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Glasgow TE, Burch JB, Arcan C, Fuemmeler BF. Cancer Prevention Among Firefighters: Examining Lifestyle, Screening Behavior, and Beliefs. Workplace Health Saf 2024:21650799241254097. [PMID: 38805485 DOI: 10.1177/21650799241254097] [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: 05/30/2024]
Abstract
BACKGROUND Firefighters are at increased risk of developing cancer due to occupational exposures, but they may also face increased risk due to their lifestyle, such as the quality of their diet and physical activity. Cancer beliefs and screening behavior could also influence their cancer risk. The current study aimed to identify individual differences associated with lifestyle behaviors, cancer screening, and cancer beliefs among firefighters; to describe the strategies firefighters use to adapt to their work schedule; and to describe topics firefighters believe are the most important to address in their workplace. METHODS Career firefighters (N = 171) in a medium-sized U.S. city completed an online survey. FINDINGS Logistic regression analyses identified age, education, racial identity, years of fire service, perceived stress, and rank as predictors of responses to items addressing cancer screening, lifestyle behaviors, and cancer beliefs. Although results varied, age, education, and racial identity were associated with most of the outcomes. Strategies related to sleep such as getting the right amount and napping, exercise, and getting family/roommate support were selected as the top adaptive strategies for work. Sleep, mental health/well-being, and work-life balance were selected most often as the most important topics to address in the fire service, with topics related to reducing occupational exposures receiving less attention. CONCLUSIONS/APPLICATION TO PRACTICE The findings suggest individual differences, such as age, education, and racial identity, should be considered when developing occupational health interventions for firefighters. Interventions related to mental health, work-life balance, and sleep may be desired most by those in the fire service.
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Affiliation(s)
| | - James B Burch
- Department of Family Medicine and Population Health, School of Medicine and School of Population Health, Virginia Commonwealth University
| | - Chrisa Arcan
- Department of Family Medicine and Population Health, School of Medicine and School of Population Health, Virginia Commonwealth University
| | - Bernard F Fuemmeler
- Department of Family Medicine and Population Health, School of Medicine and School of Population Health, Virginia Commonwealth University
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Mueller AK, Cohen H, Singh A, Webber MP, Hall CB, Prezant DJ, Zeig-Owens R. Self-reported Cardiovascular Disease in Career Firefighters With and Without World Trade Center Exposure. J Occup Environ Med 2024; 66:135-140. [PMID: 37907410 DOI: 10.1097/jom.0000000000003007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
OBJECTIVE To assess the effect of World Trade Center (WTC) exposure on cardiovascular disease (CVD) in career firefighters. Methods: Firefighters from four US cities completed health questionnaires that provide information about demographics, CVD diagnoses, and CVD risk factors. Firefighters were also compared with respondents of the 2019 National Health Interview Survey. Results: Greater WTC exposure was positively associated with combined coronary artery disease, myocardial infarction, and angina (termed "CAD") when comparing WTC-exposed with non-WTC-exposed firefighters. Compared with the National Health Interview Survey population, firefighters had lower odds of CAD and stroke. Conclusions: An occupationally appropriate comparison is important to mitigate potential bias from the healthy worker effect. While the risk of CVD in WTC-exposed and non-WTC-exposed firefighters was significantly lower than a general US population, we observed an exposure gradient where greater WTC exposure was associated with greater odds of CVD.
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Affiliation(s)
- Alexandra K Mueller
- From the Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, New York (A.K.M., A.S., M.P.W., D.J.P., R.Z.-O.); Pulmonology Division, Department of Medicine, Montefiore Medical Center, Bronx, New York (A.K.M., A.S., D.J.P., R.Z.-O.); and Department of Epidemiology and Population Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York (H.C., M.P.W., C.B.H., D.J.P., R.Z.-O.)
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Koru-Sengul T, Pinheiro PS, Zhao W, Hernandez MN, Hernandez DR, Maggioni A, Kobetz EN, Caban-Martinez AJ, Lee DJ. Lung cancer survival among Florida male firefighters. Front Oncol 2023; 13:1155650. [PMID: 37664012 PMCID: PMC10473410 DOI: 10.3389/fonc.2023.1155650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/27/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Lung cancer is a leading cause of cancer incidence and death in the United States. Although most firefighters are fit and do not smoke, they are exposed to many known carcinogens during and in the aftermath of firefighting activities. Comprehensive epidemiologic investigations on lung cancer survival for both career and volunteer firefighters have not been undertaken. Methods Data from the Florida Cancer Data System (1981-2014) were linked with firefighter certification records from the Florida State Fire Marshal's Office to identify all patients of this occupational group; lung cancer cause-specific survival data were compared with other occupational groups using Cox regression models with occupation as the main effect. Adjusted hazard ratios (aHR) and 95% confidence intervals (95% CI) were calculated. Results Out of 210,541 male lung cancer cases diagnosed in Florida (1981-2014), 761 were firefighters (604 career, 157 volunteer). Lung cancer death was similar between volunteer (75.2%) and career firefighters (74.0%) but lower than non-firefighters (80.0%). Survival at 5 years was higher among firefighters (29.7%; career: 30.3%; volunteer: 27.4%) than non-firefighters (23.8%). In a multivariable model, compared with non-firefighters, firefighters have significantly higher cause-specific survival (aHR = 0.84; 95% CI: 0.77-0.91; p < 0.001). However, there were no significant survival differences between career and volunteer firefighters (1.14; 0.93-1.39; p = 0.213). In a separate multivariable model with firefighters as the comparator, other broad occupational groups had significantly lower cause-specific survival [white collar: 1.11 (1.02-1.21); blue collar: 1.15 (1.05-1.25); service: 1.13 (1.03-1.25); others/unknown: 1.21 (1.12-1.32); all p-values < 0.02]. Conclusion Lung cancer survival is significantly higher among firefighters compared with non-firefighters, but there is no significant difference between career and volunteer firefighters. Improved survival for firefighters might be due to a healthy worker effect, lower smoking prevalence relative to other worker groups, and possibly superior treatment adherence and compliance. Many firefighters are cross-trained as EMTs/paramedics and possess a level of medical knowledge that may favorably impact treatment engagement and better navigation of complex cancer care.
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Affiliation(s)
- Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Paulo S. Pinheiro
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Wei Zhao
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Monique N. Hernandez
- Florida Cancer Data System, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Diana R. Hernandez
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Alessandra Maggioni
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Erin N. Kobetz
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Department of Medicine, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Department of Physical Medicine and Rehabilitation, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - David J. Lee
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Florida Cancer Data System, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
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DeBono NL, Daniels RD, Beane Freeman LE, Graber JM, Hansen J, Teras LR, Driscoll T, Kjaerheim K, Demers PA, Glass DC, Kriebel D, Kirkham TL, Wedekind R, Filho AM, Stayner L, Schubauer-Berigan MK. Firefighting and Cancer: A Meta-analysis of Cohort Studies in the Context of Cancer Hazard Identification. Saf Health Work 2023; 14:141-152. [PMID: 37389311 PMCID: PMC10300491 DOI: 10.1016/j.shaw.2023.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023] Open
Abstract
Objective We performed a meta-analysis of epidemiological results for the association between occupational exposure as a firefighter and cancer as part of the broader evidence synthesis work of the IARCMonographs program. Methods A systematic literature search was conducted to identify cohort studies of firefighters followed for cancer incidence and mortality. Studies were evaluated for the influence of key biases on results. Random-effects meta-analysis models were used to estimate the association between ever-employment and duration of employment as a firefighter and risk of 12 selected cancers. The impact of bias was explored in sensitivity analyses. Results Among the 16 included cancer incidence studies, the estimated meta-rate ratio, 95% confidence interval (CI), and heterogeneity statistic (I2) for ever-employment as a career firefighter compared mostly to general populations were 1.58 (1.14-2.20, 8%) for mesothelioma, 1.16 (1.08-1.26, 0%) for bladder cancer, 1.21 (1.12-1.32, 81%) for prostate cancer, 1.37 (1.03-1.82, 56%) for testicular cancer, 1.19 (1.07-1.32, 37%) for colon cancer, 1.36 (1.15-1.62, 83%) for melanoma, 1.12 (1.01-1.25, 0%) for non-Hodgkin lymphoma, 1.28 (1.02-1.61, 40%) for thyroid cancer, and 1.09 (0.92-1.29, 55%) for kidney cancer. Ever-employment as a firefighter was not positively associated with lung, nervous system, or stomach cancer. Results for mesothelioma and bladder cancer exhibited low heterogeneity and were largely robust across sensitivity analyses. Conclusions There is epidemiological evidence to support a causal relationship between occupational exposure as a firefighter and certain cancers. Challenges persist in the body of evidence related to the quality of exposure assessment, confounding, and medical surveillance bias.
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Affiliation(s)
- Nathan L. DeBono
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, Lyon, France
| | - Robert D. Daniels
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, USA
| | - Laura E. Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, USA
| | - Judith M. Graber
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, USA
| | - Johnni Hansen
- Danish Cancer Society Research Centre, Copenhagen, Denmark
| | | | - Tim Driscoll
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | | | - Paul A. Demers
- Occupational Cancer Research Centre, Ontario Health, Toronto, Canada
| | - Deborah C. Glass
- School of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - David Kriebel
- Lowell Center for Sustainable Production, University of Massachusetts Lowell, Lowell, USA
| | - Tracy L. Kirkham
- Occupational Cancer Research Centre, Ontario Health, Toronto, Canada
| | - Roland Wedekind
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, Lyon, France
| | - Adalberto M. Filho
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, Lyon, France
| | - Leslie Stayner
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, Lyon, France
- University of Illinois at Chicago, School of Public Health, Division of Epidemiology and Biostatistics
| | - Mary K. Schubauer-Berigan
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, Lyon, France
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5
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Cardiovascular Disease Risk Factors, Musculoskeletal Health, Physical Fitness, and Occupational Performance in Firefighters: A Narrative Review. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:7346408. [PMID: 36193397 PMCID: PMC9526561 DOI: 10.1155/2022/7346408] [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: 05/10/2022] [Accepted: 08/20/2022] [Indexed: 11/18/2022]
Abstract
Introduction Firefighting is a strenuous occupation that requires firefighters to be in peak physical condition. However, many firefighters have risk factors for cardiovascular disease, impaired musculoskeletal health, and are not physically fit for duty, which all negatively impact their occupational performance. Therefore, the aim of this review is to determine the relationship between cardiovascular disease risk factors, musculoskeletal health, physical fitness, and occupational performance in firefighters. Methods The electronic databases PubMed, SCOPUS, and Web of Science were searched online via the library portal of the University of the Western Cape. Publications and grey literature between the years 2000 to present were used. In total, 2607 articles were identified; after the removal of duplicates 1188 articles were then screened, and were excluded for not meeting initial screening criteria. The remaining 209 full-text articles were screened based on the inclusion and exclusion criteria, where 163 articles were excluded. Only studies that were quantitative were included. This left 46 articles that were then finally included in the current narrative review. Results The current literature indicated that significant relationships existed between cardiovascular risk factors, musculoskeletal health, physical fitness, and occupational performance. The results indicated firefighters who were aged, obese, physically inactive, cigarette smokers, and unfit were at the highest risk for cardiovascular and musculoskeletal health complications, and unsatisfactory occupational performance. Musculoskeletal health complications significantly affected occupational performance and work ability and were related to physical fitness of firefighters. Most cardiovascular risk factors were related to physical fitness, and all physical fitness parameters were related to occupational performance in firefighters. Conclusion The overwhelming evidence in the current review established that physical fitness is related to occupational performance. However, the relationship between cardiovascular risk factors and musculoskeletal health in relation to occupational performance is less clear and still understudied. Significant gaps remain in the literature.
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Nagel T, Melton B, Grosicki GJ. Fighting arterial stiffness: A case for the importance of cardiorespiratory fitness in firefighters. Med Hypotheses 2022. [DOI: 10.1016/j.mehy.2022.110831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Kim YT, Kim W, Bae MJ, Choi JE, Kim MJ, Oh SS, Park KS, Park S, Lee SK, Koh SB, Kim C. The effect of polycyclic aromatic hydrocarbons on changes in the brain structure of firefighters: An analysis using data from the Firefighters Research on Enhancement of Safety & Health study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 816:151655. [PMID: 34785224 DOI: 10.1016/j.scitotenv.2021.151655] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/17/2021] [Accepted: 11/09/2021] [Indexed: 06/13/2023]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are formed during incomplete combustion of organic matter, and firefighters are highly exposed to these toxic compounds at fire sites. Exposure to PAHs can cause cognitive decline and neurodegeneration; however, to date, few studies have examined the potential effects of PAH exposure on structural changes in the brain. We aimed to investigate the association between the four types of PAH metabolites and the corresponding changes in neuroimaging markers based on smoking status and hypertension in male firefighters. For this, we utilized the 2-year follow-up data of 301 Korean male firefighters aged over 40 years. The concentrations of four PAH metabolites in urine were measured. Subcortical volume and cortical thickness were estimated using 3 T magnetic resonance imaging of the brain. A generalized linear model was used to investigate the effects of PAHs on changes in the subcortical volume and cortical thickness. We found an association between 1-hydroxyphenathrene (1-OHPHE) and 2-hydroxyfluorene (2-OHF) and changes in several brain regions in all the study participants. Individuals who had never smoked showed significantly thinner frontal (p < 0.001), parietal (p < 0.001), temporal (p < 0.001), and cingulate lobes (p < 0.001) with 1% increase each in the urinary concentration of 1-OHPHE. Hypertension interacted with the concentration of 1-OHPHE to reduce the volume of gray matter and cause cortical thinning in the frontal, parietal, and temporal lobes. Exposure to PAHs may reduce cortical thickness and subcortical volume, which are definitive markers of neurodegeneration. Notably, hypertension can accelerate the degenerative effects of PAHs.
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Affiliation(s)
- Yun Tae Kim
- Department of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Woojin Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Mun-Joo Bae
- Department of Occupational and Environmental Health, Yonsei University Graduate School of Public Health, Seoul, Republic of Korea
| | - Jee Eun Choi
- Department of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Mi-Ji Kim
- Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Sung Soo Oh
- Department of Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Ki Soo Park
- Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Sungha Park
- Division of Cardiology, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung-Koo Lee
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang-Baek Koh
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Human Complexity and Systems Science, Yonsei University, Incheon, Republic of Korea.
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Ras J, Leach L. Relationship Between Physical Activity, Coronary Artery Disease Risk Factors and Musculoskeletal Injuries in the City of Cape Town Fire and Rescue Service. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221084485. [PMID: 35341350 PMCID: PMC8958692 DOI: 10.1177/00469580221084485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Musculoskeletal injuries in firefighters are a common occurrence, that increase as firefighters age, and may be related to the firefighters’ physical activity habits outside of the job. Certain CAD risk factors, such as obesity, cigarette smoking and ageing may be linked to increased injury risk in firefighters. Although firefighters may meet the recommended minimum physical activity minutes, they may remain at risk for sustaining musculoskeletal injuries. Therefore, this study aims to determine the relationship between physical activity and CAD risk factors, between CAD risk factors and musculoskeletal injuries and between physical activity and musculoskeletal injuries. A total of 124 full-time firefighters, males and females, were conveniently recruited from the City of Cape Town Fire and Rescue Service. A researcher-generated questionnaire was used to collect injury, CAD risk factor and physical activity data. The proportion of firefighters who participated in leisure-time physical activity (LTPA) was 63.7%, and those who were physically inactive was 69.4%. The prevalence musculoskeletal injuries among all firefighters was 27.4%. The most prevalent musculoskeletal injury was shoulder injuries in 35.3% of firefighters, followed by multiple injuries in 26.5% and back injuries in 14.7%. Age was a significant predictor of physical inactivity in firefighters [P = .002, OR = 1.08], BMI was a significant predictor of physical inactivity [P = .050, OR = 1.08], cigarette smoking was a significant predictor of firefighters not exercising [P = .007, OR = 2.31] and the total amount of vigorous-intensity exercise was a significant predictor of musculoskeletal injuries [P = .050, OR = 1.00]. In conclusion, older firefighters were more physically inactive and had a higher prevalence of musculoskeletal injuries, and the latter decreased significantly after the age of 50 years. Emphasis should be placed on firefighters exercising in their leisure-time, especially as they aged.
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Affiliation(s)
- Jaron Ras
- Department of Sport, Recreation and Exercise Science, 56390University of the Western Cape, Bellville, Western Cape, South Africa
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, 56390University of the Western Cape, Bellville, Western Cape, South Africa
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Phan L, McNeel TS, Jewett B, Moose K, Choi K. Trends of cigarette smoking and smokeless tobacco use among US firefighters and law enforcement personnel, 1992-2019. Am J Ind Med 2022; 65:72-77. [PMID: 34766643 PMCID: PMC8678355 DOI: 10.1002/ajim.23311] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/21/2021] [Accepted: 11/01/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Previous studies indicate tobacco use was more prevalent among firefighters and law enforcement personnel than in the US adult population. Trends of smoking and smokeless tobacco (SLT) use among these first responders are unknown. We examined trends in current smoking and SLT use among US firefighters and law enforcement personnel and compared smoking and SLT use prevalence in firefighters and law enforcement personnel to US adults in non-first-responder occupations. METHODS Trends of smoking and SLT use prevalence among firefighters, law enforcement personnel, and adults in other occupations were assessed by fitting joinpoint regression models using the 1992-2019 Tobacco Use Supplement to the Current Population Survey (TUS-CPS). We used multivariable logistic regression models adjusted for demographics to examine associations between occupation and smoking and SLT use status using the 2018-2019 TUS-CPS data. Analyses were conducted in 2021. RESULTS From 1992 to 2019, the smoking prevalence declined overall (all p's < 0.01). Though SLT use prevalence among adults in non-first-responder occupations declined (annual percentage change [APC] = -1.2%; 95% confidence interval [CI] = -1.7% to -0.7%), no changes were shown among firefighters and law enforcement personnel which suggests SLT use may be increasing among firefighters over time. In 2018-2019, firefighters (adjusted odds ratio [AOR] = 3.4; 95% CI = 1.7 to 6.8) and law enforcement personnel (AOR = 3.2; 95% CI = 2.1 to 4.7) were more likely than adults in non-first-responder occupations to use SLT. CONCLUSIONS While smoking prevalence declined overall, SLT use is higher among firefighters and law enforcement personnel and may be increasing over time among firefighters. Research should examine reasons for SLT use by first responders. Comprehensive tobacco policies and SLT-specific cessation programs are needed for first responders.
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Affiliation(s)
- Lilianna Phan
- National Institute on Minority Health and Health Disparities Division of Intramural Research, Bethesda, Maryland
| | | | - Bambi Jewett
- National Institute on Minority Health and Health Disparities Division of Intramural Research, Bethesda, Maryland
| | | | - Kelvin Choi
- National Institute on Minority Health and Health Disparities Division of Intramural Research, Bethesda, Maryland
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Moore BA, Judkins JL, Dyal MA, Schlenk M, Meyer E, Straud CL, Mysliwiec V, Peterson AL, Baker MT. Behavioral and Occupational Health in Military Firefighters: An Understudied Population. Behav Modif 2021; 46:453-478. [PMID: 34291696 DOI: 10.1177/01454455211033515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To our knowledge, no studies on health conditions in U.S. military firefighters exist. Data and demographics from the Defense Medical Epidemiology Database were analyzed on several shared medical issues among military personnel and civilian firefighters. Descriptive statistics and Chi-Square goodness of fit tests were conducted to support study aims. Between 2001 and 2015, substantial incidence rate increases (per 10,000) of tinnitus, PTSD, insomnia, and OSA (2005-2015) were observed. Modest to large increases in depressive disorders, adjustment reaction, generalized anxiety disorder, and panic disorder were observed. Decreasing rates were observed for alcohol dependence, hypertension, and tobacco use disorder. While efforts have examined the impact of sustained operations on military members, first responder military subgroups like firefighters are deficient. Cognitive Behavior Therapy interventions are efficacious for preventing and reducing behavioral health problems; therefore, tailoring them specifically for U.S. military firefighters could significantly improve quality of life and long-term health.
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Affiliation(s)
| | - Jason L Judkins
- US Army Institute of Environmental Medicine, Natick, MA, USA
| | | | | | | | - Casey L Straud
- University of Texas Health Science Center at San Antonio, USA.,University of Texas at San Antonio, USA.,South Texas Veterans Health Care System, San Antonio, USA
| | | | - Alan L Peterson
- University of Texas Health Science Center at San Antonio, USA.,University of Texas at San Antonio, USA.,South Texas Veterans Health Care System, San Antonio, USA
| | - Monty T Baker
- Wilford Hall Ambulatory Surgical Center, San Antonio, TX, USA
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Relationship Between Various Coronary Artery Disease Risk Factors in Firefighters. J Occup Environ Med 2021; 63:e433-e439. [PMID: 34184660 DOI: 10.1097/jom.0000000000002256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the correlation between the various coronary artery disease risk factors in firefighters. METHODS The study used a quantitative, cross-sectional, and correlational study design. A total of 124 full-time firefighters were conveniently recruited to participate. Research procedures were based on the ACSM guidelines. RESULTS Significances were found between age and body mass index (BMI) (r = 0.42, P < 0.001), age and waist circumference (WC) (r = 0.52, P < 0.001), BMI and WC (r = 0.88, P < 0.001), BMI and diastolic blood pressure (DBP) (r = 0.48, P < 0.001), between WC and DBP (r = 0.48, P < 0.001) and between gender and cigarette smoking (χ2[1] = 5.66, P = 0.017). CONCLUSION There were significant strong relationships between BMI, SBP, DBP, dyslipidemia, and increasing age, especially in male firefighters. Reducing key risk factors should be emphasized.
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12
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Jitnarin N, Poston WSC, Jahnke SA, Haddock CK, Kelley HN, Severson HH. A qualitative study to assess perceptions, barriers, and motivators supporting smokeless tobacco cessation in the US fire service. PLoS One 2021; 16:e0251128. [PMID: 33974644 PMCID: PMC8112677 DOI: 10.1371/journal.pone.0251128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 04/20/2021] [Indexed: 11/18/2022] Open
Abstract
While firefighters currently have low smoking rates, rates of smokeless tobacco (SLT) use among this population are remarkably high and substantially greater than similar occupational groups, and the general population. This study explored determinants associated with SLT use, barriers to cessation, and motivators for SLT cessation in the fire service. Key informant interviews were conducted in 23 career firefighters who were current (n = 14) and former (n = 9) SLT users from across the U.S. Discussions were recorded and independently coded according to questions and themes. Major themes that developed among firefighters regarding SLT use determinants included positive perceptions of SLT products, social influences from their peers and family members, acceptability of SLT use in the fire service, and a coping resource for job stress. Firefighters discussed several barriers to SLT cessation, including intrapersonal barriers such as SLT use habits and its dependency, concerns about withdrawal symptoms; and social-environmental barriers including lack of support from health and other services providers, and lack of enforcement of existing tobacco policies regarding SLT use. Firefighters also mentioned both internal and external motivators for cessation. Internal motivators included self-motivation and their health concerns while external motivators included friends and family support, incentives or rewards, and price of SLT products. Findings provide unique perspectives from firefighters on factors that influence SLT use and barriers and motivators to SLT cessation. These are insufficiently assessed and considered by the fire service organizations and their health care providers. Thus, the organizations must understand these issues in order to mitigate barriers and motivate the personnel to quit using SLT. Information gained from firefighters who were current and former SLT users can be used to develop an effective, culturally-tailored intervention that is acceptable to fire service personnel.
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Affiliation(s)
- Nattinee Jitnarin
- Center for Fire, Rescue & EMS Health Research, NDRI–USA, Inc., Leawood, Kansas, United States of America
| | - Walker S. C. Poston
- Center for Fire, Rescue & EMS Health Research, NDRI–USA, Inc., Leawood, Kansas, United States of America
| | - Sara A. Jahnke
- Center for Fire, Rescue & EMS Health Research, NDRI–USA, Inc., Leawood, Kansas, United States of America
| | - Christopher K. Haddock
- Center for Fire, Rescue & EMS Health Research, NDRI–USA, Inc., Leawood, Kansas, United States of America
| | - Hannah N. Kelley
- Center for Fire, Rescue & EMS Health Research, NDRI–USA, Inc., Leawood, Kansas, United States of America
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Jitnarin N, Poston WSC, Jahnke SA, Haddock CK, Severson HH. Development and beta test of a smokeless tobacco cessation program for firefighters. Tob Prev Cessat 2021; 7:26. [PMID: 33851067 PMCID: PMC8029998 DOI: 10.18332/tpc/132963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/25/2021] [Accepted: 01/31/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The prevalence of smokeless tobacco (SLT) use among firefighters is substantially higher than the general population and similar occupational groups. Despite the significant health risks associated with SLT and its impact on occupational readiness, there are no occupationally-tailored SLT education or treatment programs for the fire service. The purpose of this study was to beta test QUIT SPIT!, a self-help SLT cessation program that is culturally tailored for the US fire service and firefighters who are interested in quitting. METHODS After development and tailoring the QUIT SPIT! SLT cessation program for firefighters, the feasibility and acceptability of the program were evaluated in a sample of eleven SLT-using firefighters who wanted to quit. The primary outcome was a 7-day point prevalence of SLT abstinence measured at 4 and 12 weeks post-enrollment follow-up assessments. RESULTS Four firefighters reported having quit SLT (7-days point prevalence) at follow-up at 12 weeks. Those who did not achieve SLT abstinence reported reductions in frequency and quantity in SLT use and demonstrated a decrease in nicotine dependence. Firefighters also reported being satisfied with the QUIT SPIT! cessation program. CONCLUSIONS The results provide strong support for the feasibility and acceptability of the QUIT SPIT! in SLT-using firefighters interested in quitting. The findings provide critical information about the next steps for further development and evaluation of the QUIT SPIT! program.
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Affiliation(s)
- Nattinee Jitnarin
- Center for Fire, Rescue and EMS Health Research, NDRI-USA, Leawood, United States
| | - Walker S C Poston
- Center for Fire, Rescue and EMS Health Research, NDRI-USA, Leawood, United States
| | - Sara A Jahnke
- Center for Fire, Rescue and EMS Health Research, NDRI-USA, Leawood, United States
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Singh PK, Yadav A, Lal P, Sinha DN, Gupta PC, Swasticharan L, Singh S, Mehrotra R. Dual Burden of Smoked and Smokeless Tobacco Use in India, 2009-2017: A Repeated Cross-Sectional Analysis Based on Global Adult Tobacco Survey. Nicotine Tob Res 2021; 22:2196-2202. [PMID: 32034915 DOI: 10.1093/ntr/ntaa033] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 02/06/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The dual use of smoked and smokeless tobacco (SLT) poses a serious challenge to tobacco control efforts. This article examines the trends and patterns of this usage in India during the period 2009-2010 and 2016-2017. METHODS Data from two rounds of nationally representative cross-sectional Global Adult Tobacco Survey (GATS) conducted in 2009-2010 and 2016-2017 have been used. Dual use was assessed based on current smokers and SLT users in both rounds. RESULTS Findings reveal that dual use in India has dropped from 5.3% during 2009-2010 to 3.4% during 2016-2017, a decline of nearly 10 million dual users. However, some states have added nearly 4.6 million new dual users during this period. While dual use continues to remain high in rural areas, there has been a manifold increase in urban areas. Findings revealed that intention to quit tobacco was lower among dual tobacco users as compared to single users with considerable difference between urban and rural areas. CONCLUSION Easy availability and affordability of SLT products compared to smoking products and restrictions on smoking in public places may have pushed current smokers and dual users to take to or intensify their SLT consumption. Measures relating to awareness, pricing, taxation, and enforcement of tobacco control laws should focus on all forms of tobacco, especially targeting high dual burden in rural and urban settings. IMPLICATIONS Dual form of tobacco users represent 12% of all tobacco users in the country. The study reveals that intention to quit tobacco among dual users is significantly lower than that among single tobacco product users. This requires improving public awareness about the morbidity and mortality that arises from the use of all forms of tobacco products. Efforts to restrict the availability of tobacco products should focus on licensing the sale of all tobacco products. Reduction in dual tobacco use will not only result in multiplied health benefits but also help in achieving the Non-Communicable Diseases targets under the United Nations Sustainable Development Goals.
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Affiliation(s)
- Prashant Kumar Singh
- Division of Preventive Oncology, ICMR National Institute of Cancer Prevention and Research, Noida, India
| | - Amit Yadav
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA
| | - Pranay Lal
- The Union, South East Asia Office, New Delhi, India
| | | | | | - Leimapokpam Swasticharan
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - Shalini Singh
- ICMR National Institute of Cancer Prevention and Research, Noida, India.,WHO FCTC Global Knowledge Hub on Smokeless Tobacco, ICMR National Institute of Cancer Prevention and Research, Noida, India
| | - Ravi Mehrotra
- Indian Cancer Research Consortium, Indian Council of Medical Research, New Delhi, India
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Ras J, Leach L. Prevalence of coronary artery disease risk factors in firefighters in the city of Cape Town fire and rescue service - A descriptive study. J Public Health Res 2021; 10:2000. [PMID: 33623778 PMCID: PMC7887455 DOI: 10.4081/jphr.2021.2000] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/03/2020] [Indexed: 02/06/2023] Open
Abstract
Background: Over 45% of firefighter deaths are attributable to sudden cardiac death related to coronary artery disease (CAD), with many of these deaths attributed to comorbidities. The purpose of the study is to determine the prevalence of coronary artery disease (CAD) risk factors in firefighters in the City of Cape Town (CoCT). Design and Methods: The study used a quantitative, cross-sectional and descriptive design. A total of 124 full-time firefighters were conveniently recruited between September and November 2019 from the City of Cape Town Fire and Rescue Service. Results: The most prevalent CAD risk factors among firefighters were hypertension (33.1%), obesity (37.1%), cigarette smoking (39.5%) and dyslipidaemia (40.3%). A total of 41.9% of firefighters were categorized as low-risk, 54.8% as moderate-risk, and 3.2% as high-risk for CAD. Conclusion: The majority of firefighters had at least one CAD risk factor, with older males having the highest prevalence of multiple CAD risk factors. Compared to other regions of the world, the (CoCT) firefighters have higher prevalence of dyslipidaemia and cigarette smoking. Preventative behavioural strategies and education on CAD should be promoted to mitigate the development of CAD.
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Affiliation(s)
- Jaron Ras
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of The Western Cape, Cape Town, South Africa
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of The Western Cape, Cape Town, South Africa
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Abstract
OBJECTIVE To examine occupational injuries among career women firefighters (FFs). METHODS A national cross-sectional survey assessed injury prevalence, types, frequencies, and predictors. RESULTS A total of 3012 women career FFs were enrolled in the study. Almost a third (31.7%) reported at least one occupational injury in the past 12 months. The most common injuries were dislocations, sprains, or strains (59.3%). Racial minority status, self-rated health, body composition, exercise habits, substance use, mental health, and job dissatisfaction were all significant injury correlates. Nearly 43% of injuries resulted in missed workdays. Additionally, 25% reported incurring chronic injuries. CONCLUSIONS Women FFs reported a high prevalence of occupational injury and a significant percentage reported chronic injuries. These data can inform initiatives to curtail injuries in the fire service and better protect women FFs.
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Cancer Perceptions Among Smokeless Tobacco Users: A Qualitative Study of US Firefighters. Saf Health Work 2020; 11:284-290. [PMID: 32995053 PMCID: PMC7502578 DOI: 10.1016/j.shaw.2020.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/04/2020] [Accepted: 04/12/2020] [Indexed: 11/25/2022] Open
Abstract
Background Prevalence rates of smokeless tobacco (SLT) use among firefighters are remarkably high and substantially higher than similar occupational groups and the general U.S. population. The purpose of this study was to explore the perspectives of fire service personnel regarding cancer and its associations with tobacco and SLT use. Methods This descriptive study used a qualitative approach. Key informant interviews were conducted in 39 career firefighters and fire service administration from across the U.S. Discussion were recorded, transcribed verbatim and transferred to NVivo software for narrative analysis. Topics explored included cancer perceptions, attitudes and beliefs, and cultural factors related to SLT use behaviors. Results: Major themes that emerged among fire service personnel included concerns about cancer and its risk factors including firefighting tasks, such as fire overhaul operations, and from their lifestyle behaviors, such as alcohol and tobacco use. Firefighters also suggested a number of reasons for their increased SLT use, such as fire department tobacco-free policy and fire service culture. Conclusion The current study provides a rich foundation for future research, prevention, and intervention efforts for the fire service and research communities regarding tobacco and SLT use and cancer risk. Additional research on firefighters' cancer beliefs deserves future research in order to improve messaging about the risks of cancer due to firefighting.
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Pinkerton L, Bertke SJ, Yiin J, Dahm M, Kubale T, Hales T, Purdue M, Beaumont JJ, Daniels R. Mortality in a cohort of US firefighters from San Francisco, Chicago and Philadelphia: an update. Occup Environ Med 2020; 77:84-93. [PMID: 31896615 PMCID: PMC10165610 DOI: 10.1136/oemed-2019-105962] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 11/13/2019] [Accepted: 12/08/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To update the mortality experience of a previously studied cohort of 29 992 US urban career firefighters compared with the US general population and examine exposure-response relationships within the cohort. METHODS Vital status was updated through 2016 adding 7 years of follow-up. Cohort mortality compared with the US population was evaluated via life table analyses. Full risk-sets, matched on attained age, race, birthdate and fire department were created and analysed using the Cox proportional hazards regression to examine exposure-response associations between select mortality outcomes and exposure surrogates (exposed-days, fire-runs and fire-hours). Models were adjusted for a potential bias from healthy worker survivor effects by including a categorical variable for employment duration. RESULTS Compared with the US population, mortality from all cancers, mesothelioma, non-Hodgkin's lymphoma (NHL) and cancers of the oesophagus, intestine, rectum, lung and kidney were modestly elevated. Positive exposure-response relationships were observed for deaths from lung cancer, leukaemia and chronic obstructive pulmonary disease (COPD). CONCLUSIONS This update confirms previous findings of excess mortality from all cancers and several site-specific cancers as well as positive exposure-response relations for lung cancer and leukaemia. New findings include excess NHL mortality compared with the general population and a positive exposure-response relationship for COPD. However, there was no evidence of an association between any quantitative exposure measure and NHL.
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Affiliation(s)
- Lynne Pinkerton
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Stephen J Bertke
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - James Yiin
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Matthew Dahm
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Travis Kubale
- World Trade Center Health Program, National Institute for Occupational Safety and Health (NIOSH), Washington, District of Columbia, USA
| | - Thomas Hales
- Division of Safety Research, National Institute for Occupational Safety and Health (NIOSH), Denver, Colorado, USA
| | - Mark Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - James J Beaumont
- Department of Public Health Sciences, University of California Davis, Davis, California, USA
| | - Robert Daniels
- Education and Information Division, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio, USA
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Jitnarin N, Poston WSC, Haddock CK, Jahnke SA. Tobacco Use among Women Firefighters. Womens Health Issues 2019; 29:432-439. [PMID: 31229361 PMCID: PMC6755060 DOI: 10.1016/j.whi.2019.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 04/30/2019] [Accepted: 05/16/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Firefighters play a crucial role in protecting the lives and property of the communities they serve. Health and readiness for duty among women firefighters is of great concern because they are a significantly understudied group in this critical occupation. A tobacco-free fire service has been strongly promoted, but there are no published data on the extent and types of tobacco use among women firefighters. METHODS Data were collected as part of a national online study of the health of women in the fire service. RESULTS A total of 1,712 women firefighters completed questions regarding tobacco use. Unadjusted smoking and smokeless tobacco rates were 5.1% and 1.2%, respectively. Age standardized smoking rates were lower than those of male firefighters and U.S. adult women. Smokeless tobacco use prevalence was very low compared with male firefighters, but comparable with U.S. adult women. Tobacco users were more likely to have lower education and income and were younger when compared with those who did not use tobacco. There was a strong association between tobacco use and problem and binge drinking. CONCLUSIONS Current findings suggest that the rates of cigarette and smokeless tobacco use are relatively low among women firefighters. Unhealthy lifestyle behaviors such as problem and binge drinking were strongly associated with tobacco use.
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Affiliation(s)
- Nattinee Jitnarin
- Center for Fire, Rescue & EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, Kansas.
| | - Walker S C Poston
- Center for Fire, Rescue & EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, Kansas
| | - Christopher K Haddock
- Center for Fire, Rescue & EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, Kansas
| | - Sara A Jahnke
- Center for Fire, Rescue & EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, Kansas
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Jitnarin N, Poston WSC, Haddock CK, Jahnke SA, Day RS, Severson HH. Prevalence and Correlates of Late Initiation of Smokeless Tobacco in US Firefighters. Nicotine Tob Res 2018; 20:130-134. [PMID: 27940900 DOI: 10.1093/ntr/ntw321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 11/29/2016] [Indexed: 11/13/2022]
Abstract
Introduction Prevalence rates of smokeless tobacco (SLT) use and late initiation among firefighters (ie, starting use as an adult after joining the fire service) are remarkably high, 10.5% and 26.0%, respectively. The purpose of this study is to examine characteristics associated with late SLT initiation in a sample comprised of male career firefighters from two large cohort studies. Methods We examined correlates of late SLT initiation in a secondary analysis of data combining the baseline evaluations of two published firefighter health studies with 1474 male career firefighters in the United States. Results Fourteen percent of participants were current SLT users. Among this group, the unadjusted rate of firefighters who initiated SLT use after joining the fire service was 15.9%, while the age-standardized rate was 38.2%; this is substantially higher than the national adjusted late initiation rate among adult males (0.8%). In addition, firefighters demonstrated higher rates of late SLT initiation (15.9% unadjusted; 18.4% age-standardized) when compared to males in the military overall (13.8%). Conclusions The exceptionally high prevalence of SLT use overall and late initiation in the fire service suggest that joining the fire service in the United States is a risk factor for SLT use. There is a need to develop interventions aimed at reducing SLT use in the fire service that are specifically tailored for this occupational group. Implications The high prevalence of late SLT initiation (ie, starting use as an adult after joining the fire service) among firefighters should be addressed by both researchers and fire service organizations given the significant health risks associated with SLT and its impact on occupational readiness. There is a need for developing intervention programs aimed at reducing SLT use in the fire service. Interventions would need to be specifically tailored for this occupational group and their unique culture, given that joining the fire service appears to be a risk factor for SLT initiation among firefighters who did not use tobacco prior to joining the fire service.
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Affiliation(s)
- Nattinee Jitnarin
- Center for Fire Rescue and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, KS
| | - Walker S C Poston
- Center for Fire Rescue and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, KS
| | - Christopher K Haddock
- Center for Fire Rescue and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, KS
| | - Sara A Jahnke
- Center for Fire Rescue and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, KS
| | - Rena S Day
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX
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Cunradi CB, Moore RS, Battle RS. Prevalence and Correlates of Current and Former Smoking among Urban Transit Workers. Saf Health Work 2017; 8:402-406. [PMID: 29276641 PMCID: PMC5715449 DOI: 10.1016/j.shaw.2016.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 02/22/2016] [Accepted: 12/13/2016] [Indexed: 11/30/2022] Open
Abstract
Transit workers constitute a blue-collar occupational group that have elevated smoking rates relative to other sectors of employed adults in the United States. This study analyzed cross-sectional tobacco survey data from 935 workers (60% African American; 37% female) employed at an urban public transit agency in California. Prevalence of current and former smoking was 20.3% and 20.6%, respectively. Younger workers were less likely than older workers to be current or former smokers. Having a complete home smoking ban was associated with decreased likelihood of being a smoker [odds ratio (OR) = 0.04, 95% confidence interval (CI) = 0.01–0.17], as were neutral views about whether it is easy for a smoker to take a smoking break during their shift (OR = 0.50, 95% CI 0.28–0.88). Current smoking among the sample is > 50% higher than the adult statewide prevalence. Potential points of intervention identified in this study include perceived ease of worksite smoking breaks and establishing home smoking bans. Tailored cessation efforts focusing on older transit workers more likely to smoke are needed to reduce tobacco-related disparities in this workforce.
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Affiliation(s)
- Carol B Cunradi
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, CA, USA
| | - Roland S Moore
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, CA, USA
| | - Robynn S Battle
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, CA, USA
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