parameters such as the function of firefighters and the decrease in BLLs during the follow-up investigations. The emission of 138kg of melted lead from the roof and spire of the Notre Dame Cathedral during the fire was estimated by the National Institute for Industrial Environment and Risks. Three categories were defined according to the estimated levels of external lead exposure and fire proximity: high (category 1, n=170), medium (category 2, n=151), and low (category 3, n=93). Two to three weeks after the fire, blood samples to assess the BLLs were taken from firefighters in category 1 (N=164) and from every female firefighter in category 1 and 2 (N=4). When the BLL was above 50μg/L (95th percentile of reference range concentrations for a sample of the French population), it was checked again at one month later (N=31) and then, if still above 50μg/L, at six months later (N=10). The geometric mean of initial blood lead level was 31.5μg/L (CI 95% [27.7-35.9]; Min-Max: 7.0-307.6μg/L). Twenty-five percent (n=42) of initial BLLs were above 50μg/L, versus 10% (n=16) at 1 month, and 2% (n=3) at 6 months. The French binding biological BLL limit value (400μg/L for men and 300μg/L for women was never exceeded and all BLLs decreased over time. BLLs varied according to the function occupied during the extinguishing of the fire: operators', officers' and those of unknown function. BLLs were significantly higher compared to drivers reflecting their lower distance to fire and fume. The fire at Notre Dame Cathedral, Paris, resulted in moderate lead contamination among firefighters. Individual and collective protection measures probably helped to limit the contamination. Nevertheless, an effort could be made to improve the working conditions by rethinking the respiratory protection.

Cardiorespiratory fitness assessment among firefighters: Is the non-exercise estimate accurate?

Minimum cardiorespiratory fitness (CRF) has been recommended for firefighters due to job requirements. Thus, it is important to identify accurate and readily available methods to assess CRF in this population. Non-exercise CRF estimates (NEx-CRF) have been proposed but this approach requires validation in this population. To evaluate the accuracy of a NEx-CRF, as compared to a field maximum exercise test, among career military firefighters of both genders using a comprehensive agreement analysis. We evaluated the accuracy of a NEx-CRF estimate compared to the Cooper 12 min running test among 702 males and 106 female firefighters. Cooper and NEx-CRF tests yielded similar CRF in both genders (differences <1.8±4.7 ml/kg-1.min-1; effect size <0.34). However, NEx-CRF underestimated Cooper-derived CRF among the fittest firefighters. NEx-CRF showed moderate to high sensitivity/specificity to detect fit or unfit firefighters (71.9% among men and 100% among women). Among men, the NEx-CRF method correctly identified most firefighters with less than 11 METs or greater than 13 METs, but showed lower precision to discriminate those with CRF between 11-13 METs. The NEx-CRF method to estimate firefighters' CRF may be considered as an alternative method when an exercise-based method is not available or may be used to identify those who require more traditional testing (CRF 11-13 METs).

Factors Influencing the Mental Health of Firefighters in Shantou City, China.

BackgroundFirefighters are routinely exposed to occupational stress and are therefore vulnerable to psychological problems.Patients and MethodsThis study assessed the prevalence of mental health symptoms and potential contributing factors in a sample of firefighters in Shantou city, in the Guangdong Province of China. We conducted a cross-sectional survey with 335 firefighters, including 329 male and 6 female firefighters. We used a questionnaire which assessed anxiety and depression, as indicated by the Zung Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), as well as other mental health symptoms, using the Symptom Checklist-90 (SCL-90). Basic information and potential-related factors were also collected.ResultsThe average age of participants was 27.38 (SD ± 6.11) years. Assessed by the indexed score of different scales, SAS and SDS positive screening rates were 6.86% and 22.68%, respectively. SCL-90 scores indicated that 6.86% of participants had mental health symptoms. Logistic regression analysis showed that educational level, firefighter rank, and birth order were associated with mental health outcomes. Firefighters in Shantou were also shown to have better mental health outcomes than the Chinese military, but worse than the national population of firefighters.ConclusionThese findings indicated the mental health of firefighters is not good. It is necessary to explore effective approaches to help preventing and treating mental disorder in firefighters.

Tobacco use in female firefighters

Tobacco use in female firefighters

Physical fitness levels of South Korean national male and female firefighters

Background/ObjecitvesFire-fighting is highly required with aerobic fitness, strength, and body composition. However, there is a lack of comprehensive physical fitness data for South Korean firefighters. The purpose of this study was to collect fundamental data obtained with precise methods to compare with previously reported values form other countries. MethodsA total of 102 Korean national firefighters (84 males and 18 females) participated in this study. A graded exercise test was performed to measure the VO2max of the participants. Muscle strength and muscular endurance of the knees, shoulders, and trunk were measured with an isokinetic dynamometer and grip strength was measured using a grip dynamometer. DXA was utilized for body composition measurements. ResultsThe VO2max of the Korean male firefighters was 42.27 ml/kg/min and it was 35.93 ml/kg/min in the female firefighters. The right and left shoulder peak torque values were 103.1 Nm and 93.3 Nm in male firefighters and the torques in the female firefighters were 37.5% and 37.4% of those values, respectively. The grip strength of male and female firefighters was 49.9 kg and 30.8 kg. The body fat percentage of the male firefighters was 25.1% and it was 33.4% for female firefighters ConclusionIn our study, the Korean firefighters had relatively lower levels of physical fitness compared to different country's firefighters. The Korean National Fire Agency may reconsider modifying physical fitness test standards or making exercise guidelines to conform to published standards.