Health Of Firefighters Research Articles

Civilians Have Higher Adherence and More Improvements in Health With a Mediterranean Diet and Circuit Training Program Compared With Firefighters.

To examine the relationship between diet adherence and cardiovascular disease (CVD) risk-reduction between civilians and firefighters with a 6-week Mediterranean diet and tactical training intervention. Forty firefighters and 30 civilians participated. Blood pressure, body composition, lipid levels, vascular measures, and aerobic capacity were measured pre- and post-intervention. Diet was self-report based on number of servings consumed. Weekly diet-scores were calculated. Both groups had improvements in blood pressure and body composition. Civilians had improved lipid levels, higher overall adherence, a relationship between total Med-diet score and cholesterol (R = 0.68), and higher servings consumed in foods typical of Mediterranean-dietary pattern ( P < 0.05). This is the first exercise and diet intervention comparing firefighters to civilians. Adherence to a Mediterranean-dietary pattern coupled with exercise is effective at improving cardiac health. These findings substantiate the need for wellness interventions in firefighters.

Characterizing Steam Penetration through Thermal Protective Fabric Materials

This study performs an analysis of steam penetration through thermal protective fabric materials. Different, multilayered thermal protective fabrics were selected and tested in a laboratory-simulated steam exposure, and their steam protective performance (SPP) was measured in terms of the time required to generate second-degree burns on the bodies of wearers. Additionally, the total transmitted thermal energy (TTTE) through the fabrics during testing was measured. Through statistical analysis, it was established that fabric properties, namely air permeability and thickness, are the key factors that affect the SPP and TTTE; the relationship among the fabric properties, SPP, and TTTE is also summarized. Theoretically, it has been found that heat and mass (steam) transfer occur through fabrics in the course of steam exposure, which mainly affect the SPP and TTTE. This study could help textile/materials engineers to develop high performance thermal protective fabrics for the increased occupational health and safety of firefighters and industrial workers.

Cardiovascular Disease Risk Factors, Musculoskeletal Health, Physical Fitness, and Occupational Performance in Firefighters: A Narrative Review.

Introduction Firefighting is a strenuous occupation that requires firefighters to be in peak physical condition. However, many firefighters have risk factors for cardiovascular disease, impaired musculoskeletal health, and are not physically fit for duty, which all negatively impact their occupational performance. Therefore, the aim of this review is to determine the relationship between cardiovascular disease risk factors, musculoskeletal health, physical fitness, and occupational performance in firefighters. Methods The electronic databases PubMed, SCOPUS, and Web of Science were searched online via the library portal of the University of the Western Cape. Publications and grey literature between the years 2000 to present were used. In total, 2607 articles were identified; after the removal of duplicates 1188 articles were then screened, and were excluded for not meeting initial screening criteria. The remaining 209 full-text articles were screened based on the inclusion and exclusion criteria, where 163 articles were excluded. Only studies that were quantitative were included. This left 46 articles that were then finally included in the current narrative review. Results The current literature indicated that significant relationships existed between cardiovascular risk factors, musculoskeletal health, physical fitness, and occupational performance. The results indicated firefighters who were aged, obese, physically inactive, cigarette smokers, and unfit were at the highest risk for cardiovascular and musculoskeletal health complications, and unsatisfactory occupational performance. Musculoskeletal health complications significantly affected occupational performance and work ability and were related to physical fitness of firefighters. Most cardiovascular risk factors were related to physical fitness, and all physical fitness parameters were related to occupational performance in firefighters. Conclusion The overwhelming evidence in the current review established that physical fitness is related to occupational performance. However, the relationship between cardiovascular risk factors and musculoskeletal health in relation to occupational performance is less clear and still understudied. Significant gaps remain in the literature.

Mental health of Japanese firefighters administering emergency medical treatments during COVID-19

This is the first study investigating the determinants of mental health among Japanese firefighters with the COVID-19 outbreak. Firefighters who respond to emergency calls and administer emergency medical treatment face numerous serious threats to their mental health because of the spread of COVID-19. These threats range from significant infection risks to changes in daily operations. We conducted an online questionnaire survey with Japanese firefighters (n = 2,748, valid responses = 2,204) who also served as ambulance workers during the second COVID-19 wave in August 2020. The questionnaires inquired about personal and occupational demographics, occupational stress resulting from COVID-19, social support, germ aversion using a subscale of the Perceived Vulnerability to Disease (PVD) scale, and the General Health Questionnaire (GHQ-12). The results indicated that the burdens of infection prevention, anxiety about infection and furloughs, interpersonal conflicts related to COVID-19, reduced social support, and germ aversion were associated with deterioration of mental health. Measures for maintaining the mental health of firefighters are discussed based on these results.

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.

Firefighter Stress and Mental Health: Introduction to the Special Issue.

The past decade has witnessed burgeoning interest and concern regarding the mental health of firefighters. This increased attention is due, in part, to research documenting higher rates of psychiatric problems, including depression, substance abuse, sleep disturbances, posttraumatic stress disorder, and suicidality in fire rescue personnel compared to civilians. Similarly, the National Institute for Occupation Safety and Health (2014) has identified disturbingly elevated rates of physical health difficulties in firefighters, most notably high blood pressure, coronary heart disease, death due heart attacks, as well as different forms of cancer. Despite the heightened awareness of the mental and physical health challenges in this population, behavioral research specifically targeting firefighters is limited. With this is mind, we asked prominent researchers and clinicians working in this area to present results of their early investigative efforts in our Special Issue on "First Responder Stress and Mental Health". In this Introduction, we provide brief summaries of the studies comprising the Issue. Articles in this issue address topics of sleep, PTSD, substance use, physical health concerns, and provide assessment and treatment considerations. A primary goal of the Issue is to stimulate further behavioral research with this group of deserving yet underserved first responders. Moreover, the Issue serves as a tribute to the men and women of the fire service who dedicate and risk their lives to serve their community.

Wildfires in the Atomic Age: Mitigating the Risk of Radioactive Smoke

This Perspective highlights the lingering consequences of nuclear disasters by examining the risks posed by wildfires that rerelease radioactive fallout originally deposited into the environment by accidents at nuclear power plants or testing of nuclear weapons. Such wildfires produce uncontainable, airborne, and hazardous smoke, which potentially carries radioactive material, thus becoming the specter of the original disaster. As wildfires occur more frequently with climate change and land use changes, nuclear wildfires present a pressing yet little discussed problem among wildfire management and fire scholars. The problem requires urgent attention due to the risks it poses to the health and wellbeing of wildland firefighters, land stewards, and smoke-impacted communities. This Perspective explains the problem, outlines future research directions, suggests potential solutions, and underlines the broader benefits of mitigating the risks.

The Wildland Firefighter Exposure and Health Effect (WFFEHE) Study: Rationale, Design, and Methods of a Repeated-Measures Study.

The wildland firefighter exposure and health effect (WFFEHE) study was a 2-year repeated-measures study to investigate occupational exposures and acute and subacute health effects among wildland firefighters. This manuscript describes the study rationale, design, methods, limitations, challenges, and lessons learned. The WFFEHE cohort included fire personnel ages 18-57 from six federal wildland firefighting crews in Colorado and Idaho during the 2018 and 2019 fire seasons. All wildland firefighters employed by the recruited crews were invited to participate in the study at preseason and postseason study intervals. In 2019, one of the crews also participated in a 3-day midseason study interval where workplace exposures and pre/postshift measurements were collected while at a wildland fire incident. Study components assessed cardiovascular health, pulmonary function and inflammation, kidney function, workplace exposures, and noise-induced hearing loss. Measurements included self-reported risk factors and symptoms collected through questionnaires; serum and urine biomarkers of exposure, effect, and inflammation; pulmonary function; platelet function and arterial stiffness; and audiometric testing. Throughout the study, 154 wildland firefighters participated in at least one study interval, while 144 participated in two or more study interval. This study was completed by the Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health through a collaborative effort with the U.S. Department of Agriculture Forest Service, Department of the Interior National Park Service, and Skidmore College. Conducting research in the wildfire environment came with many challenges including collecting study data with study participants with changing work schedules and conducting study protocols safely and operating laboratory equipment in remote field locations. Forthcoming WFFEHE study results will contribute to the scientific evidence regarding occupational risk factors and exposures that can impact wildland firefighter health over a season and across two wildland fire seasons. This research is anticipated to lead to the development of preventive measures and policies aimed at reducing risk for wildland firefighters and aid in identifying future research needs for the wildland fire community.

VERIFICATION OF TACTICAL AND TECHNICAL DATA OF THE BREATHING APPARATUS

The function of the breathing apparatus is to protect the health of firefighters in a harmful and non-respirable environment. Closed-circuit breathing apparatus provides members of the Fire and Rescue Service with respiratory protection in the elimination of adverse events in tunnels and underground spaces. The MSA 4h Air Elite is a four-hour self-contained breathing apparatus that operates on the principle of generating oxygen by an exothermic reaction of potassium hyperoxide. Each breathing apparatus has its tactical technical parameters. We verified the tactical and technical data of the MSA AIRE ELITE by the experiment they participated in the firefighter. Each firefighter was equally coupled. An MSA Air Elite was used during the experiment. Tactical-technical data reported by the manufacturer varies in some points with the practical results that we have managed to obtain. The manufacturer's largest deviations in tactical and technical data and practical results are mainly in the length of work activity, temperature in use in intervention, and air consumption. According to our experiment, the MSA 4h Air Elite breathing apparatus does not last in the working activity 240 minutes as it discloses a manufacturer, but on the other hand, this time-inconsistency may be caused by the intensity of training and demanding of the training track.

Cancer incidence in World Trade Center-exposed and non-exposed male firefighters, as compared with the US adult male population: 2001–2016

ObjectiveTo compare cancer incidence in Fire Department of the City of New York (FDNY) firefighters who worked at the World Trade Center (WTC) site to incidence in a population of...

A Comparative Analysis of the Needs of Firefighters and Paramedic Students for Training in Basic Medical Science Disciplines

This study aims to facilitate measures to increase the on-site response capabilities of firefighters by suggesting an appropriate curriculum for the inculcation of basic medical science disciplines through Borich needs assessment and the Locus and Focus model analysis by defining the learning outcomes. A survey was conducted among 188 firefighters and 48 paramedic students the results showed a need for microbiology (2.10) and public health (2.07) for firefighters, pharmacology (4.64) and anatomy and physiology (3.82) for paramedic student. The priority subjects identified in the High-High dimension of the Locus and Focus model for firefighters included public health, microbiology, anatomy and physiology. The learning outcomes, based on the level of present acknowledgment, showed a significant difference between the required and current level in 42 and 37 items of the questionnaires for firefighters and paramedic students respectively (p &lt; .001). The highest discrepancy in priority, based on the level of present acknowledgment between firefighters and paramedic students were in: “sterilization and mechanism of antibiotic action (4th vs. 31st),” “pathogenesis of viral infection (1st vs. 23rd),” and “prevention of diseases and health promotion (14th vs. 36th).” The priority for paramedic students was “receptor-mediated drug response (25th vs. 4th).” Given the difference in the priority level of need of basic medical science disciplines between firefighters and students, an appropriate curriculum for paramedic students that also reflects the needs of firefighters should be developed.

Studies Detail Heart Risks for Firefighters

Studies Detail Heart Risks for Firefighters

Firefighters On Medication Have Worse Health Profiles But Larger Improvements With Diet &amp; Exercise

Heart disease and sudden cardiac death account for an overwhelming number of on- and off-duty deaths in firefighters (FF). The alarm response, the FF lifestyle, and the heavy work of the job all add to the stress of firefighting. These inherent risks aggravate existing CVD, many FF are on medication regimen, yet it is unknown whether medication status affects vascular health in FF. Furthermore, using ambulatory BP (ABP) monitors to quantify the BP surge with alarm is a novel way to assess CVD risk in FF. PURPOSE: To compare changes in health after a 6-wk Mediterranean diet & circuit training program between medicated (MedFF) or non-medicated (NmFF) FF. METHODS: We included 40 FF who completed a 6-wk intervention. Pre- and post-testing included ABP monitoring, a fasted clinical appt, and fitness test. FF wore the ABP cuff for 12-hrs and were paged by emergency service dispatch or by a pager app (OnPage). When the pager sounded, they forced an ABP reading to measure BP surge. Fasted visit included BP, body fat, lipid panel, blood draw, and vascular health measures. VO2peak was measured on treadmill. Serum was isolated for ELISA analysis of superoxide dismutase (SOD) and C-reactive protein (CRP). RESULTS: MedFF were on medication for BP, cholesterol, and multiple other types. Nine of the FF reported multiple medications. MedFF (N = 19, 48.4 ± 2 yrs) had worse health and higher BP surges, but more improvements with diet+exercise compared to NmFF (N = 21, 31.7 ± 2 yrs), P < 0.05 with differences. MedFF had higher BP (130.2/81.3 vs 121.6/77.7 mmHg), higher average ABP (133.7/80.4 vs 123.7/75.2 mmHg), lower VO2peak (33.3 vs 37.1 ml/kg-min), lower FMD (8.5 vs 10.2 %), higher PWV (7.4 vs 5.7 m/s), and higher CRP (3.8 vs 3.1 mg/L) levels. MedFF also tend toward larger SBP and DBP surges with alarm (15.9 vs 13.9 mmHg SBP and 9.9 vs 8.1 mmHg DBP) and an improvement in surge after intervention (SBP surge 15.9 to 8.6 in MedFF vs 13.9 to 15.8 mmHg in NmFF; DBP surge 9.9 to 3.7 in MedFF vs 8.1 to 5.4 mmHg in NmFF). With intervention we found that BP lowered, body composition, vascular health, and VO2peak improved in MedFF. CONCLUSION: With this subset of data, we show that FF on medication have worse health profiles but may have larger improvements with exercise + diet. Data confirms the importance of wellness programs in the firehouse, in particular for FF already on medication.

Firefighters and COVID-19: An Occupational Health Perspective.

Firefighters and COVID-19: An Occupational Health Perspective.

Assembling the Career Firefighter Health Study cohort: A methods overview.

Studies of World Trade Center (WTC)-exposed rescue/recovery workers report the increased occurrence of health conditions after work at the WTC disaster site. However, the extent to which these associations are due to WTC exposure is unclear, in part due to the lack of suitable comparison groups. Accordingly, we identified a previously assembled National Institute for Occupational Safety and Health (NIOSH) cohort of career firefighters from three US cities (n = 29,992). Here, we document the challenges in establishing this non-WTC-exposed firefighter cohort for the goal of tracking and comparing cancer and chronic health conditions in WTC-exposed and non-WTC-exposed firefighters. Follow-up process included institutional review board applications, data use agreements, state cancer registry linkages and vital status determination for the NIOSH firefighter cohort. After completion of these steps, we undertook outreach to the three original city fire departments and union officials, before contact tracing and direct recruitment of 14,566 living firefighters to complete a confidential health survey. We staggered recruitment efforts by the city, using letters, postcards, emails, videos, and telephone outreach. Participants who completed the survey received $10. A total of 4962 of 14,566 alive firefighters responded to the baseline survey (34.1% response rate). Respondents were older and more likely to be non-Hispanic white than nonrespondents. We provide an overview of the process for the first survey to collect information on physical and mental health conditions among US firefighters. The data collected will have an important impact on studies of WTC rescue/recovery work, firefighting, and related health conditions.

Respiratory Outcomes of Firefighter Exposures in the Fort McMurray Fire: A Cohort Study From Alberta Canada.

Determine effects on respiratory health of firefighters attending a catastrophic wildfire. Within the Alberta Administrative Health Database, we identified five community-based controls for each firefighter in a cohort of 1234 deployed to the 2016 Fort McMurray fire. Spirometry records were identified and a stratified sample assessed clinically. We estimated PM2.5 particles exposure. Firefighters had an increased risk of asthma consultation post-fire (OR new onset asthma = 2.56; 95%CI 1.75 to 3.74). Spirometry showed decreased FEV1 and FVC with increasing exposure. In the clinical assessment, 20% had a positive MCT and 21% BWT. Those with ongoing fire-related symptoms had a higher concurrence of positive MCT and BWT (OR = 4.35; 95%CI 1.11 to 17.12). Lower diffusion capacity related to higher exposure. Massive exposures during a wildfire are associated with non-resolving airways damage.

Numerical Analysis of Smoke Spreading in a Medium-High Building under Different Ventilation Conditions

Smoke from fires in residential buildings represents the greatest threat to the life and health of inhabitants and firefighters at the scene of an accident. Therefore, the aim of this study was to reconstruct a numerical model for the estimation of smoke spread in a medium-high building under different ventilation conditions. Here, the three-dimensional geometry of a designated medium-high building was reconstructed and an exit door in the basement was specified as a smoke inlet; a window in the upper part was marked as outlet; and an entrance door, which allowed the outside air to enter the building after opening, was designated as an inlet door. The initial simulation, in which no air could enter the building, predicted the time taken for the staircase to become filled with smoke. In a second simulation, the entrance door was a fresh air inlet. The results showed that, for the analyzed building, rapid use of the mechanical ventilation can shorten the time of operations and improve their safety.

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.

The role of organizational supports in mitigating mental ill health in firefighters: A cohort study in Alberta, Canada.

IntroductionLittle is known about the effectiveness of ongoing mental health support in reducing the mental health impacts of a traumatic deployment.MethodsA cohort of firefighters was established among those deployed to a devastating wildfire in Alberta, Canada in May 2016. Firefighters completed three questionnaires: at recruitment giving details of exposures, a first follow‐up reporting mental health supports before, during, and after the fire and a second follow‐up, at least 30 months after the fire, with screening questionnaires for anxiety, depression, and posttraumatic stress disorder (PTSD). Fire chiefs were interviewed about mental health provisions. The impact of supports on mental ill health was estimated, adjusting for clustering within fire service and potential confounders.ResultsOf 1234 firefighters in the cohort, 840 completed the questionnaire on mental health supports. In total, 78 of 82 fire chiefs were interviewed. Analysis of the impact of supports on mental ill health included 745 firefighters from 67 fire services. Only 45.8% of reports of peer support were concordant between firefighters and fire chiefs. After adjusting for confounding, the odds ratios (OR) for peer support reported by both fire chief and firefighter were depressive disorder: OR = 0.22, 95% confidence interval (CI), 0.08–0.61; anxiety disorder: OR = 0.45, 95% CI, 0.24–0.82; PTSD: OR = 0.62, 95% CI, 0.37–1.02. Symptoms of anxiety and depression but not PTSD were reduced by resiliency training before the fire and by support offered within 48 h of return from deployment.ConclusionThe results suggest peer support in firefighters is protective but its availability is poorly recognized. PTSD was somewhat less responsive, perhaps reflecting the cumulative effects of previous exposures.

Shifted Firefighter Health Investigation by Personal Health Insurance Record in Taiwan.

IntroductionTaiwan’s firefighters use a shift rotation system with 2 days of work and 1 day of rest. Numerous papers have already explored the risks of shift work to the body. However, little data concern the impact of shift work on health as reflected in medical visits. This study used individuals’ medical visit record in Taiwan’s health insurance system. The locally called “health bank” contains individuals’ medical visit record, health insurance payment points and the medicine used.MethodsConsent was obtained from 150 firefighters who were serving under the shift rotation system to obtain their 2015 individual “My Health Bank” medical data. Comparisons were made between national health insurance data norm.ResultsFirefighters make significantly more visits for Western medicine than the annual average (firefighters 6.27 vs norm 5.24, P = 0.04142), more total number of medical visits (9.57 vs 7.75, P = 0.0102), more annual average payment points for Western medicine (4079 vs 2741, P = 0.003151), and a greater average number of total annual medical visit points (7003 vs 4940, p = 0.0003157). Firefighters had significantly higher incidents of respiratory diseases, urogenital diseases, skin and subcutaneous tissue diseases, musculoskeletal system and connective tissue diseases, injuries, and illness from poisoning than did the norm (P<0.05).ConclusionA persuasive health-survey-based method for workers in high occupational hazard industries was proposed in this study, and the result was highly correlated with risk factors of fireworkers. The proposed study method is potential to investigate risk factors of other working.