Physiological Demands of a Self-Paced Firefighter Air-Management Course and Determination of Work Efficiency

Firefighters often complete air management courses (AMC) to assess the ability to tolerate personal protective equipment, appropriately manage the breathing system and assess occupational performance. Little information is known relative to the physiological demands of AMCs, nor how to assess work efficiency in order to characterize occupational performance and evaluate progress.

PURPOSE

To assess the physiological demands of an AMC and examine differences across BMI categories. A secondary aim was to develop an equation to assess work efficiency in firefighters.

METHODS

Fifty-seven firefighters (Women, n = 4; age: 37.2 ± 8.4 yr.; height: 182.0 ± 6.9 cm; body mass: 90.8 ± 13.1 kg; BMI: 27.8 ± 3.6 kg·m^-2) completed an AMC per routine evaluation while wearing a department issued self-contained breathing apparatus and full protective gear. Course completion time, starting pounds per square inch (PSI) on the air cylinder, changes in PSI, and distance traveled were recorded. All firefighters were equipped with a wearable sensor integrated with a triaxial accelerometer and telemetry to assess movement kinematics, heart rate, energy expenditure, and training impulse. The AMC consisted of an initial section involving a hose line advance, rescue (body drag), stair climb, ladder raise, and forcible entry. This section was followed by a repeating loop, which consisted of a stair climb, search, hoist, and recovery walk. Firefighters repeated the course loop until the self-contained breathing apparatus air supply pressure reached 200 PSI, at which time they were instructed to lay down until the PSI reached zero.

RESULTS

Average completion time was 22.8 ± 1.4 min, with a mean distance of 1.4 ± 0.3 km and an average velocity of 2.4 ± 1.2 m·s^-1. Throughout the AMC, the mean heart rate was 158.7 ± 11.5 bpm equating to 86.8 ± 6.3% of the age-predicted max heart rate and a training impulse of 55 ± 3 AU. Mean energy expenditure was 464 ± 86 kcals and work efficiency was 49.8 ± 14.9 km·PSI^-1·s. Regression analysis determined that fat-free mass index (R² = 0.315; β = -5.069), body fat percentage (R² = 0.139; β = -0.853), fat-free mass (R² = 0.176; β = -0.744), weight (R² = 0.329; β = -0.681), and age (R² = 0.096; β = -0.571) were significant predictors of work efficiency.

CONCLUSIONS

The AMC is a highly aerobic task with near-maximal heart rates reached throughout the course. Smaller and leaner individuals achieved a higher degree of work efficiency during the AMC.

Occupational exposures to airborne per- and polyfluoroalkyl substances (PFAS)-A review

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) are a group of synthetically-made chemicals with diverse functional properties that have become ubiquitous in our environment because of their widespread use. PFAS exposure has been associated with adverse health effects, and it is therefore vital to know how exposure may occur. Many studies have focused on environmental exposure from drinking water, but there is a paucity of data on inhalation exposure, especially in occupational settings.

METHODS

In this study, through a comprehensive literature search, measured airborne (i.e., aerosols, volatiles, and dust) inhalation exposure and area levels were compiled for various occupations to compare reported levels of PFAS exposure. Airborne PFAS levels measured in various occupations such as ski waxing, textile manufacturing, firefighting, and floor waxing were analyzed and compared.

RESULTS

Results of this review demonstrate that workers experience varying levels of PFAS exposure contingent on the workplace and industry and the work tasks performed within the workplace. Out of all occupations, ski waxing exhibited the highest total PFAS airborne concentrations when compared to all other reported occupational and residential exposures.

CONCLUSIONS

Further research is recommended to estimate the risk of PFAS exposures in the occupations reviewed and to identify other potential occupations at risk of PFAS exposure. In addition, informed recommendations to implement safety measures ought to be developed to protect workers from adverse health effects.

Using machine learning algorithm to predict the risk of post-traumatic stress disorder among firefighters in Changsha

OBJECTIVES

Firefighters are prone to suffer from psychological trauma and post-traumatic stress disorder (PTSD) in the workplace, and have a poor prognosis after PTSD. Reliable models for predicting PTSD allow for effective identification and intervention for patients with early PTSD. By collecting the psychological traits, psychological states and work situations of firefighters, this study aims to develop a machine learning algorithm with the aim of effectively and accurately identifying the onset of PTSD in firefighters, as well as detecting some important predictors of PTSD onset.

METHODS

This study conducted a cross-sectional survey through convenient sampling of firefighters from 20 fire brigades in Changsha, which were evenly distributed across 6 districts and Changsha County, with a total of 628 firefighters. We used the synthetic minority oversampling technique (SMOTE) to process data sets and used grid search to finish the parameter tuning. The predictive capability of several commonly used machine learning models was compared by 5-fold cross-validation and using the area under the receiver operating characteristic curve (ROC-AUC), accuracy, precision, recall, and F1 score.

RESULTS

The random forest model achieved good performance in predicting PTSD with an average AUC score at 0.790. The mean accuracy of the model was 90.1%, with an F1 score of 0.945. The three most important predictors were perseverance, forced thinking, and reflective deep thinking, with weights of 0.165, 0.158, and 0.152, respectively. The next most important predictors were employment time, psychological power, and optimism.

CONCLUSIONS

PTSD onset prediction model for Changsha firefighters constructed by random forest has strong predictive ability, and both psychological characteristics and work situation can be used as predictors of PTSD onset risk for firefighters. In the next step of the study, validation using other large datasets is needed to ensure that the predictive models can be used in clinical setting.

Change in heart rate variability during two firefighting work cycles

This study aimed to determine whether the change in heart rate variability from pre to post firefighting is modulated by different work cycles. Thirteen male firefighters underwent two firefighting simulations that comprised two identical 25-min work bouts intercalated by a passive recovery period of either 20 min (T20) or 5 min (T5). The square root of the mean squared differences of successive R-R intervals (RMSSD) and aural temperature were measured at rest before (PRE) and after (POST) firefighting simulations. The decrease in RMSSD was different between firefighting simulations (T20: -10 ± 21.2 ms, T5: -19.9 ± 20.9 ms, interaction, p = 0.02). Post-firefighting aural temperature was greater (p = 0.05) in T5 (37.18 ± 0.53 °C) than in T20 (36.88 ± 0.49 °C). In conclusion, a shorter recovery period of 5 min between firefighting work bouts decreases post-firefighting heart rate variability, possibly attributed to a lower parasympathetic reactivation and a higher absolute value of body temperature.

Comparison of the risks of occupational diseases, avoidable hospitalization, and all-cause deaths between firefighters and non-firefighters: A cohort study using national health insurance claims data

Objectives

National Health Insurance claims data were used to compare the incidence of occupational diseases, avoidable hospitalization, and all-cause death standardized incidence ratio and hazard ratio between firefighters and non-firefighters.

Methods

The observation period of the study was from 2006 to 2015 and a control group (general workers and national and regional government officers/public educational officers) and a firefighter group was established. The dependent variables were occupational diseases, avoidable hospitalization (AH), and all-cause death. The analysis was conducted in three stages. First, the standardized incidence ratios were calculated using the indirect standardization method to compare the prevalence of the disease between the groups (firefighter and non-firefighter groups). Second, propensity score matching was performed for each disease in the control group. Third, the Cox proportional hazards model was applied by matching the participants.

Results

The standardized incidence ratio and Cox regression analyses revealed higher rates of noise-induced hearing loss, ischemic heart disease, asthma, chronic obstructive pulmonary disease, cancer, back pain, admission due to injury, mental illness, depression, and AH for firefighters than general workers. Similarly, the rates of noise-induced hearing loss, ischemic heart disease, asthma, chronic obstructive pulmonary disease, back pain, admission due to injury, mental illness, depression, and AH were higher in the firefighter group than in the national and regional government officer/public educational officer group.

Conclusions

The standardized incidence ratios and hazard ratios for most diseases were high for firefighters. Therefore, besides the prevention and management of diseases from a preventive medical perspective, management programs, including social support and social prescriptions in the health aspect, are needed.

Post-traumatic stress disorder and depressive symptoms among firefighters: a network analysis

Background

Firefighters, as first responders with a high risk of occupational exposure to traumatic events and heavy working stress, have a high prevalence of PTSD symptoms and depressive symptoms. But no previous studies analyzed the relationships and hierarchies of PTSD and depressive symptoms among firefighters. Network analysis is a novel and effective method for investigating the complex interactions of mental disorders at the symptom level and providing a new understanding of psychopathology. The current study was designed to characterize the PTSD and depressive symptoms network structure in the Chinese firefighters.

Method

The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) and the Self-Rating Depression Scale (SDS) were applied to assess PTSD and depressive symptoms, respectively. The network structure of PTSD and depressive symptoms was characterized using "expected influence (EI)" and "bridge EI" as centrality indices. The Walktrap algorithm was conducted to identify communities in the PTSD and depressive symptoms network. Finally, Network accuracy and stability were examined using the Bootstrapped test and the case-dropping procedure.

Results

A total of 1,768 firefighters were enrolled in our research. Network analysis revealed that the relationship between PTSD symptoms, "Flashback" and "Avoidance," was the strongest. "Life emptiness" was the most central symptom with the highest EI in the PTSD and depression network model. Followed by "Fatigue" and "Interest loss." Bridge symptoms connecting PTSD and depressive symptoms in our study were "Numb," "High alertness," "Sad mood," and "Compunction and blame," successively. The data-driven community detection suggested the differences in PTSD symptoms in the clustering process. The reliability of the network was approved by both stability and accuracy tests.

Conclusion

To the best of our knowledge, the current study first demonstrated the network structure of PTSD and depressive symptoms among Chinese firefighters, identifying the central and bridge symptoms. Targeting interventions to the symptoms mentioned above may effectively treat firefighters suffering from PTSD and depressive symptoms.

Investigation of Psychological Stress and Sleep Quality of Emergency Medical Technicians in Taiwan Fire Department during the COVID-19 Pandemic

When the coronavirus disease 2019 (COVID-19) began to ravage the world in 2019, the World Health Organization became concerned. The epidemic has a high mortality and contagion rate, with severe health and psychological impacts on frontline emergency medical service system practitioners. There are many hospital staff surveys, but few have covered the stress among emergency medical technicians. DASS-21, PSQI, and AUDIT questionnaires were used to evaluate the sources of psychological stress factors of firefighters in Taiwan. Multiple logistic regression was used to analyze the questionnaire content. We conducted questionnaire surveys from May 2022 to July 2022. Our sample comprised 688 participants. The odds ratios of increased depression, anxiety, and stress levels due to reduced family or peer understanding and support were 2.72 (95% CI: 1.50−4.92), p = 0.001; 2.03 (95% CI: 1.11−3.68), p = 0.021; and 3.27 (95% CI: 1.83−5.86), p < 0.001, respectively. The odds ratios of poor sleep quality due to depression, anxiety, and increased stress levels were 5.04 (3.18−7.99), p < 0.001; 2.44 (95% CI: 1.57−3.81), p < 0.001; and 4.34 (95% CI: 2.76−6.82), p-value < 0.001, respectively. During the COVID-19 pandemic, poor sleep quality and a lack of understanding and support from the Taiwan firefighting agency staff, family, or peers resulted in increased depression, anxiety, and stress levels.

A Database of Static Thermal Insulation and Evaporative Resistance Values of Dutch Firefighter Clothing Items and Ensembles

The rescue operations' environment can impair firefighters' performance and increase the risk of injuries, e.g., burns and hyperthermia. The bulk and carried weight of heavy protection contributes to lower physical performance, higher metabolic load and internal body heat production. For recommending optimal protection for the tasks and incident scenarios, knowledge of clothing thermal properties is needed. However, detailed data on firefighter protective clothing systems are not available. The aim of the study was to provide scientific background and a dataset that would allow for validation of thermo-physiological models for task-specific conditions of rescue work. Thermal insulation of 37 single items and their variations and 25 realistic protective clothing ensembles were measured on a thermal manikin. Twelve (12) ensembles that evenly covered the whole insulation range were selected for evaporative resistance testing. The equations for summing up individual item's insulation to ensemble insulation and calculating clothing area factor were derived from the dataset. The database of a firefighter clothing system was created. In addition, the local and regional thermal properties of the clothing ensembles were provided for use in future validation of advanced thermo-physiological models for rescue worker exposure predictions and for designing decision aid tools.

Norms about Alcohol Use among US Firefighters

Background

Problem drinking is a perennial concern in the US fire service. A large literature has documented the importance of addressing alcohol norms in intervention research. The purpose of this study was to explore alcohol norms in a national cohort of firefighters (FFs) to inform intervention development in this occupational group.

Methods

Data were from a national online survey of career and volunteer FFs (N = 674). Participants were recruited through national fire service listservs and a database of FFs who had agreed to be contacted for research.

Results

When asked about "acceptable" levels of alcohol consumption, FFs on average suggested levels which exceeded public health guidelines. Further, approximately half of career and volunteer FFs believed that, at least under some circumstances, drinking until intoxicated was normative. When asked how long should elapse between a FFs last drink and reporting for duty, the average suggested lag was 11.2 hours (sd = 4.6). However, among male volunteer FFs who reported heavy drinking, the average was 6.68 hours (sd = 4.77).

Conclusions

Given the high prevalence of heavy and binge drinking in the fire service, it is not surprising that the alcohol norms found in this study were consistent with a culture of drinking. Participants' reports of alcohol use among their peers were consistent with the actual prevalence of problem drinking. Thus, education and prevention efforts in this occupation should focus on changing norms about alcohol use, including linking heavy drinking to other health and safety issues they face.

Inter-Rater and Intra-Rater Reliability of Return-to-Work Screening Tests for UK Firefighters Following Injury

The aim of this study was to assess the inter-rater and intra-rater reliability of a return-to-work (RTW) screening test to be used on UK firefighters following injury. The inter rater and intra-rater reliability of eight tasks involved in a screening test was used to assess readiness to RTW for UK firefighters following injury. These tasks included the following: (1) putting on and removing a breathing apparatus set (BA), (2) a ladder lift simulation, (3) a ladder carry simulation, (4) a light portable pump (LPP) lift and carry simulation, (5) a hose run, (6) a ladder climb with leg lock, (7) a casualty evacuation and (8) a confined space crawl simulation. The inter-rater reliability between each individual screening task was interpreted as Excellent (ICC = 0.94-1.00) for eleven (68.75%) of the screening task videos and as Good (ICC = 0.75-0.88) for five (31.25%) of the screening task videos. Intra-rater reliability was interpreted as Excellent (ICC = 1) for twenty-six participants (74.3%), Good (ICC = 0.76-0.88) for eight participants (22.9%) and Moderate for one participant (2.8%). Due to the reliability of this screening test, it allows conclusions to be made from the results which can inform a RTW decision for a firefighter.

Hierarchy of contamination control in the fire service: Review of exposure control options to reduce cancer risk

The international fire service community is actively engaged in a wide range of activities focused on development, testing, and implementation of effective approaches to reduce exposure to contaminants and the related cancer risk. However, these activities are often viewed independent of each other and in the absence of the larger overall effort of occupational health risk mitigation. This narrative review synthesizes the current research on fire service contamination control in the context of the National Institute for Occupational Safety and Health (NIOSH) Hierarchy of Controls, a framework that supports decision making around implementing feasible and effective control solutions in occupational settings. Using this approach, we identify evidence-based measures that have been investigated and that can be implemented to protect firefighters during an emergency response, in the fire apparatus and at the fire station, and identify several knowledge gaps that remain. While a great deal of research and development has been focused on improving personal protective equipment for the various risks faced by the fire service, these measures are considered less effective. Administrative and engineering controls that can be used during and after the firefight have also received increased research interest in recent years. However, less research and development have been focused on higher level control measures such as engineering, substitution, and elimination, which may be the most effective, but are challenging to implement. A comprehensive approach that considers each level of control and how it can be implemented, and that is mindful of the need to balance contamination risk reduction against the fire service mission to save lives and protect property, is likely to be the most effective.

Effects of personal protective clothing on firefighters' gait analyzed using 3D motion capture system

OBJECTIVES

The effects of personal protective clothing (PPC) on firefighters' gait were investigated to develop high-performance PPC.

METHODS

Thirteen participants participated in human trials with three types of PPC (firefighter protective clothing (FPC); semi-enclosed chemical protective clothing (CPC_semi); full-enclosed chemical protective clothing (CPC_full)) and T-shirt (CON). A 3D motion capture system was used to obtain gait parameters (step length, step width, stride frequency, gait speed, and toe-out angle) and the range of motion (ROM) of the joints (hip, knee, and ankle).

RESULTS

PPCs produced an increase in step width (23.4%, p > 0.05), but the gait speed (9.1%) and stride frequency (6.4%) decreased compared with the CON results. ROM is affected by the PPC type and joint. FPC and CPC_semi had no significant effect in terms of the ROM of the hip and knee besides the landing angle of the knee. However, CPC_full had a significant effect on the maximum extension angle of the hip and maximum flexion angle of the knee, which reached up to 27.2%.

CONCLUSION

The ROM of the firefighter's lower limbs were limited by PPC. This study offers insights into next-generation PPC design and development, as well as guidelines for training and firefighting.

Urinary Metabolites of Polycyclic Aromatic Hydrocarbons in Firefighters: A Systematic Review and Meta-Analysis

Firefighters are intermittently exposed to complex, mixed pollutants in random settings. Of those pollutants, PAHs (polycyclic aromatic hydrocarbons) are the most commonly studied and best understood. PAH exposure can occur via multiple routes; therefore, the levels of hydroxylated metabolites of PAHs in urine have been used as a biomonitoring tool for risk assessment. We performed a systematic review and meta-analysis of the literature to estimate the levels of urinary hydroxylated PAH (OHPAH) among firefighters, determine risk attributions, and, finally, evaluate the scope of preventive efforts and their utility as diagnostic tools. The meta-regression confirmed increases in OHPAH concentrations after fire activities by up to 1.71-times (p-values: <0.0001). Samples collected at a time point of 2−4 h after a fire suppression showed a consistent, statistically significant pattern as compared with baseline samples. The National Fire Protection Association (NFPA) standard 1582 Standard on Comprehensive Occupational Medical Program for Fire Departments lists various health examinations, including a urinalysis for occupational chemical exposure if indicated and medical screening for cancers and cardiovascular diseases. Biomonitoring is a valuable screening tool for assessing occupational exposure and the results of this meta-analysis support their inclusion in regular health screenings for firefighters.

Effects of Emergency Duties on Cardiovascular Diseases in Firefighters: A 13-Year Retrospective Cohort Study

OBJECTIVES

This study aimed to examine the effects of firefighters' emergency duties on the incidence of cardiovascular disease (CVD).

METHODS

We used a 13-year follow-up in a nationwide retrospective cohort study. A total of 363,137 employees were recruited. The sex-and age-specific incidence of CVD (hypertension, angina pectoris, and acutemyocardial infarction [AMI]) in firefighters and public officials was estimated.

RESULTS

The overall age-specific sex-based incidence of CVD, except for hypertension, was higher in firefighters than in public officials. The age-stratified hazard ratios for the three types of CVD in male firefighters were also higher. AMI was more common in younger firefighters, whereas angina pectoris and hypertension were common in older firefighters.

CONCLUSIONS

Firefighters' duties are more likely to increase the risk of CVD, and preventive strategies with proven benefits are required.

The short form effort-reward imbalance: Measure of occupational stress for firefighters

PURPOSE

The original effort-reward imbalance (ERI) questionnaire has been widely used as a measure of occupational stress. The need for brief measurement of psychosocial stress at work has risen. This study examined the psychometric properties of a 16-item short form ERI (S-ERI) questionnaire.

METHODS

A cross-sectional study was conducted with a convenience sample of 247 career firefighters in the United States. An internet-based survey contained the S-ERI questionnaire, and assessed perceived health, demographics, and work characteristics. Internal consistency was tested by item-total correlation and Cronbach's α coefficients. Factorial validity was assessed by confirmatory factor analysis (CFA), and criterion validity was examined by testing the S-ERI's association with perceived health, controlling for other factors.

RESULTS

The study participants were primarily young and mid-aged White males (mean age = 42 years, 75% White non-Hispanic, 93% males). The S-ERI questionnaire showed satisfactory internal consistency, with Cronbach α coefficients above 0.80 for all three scales: effort 0.82, reward 0.83, and overcommitment 0.81. CFA showed all the S-ERI components had a good fit (goodness-of-fit index = 0.99, comparative fit index = 0.92, root mean square error of approximation = 0.06). In terms of criterion validity, significantly increased odds ratios (ORs) for perceived health (those indicating they were less healthy) were found in firefighters in the lowest tertile of reward (OR = 7.06, 95% confidence interval [CI]: 2.86-17.43), and highest tertile of overcommitment (OR = 2.29, 95% CI: 1.00-5.22), after controlling for other factors.

CONCLUSION

The S-ERI questionnaire is a reliable and valid measure to assess occupational stress. We recommend the use of S-ERI as a measure of occupational stress when initiating efforts to improve firefighters' wellness.

Insecure Adult Attachment Style and PTSD Symptom Severity among Firefighters: The Role of Distress Tolerance

Trauma exposure and posttraumatic stress disorder (PTSD) symptoms among firefighters are prevalent and well-documented. Insecure adult attachment style (AAS) and distress tolerance (DT) present two factors with demonstrated relevance to the etiology and maintenance of PTSD. Few studies have examined these constructs in relation to PTSD symptomatology among firefighter populations. The present investigation examined the indirect effect of insecure romantic AAS (i.e., anxious AAS, avoidant AAS) on PTSD symptom severity through DT among firefighters. Exploratory analyses examined this model with each of the PTSD symptom clusters as outcomes. The sample was comprised of 105 firefighters (Mage=40.43, SD=9.15, 95.2% male) recruited from various departments in the southern U.S. An indirect effect was calculated using 10,000 bootstrapped samples. Indirect effects models in the primary analyses were significant when both anxious AAS (β=.20, SE=.10, CI=.06-.43) and avoidant AAS (β=.28, SE=.12, CI=.08-.54) were evaluated as predictors. Effects were evident after accounting for gender, relationship status, years of fire service, and trauma load (i.e., number of potentially traumatic event types experienced). Exploratory analyses revealed that anxious and avoidant AAS are both indirectly related to the PTSD intrusion, negative alterations in cognitions and mood, and alterations in arousal and reactivity symptom clusters through DT. Anxious AAS also demonstrated an indirect association with PTSD avoidance symptoms through DT. Attachment styles may influence PTSD symptoms among firefighters through a firefighter's perceived ability to withstand emotional distress. This line of inquiry has potential to inform specialized intervention programs for firefighters. Clinical and empirical implications are discussed.

Association Between Atrial Fibrillation and Occupational Exposure in Firefighters Based on Self-Reported Survey Data

Background Exposure to inhaled smoke, pollutants, volatile organic compounds, and polycyclic aromatic hydrocarbons in the firefighting environment has been associated with detrimental respiratory and cardiovascular effects, making firefighters a unique population with both personal and occupational risk factors for cardiovascular disease. Some of these exposures are also associated with development of atrial fibrillation. We aimed to study the association of atrial fibrillation and occupational exposure in firefighters. Methods and Results A cross-sectional survey was conducted between October 2018 and December 2019. Data were gathered electronically and stored in a secure REDCap database through Louisiana State University Health Shreveport. Firefighters who were members of at least 1 of 5 preselected professional organizations were surveyed via electronic links distributed by the organizations. The survey queried the number of fires fought per year as a measure of occupational exposure, as well as self-reported cardiovascular disease. A total of 10 860 active firefighters completed the survey, of whom 93.5% were men and 95.5% were aged ≤60 years. Firefighters who fought a higher number of fires per year had a significantly higher prevalence of atrial fibrillation (0-5 fires per year 2%, 6-10 fires per year 2.3%, 11-20 fires per year 2.7%, 21-30 fires per year 3%, 31 or more fires per year 4.5%; P<0.001). Multivariable logistic regression showed that a higher number of fires fought per year was associated with an increased risk of atrial fibrillation (odds ratio 1.14 [95% CI, 1.04-1.25]; P=0.006). Conclusions Firefighters may have an increased risk of atrial fibrillation associated with the number of fires they fight per year. Further clinical and translational studies are needed to explore causation and mechanisms.

Supporting Volunteer Firefighter Well-Being: Lessons from the Australian "Black Summer" Bushfires

INTRODUCTION

The 2019-2020 "Black Summer" bushfires in Australia focused the attention of the nation on the critical role that volunteer firefighters play in the response to such a disaster, spurring a national conversation about how to best support those on the frontline. The objective of this research was to explore the impact of the Black Summer bushfires on volunteer firefighter well-being and to investigate how to deliver effective well-being support.

METHODS

An explorative qualitative design underpinned by a phenomenological approach was applied. Participant recruitment followed a multi-modal sampling strategy and data were collected through semi-structured, in-depth interviews.

RESULTS

Qualitative data were collected from 58 participants aged from 23 to 61-years-of-age (average age of 46 years). All self-reported as volunteer firefighters who had responded to the Black Summer bushfires in Australia. Just over 80% of participants were male and the majority lived in the Australian states of New South Wales (65%) and Victoria (32%). All participants reported impact on their well-being, resulting from cumulative trauma exposure, responding to fires in local communities, intense work demands, minimal intervals between deployments, and disruption to primary employment. In regard to supporting well-being, four key themes emerged from data analysis: (1) Well-being support needs to be both proactive and reactive and empower local leaders to "reach in" while encouraging responders to "reach out;" (2) Employee Assistance Programs (EAPs) should not be the only well-being support option available; (3) The sharing of lived experience is important; and (4) Support programs need to address self-stigmatization.

CONCLUSION

Participants in this research identified that effective well-being support needs to be both proactive and reactive and holistic in approach.

Examination of Factors Influencing SCBA Washing Behavior among Firefighters in Metropolitan

Field-washing decontamination of equipment is an effective way for firefighters to reduce their risk of secondary contamination. No study has yet clarified the factors influencing effective field decontamination of equipment such as self-contained breathing apparatuses (SCBAs). This study sought to examine factors that influence the SCBA washing and decontamination behavior of firefighters. We conducted a questionnaire using the web-based Seoul Metropolitan Electronic Questionnaire System. As of May 2021, the survey had been sent to 3626 of 7198 Seoul career firefighters, and 1940 subjects were selected to participate in the study. Binomial logistic regression and χ2-test analyses were performed. We confirmed that previous training in SCBA washing was an important factor in effective field decontamination of SCBAs. Firefighters should be trained to perform field decontamination procedures systematically and regulations to perform field decontamination before leaving the scene of a fire should be introduced.

Informal management of health and safety risks associated with alarm response by Australian firefighters

Fire-fighters use informal strategies to manage risks to health and safety during operations. It is not known whether such strategies are used during the high-risk alarm response period. The aim of this study was to determine if informal risk management strategies are employed by Australian firefighters during the alarm response procedure, and if these strategies differ between salaried and retained personnel. Forty-six metropolitan firefighters (all male; mean age 38 years ± 10 years; 22 salaried; 24 retained) participated in semi-structured group interviews. A general inductive data analysis approach revealed that firefighters use multiple informal risk management strategies. Some similar themes were reported by both salaried and retained personnel, for example leveraging team dynamics, communication about sleep and fatigue, stress adaptation, informal debriefs, and enhancing physical preparedness. These findings could be used by fire services to tailor risk management approaches during the alarm response period. Practitioner summary: Identifying informal risk management strategies firefighters use during alarm response will allow their development, refinement and dissemination, and may help other firefighters and emergency service workers to manage these risks. This qualitative study reveals multiple informal strategies that firefighters employ during alarm response to keep themselves and their team-mates safe.

Exploring the comfort of head personal protective equipment for Chinese firefighters: An interview study

Head personal protective equipment (HPPE), such as helmets and masks, are protective equipment worn by firefighters to protect their head, neck, and face when they are performing tasks. As a wearable device, HPPE significantly affects firefighters' occupational safety and health along with job performance. This study aims to explore the influential factors of HPPE comfort and collect corresponding functional requirements. A semi-structured interview was conducted among 5 focus groups comprising 31 Chinese firefighters. Through a qualitative analysis of the interview results, eight dimensions of HPPE comfort were proposed: perceived change, movement, attachment, harm, emotion, anxiety, thermal comfort, and comfort of vision and hearing. The aspects of weight and size matching are the important reasons behind the comfort problems of the current HPPE. Four aspects of functional requirements were summarized: communication tools, goggles, full-face helmets, and lighting. The study findings will provide references for improving HPPE design.

High Intensity Functional Training (HIFT) Improves Fitness in Recruit Firefighters

BACKGROUND

Firefighting is a strenuous profession requiring adequate levels of fitness for effective job performance. Providing firefighters with a safe and effective fitness program is essential for optimal performance. The purpose of this project was to examine changes in various parameters of physical fitness and firefighter ability following a 7-week high intensity functional training (HIFT) program.

METHODS

Participants were male firefighter recruits (N = 89; age = 27.1 ± 4.2 years, height = 1.78 ± 0.1 m, BMI = 28.1 ± 4.2) enrolled in a Basic Operations Firefighter Academy. Fitness and firefighting ability (via the Academy Firefighter Challenge) were assessed at Weeks 1 and 7 of the Academy.

RESULTS

Significant improvements in both fitness and firefighter ability were seen following the HIFT program. Specifically, fitness (BMI, cardiovascular fitness, muscular endurance) improved significantly [Hotelling's T² = 8.98, F(5, 84) = 150.92, p < 0.001, η²_p = 0.90]. Firefighter ability also improved significantly [Hotelling's T² = 3.95, F(7, 88) = 46.26, p < 0.001, η²_p = 0.80].

CONCLUSIONS

Following a 7-week Basic Operations Firefighter Academy that included daily HIFT, significant increases in fitness and firefighting ability were observed. These findings suggest that HIFT appears to be an effective means of improving fitness and firefighting ability in recruit firefighters.

Bacteria Associated with Healthcare-Associated Infections on Environmental Samples Obtained from Two Fire Departments

(1) Background: Firefighters spend about 64% of their time responding to medical emergencies and providing medical care without a patient history, which can render them vulnerable to healthcare-associated infections (HAI). Infection prevention, control, and surveillance systems have been instituted at hospitals. However, the prevalence of firefighters’ exposure to HAI is unknown. The objective of this study was to document evidence of HAI on surfaces in fire stations and engines to inform disinfection procedures and identify which pathogens might contribute to occupational exposures. (2) Methods: High-touch or high-use surfaces of two fire departments were sampled during five separate occasions. One fire station from one fire department was sampled over a 4-week period, whereas four fire stations were sampled from a different fire department only once. Sampled surfaces included: entryway floor, washing machine, medical bag, back seat of engine, keyboard of reporting computer, engine console, and uniform pants. (3) Results: Multiple statistical models determined that bacterial contamination was similar between the two fire departments and their stations. Keyboards were the most contaminated surface for all fire stations and departments, E. coli was the most common bacteria detected, and C. difficile was the least detected bacteria. Adjustments for rates of contamination found that contamination rates varied between fire stations. (4) Conclusions: Comprehensive environmental sampling and clinical studies are needed to better understand occupational exposures of firefighters to HAI.