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Hasan MZ, Semmens EO, Navarro DuBose K, McCray LK, Noonan CW. Wildland Firefighter Work History and Clinical Indicators of Cardiovascular Health. J Occup Environ Med 2024; 66:e418-e422. [PMID: 38955802 PMCID: PMC11371509 DOI: 10.1097/jom.0000000000003172] [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: 07/04/2024]
Abstract
OBJECTIVE To determine the association between the occupational history as a wildland firefighter (WFF) and clinical indicators of cardiovascular health. METHODS Among 2862 WFFs, we evaluated associations between the number of total days assigned on fire and high-risk categories of three clinically measured cardiovascular indicators. RESULTS Almost one-third (32%) of WFFs had one or more clinical measures that would place them in high-risk categories for body mass index, blood pressure, and total cholesterol. WFF work history was associated with some of these measures: odds ratio (and 95% confidence interval) for highest versus lowest tertile of days on fire were 1.4 (1.2, 1.8) and 1.2 (1.0, 1.5) for high-risk categories of body mass index and cholesterol, respectively. CONCLUSION More frequent screening and targeted health promotion programs for WFFs are warranted to increase awareness of cardiovascular risk and prevention strategies.
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Affiliation(s)
- Md Zahid Hasan
- From the Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, MT (M.Z.H., E.O.S., C.W.N.); and Department of the Interior, Office of Wildland Fire, Boise, ID (K.N.D.B., L.K.M.C.)
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García-Heras F, Rodríguez-Medina J, Castañeda A, León-Guereño P, Gutiérrez-Arroyo J. Occupational Injuries of Spanish Wildland Firefighters: A Descriptive Analysis. Healthcare (Basel) 2024; 12:1615. [PMID: 39201173 PMCID: PMC11354085 DOI: 10.3390/healthcare12161615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 08/01/2024] [Accepted: 08/12/2024] [Indexed: 09/02/2024] Open
Abstract
The work of wildland firefighters, especially of the so-called 'Brigadas de Refuerzo contra Incendios Forestales', is characterised by high physical demands and extreme operating conditions. These professionals face long workdays (12 h), walking with heavy loads (~25 kg), being exposed to high temperatures (>30 °C), and handling specialised tools in high-risk environments. This study aimed to describe the prevalence of occupational injuries among members of the 'Brigadas de Refuerzo contra Incendios Forestales' and its relationship to variables such as age and work experience. A total of 217 wildland firefighters (18 female and 199 male) correctly answered a questionnaire developed on an ad hoc basis to meet the study's objectives. A high prevalence of occupational injuries was observed among them (~76%). Age and work experience were shown to be significantly associated with injuries. Individuals over 35 years of age with more than 10 years' experience had a higher probability of injury (OR = 2.14, CI = 1.12-4.06 and OR = 2.46, CI = 1.30-4.67, respectively). Injuries occurred mainly during physical training (~46%), followed by preventive work (~33%) and forest fires (~20%). The most common injuries were tendonitis and muscle pain (~44% and ~21% respectively), followed by sprains (~21%). The results underline the need for physical activity programmes adapted to help wildland firefighters, especially older and more experienced individuals. The identification of risk factors such as age and work experience can contribute to the prevention and management of occupational injuries among this group of highly specialised forestry workers. Specific preventative measures during training are required to mitigate the risk of injury among these crews, who play a crucial role in protecting the environment and public safety.
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Affiliation(s)
- Fabio García-Heras
- VALFIS Research Group, Department of Physical Education and Sports, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain;
| | - Juan Rodríguez-Medina
- VALFIS Research Group, Department of Physical Education and Sports, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain;
| | - Arkaitz Castañeda
- Health, Physical Activity and Sports Science Laboratory, Department of Physical Activity and Sports, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.C.); (P.L.-G.)
| | - Patxi León-Guereño
- Health, Physical Activity and Sports Science Laboratory, Department of Physical Activity and Sports, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.C.); (P.L.-G.)
| | - Jorge Gutiérrez-Arroyo
- VALFIS Research Group, Department of Physical Education and Sports, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain;
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Scott KA, Wingate KC, DuBose KN, Butler CR, Ramirez-Cardenas A, Hale CR. The wildland firefighter exposure and health effect (WFFEHE) study: cohort characteristics and health behavior changes in context. Ann Work Expo Health 2024; 68:122-135. [PMID: 38164597 PMCID: PMC10922597 DOI: 10.1093/annweh/wxad080] [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] [Received: 09/09/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES Work is an under-recognized social determinant of health. There is limited research describing US wildland firefighter (WFF) workforce demographics or how to work associates with WFF health behaviors. In this study researchers characterized a WFF cohort and tested hypotheses that WFFs used tobacco, alcohol, and sugar-sweetened beverages (SSBs) differently over the course of the fire season and that different fire crews may exhibit different behavior patterns. METHODS Researchers collected data in the field with 6 WFF crews during 2 consecutive fire seasons (2018 and 2019). WFF crews completed questionnaires before and after each season. WFFs with an initial preseason questionnaire and at least 1 follow-up questionnaire were included (n = 138). Descriptive statistics summarized WFFs' baseline demographic, employment, and health characteristics. Linear mixed models were used to test for changes in WFFs' substance use over time and assess crew-level differences. A meta-analysis of WFF longitudinal studies' population characteristics was attempted to contextualize baseline findings. RESULTS WFFs were predominately male, less than 35 yr of age, non-Hispanic White, and had healthy weight. Smokeless tobacco use and binge drinking were prevalent in this cohort (52% and 78%, respectively, among respondents). Longitudinal analyses revealed that during the fire season WFFs' use of tobacco and SSBs increased and the number of days they consumed alcohol decreased. Crew-level associations varied by substance. The meta-analysis was not completed due to cross-study heterogeneity and inconsistent reporting. DISCUSSION WFF agencies can promote evidence-based substance use prevention and management programs and modify working conditions that may influence WFF stress or substance use.
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Affiliation(s)
- Kenneth A. Scott
- United States Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Western States Division, Denver, CO, USA
| | | | - Kathleen N. DuBose
- United States Department of the Interior, Office of Wildland Fire, Denver, CO, USA
| | - Corey R. Butler
- United States Department of the Interior, Office of Occupational Safety and Health, Denver, CO, USA
| | - Alejandra Ramirez-Cardenas
- United States Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Western States Division, Denver, CO, USA
| | - Christa R. Hale
- United States Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Western States Division, Denver, CO, USA
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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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Naserinejad N, Costanian C, Birot O, Barboni T, Roudier E. Wildland fire, air pollution and cardiovascular health: is it time to focus on the microvasculature as a risk assessment tool? Front Physiol 2023; 14:1225195. [PMID: 37538378 PMCID: PMC10394245 DOI: 10.3389/fphys.2023.1225195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/06/2023] [Indexed: 08/05/2023] Open
Abstract
Climate change favors weather conditions conducive to wildland fires. The intensity and frequency of forest fires are increasing, and fire seasons are lengthening. Exposure of human populations to smoke emitted by these fires increases, thereby contributing to airborne pollution through the emission of gas and particulate matter (PM). The adverse health outcomes associated with wildland fire exposure represent an important burden on the economies and health systems of societies. Even though cardiovascular diseases (CVDs) are the main of cause of the global burden of diseases attributable to PM exposure, it remains difficult to show reliable associations between exposure to wildland fire smoke and cardiovascular disease risk in population-based studies. Optimal health requires a resilient and adaptable network of small blood vessels, namely, the microvasculature. Often alterations of this microvasculature precede the occurrence of adverse health outcomes, including CVD. Biomarkers of microvascular health could then represent possible markers for the early detection of poor cardiovascular outcomes. This review aims to synthesize the current literature to gauge whether assessing the microvasculature can better estimate the cardiovascular impact of wildland fires.
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Affiliation(s)
- Nazgol Naserinejad
- School of Global Health, Faculty of Health, York University, Toronto, ON, Canada
| | - Christy Costanian
- School of Global Health, Faculty of Health, York University, Toronto, ON, Canada
- Department of Family and Community Medicine, St. Michael’s Hospital, Toronto, ON, Canada
| | - Olivier Birot
- Muscle Health Research Center, School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Toussaint Barboni
- Laboratoire des Sciences Pour l’Environnement (SPE), UMR-CNRS 6134, University of Corsica Pasquale Paoli, Campus Grimaldi, Corte, France
| | - Emilie Roudier
- School of Global Health, Faculty of Health, York University, Toronto, ON, Canada
- Muscle Health Research Center, School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
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Eden MJ, Matz J, Garg P, Gonzalez MP, McElderry K, Wang S, Gollner MJ, Oakes JM, Bellini C. Prolonged smoldering Douglas fir smoke inhalation augments respiratory resistances, stiffens the aorta, and curbs ejection fraction in hypercholesterolemic mice. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 861:160609. [PMID: 36470384 PMCID: PMC10699119 DOI: 10.1016/j.scitotenv.2022.160609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
While mounting evidence suggests that wildland fire smoke (WFS) inhalation may increase the burden of cardiopulmonary disease, the occupational risk of repeated exposure during wildland firefighting remains unknown. To address this concern, we evaluated the cardiopulmonary function in mice following a cumulative exposure to lab-scale WFS equivalent to a mid-length wildland firefighter (WLFF) career. Dosimetry analysis indicated that 80 exposure hours at a particulate concentration of 22 mg/m3 yield in mice the same cumulative deposited mass per unit of lung surface area as 3600 h of wildland firefighting. To satisfy this condition, male Apoe-/- mice were whole-body exposed to either air or smoldering Douglas fir smoke (DFS) for 2 h/day, 5 days/week, over 8 consecutive weeks. Particulate size in DFS fell within the respirable range for both mice and humans, with a count median diameter of 110 ± 20 nm. Expiratory breath hold in mice exposed to DFS significantly reduced their minute volume (DFS: 27 ± 4; Air: 122 ± 8 mL/min). By the end of the exposure time frame, mice in the DFS group exhibited a thicker (DFS: 109 ± 3; Air: 98 ± 3 μm) and less distensible (DFS: 23 ± 1; Air: 28 ± 1 MPa-1) aorta with reduced diastolic blood augmentation capacity (DFS: 53 ± 2; Air: 63 ± 2 kPa). Cardiac magnetic resonance imaging further revealed larger end-systolic volume (DFS: 14.6 ± 1.1; Air: 9.9 ± 0.9 μL) and reduced ejection-fraction (DFS: 64.7 ± 1.0; Air: 75.3 ± 0.9 %) in mice exposed to DFS. Consistent with increased airway epithelium thickness (DFS: 10.4 ± 0.8; Air: 7.6 ± 0.3 μm), airway Newtonian resistance was larger following DFS exposure (DFS: 0.23 ± 0.03; Air: 0.20 ± 0.03 cmH2O-s/mL). Furthermore, parenchyma mean linear intercept (DFS: 36.3 ± 0.8; Air: 33.3 ± 0.8 μm) and tissue thickness (DFS: 10.1 ± 0.5; Air: 7.4 ± 0.7 μm) were larger in DFS mice. Collectively, mice exposed to DFS manifested early signs of cardiopulmonary dysfunction aligned with self-reported events in mid-career WLFFs.
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Affiliation(s)
- Matthew J Eden
- Department of Bioengineering, Northeastern University, MA, USA
| | - Jacqueline Matz
- Department of Bioengineering, Northeastern University, MA, USA
| | - Priya Garg
- Department of Mechanical Engineering, University of California, Berkeley, CA, USA
| | | | | | - Siyan Wang
- Department of Mechanical Engineering, University of California, Berkeley, CA, USA
| | - Michael J Gollner
- Department of Mechanical Engineering, University of California, Berkeley, CA, USA
| | - Jessica M Oakes
- Department of Bioengineering, Northeastern University, MA, USA
| | - Chiara Bellini
- Department of Bioengineering, Northeastern University, MA, USA.
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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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Brooks SJ, West MR, Domitrovich JW, Sol JA, Holubetz H, Partridge C, Ruby BC, Brown AF, Roe AJ. Nutrient Intake of Wildland Firefighters During Arduous Wildfire Suppression: Macronutrient and Micronutrient Consumption. J Occup Environ Med 2021; 63:e949-e956. [PMID: 34654035 PMCID: PMC8631152 DOI: 10.1097/jom.0000000000002413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Wildland firefighters (WLFFs) perform in adverse environments making rapid adjustments to dietary needs. The National Mobile Food Services (NMFS) contract details WLFF dietary provisions on wildfire incidents. OBJECTIVE Determine the nutrient content of food and drink provided to and consumed by WLFFs under the NMFS contract. METHODS Individual (n = 122) dietary provisions and consumption was recorded during 1 workday. Nutritional analysis of items provided was compared with consumption and the recommended dietary allowance (RDA). RESULTS WLFFs consumed significantly (P < 0.05) fewer macronutrients than provided for calories, protein, and fat. Provided and consumed micronutrients were below the RDA for vitamins D and E, magnesium, and manganese. CONCLUSION Most dietary recommendations were met by NMFS provisions. Next steps include WLFF nutrition education to improve consumption and contract revisions to meet micronutrient recommendations.
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Affiliation(s)
- Samantha J Brooks
- Department of Movement Sciences, College of Education, Health & Human Sciences (Dr Brooks, Dr Brown); National Technology and Development Program (Ms West, Dr Domitrovich, Ms Sol, Ms Holubetz); Department of Family and Consumer Sciences (Dr Brooks, Ms Partridge, Ms Holubetz, Dr Brown, Dr Roe); Department of Animal, Veterinary and Food Sciences (Ms Partridge), College of Agricultural and Life Sciences, University of Idaho, Moscow, Idaho; University of Montana Missoula (Dr Ruby), Missoula, Montana
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Rosales AM, Dodds PS, Hailes WS, Sol JA, Coker RH, Quindry JC, Ruby BC. Deterioration of Lipid Metabolism Despite Fitness Improvements in Wildland Firefighters. J Occup Environ Med 2021; 64:385-389. [PMID: 34817456 DOI: 10.1097/jom.0000000000002446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Determine serum lipid and general health/fitness alterations following a 5-month wildfire suppression season. METHODS We recruited 100 wildland firefighters (WLFFs) to a 5-month pre- to post-season observational study. Nude body mass, blood pressure (BP), grip strength, and step-test heart rate (HR) were recorded. Blood samples were collected for lipid panel analysis (total cholesterol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, triglycerides, triglyceride:HDL-cholesterol ratio). Two-tailed dependent t-tests determined statistical significance (p < 0.05). RESULTS There were pre- to post-season changes in nude body mass (+2 ± 4%, p = 0.001), systolic BP (-2 ± 10%, p = 0.01), step-test HR (-5 ± 10%, p < 0.001), and all serum lipids (total cholesterol: +5 ± 14%, p = 0.02, HDL-cholesterol: -1 ± 17%, p = 0.04, LDL-cholesterol: +8 ± 22%, p = 0.02, VLDL-cholesterol: +31 ± 49%, p < 0.001, triglycerides: +30 ± 49%, p < 0.001, triglyceride:HDL-cholesterol ratio: +37 ± 58%, p < 0.001). Pre- to post-season diastolic BP (p = 0.12) and grip strength (p = 0.60) remained stable. CONCLUSIONS WLFFs demonstrate maladaptive serum lipids and body mass alterations despite subtle aerobic fitness improvements.
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Affiliation(s)
- Alejandro M Rosales
- Montana Center for Work Physiology and Exercise Metabolism, The University of Montana, Missoula, MT (Rosales, Dodds, Hailes, Ruby), Cardio Protection Laboratory, The University of Montana, Missoula, MT (Quindry), Integrative Physiology Laboratory, Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK (Coker), National Technology and Development Program, United States Department of Agriculture Forest Service, Missoula, MT (Sol)
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Barros B, Oliveira M, Morais S. Firefighters' occupational exposure: Contribution from biomarkers of effect to assess health risks. ENVIRONMENT INTERNATIONAL 2021; 156:106704. [PMID: 34161906 DOI: 10.1016/j.envint.2021.106704] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
Firefighting is physically and physiologically exhausting besides encompassing exposure to toxic fire emissions. Biomonitoring studies from the past five years have been significantly contributing to characterize the occupational-related health effects in this group of professionals and to improve risk assessment. Therefore, this study gathers and critically discusses the most characterized biomarkers of effect (oxidative stress, DNA and protein damage, stress hormones, inflammation, and vascular, lung, and liver injury), including those potentially more promising to be explored in future studies, and their relation with health outcomes. Various studies proved an association between exposures to fire emissions and/or heat and significantly altered values of biomarkers of inflammation (soluble adhesion molecules, tumor necrosis factor, interleukins, and leucocyte count), vascular damage and tissue injury (pentraxin-3, vascular endothelial growth factor, and cardiac troponin T) in firefighting forces. Moreover, preliminary data of DNA damage in blood, urinary mutagenicity and 8-isoprostaglandin in exhaled breath condensate suggest that these biomarkers of oxidative stress should be further explored. However, most of the reported studies are based on cross-sectional designs, which limit full identification and characterization of the risk factors and their association with development of work-related diseases. Broader studies based on longitudinal designs and strongly supported by the analysis of several types of biomarkers in different biological fluids are further required to gain deeper insights into the firefighters occupational related health hazards and contribute to implementation of new or improved surveillance programs.
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Affiliation(s)
- Bela Barros
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015 Porto
| | - Marta Oliveira
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015 Porto
| | - Simone Morais
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015 Porto.
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Estimating Total Energy Expenditure for Fire-Fighters during Large Scale Disaster Response Training Using a Tri-Axial Accelerometer. Nutrients 2021; 13:nu13082789. [PMID: 34444948 PMCID: PMC8397967 DOI: 10.3390/nu13082789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/08/2021] [Accepted: 08/10/2021] [Indexed: 11/16/2022] Open
Abstract
The present study was conducted to estimate total energy expenditure (TEE) of fire-fighters using tri axial-accelerometers in conjunction with an activity log survey on a large number of subjects undergoing training mimicking a large-scale disaster. Subjects were 240 fire-fighters participating in a two-day fire-fighting training dedicated to large-scale natural disasters. Data was analyzed by job type of activity group and the job rank, and by comparing the average. The average TEE of the total survey training period is about 3619 (±499) kcal, which is the same value of expenditure for professional athletes during the soccer game season. From the activity group, the rescue and other teams consumed significantly more energy than the fire and Emergency Medical Team (EMS) teams. From the job rank, Fire Captain (conducting position) consumed significantly lower energy than the Fire Lieutenant and Fire Sergeant. Furthermore, it was found that a middle position rank consumed the most energy. This research supports a need to reconsider the current rescue food (and protocols) to supplement the energy expenditure of fire-fighters. In addition, since there was a significant difference between the job type and the job rank, it is necessary to examine the energy amount and shape suitable for each.
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12
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Gurney SC, Christison KS, Williamson-Reisdorph CM, Sol JA, Quindry TS, Quindry JC, Dumke CL. Alterations in Metabolic and Cardiovascular Risk Factors During Critical Training in Wildland Firefighters. J Occup Environ Med 2021; 63:594-599. [PMID: 34184652 DOI: 10.1097/jom.0000000000002191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To identify physiologic stressors related to cardiovascular disease via changes in metabolic, inflammatory, and oxidative stress biomarkers during 2 weeks of preseason training in wildland firefighters (WLFFs). METHODS Participants were recruited from a local hotshot crew and monitored during preseason training. Fitness was assessed via the Bureau of Land Management fitness challenge. Venipuncture blood was collected on days 1, 4, 8, and 11 and analyzed for changes in a lipid and glucose panel, C-reactive protein, and oxidative stress markers 8-isoprostane (8ISO), 3-nitrotyrosine (3NT), lipid hydroperoxides (LOOH), and protein carbonyls. RESULTS The high physical demands of training resulted in significant (P < 0.05) reductions in total cholesterol, glucose, and hemoglobin A1c. A main effect for time was observed in 8ISO, 3NT, and LOOH. CONCLUSIONS Alterations in metabolic and oxidative stress markers suggest an acute, high-intensity physical stress during WLFF preseason training.
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Affiliation(s)
- Shae C Gurney
- School of Integrative Physiology and Athletic Training, University of Montana (Mr Gurney, Ms Christison, Mrs Williamson-Reisdorph, Mr Sol, Mrs Tiffany Quindry, Dr John Quindry, Dr Dumke); United States Department of Agriculture, Forest Service, National Technology and Development Program (Mr Sol), Missoula, Montana
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13
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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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Zeigler Z, Sol J, Greer P, Verduzco L. Impact of wildland firefighting on arterial stiffness and cardiorespiratory fitness. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:415-422. [PMID: 33939591 DOI: 10.1080/19338244.2021.1917497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to assess the effect of wildland firefighting on measures of cardiovascular health. The study was carried out in two parts. Part one assessed relationships between years of wildland firefighting and cardiovascular variables (n = 28). Part two looked at cardiovascular variables pre and post a wildland firefighting season (n = 18). Independent of age, a statistically significant relationship between number of seasons firefighting and VO2max was found (r2=.140, p=.048). A statistically significant reduction in VO2max of -4.1 ± 5.7 ml·kg-1 min-1 was witnessed following fire season (95%CI=-6.9 to -1.3, p=.048). Year to date hazard pay was significantly correlated with ankle-brachial index (r=-.474, p=.040). Wildland firefighters who reported >640 h of hazard pay had a greater VO2max reduction than those reporting less hazard pay (-1.7 ± 5.7 ml·kg-1·min-1 vs. -7.1 ± 4.3 ml·kg-1·min-1, p=.037). Wildland firefighting may negatively impact cardiorespiratory fitness and arterial health.
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Affiliation(s)
- Zachary Zeigler
- College of Science, Engineering, and Technology, Grand Canyon University, Phoenix, AZ, USA
| | - Joe Sol
- National Technology and Development Program, Missoula, MT, USA
| | | | - Laura Verduzco
- College of Science, Engineering, and Technology, Grand Canyon University, Phoenix, AZ, USA
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15
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Christison KS, Gurney SC, Sol JA, Williamson-Reisdorph CM, Quindry TS, Quindry JC, Dumke CL. Muscle Damage and Overreaching During Wildland Firefighter Critical Training. J Occup Environ Med 2021; 63:350-356. [PMID: 33769401 DOI: 10.1097/jom.0000000000002149] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To document the effects of wildland firefighter (WLFF) critical training (CT) on physiologic markers of muscle damage and acute overreaching. METHODS Eighteen male and three female WLFFs were studied during an 11-day CT. Upper-body (US), lower-body (LS) muscle soreness and body weight (BW) were collected daily. Blood was collected on days 1, 4, 8, and 11 to measure creatine kinase (CK), lactate dehydrogenase (LDH), cortisol, and testosterone. Skinfolds were taken on days 1 and 11 to estimate body fat (BF) and lean body weight (LBW). RESULTS CT resulted in a significant depression in BF and elevation in LBW, while main effects of time were seen in US, LS, CK, LDH, cortisol, and testosterone/cortisol ratio (P < 0.05). CONCLUSION These data suggest WLFFs undergo significant physiological stressors resulting in muscle soreness, damage, and possible overreaching during CT.
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Affiliation(s)
- Katherine S Christison
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, Montana (Ms Christison, Mr Gurney, Mr Sol, Ms Williamson-Reisdorph, Ms Quindry, Dr Quindry, Dr Dumke); United States Department of Agriculture, Forest Service, National Technology and Development Program, Missoula, Montana (Mr Sol)
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16
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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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17
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The association between heart rate variability, reaction time, and indicators of workplace fatigue in wildland firefighters. Int Arch Occup Environ Health 2021; 94:823-831. [PMID: 33426591 DOI: 10.1007/s00420-020-01641-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 12/19/2020] [Indexed: 01/11/2023]
Abstract
PURPOSE To understand the association between heart rate variability and indices of fatigue, total sleep time, and reaction time in shift workers. METHODS Ten participants from the British Columbia Wildfire Service management team were examined over a 14-day active fire-line period. Daily measures of subjective fatigue, sleepiness, and alertness were recorded using a visual analog scale. Daily total sleep time was recorded using a wrist actigraph. Cardiac autonomic modulation was examined each morning using heart rate variability (HRV). Three measures of reaction time (simple reaction time, choice reaction tie, and discriminatory reaction time) was examined on days 1, 5, 10, and 14. Multiple linear regression analysis was utilized to examine the association between HRV and indices of fatigue, total sleep time, and reaction time. RESULTS Mean shift duration was 13.8 ± 0.77 h. Significant inverse associations were observed between HRV and sleepiness [r = - 0.60, p = 0.000] and fatigue [r = - 0.55, p = 0.000], and a positive association with total sleep time (min) [r = 0.28, p = 0.009]. There were no significant relationships between HRV and simple reaction time (ms) [r = - 0.32, p = 0.182], choice reaction time (ms) [r = - 0.10, p = 0.850], or discriminatory reaction time (ms) [r = - 0.09, p = 0.881]. CONCLUSIONS HRV displayed significant associations with indices of fatigue and sleep, whereby demonstrating its utility as a practical tool for monitoring the development of fatigue in wildland firefighters and for providing insight when to make lifestyle modifications to preserve alertness.
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Potential COVID-19 Outbreak in Fire Camp: Modeling Scenarios and Interventions. FIRE-SWITZERLAND 2020. [DOI: 10.3390/fire3030038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The global COVID-19 pandemic will pose unique challenges to the management of wildland fire in 2020. Fire camps may provide an ideal setting for the transmission of SARS-CoV-2, the virus that causes COVID-19. However, intervention strategies can help minimize disease spread and reduce the risk to the firefighting community. We developed a COVID-19 epidemic model to highlight the risks posed by the disease during wildland fire incidents. Our model accounts for the transient nature of the population on a wildland fire incident, which poses unique risks to the management of communicable diseases in fire camps. We used the model to assess the impact of two types of interventions: the screening of a firefighter arriving on an incident, and social distancing measures. Our results suggest that both interventions are important to mitigate the risks posed by the SARS-CoV-2 virus. However, screening is relatively more effective on short incidents, whereas social distancing is relatively more effective during extended campaigns. We conclude with a discussion of model limitations and potential extensions to the model.
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Marks AN, Sol JA, Domitrovich JW, West MR, Ruby BC. Total Energy Intake and Self-Selected Macronutrient Distribution During Wildland Fire Suppression. Wilderness Environ Med 2020; 31:188-196. [DOI: 10.1016/j.wem.2020.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 01/26/2023]
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Coker MS, Ladd KR, Kim J, Murphy CJ, DeCort R, Newcomer BR, Wolfe RR, Coker RH. Essential Amino Acid Supplement Lowers Intrahepatic Lipid despite Excess Alcohol Consumption. Nutrients 2020; 12:E254. [PMID: 31963802 PMCID: PMC7019240 DOI: 10.3390/nu12010254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 12/18/2022] Open
Abstract
Excess alcohol consumption is a top risk factor for death and disability. Fatty liver will likely develop and the risk of liver disease increases. We have previously demonstrated that an essential amino acid supplement (EAAS) improved protein synthesis and reduced intrahepatic lipid in the elderly. The purpose of this exploratory pilot study was to initiate the evaluation of EAAS on intrahepatic lipid (IHL), body composition, and blood lipids in individuals with mild to moderate alcohol use disorder (AUD). Following consent, determination of eligibility, and medical screening, 25 participants (18 males at 38 ± 15 years/age and 7 females at 34 ± 18 years/age) were enrolled and randomly assigned to one of two dosages: a low dose (LD: 8 g of EAAS twice/day (BID)) or high dose (HD: 13 g of EAAS BID). Five of the twenty-five enrolled participants dropped out of the intervention. Both groups consumed the supplement BID for 4 weeks. Pre- and post-EAAS administration, IHL was determined using magnetic resonance imaging/spectroscopy, body composition was analyzed using dual-energy X-ray absorptiometry, and blood parameters were measured by LabCorp. T-tests were used for statistical analysis and considered significant at p < 0.05. While there was no significant change in IHL in the LD group, there was a significant 23% reduction in IHL in the HD group (p = 0.02). Fat mass, lean tissue mass, bone mineral content, and blood lipids were not altered. Post-EAAS phosphatidylethanol was elevated and remained unchanged in LD at 407 ± 141 ng/mL and HD at 429 ± 196 ng/mL, indicating chronic and excess alcohol consumption. The HD of the proprietary EAAS formulation consumed BID seemed to lower IHL in individuals with mild to moderate AUD. We suggest that further studies in a larger cohort be conducted to more completely address this important area of investigation.
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Affiliation(s)
- Melynda S. Coker
- Department of Natural Resources and Environment, University of Alaska Fairbanks, 505 South Chandalar Drive, Fairbanks, AK 99775, USA;
| | - Kaylee R. Ladd
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK 99775, USA; (K.R.L.); (J.K.)
| | - Jimin Kim
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK 99775, USA; (K.R.L.); (J.K.)
| | - Carl J. Murphy
- Institute of Arctic Biology, Department of Chemistry & Biochemistry, University of Alaska Fairbanks1930 Yukon Dr. Room 136, Fairbanks, AK 99775, USA;
| | - Ryan DeCort
- Bassett Army Community Hospital, 4076 Neely Road, FortWainwright, United States Army, Fairbanks, AK 99703, USA;
| | - Bradley R. Newcomer
- Honors College, 1501 251Warren Service Drive, Room 105, James Madison University, Harrisonburg, VA 22807, USA;
| | - Robert R. Wolfe
- Department of Geriatrics, Center for Translational Research in Aging & Longevity, Donald W. Reynolds Institute on Aging, 4301 West Markham, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Robert H. Coker
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK 99775, USA; (K.R.L.); (J.K.)
- Institute of Arctic Biology, Department of Chemistry & Biochemistry, University of Alaska Fairbanks1930 Yukon Dr. Room 136, Fairbanks, AK 99775, USA;
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