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Orysiak J, Młynarczyk M, Piec R, Jakubiak A. Lifestyle and environmental factors may induce airway and systemic inflammation in firefighters. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:73741-73768. [PMID: 36094704 PMCID: PMC9465149 DOI: 10.1007/s11356-022-22479-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/07/2022] [Indexed: 06/15/2023]
Abstract
Health status depends on multiple genetic and non-genetic factors. Nonheritable factors (such as lifestyle and environmental factors) have stronger impact on immune responses than genetic factors. Firefighters work is associated with exposure to air pollution and heat stress, as well as: extreme physical effort, mental stress, or a changed circadian rhythm, among others. All these factors can contribute to both, short-term and long-term impairment of the physical and mental health of firefighters. Increased levels of some inflammatory markers, such as pro-inflammatory cytokines or C-reactive protein (CRP) have been observed in firefighters, which can lead to local, acute inflammation that promotes a systemic inflammatory response. It is worth emphasizing that inflammation is one of the main hallmarks of cancer and also plays a key role in the development of cardiovascular and respiratory diseases. This article presents possible causes of the development of an inflammatory reaction in firefighters, with particular emphasis on airway inflammation caused by smoke exposure.
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Affiliation(s)
- Joanna Orysiak
- Central Institute for Labour Protection - National Research Institute, Czerniakowska St. 16, 00-701, Warsaw, Poland.
| | - Magdalena Młynarczyk
- Central Institute for Labour Protection - National Research Institute, Czerniakowska St. 16, 00-701, Warsaw, Poland
| | - Robert Piec
- Institute of Internal Security, The Main School of Fire Service, Słowackiego St. 52/54, 01-629, Warsaw, Poland
| | - Agnieszka Jakubiak
- Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Żwirki and Wigury St. 61, 02-091, Warsaw, Poland
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Carballo-Leyenda B, Villa-Vicente JG, Delogu GM, Rodríguez-Marroyo JA, Molina-Terrén DM. Perceptions of Heat Stress, Heat Strain and Mitigation Practices in Wildfire Suppression across Southern Europe and Latin America. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12288. [PMID: 36231589 PMCID: PMC9566145 DOI: 10.3390/ijerph191912288] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to assess current perceptions of heat stress, heat strain, acclimatisation and recovery practices in wildland fire suppression. A total of 1459 wildfire and structural firefighters, all involved in wildland fire suppression, completed an 18-question survey. Most participants (81.3%) reported heat strain as one of the main risks faced during wildland firefighting. Thermal strain is considered an important risk for health and safety in wildland firefighting. The best-valued heat strain mitigation strategies were those traditionally recommended in wildland fire suppression: (i) an adequate work/rest ratio (79.0%), (ii) acclimatisation (71.6%), (iii) enhancing body ventilation by opening protective clothing or removing helmets or gloves (63.5%), and (iv) drinking water and food supplementation (52.1%). Despite these results, only 22% of the participants reported carrying out acclimatisation in the workplace. The vast majority of the respondents (87.4%) consider active cooling strategies (i.e., ice slurry ingestion, ice vests, etc.) impractical in combating heat strain during wildfire suppression. We identified a gap between knowledge about heat strain, its mitigation strategies and the level of actual implementation of these practices in the workplace. Our results highlight the need to improve heat strain management and implement operational directives for acclimatisation and active cooling interventions.
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Affiliation(s)
- Belén Carballo-Leyenda
- VALFIS Research Group, Department of Physical Education and Sports Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - José Gerardo Villa-Vicente
- VALFIS Research Group, Department of Physical Education and Sports Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Giuseppe M. Delogu
- Department of Science for Nature and Environmental Resources (DipNeT), University of Sassari, Sardinia, 07100 Sassari, Italy
| | - Jose A. Rodríguez-Marroyo
- VALFIS Research Group, Department of Physical Education and Sports Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Domingo M. Molina-Terrén
- Department of Crops and Forest Sciences, School of Agrifood and Forestry Science and Engineering, University of Lleida, 25198 Lleida, Spain
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Park GJ, Kong SY, Shin DM, Lee DI, Ku BS, Oh JH, Kim SC. Acute Physiological Response of Live-Fire Simulation Activities Affecting Cardiovascular Health in Live-Fire Instructors: A Randomized Controlled Simulation Study. J Occup Environ Med 2022; 64:46-51. [PMID: 34310541 DOI: 10.1097/jom.0000000000002330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to assess acute physiological response of fire suppression simulation affecting cardiovascular health during repeated bouts of simulation. METHODS Fifteen live-fire instructors were randomly divided into three groups according to fire suppression simulation frequency. Vital signs, biomarkers, and heart rate variability (HRV) were measured before and after simulation. RESULTS Vital signs increased immediately after fire simulation and returned to the normal range after 2 h. Most biomarker levels were changed within the normal ranges 72 h after the simulation training. However, one of the HRV frequency domains, high frequency power, was severely suppressed after 1 h and tended to recover after 2 h of simulation (P < 0.05). CONCLUSIONS Vital signs and their biomarkers were changed within the normal range regardless of the number of bouts of fire suppression simulations. HRV could be used to assess the effects of fire suppression simulation on cardiovascular health.
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Affiliation(s)
- Gwan-Jin Park
- Department of Emergency Medicine, Chungbuk National University Hospital, 776, 1st Sunhwan-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do 28646, South Korea (Dr Park and Dr Kim); Strategic Research, Laerdal Medical Tanke Svilandsgate 30, 4002 Stavanger, Norway (Dr Kong); Department of Paramedic Science, Korea National University of Transportation, 61, Daehak-ro, Jeungpyeong-gun, Chungcheongbuk-do, 27909, South of Korea (Dr Shin); Division of Cardiology, Chungbuk National University Hospital, 776, 1st Sunhwan-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do 28646, South Korea (Dr Lee); Department of Fire Investigation and Analysis, Yongin Fire Station, 45, Myongji-ro, Cheoin-gu, Yongin-si, Gyeonggi-do, 17057, South Korea (Mr Ku); Icheon Fire Station, 2739, Gyeongchung-daero, Icheon-si, Gyeonggi-do, 17379, South Korea (Mr Oh); Department of Emergency Medicine, College of Medicine, Chungbuk National University, 1 Chungdae-ro, Seowongu, Cheongju-si, Chungcheongbuk-do 28646, South Korea (Dr Kim)
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Fullagar HHK, Schwarz E, Richardson A, Notley SR, Lu D, Duffield R. Australian firefighters perceptions of heat stress, fatigue and recovery practices during fire-fighting tasks in extreme environments. APPLIED ERGONOMICS 2021; 95:103449. [PMID: 34015663 DOI: 10.1016/j.apergo.2021.103449] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/21/2021] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The aim of this study was to assess current perceptions of heat stress, fatigue and recovery practices during active duty in Australian firefighters. DESIGN Prospective survey. METHODS 473 firefighters from Fire and Rescue New South Wales completed a two-part, 16-item survey. Questions included perceptions of the operational activities and body areas associated with the most heat stress, the most mentally and physically demanding activities, and levels of fatigue felt. Further questions focussed on the use and importance of recovery practices, effectiveness of currently used heat-mitigation strategies and additional cooling strategies for future use. RESULTS Around a third of firefighters (62%) reported structural fire-fighting as the hottest operational activities experienced, followed by bushfire-fighting (51%) and rescue operations (38%). The top three responses for which body-parts get the hottest ranked as 'the head' (58%), 'the whole body' (54%) and 'the upper back' (40%), respectively. The majority of firefighters (~90%) stated they always or sometimes use the opportunity to recover at an incident, with the top three being 'sit in the shade' (93%), 'cold water ingestion (drinking)' (90%) and 'removing your helmet, flash hood and jacket' (89%). Firefighters reported higher usefulness for more easily deployed strategies compared to more advanced strategies. Limited age and gender differences were found, although location of active service differences were present. CONCLUSION These findings may inform future research, and translation to operational directives for recovery interventions; including exploration of protective gear and clothing, education, resources and provision of cooling methods, as well as recovery aid development.
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Affiliation(s)
- Hugh H K Fullagar
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Australia.
| | - Edgar Schwarz
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Australia; Institute of Sports and Preventive Medicine, Saarland University, Campus, Geb. B8 2, 66123, Saarbrücken, Germany. https://twitter.com/edgarschwarz
| | | | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada. https://twitter.com/seannotley
| | - Donna Lu
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Australia
| | - Rob Duffield
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Australia
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Watkins ER, Hayes M, Watt P, Renshaw D, Richardson AJ. Extreme occupational heat exposure is associated with elevated haematological and inflammatory markers in Fire Service Instructors. Exp Physiol 2020; 106:233-243. [PMID: 32462715 DOI: 10.1113/ep088386] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/20/2020] [Indexed: 12/22/2022]
Abstract
NEW FINDINGS What is the central question of this study? Fire service instructors are frequently exposed to live fire scenarios, representing the most extreme chronic occupational heat exposure. These individuals report a series of unique health issues. We sought to identify whether the number of exposures completed was associated with inflammatory and immunological markers and symptoms of ill health. What is the main finding and its importance? Fire service instructors exhibit greater levels of inflammatory markers in comparison to firefighters. The number of exposures to fire is positively related to the prevalence of ill health and inflammation. Implementation of a proposed limit of nine exposures per month might be appropriate to minimize health issues. ABSTRACT Fire Service Instructors (FSIs) experience ∼10 times more fire exposures than firefighters (FFs), and the increased physiological stress from this potentially puts them at risk of ill health and future cardiac events. The aim of the study was to establish whether FSIs exhibit elevated biomarkers associated with cardiac event risk, identify whether FSIs experience systemic inflammation linked to the frequency of fire exposure and evaluate a proposed exposure limit of nine exposures per month. Blood samples were collected from 110 Fire Service personnel (mean ± SD, age,44 ± 7 years; height, 178.1 ± 7.1 cm; and body mass, 84.3 ± 12.0 kg; FSIs n = 53 and FFs n = 57) for biomarker analysis. Work history details were collected from all participants. Participants with biomarker concentrations above healthy reference ranges were classified as being 'at risk'. The neutrophil-to-lymphocyte ratio, platelet count, cardiac troponin T, interleukin (IL)-6, IL-1β, C-reactive protein and immunoglobulin G were greater in FSIs than in FFs (P < 0.05). Multiple regression analysis revealed that 18.8% of IL-6, 24.9% of IL-1β, 29.2% of C-reactive protein and 10.9% of immunoglobulin G variance could be explained by the number of exposures to heat per month. Odds ratios revealed that those FSIs above the nine per month exposure limit were six to 12 times more likely to be classified as 'at risk' and were 16 times more likely to experience symptoms of ill health. Increased cytokine levels suggest that FSIs experience systemic inflammation, which is related to symptoms of ill health. We propose that an exposure limit could reduce the prevalence of these biomarker risk factors and ill health.
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Affiliation(s)
- Emily R Watkins
- Department of Life Sciences, University of Roehampton, London, UK
| | - Mark Hayes
- Environmental Extremes Laboratory, Welkin Laboratories, University of Brighton, Eastbourne, UK
| | - Peter Watt
- Environmental Extremes Laboratory, Welkin Laboratories, University of Brighton, Eastbourne, UK
| | - Derek Renshaw
- Centre for Sport, Exercise & Life Sciences, Coventry University, Coventry, UK
| | - Alan J Richardson
- Environmental Extremes Laboratory, Welkin Laboratories, University of Brighton, Eastbourne, UK
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Watkins ER, Hayes M, Watt P, Richardson AJ. Heat tolerance of Fire Service Instructors. J Therm Biol 2019; 82:1-9. [DOI: 10.1016/j.jtherbio.2019.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/21/2019] [Accepted: 03/12/2019] [Indexed: 12/19/2022]
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Watkins ER, Walker A, Mol E, Jahnke S, Richardson AJ. Women Firefighters' Health and Well-Being: An International Survey. Womens Health Issues 2019; 29:424-431. [PMID: 30930075 DOI: 10.1016/j.whi.2019.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/07/2019] [Accepted: 02/22/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to identify specific health and well-being issues that women firefighters may experience as part of their daily working practices. Issues identified from this under-represented population can drive future research, education, and strategy to guide safety and health practices. METHODS A total of 840 women firefighters from 14 separate countries (255 United Kingdom and Ireland, 320 North America, 177 Australasia, and 88 mainland Europe) completed the survey over a 4-month period. Questions related to general health and well-being and role-specific health concerns, gender-related issues, and available exercise facilities. RESULTS Women firefighters in North America reported a higher prevalence of lower back (49%) and lower limb (51%) injuries than all other groups. North American respondents reported more heat illnesses (45%) than respondents from other places (36%). Although many participants did not respond, of those who did, 39% thought the menstrual cycle (199/512) or menopause (55/151) affected their work, and 36% were concerned for their ability to meet future job demands. Sixteen percent felt confident they could complete the role after 60 years of age. Women firefighters identified a lack of strength and conditioning support (50%) or lack of gym access (21%). There appears to be poor availability of female-specific personal protective equipment, with availability greatest in the United Kingdom (66%) compared with the sample as a whole (42%). CONCLUSIONS There is a need for female-specific strength and conditioning support and facilities to decrease injury and illness risk and improve longevity. Research and education into gynecological issues, heat exposure, and their effects on women firefighters' fertility and cancer risk is required.
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Affiliation(s)
- Emily R Watkins
- Extreme Environments Lab, University of Brighton, Welkin Laboratories, Eastbourne, East Sussex, UK
| | - Anthony Walker
- University of Canberra Research Institute for Sports and Exercise, University of Canberra, Canberra, Australia
| | - Eric Mol
- Experts in Firefighting Performance, Dutch Safety Board, Baarn, The Hague, The Netherlands
| | - Sara Jahnke
- Center for Fire, Rescue & EMS Health Research, National Development & Research Institutes, Leawood, Kansas
| | - Alan J Richardson
- Extreme Environments Lab, University of Brighton, Welkin Laboratories, Eastbourne, East Sussex, UK.
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Watkins ER, Hayes M, Watt P, Richardson AJ. The acute effect of training fire exercises on fire service instructors. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2019; 16:27-40. [PMID: 30277854 DOI: 10.1080/15459624.2018.1531132] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Fire service instructors (FSI) regularly experience different types of fire exercises, however the strain experienced from these scenarios is not well understood. This study aims to identify the physiological and perceptual strain of Fire Service Instructors (FSI) to three training exercises: DEMO, ATTACK, COMPARTMENT, and the different roles performed: SETTER, INSTRUCTOR. The study also aims to assess the effect that different exercise patterns over a day (BOX, MULTI, COMBINATION) have on immunological responses. Sixteen FSI (age: 41 ± 8 years, body mass: 83.7 ± 6.7 kg, height: 177.0 ± 6.7 cm) were recruited, with 10 FSI completing the three exercises. Physiological and perceptual measures were collected prior to and immediately post each exercise. Venous blood samples were collected at the beginning and end of each day. One-way analysis of variance (ANOVA) were conducted to assess differences in physiological variables between exercise types, independent samples t-tests were conducted between roles. Day changes in hematological variables were assessed by paired sample t-tests and analyzed by one-way ANOVAs to identify differences between exercise patterns. The COMPARTMENT exercise resulted in a greater change in rectal temperature (ΔTre) (0.49 ± 0.28 °C) than both the DEMO (0.23 ± 0.19 °C, p = 0.045) and ATTACK (0.27 ± 0.22 °C, p = 0.016). Within the COMPARTMENT exercise, the SETTER resulted in a greater ΔTre and rating of perceived exertion than the INSTRUCTOR (0.67 ± 0.29 °C vs. 0.43 ± 0.18 °C, p = 0.027 and 14 ± 2 vs. 11 ± 2, p = 0.001, respectively). Following a day of fire exercises white blood cells (WBC), neutrophils, lymphocytes (LYMPH), monocytes (MONO), platelets (PLT), mean platelet volume (MPV), Interleukin (IL)-6, and cardiac troponin T (cTnT) all increased (p < 0.05). Exercise patterns containing a COMPARTMENT exercise resulted in greater PLT, MPV, and IL-6. Total daily variation in ΔTre was correlated with post-exercise WBC, MONO, and LYMPH. COMPARTMENT exercises produce the greatest physiological strain, with the SETTER role within this exercise causing the greatest ΔTre. Although predominately physiological responses remain within safe limits. Exercise patterns that include a COMPARTMENT exercise also generate a greater inflammatory response.
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Affiliation(s)
- Emily R Watkins
- a Environmental Extremes Laboratory , University of Brighton , Eastbourne , UK
| | - Mark Hayes
- a Environmental Extremes Laboratory , University of Brighton , Eastbourne , UK
| | - Peter Watt
- a Environmental Extremes Laboratory , University of Brighton , Eastbourne , UK
| | - Alan J Richardson
- a Environmental Extremes Laboratory , University of Brighton , Eastbourne , UK
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Bach AJE, Maley MJ, Minett GM, Stewart IB. Occupational cooling practices of emergency first responders in the United States: A survey. Temperature (Austin) 2018; 5:348-358. [PMID: 30574527 DOI: 10.1080/23328940.2018.1493907] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/01/2018] [Accepted: 06/22/2018] [Indexed: 10/28/2022] Open
Abstract
Despite extensive documentation directed specifically toward mitigating thermal strain of first responders, we wished to ascertain the degree to which first responders applied cooling strategies, and what opinions are held by the various agencies/departments within the United States. An internet-based survey of first responders was distributed to the International Association of Fire Chiefs, International Association of Fire Firefighters, National Bomb Squad Advisory Board and the USA Interagency Board and their subsequent departments and branches. Individual first responder departments were questioned regarding the use of pre-, concurrent, post-cooling, types of methods employed, and/or reasons why they had not incorporated various methods in first responder deployment. Completed surveys were collected from 119 unique de-identified departments, including those working in law enforcement (29%), as firefighters (29%), EOD (28%) and HAZMAT technicians (15%). One-hundred and eighteen departments (99%) reported heat strain/illness to be a risk to employee safety during occupational duties. The percentage of departments with at least one case of heat illness in the previous year were as follows: fire (39%) HAZMAT (23%), EOD (20%) and law enforcement (18%). Post-cooling was the scheduled cooling method implemented the most (63%). Fire departments were significantly more likely to use post-cooling, as well as combine two types of scheduled cooling compared to other departments. Importantly, 25% of all departments surveyed provided no cooling whatsoever. The greatest barriers to personnel cooling were as follows - availability, cost, logistics, and knowledge. Our findings could aid in a better understanding of current practices and perceptions of heat illness and injury prevention in United States first responders. Abbreviations: EOD: explosive ordnance disposal; HAZMAT: hazardous materials.
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Affiliation(s)
- Aaron J E Bach
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Matthew J Maley
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Geoffrey M Minett
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Ian B Stewart
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
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