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Cochran SJ, Dunigan-Russell K, Hutton GM, Nguyen H, Schladweiler MC, Jones DP, Williams WC, Fisher AA, Gilmour MI, Dye JA, Smith MR, Miller CN, Gowdy KM. Repeated exposure to eucalyptus wood smoke alters pulmonary gene and metabolic profiles in male Long-Evans rats. Toxicol Sci 2024; 199:332-348. [PMID: 38544285 PMCID: PMC11131017 DOI: 10.1093/toxsci/kfae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Exposure to wildfire smoke is associated with both acute and chronic cardiopulmonary illnesses, which are of special concern for wildland firefighters who experience repeated exposure to wood smoke. It is necessary to better understand the underlying pathophysiology by which wood smoke exposure increases pulmonary disease burdens in this population. We hypothesize that wood smoke exposure produces pulmonary dysfunction, lung inflammation, and gene expression profiles associated with future pulmonary complications. Male Long-Evans rats were intermittently exposed to smoldering eucalyptus wood smoke at 2 concentrations, low (11.0 ± 1.89 mg/m3) and high (23.7 ± 0.077 mg/m3), over a 2-week period. Whole-body plethysmography was measured intermittently throughout. Lung tissue and lavage fluid were collected 24 h after the final exposure for transcriptomics and metabolomics. Increasing smoke exposure upregulated neutrophils and select cytokines in the bronchoalveolar lavage fluid. In total, 3446 genes were differentially expressed in the lungs of rats in the high smoke exposure and only 1 gene in the low smoke exposure (Cd151). Genes altered in the high smoke group reflected changes to the Eukaryotic Initiation Factor 2 stress and oxidative stress responses, which mirrored metabolomics analyses. xMWAS-integrated analysis revealed that smoke exposure significantly altered pathways associated with oxidative stress, lung morphogenesis, and tumor proliferation pathways. These results indicate that intermittent, 2-week exposure to eucalyptus wood smoke leads to transcriptomic and metabolic changes in the lung that may predict future lung disease development. Collectively, these findings provide insight into cellular signaling pathways that may contribute to the chronic pulmonary conditions observed in wildland firefighters.
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Affiliation(s)
- Samuel J Cochran
- Division of Pulmonary, Critical Care and Sleep Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio 43210, USA
| | - Katelyn Dunigan-Russell
- Division of Pulmonary, Critical Care and Sleep Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio 43210, USA
| | - Grace M Hutton
- Division of Pulmonary, Critical Care and Sleep Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio 43210, USA
| | - Helen Nguyen
- Oak Ridge Institute for Science and Education, U.S. Environmental Protection Agency, Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina 27711, USA
| | - Mette C Schladweiler
- Cardiopulmonary and Immunotoxicology Branch, Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA
| | - Dean P Jones
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University, Atlanta, Georgia 30322, USA
| | - Wanda C Williams
- Cardiopulmonary and Immunotoxicology Branch, Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA
| | - Anna A Fisher
- Cardiopulmonary and Immunotoxicology Branch, Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA
| | - M Ian Gilmour
- Cardiopulmonary and Immunotoxicology Branch, Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA
| | - Janice A Dye
- Cardiopulmonary and Immunotoxicology Branch, Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA
| | - M Ryan Smith
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University, Atlanta, Georgia 30322, USA
- Atlanta Veterans Affairs Healthcare System, Decatur, Georgia 30033, USA
| | - Colette N Miller
- Cardiopulmonary and Immunotoxicology Branch, Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA
| | - Kymberly M Gowdy
- Division of Pulmonary, Critical Care and Sleep Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio 43210, USA
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Marvin G, Schram B, Orr R, Canetti EFD. Occupation-Induced Fatigue and Impacts on Emergency First Responders: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7055. [PMID: 37998287 PMCID: PMC10671419 DOI: 10.3390/ijerph20227055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
Fatigue in emergency first responders (EFRs) is known to affect performance abilities and safety outcomes for both patients and EFRs. The primary aim of this review was to determine the main contributors to occupation-induced fatigue in EFRs and its subsequent impacts. Following the PRIMSA checklist, academic databases (Medline, Embase, CINAHL, and SPORTDiscus) were searched using key terms with results subjected to inclusion and exclusion criteria. Populations of interest were firefighters, paramedics, or emergency call centre personnel. Of the 5633 records identified, 43 studies, which reported on 186 unique measures from a total population of 6373 participants, informed the review. Synthesis revealed fatigue was caused by lack of sleep during the shift and consistent poor sleep quality which negatively impacted cognitive function, alertness, and physical and mental health while increasing safety-compromising behaviours and injuries. Both subjective and objective assessments of fatigue are necessary for effective risk management in EFRs. EFRs that are consistently fatigued are at a greater risk of poor physical and mental health, reduced cognitive function, and increased injuries. No studies reported on fatigue in emergency call centre personnel, highlighting a literature gap. Funding was provided by the Australian Capital Territory Emergency Services Agency. Preregistration was filed in OSF: osf.io/26f3s.
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Affiliation(s)
- Graham Marvin
- Tactical Research Unit, Faculty of Health Sciences & Medicine, Bond University, Robina, QLD 4226, Australia
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Christison KS, Sol JA, Gurney SC, Dumke CL. Wildland Firefighter Critical Training Elicits Positive Adaptations to Markers of Cardiovascular and Metabolic Health. Wilderness Environ Med 2023; 34:328-333. [PMID: 37258395 DOI: 10.1016/j.wem.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/03/2023] [Accepted: 04/10/2023] [Indexed: 06/02/2023]
Abstract
INTRODUCTION The purpose of this study was to identify physiologic changes in body composition and resting metabolic markers of health across 2 wk of critical training (CT) in wildland firefighters (WLFFs). METHODS Twenty-two male and 3 female participants were recruited from 2 hotshot crews across the western United States prior to the 2022 fire season and monitored over their 80-h CT. Body weight (BW) and skinfolds were recorded before and after CT to estimate body fat (BF) and lean body weight (LBW). Blood was analyzed for changes in hematocrit, hemoglobin, plasma volume, and resting values of a lipid and metabolic panel. RESULTS The high physical demands of CT resulted in improvements in total cholesterol (-19.3 mg/dL, P<0.001), triglycerides (-34.4 mg/dL, P<0.001), low-density lipoprotein cholesterol (-18.1 mg/dL, P<0.001), very-low-density lipoprotein cholesterol (-5.2 mg/dL, P<0.001), high-density lipoprotein cholesterol (+4.0 mg/dL, P=0.002), non-high-density lipoprotein cholesterol (-19.3 mg/dL, P<0.001), and fasting glucose (-4.3 mg/dL, P=0.008) from before CT to after CT. Significant decreases in hemoglobin and hematocrit were also seen (P<0.001) with corresponding increases in estimated plasma volume (+6.1%, P<0.001). These alterations were seen despite maintenance of BW, LBW, and BF. Lower pretraining BF was associated with a greater magnitude of improvements in fasting glucose and cholesterol markers. CONCLUSIONS The observed improvements in baseline metabolic and cardiovascular markers along with plasma volume expansion suggest a positive response to the physical stress of WLFF CT. It appears that higher preseason fitness was associated with greater adaptations to the CT stressor.
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Affiliation(s)
- Katherine S Christison
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT
| | - Joseph A Sol
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT; United States Department of Agriculture, Forest Service, National Technology and Development Program, Missoula, MT
| | - Shae C Gurney
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT
| | - Charles L Dumke
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT.
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D King G, Pan E, Millin MG. Wilderness First Responder Medical Clearance - A Scoping Review with Recommendations. PREHOSP EMERG CARE 2023; 28:50-75. [PMID: 36595615 DOI: 10.1080/10903127.2022.2162650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/13/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE Due to environmental extremes, as well as the nature of the work itself, wilderness first responders are at risk of incurring medical events in the line of duty. There currently do not exist standardized and scientifically supported methods to screen for a wilderness first responder's risk of incurring a medical event. METHODS We performed multiple scoping reviews using PubMed and CINAHL. The reviews covered six medical screening criteria based on previous recommendations from the National Fire Protection Association (NFPA) and the US Forest Service, and we grouped our reviews into two categories: articles that addressed objective screening criteria, and articles that addressed subjective findings with the first responder. RESULTS Of the objective criteria, our reviews identified 21 articles addressing the ability to screen for risk of incurring a medical event by evaluation of a first responder's heart rate, 12 by blood pressure assessment, and 56 by assessment of body temperature. Of the subjective criteria we identified 19 articles focused on self-assessment, 34 articles on the use of standardized tools to assess for fatigue and sleepiness, and two articles on assessment of a first responder's urine to determine level of dehydration. We also identified seven additional articles through a hand search. Overall, there were 151 articles identified in our scoping reviews. These articles were largely of low quality, consisting mostly of case series without comparison groups. CONCLUSION There is a dearth of high-quality research into the medical assessment of first responders. We recommend that this paper, and measures discussed within it, be used as a starting point in the development of an evidence-based assessment protocol for wilderness first responders. We also recommend the development of a national database of medical events incurred by wilderness first responders to facilitate higher-quality research of screening protocols in this community.
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Affiliation(s)
- Gregory D King
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Maryland and Mid-Atlantic Wilderness Rescue Squad, Inc./Austere Medical Professionals, Dayton, Maryland, USA
| | - Erik Pan
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Maryland and Mid-Atlantic Wilderness Rescue Squad, Inc./Austere Medical Professionals, Dayton, Maryland, USA
| | - Michael G Millin
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Maryland and Mid-Atlantic Wilderness Rescue Squad, Inc./Austere Medical Professionals, Dayton, Maryland, USA
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Billings JM, Haddock CK, Jahnke SA. Intra-Tour Variation of Firefighter Sleep Duration and Sleep-Wake Cycle within the 24/48 and 48/96 Shift Schedules. Behav Sleep Med 2023; 21:1-12. [PMID: 34989296 DOI: 10.1080/15402002.2021.2021912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The purpose of this paper is to investigate intra-tour variation in total sleep time (TST) and sleep-wake cycle among US firefighters working the 24 hours on and 48 hours off shift schedule (24/48) and the 48 hours on and 96 hours off shift schedule (48/96). METHODS Twenty-four firefighters were recruited for this sleep study and were evaluated over 18 days during a 24/48 shift schedule and again 6 months after firefighters transitioned to a 48/96 shift schedule. The primary outcome variables included TST, measured by actigraphy, and sleep-wake cycle (in-bed time and sleep offset) using the Emergency Services Sleep Diary. RESULTS Firefighters experienced intra-tour variations in TST and sleep offset. The least TST occurred at home prior to starting shift on the 24/48 and 48/96 schedules (5.80 hours and 5.66 hours, respectively). The second least TST occurred the night preceding shift end (5.84 hours and 5.81 hours, respectively). In contrast to in-bed time, sleep offset varied throughout the schedule and was found to correlate with TST. In addition, shift start/end time appears to be responsible for advanced sleep offset. CONCLUSION Results indicate that firefighters' sleep is complex and should not be reduced to singular averages. In both schedules, firefighters arrived at work with insufficient sleep, received insufficient sleep while on shift, and would commute home with insufficient sleep. These findings can inform future firefighter sleep research by accounting for intra-tour variations.
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Affiliation(s)
- Joel M Billings
- Department of Security and Emergency Services, Embry-Riddle Aeronautical University, Daytona Beach, Florida, USA
| | - C K Haddock
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Leawood, Kansas, USA
| | - S A Jahnke
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Leawood, Kansas, USA
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Pelletier C, Ross C, Bailey K, Fyfe TM, Cornish K, Koopmans E. Health research priorities for wildland firefighters: a modified Delphi study with stakeholder interviews. BMJ Open 2022; 12:e051227. [PMID: 35115350 PMCID: PMC8814744 DOI: 10.1136/bmjopen-2021-051227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES The increase in global wildland fire activity has accelerated the urgency to understand health risks associated with wildland fire suppression. The aim of this project was to identify occupational health research priorities for wildland firefighters and related personnel. DESIGN In order to identify, rank and rate health research priorities, we followed a modified Delphi approach. Data collection involved a two-stage online survey followed by semi-structured interviews. SETTING British Columbia, Canada. PARTICIPANTS Participants included any current or past wildland firefighter or individuals engaged in related roles. There were 132 respondents to the first survey. Responses to the first survey were analysed to produce 10 research topics which were ranked by 75 participants in the second survey (response rate: 84%). PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the identification, ranking and level of agreement of research priorities through a two-round online survey. We contextualised these findings through deductive and inductive qualitative content analysis of semi-structured interviews. RESULTS The most important research priorities identified were (% consensus): effects of smoke inhalation on respiratory health (89%), fatigue and sleep (80%), mental health (78%), stress (76%) and long-term risk of disease (67%). Interviews were completed with 14 individuals. Two main themes were developed from an inductive content analysis of interview transcripts: (1) understanding the dynamic risk environment; and (2) organisational fit of mitigation strategies. CONCLUSIONS Participants expressed a general concern with the unknown mental and physical health impacts of their jobs, including the long-term risk of morbidity and mortality. Future research must address knowledge gaps in our understanding of the health impacts of wildland fire and work to develop appropriate mitigation strategies while considering the needs of workers and unpredictable workplace environment. TRIAL REGISTRATION NUMBER Open Science Framework, https://osf.io/ugz4s/.
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Affiliation(s)
- Chelsea Pelletier
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Christopher Ross
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Katherine Bailey
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Trina M Fyfe
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Katie Cornish
- Health Research Institute, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Erica Koopmans
- Health Research Institute, University of Northern British Columbia, Prince George, British Columbia, Canada
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Canetti EFD, Gayton S, Schram B, Pope R, Orr RM. Psychological, Physical, and Heat Stress Indicators Prior to and after a 15-Minute Structural Firefighting Task. BIOLOGY 2022; 11:biology11010104. [PMID: 35053102 PMCID: PMC8773347 DOI: 10.3390/biology11010104] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/07/2022] [Accepted: 01/07/2022] [Indexed: 11/16/2022]
Abstract
Firefighters work in strenuous conditions for prolonged periods wearing up to 20 kg of personal protective equipment. This often contributes to significant heat and cardiovascular strain. This study examined the relationships between psychological and physical measures taken prior to undertaking a 15 min firefighting task, and the occurrence of heat stress and high levels of fatigue following the task. Nine qualified firefighters completed a 15 min “live burn” scenario designed to mimic a fire started by a two-seater couch in a lounge room and completed simulated tasks throughout the duration. Logical reasoning, speed and accuracy, general motivation and fatigue, and physical and mental effort were recorded pre-scenario, and at 0- and 20-min post-scenario. General motivation and fatigue scores at 0- and 20-min post-scenario were highly correlated with each other (rs = 0.90; p = 0.001). The general motivation and fatigue scores, at 0- and 20-min post-scenario, were also strongly related to pre-task logic/reasoning test scores (Post 0 rs = −0.77, p = 0.016; Post 20 rs = −0.87, p = 0.002). Firefighters with lower logical reasoning and speed and accuracy scores were more susceptible to fatigue and impaired cognition when exposed to rises in core temperature and heat stress.
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Affiliation(s)
- Elisa F. D. Canetti
- Tactical Research Unit, Bond University, Gold Coast 4226, Australia; (S.G.); (B.S.); (R.P.); (R.M.O.)
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast 4226, Australia
- Correspondence: ; Tel.: +61-(07)-5595-4106
| | - Scott Gayton
- Tactical Research Unit, Bond University, Gold Coast 4226, Australia; (S.G.); (B.S.); (R.P.); (R.M.O.)
| | - Ben Schram
- Tactical Research Unit, Bond University, Gold Coast 4226, Australia; (S.G.); (B.S.); (R.P.); (R.M.O.)
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast 4226, Australia
| | - Rodney Pope
- Tactical Research Unit, Bond University, Gold Coast 4226, Australia; (S.G.); (B.S.); (R.P.); (R.M.O.)
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury-Wodonga 2640, Australia
| | - Robin M. Orr
- Tactical Research Unit, Bond University, Gold Coast 4226, Australia; (S.G.); (B.S.); (R.P.); (R.M.O.)
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast 4226, Australia
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Koopmans E, Cornish K, Fyfe TM, Bailey K, Pelletier CA. Health risks and mitigation strategies from occupational exposure to wildland fire: a scoping review. J Occup Med Toxicol 2022; 17:2. [PMID: 34983565 PMCID: PMC8725416 DOI: 10.1186/s12995-021-00328-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/24/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Due to accelerating wildland fire activity, there is mounting urgency to understand, prevent, and mitigate the occupational health impacts associated with wildland fire suppression. The objectives of this review of academic and grey literature were to: 1. Identify the impact of occupational exposure to wildland fires on physical, mental, and emotional health; and 2. Examine the characteristics and effectiveness of prevention, mitigation, or management strategies studied to reduce negative health outcomes associated with occupational exposure to wildland fire. METHODS Following established scoping review methods, academic literature as well as government and industry reports were identified by searching seven academic databases and through a targeted grey literature search. 4679 articles were screened using pre-determined eligibility criteria. Data on study characteristics, health outcomes assessed, prevention or mitigation strategies studied, and main findings were extracted from each included document. The results of this scoping review are presented using descriptive tables and a narrative summary to organize key findings. RESULTS The final sample was comprised of 100 articles: 76 research articles and 24 grey literature reports. Grey literature focused on acute injuries and fatalities. Health outcomes reported in academic studies focused on respiratory health (n = 14), mental health (n = 16), and inflammation and oxidative stress (n = 12). The identified studies evaluated short-term outcomes measuring changes across a single shift or wildland fire season. Most research was conducted with wildland firefighters and excluded personnel such as aviation crews, contract crews, and incident management teams. Five articles reported direct study of mitigation strategies, focusing on the potential usage of masks, advanced hygiene protocols to reduce exposure, fluid intake to manage hydration and core temperature, and glutamine supplementation to reduce fatigue. CONCLUSIONS While broad in scope, the evidence base linking wildland fire exposure to any one health outcome is limited. The lack of long-term evidence on changes in health status or morbidity is a clear evidence gap and there is a need to prioritize research on the mental and physical health impact of occupational exposure to wildland fire.
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Affiliation(s)
- Erica Koopmans
- Health Research Institute, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Katie Cornish
- Health Research Institute, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Trina M Fyfe
- Northern Medical Program, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Katherine Bailey
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Chelsea A Pelletier
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada.
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Billings JM. Firefighter sleep: a pilot study of the agreement between actigraphy and self-reported sleep measures. J Clin Sleep Med 2022; 18:109-117. [PMID: 34314350 PMCID: PMC8807900 DOI: 10.5664/jcsm.9566] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
STUDY OBJECTIVES The aim of this study is to determine the extent of agreement between self-reported measurements of total sleep time (TST) and actigraphy in the fire and emergency services occupation. METHODS Twenty-four firefighters participated in an 18-day study. Four measurements were used to assess TST: Pittsburgh Sleep Quality Index, a newly developed habitual Extended Sleep Survey, a newly developed daily Emergency Services Sleep Diary (ESSD), and actigraphy. The Extended Sleep Survey and ESSD were constructed to address the specific job-related characteristics of fire and emergency services that other measurements cannot achieve (eg, multiple sleep episode in a single night). RESULTS The Pittsburgh Sleep Quality Index TST is least accurate compared to actigraphy. The Extended Sleep Survey TST shows improvement over Pittsburgh Sleep Quality Index TST, but was statistically different from actigraphy TST. No difference in mean TST was found between ESSD TST and actigraphy TST. Furthermore, ESSD TST and actigraphy TST correlated strongly together. CONCLUSIONS Without modification, traditional self-reported measures may not be appropriate in the fire and emergency service occupation. This study suggests that the ESSD may serve as a useful alternative to actigraphy to measure TST. CITATION Billings JM. Firefighter sleep: a pilot study of the agreement between actigraphy and self-reported sleep measures. J Clin Sleep Med. 2022;18(1):109-117.
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Affiliation(s)
- Joel M. Billings
- Address correspondence to: Joel M. Billings, PhD, Department of Security and Emergency Services, Embry-Riddle Aeronautical University, 1 Aerospace Boulevard, Daytona Beach, Florida 32114;
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Demiralp N, Özel F. Evaluation of metabolic syndrome and sleep quality in shift workers. Occup Med (Lond) 2021; 71:453-459. [PMID: 34791382 DOI: 10.1093/occmed/kqab140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Shift workers have risks associated with metabolic syndrome and low sleep quality. AIMS This study aimed to examine metabolic syndrome and sleep quality in firefighters and mine workers working shifts and daytime hours. METHODS A comparative descriptive study was conducted in two institutions on firefighters and mine workers (n = 120) who were working shifts (n = 84) and working daytime hours (n = 36). The data were obtained using a questionnaire including socio-demographic information, anthropometric measurements and the Pittsburgh Sleep Quality Index. RESULTS When risk of metabolic syndrome was compared with sleep quality, it was found that according to International Diabetes Federation criteria, 11% of those diagnosed with metabolic syndrome among shift-working firefighters and 5% of those diagnosed with metabolic syndrome among shift-working miners had low sleep quality. It was found that according to the National Cholesterol Education Program-Adult Treatment Panel III criteria, 9% of those diagnosed with metabolic syndrome among shift firefighters and 2% of those diagnosed with metabolic syndrome among shift miners had low sleep quality. CONCLUSIONS Preventive measures should be taken to reduce the risk of metabolic syndrome in shift workers.
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Affiliation(s)
- N Demiralp
- Department of Civil Defense and Fire Fighting Program, Kastamonu University, Bozkurt Vocational High School, Kastamonu, Turkey
| | - F Özel
- Department of Nursing, Kastamonu University, School of Health Science, Kastamonu, Turkey
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