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Sandsund M, Aamodt E, Renberg J. Heat strain in professional firefighters: physiological responses to a simulated smoke dive in extremely hot environments and the subsequent recovery phase. INDUSTRIAL HEALTH 2024; 62:312-323. [PMID: 38631878 DOI: 10.2486/indhealth.2023-0151] [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: 04/19/2024]
Abstract
Firefighters risk heat strain during occupational tasks when exposed to extremely hot environmental conditions and performing high-intensity work. Relevant training scenarios are therefore essential. This study investigated the effect of a single simulated smoke dive and the following recovery phase on physiological and perceptual responses. Nineteen professional male firefighters (43 ± 8 yr) performed a 2-min stair walk and a15-min simulated smoke dive in a two-floor heat chamber (110°C to 272°C) (HEAT), followed by a 5-min stair walk outside the heat chamber. Heart rate (HR), gastrointestinal temperature (Tgi) and skin temperatures were registered continuously during the test. The Tgi increased significantly from the start (37.5 ± 0.3°C) to the end of HEAT (38.4 ± 0.4°C) and further increased after the heat exposure (39.6 ± 0.5°C). The HR also increased significantly from the start (92 ± 14 bpm) to the end of HEAT (185 ± 13 bpm) and increased after the heat exposure to a maximum of 190 ± 13 bpm. The simulated smoke dive induced high physiological strain on the firefighters, and the increase in Tgi and HR after the hot exposure must be considered during live fire events when repeated smoke dives are required.
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Affiliation(s)
| | | | - Julie Renberg
- Department of Health Research, SINTEF Digital, Norway
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2
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Farinha VM, de Borba EF, dos Santos PP, Ulbrich AZ, Ribeiro EJF, Tartaruga MP. Association of Physical and Emotional Parameters with Performance of Firefighters: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1097. [PMID: 39200706 PMCID: PMC11354647 DOI: 10.3390/ijerph21081097] [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: 07/02/2024] [Revised: 07/22/2024] [Accepted: 08/15/2024] [Indexed: 09/02/2024]
Abstract
Firefighting requires a high level of physical fitness and causes substantial psychological stress, engendering musculoskeletal, mental, and cardiac issues. Consequently, it is necessary to measure the preparation of the firefighters daily through the Firefighting Physical Ability Tests (FPATs). According to the literature, some variables are more important for performance in the FPAT. Therefore, we aimed to summarize evidence that relates physical and mental aspects to the FPAT performance. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) method, screening 1055 records from databases and selecting 15 that met inclusion criteria. No emotional and psychological variables were correlated with the FPAT. Most research shows significant correlations between the FPAT performance and the following: aerobic fitness, upper body endurance and strength, anaerobic capacity, body fat, and age. Lower body endurance and strength, as well as anaerobic power, had a low number of investigations and need to be further explored. Abdominal endurance showed weak correlations, while flexibility did not show any correlations in most studies, although these should be considered for injury prevention. We recommend that fitness programs and evaluations include a global analysis considering the evidence presented for methodological improvements.
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Affiliation(s)
- Vinícius Montaguti Farinha
- Physical Education Department, Federal University of Paraná-UFPR, Curitiba 81530-000, PR, Brazil; (V.M.F.); (E.F.d.B.); (A.Z.U.); (E.J.F.R.J.)
| | - Edilson Fernando de Borba
- Physical Education Department, Federal University of Paraná-UFPR, Curitiba 81530-000, PR, Brazil; (V.M.F.); (E.F.d.B.); (A.Z.U.); (E.J.F.R.J.)
| | | | - Anderson Zampier Ulbrich
- Physical Education Department, Federal University of Paraná-UFPR, Curitiba 81530-000, PR, Brazil; (V.M.F.); (E.F.d.B.); (A.Z.U.); (E.J.F.R.J.)
| | - Evaldo José Ferreira Ribeiro
- Physical Education Department, Federal University of Paraná-UFPR, Curitiba 81530-000, PR, Brazil; (V.M.F.); (E.F.d.B.); (A.Z.U.); (E.J.F.R.J.)
| | - Marcus Peikriszwili Tartaruga
- Physical Education Department, Federal University of Paraná-UFPR, Curitiba 81530-000, PR, Brazil; (V.M.F.); (E.F.d.B.); (A.Z.U.); (E.J.F.R.J.)
- Physical Education Department, Midwestern Parana State University-UNICENTRO, Guarapuava 85040-167, PR, Brazil
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Marciniak RA, Wahl CA, Ebersole KT. Differences in Workloads of Maximal Tasks in Active-Duty Firefighters. Healthcare (Basel) 2024; 12:1495. [PMID: 39120198 PMCID: PMC11312066 DOI: 10.3390/healthcare12151495] [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: 06/19/2024] [Revised: 07/22/2024] [Accepted: 07/25/2024] [Indexed: 08/10/2024] Open
Abstract
The purpose of this study was to compare the workload of a maximal treadmill test (TREAD) and a fire suppression task (BURN) in firefighters and to examine their relationships to fitness as measured by body mass index (BMI), percent body fat (BF%), and peak aerobic capacity (VO2PEAK). The amount of time spent in the heart rate (HR) intensity ranges of 50-59% HRMAX (ZONE1), 60-69% HRMAX (ZONE2), 70-79% HRMAX (ZONE3), 80-89% HRMAX (ZONE4), and ≥90% HRMAX (ZONE5) quantified the workload as the Edward's Training Impulse for TREAD (ETRIMPTREAD) and BURN (ETRIMPBURN). The ETRIMPTREAD was significantly less than ETRIMPBURN. For TREAD, ZONE5 > ZONE2 and ZONE3. For BURN, ZONE4 > ZONE1, ZONE2, and ZONE5 > ZONE1, ZONE2, and ZONE3. A lower BF% and greater VO2PEAK were related to a greater ETRIMPTREAD and unrelated to ETRIMPBURN. For BURN only, a lower BF% and greater VO2PEAK were related to less time in ZONE5. BMI was unrelated to all workload measures. Laboratory-based maximal exercise testing does not adequately reflect the workload of simulated fire suppression and therefore may not be indicative of firefighter readiness to meet job demands. Less-fit firefighters rely on higher cardiovascular intensities to complete the same workload, and practitioners should consider this when selecting strategies to reduce job-associated cardiovascular risk.
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Affiliation(s)
| | - Carly A. Wahl
- Department of Kinesiology, Sport, and Recreation, Eastern Illinois University, Charleston, IL 61920, USA;
| | - Kyle T. Ebersole
- School of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
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Wohlgemuth KJ, Conner MJ, Tinsley GM, Palmer TB, Mota JA. Strategies for Improving Firefighter Health On-Shift: A Review. J Funct Morphol Kinesiol 2024; 9:105. [PMID: 38921641 PMCID: PMC11204757 DOI: 10.3390/jfmk9020105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/11/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
The fire service suffers from high rates of cardiovascular disease and poor overall health, and firefighters often suffer fatal and non-fatal injuries while on the job. Most fatal injuries result from sudden cardiac death, while non-fatal injuries are to the musculoskeletal system. Previous works suggest a mechanistic link between several health and performance variables and injury risk. In addition, studies have suggested physical activity and nutrition can improve overall health and occupational performance. This review offers practical applications for exercise via feasible training modalities as well as nutritional recommendations that can positively impact performance on the job. Time-efficient training modalities like high-intensity interval training and feasible modalities such as resistance training offer numerous benefits for firefighters. Also, modifying and supplementing the diet and can be advantageous for health and body composition in the fire service. Firefighters have various schedules, making it difficult for planned exercise and eating while on shift. The practical training and nutritional aspects discussed in this review can be implemented on-shift to improve the overall health and performance in firefighters.
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Affiliation(s)
- Kealey J. Wohlgemuth
- Neuromuscular and Occupational Performance Laboratory, Texas Tech University, Lubbock, TX 79409, USA;
| | | | - Grant M. Tinsley
- Energy Balance and Body Composition Laboratory, Texas Tech University, Lubbock, TX 79409, USA;
| | - Ty B. Palmer
- Muscular Assessment Laboratory, Texas Tech University, Lubbock, TX 79409, USA;
| | - Jacob A. Mota
- Neuromuscular and Occupational Performance Laboratory, Texas Tech University, Lubbock, TX 79409, USA;
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Gonzalez DE, Dillard CC, Johnson SE, Martin SE, McAllister MJ. Physiological Stress Responses to a Live-Fire Training Evolution in Career Structural Firefighters. J Occup Environ Med 2024; 66:475-480. [PMID: 38471807 DOI: 10.1097/jom.0000000000003088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVE This study assessed firefighters' physiological stress response to a live fire training evolution (LFTE). METHODS Seventy-six ( n = 76) firefighters completed an LFTE. Salivary samples were collected pre-, immediately post, and 30-min post-LFTE and analyzed for α-amylase (AA), cortisol (CORT), and secretory immunoglobulin-A (SIgA). RESULTS Concentrations of AA, CORT, and SIgA were elevated immediately post LFTE versus pre (P<0.001) and 30-min post (P<0.001). Cohen's d effect size comparing pre and immediately-post means were 0.83, 0.77, and 0.61 for AA, CORT, and SIgA and were 0.54, 0.44, and 0.69 for AA, CORT, and SIgA, comparing immediately-post and 30-min post, respectively. CONCLUSIONS These data demonstrate the stress response and activation of the hypothalamic-pituitary-adrenal/sympathetic-adreno-medullar axis and immune system immediately after real-world firefighting operations. Future work is needed to understand the impact of elevated stress biomarkers on firefighter performance and disease risk.
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Affiliation(s)
- Drew E Gonzalez
- From the Tactical Athlete Research Unit, Department of Kinesiology & Sport Management, Texas A&M University, College Station, Texas (D.E.G., S.E.J., S.E.M.); Exercise Biochemistry Laboratory, Department of Kinesiology, University of North Alabama, Florence, Alabama (C.C.D.); Sydney and JL Huffines Institute for Sports Medicine and Human Performance, Department of Kinesiology & Sport Management, Texas A&M University, College Station, Texas (S.E.M.); and Metabolic and Applied Physiology Laboratory, Department of Health & Human Performance, Texas State University, San Marcos, Texas (C.C.D., M.J.M.)
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Kollock RO, Hale WD, Fulk M, Seidner M, Szabo Z, Sanders GJ, Peveler W. Relationship between Simulated Fire Suppression Activities and Acute Cardiac and Respiratory Events in Firefighters. J Funct Morphol Kinesiol 2024; 9:96. [PMID: 38921632 PMCID: PMC11205065 DOI: 10.3390/jfmk9020096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/27/2024] Open
Abstract
Cardiac deaths account for the largest share of on-duty firefighter deaths. To help ensure duty fitness and minimize injury risk, many fire departments require the passing of an annual physical ability test, consisting of a battery of simulated fire suppression activities (sFSAs). The purpose of the study was to determine the relationship of sFSA performance to acute cardiac and respiratory events (ACREs) and the effect that estimated VO2max has on sFSA performance. The study was retrospective. As part of an annual physical ability test, five timed sFSAs were performed, summed for a composite time, and categorized into three performance levels (fast, moderate, and slow). Estimated VO2max was determined using the Forestry Step Test. A significant (p = 0.023) linear trend was observed with higher sFSA performance times being associated with a higher proportion of firefighters going on to suffer an ACRE. The estimated VO2max was significantly (p < 0.001) higher in the fast group compared to the slow group. There was not a significant (p = 0.70) difference in estimated VO2max between the moderate and slow groups. Estimated VO2max performance and sFSA performance were significantly correlated, with rs(488) = -0.272 and p < 0.001. Poorer sFSA performance was found to be associated with a higher proportion of ACREs. The results suggest that sFSA performance may be a valid indicator of ACRE injury risk and aerobic capacity.
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Affiliation(s)
- Roger O. Kollock
- Department of Kinesiology and Rehabilitative Sciences, The University of Tulsa, Tulsa, OK 74104, USA; (W.D.H.); (M.F.); (M.S.); (Z.S.)
| | - William D. Hale
- Department of Kinesiology and Rehabilitative Sciences, The University of Tulsa, Tulsa, OK 74104, USA; (W.D.H.); (M.F.); (M.S.); (Z.S.)
| | - Maddie Fulk
- Department of Kinesiology and Rehabilitative Sciences, The University of Tulsa, Tulsa, OK 74104, USA; (W.D.H.); (M.F.); (M.S.); (Z.S.)
| | - Maddie Seidner
- Department of Kinesiology and Rehabilitative Sciences, The University of Tulsa, Tulsa, OK 74104, USA; (W.D.H.); (M.F.); (M.S.); (Z.S.)
| | - Zora Szabo
- Department of Kinesiology and Rehabilitative Sciences, The University of Tulsa, Tulsa, OK 74104, USA; (W.D.H.); (M.F.); (M.S.); (Z.S.)
| | - Gabriel J. Sanders
- Exercise Science Department, University of Cincinnati, Cincinnati, OH 45221, USA;
| | - Will Peveler
- School of Health Sciences, Liberty University, Lynchburg, VA 24515, USA;
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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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Ras J, Soteriades ES, Smith DL, Kengne AP, Leach L. Evaluation of the relationship between occupational-specific task performance and measures of physical fitness, cardiovascular and musculoskeletal health in firefighters. BMC Public Health 2024; 24:20. [PMID: 38166790 PMCID: PMC10763081 DOI: 10.1186/s12889-023-17487-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Firefighters are required to perform physically strenuous tasks such as hose drags, victim rescues, forcible entries and stair climbs to complete their public safety mission. Occupational-specific tasks are often used to evaluate the ability of firefighters to adequately/safely perform their duties. Depending on the regions, occupational-specific tasks include six to eight individual tasks, which emphasize distinct aspects of their physical fitness, while also requiring different levels of cardiovascular (CVH) and musculoskeletal health (MSH). Therefore, the aim of this study was to evaluate the relationship between specific occupational task performance and measures of physical fitness, cardiovascular and musculoskeletal health. METHODS Using a cross-sectional design, 282 full-time male and female firefighters were recruited. A researcher-generated questionnaire and physical measures were used to collect data on sociodemographic characteristics, CVH, MSH and weekly physical activity habits. Physical measures were used to collect data on physical fitness and occupational-specific task performance. RESULTS Absolute cardiorespiratory fitness (abV̇O2max), grip strength, leg strength, push-ups, sit-ups and lean body mass (all p < 0.001) had an inverse association with completion times on all occupational-specific tasks. Age was positively related to the performance of all tasks (all p < 0.05). Higher heart rate variability (HRV) was associated with better performance on all tasks (all p < 0.05). Bodyfat percentage (BF%) and diastolic blood pressure were positively associated with the step-up task (p < 0.05). Lower back musculoskeletal injury (LoBMSI), musculoskeletal discomfort (MSD), and lower limb MSD were associated with a decreased odds of passing the step-up. Upper body MSIs (UBMSI), LoBMSIs and Lower back MSD were associated with decreased odds of passing the rescue drag. CONCLUSION Firefighters that were taller, leaner, stronger and fitter with a more favourable CVH profile, higher HRV and less musculoskeletal discomfort performed best on all occupational-specific tasks.
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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.
| | - Elpidoforos S Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
- Environmental and Occupational Medicine and Epidemiology (EOME), Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Denise L Smith
- Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, New York, USA
| | - Andre P Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, 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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Lockie RG, Orr RM, Montes F, Dawes JJ. Physical fitness test performance in firefighter trainees: Differences between graduated and released trainees and predicting academy graduation. Work 2024; 77:1377-1389. [PMID: 38160386 DOI: 10.3233/wor-230258] [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] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Fitness tests have been previously used to predict academy graduation and highlight specific capacities to be targeted in applicants/trainees to optimise their potential for academy success. OBJECTIVE To compare the fitness of graduated and released (did not complete academy requirements) firefighter trainees and explore using decision tree analysis to predict academy graduation via fitness tests. METHODS Retrospective analysis was conducted on 686 trainees who completed an occupational physical ability test (OPAT): Illinois agility test; push-ups; pull-ups; leg tucks; estimated maximal aerobic capacity (VO2max); backwards overhead 4.54-kg medicine ball throw; 10-repetition maximum deadlift; and 91.44-m farmer's carry. Data were recorded in raw and scaled scores (tests scored from 0-100; maximum OPAT score was 800). Trainees were split into 'graduated' (GRAD; n = 576) or 'released' (REL; n = 110) groups. Mann-Whitney U-tests compared between-group OPAT scores. A decision tree analysis using Chi-square automatic interaction detection was conducted, with raw and scaled scores entered into the analysis. A separate analysis was conducted with only the raw scores. RESULTS GRAD trainees outperformed REL trainees in all OPAT events (p < 0.001). OPAT total score was the best predictor of academy graduation (p < 0.001), followed by the deadlift score (p = 0.003). Estimated VO2max was the only significant raw score predictor (p < 0.001). CONCLUSIONS GRAD trainees were fitter than the REL trainees. Fitness could predict trainees who graduated from the academy. Overall fitness (OPAT total score), muscular strength (deadlift) and aerobic capacity were important graduation predictors. Training staff could develop these fitness qualities in their trainees to potentially improve fire academy graduation rates.
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Affiliation(s)
- Robert G Lockie
- Department of Kinesiology, California State University, Fullerton, CA, USA
| | - Robin M Orr
- Tactical Research Unit, Bond University, Robina, Qld, Australia
| | | | - J Jay Dawes
- School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, OK, USA
- Tactical Fitness and Nutrition Lab, Oklahoma State University, Stillwater, OK, USA
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Cornell DJ, Flees RJ, Shemelya CM, Ebersole KT. Influence of Cardiorespiratory Fitness on Cardiac Autonomic Recovery Among Active-Duty Firefighters. J Strength Cond Res 2024; 38:66-73. [PMID: 37815269 DOI: 10.1519/jsc.0000000000004581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Abstract
Cornell, DJ, Flees, RJ, Shemelya, CM, and Ebersole, KT. Influence of cardiorespiratory fitness on cardiac autonomic recovery among active-duty firefighters. J Strength Cond Res 38(1): 66–73, 2024—It has been suggested that an inability of the autonomic nervous system (ANS) to recover after strenuous events is a potential cause of sudden cardiac death among firefighters. The purpose of this study was to examine the influence of cardiorespiratory fitness (CRF) on the heart rate recovery (HRR) kinetics of firefighters. Thirty-seven male career active-duty firefighters completed both a submaximal step test and a maximal treadmill graded exercise test. A monoexponential curve was fit to postexercise submaximal and maximal HRR data of each subject. Subjects were placed into Low CRF (n = 13) and High CRF (n = 24) groups based on the standard peak aerobic capacity (V̇O2peak) criterion of <42 ml·kg−1·minute−1 and ≥42 ml·kg−1·minute−1, respectively. After controlling for age and body mass index, CRF was significantly (p < 0.05) correlated with the decay rate (
) and asymptote (
) after submaximal exercise (r
sp = −0.556; r
sp = −0.637, respectively), as well as the
,
, and amplitude (
) after maximal exercise (r
sp = −0.353; r
sp = −0.416; r
sp = 0.603, respectively). High CRF firefighters demonstrated a significantly faster
after both submaximal (p = 0.003) and maximal exercise (p = 0.043), a lower
after submaximal exercise (p = 0.002), and a higher
after maximal exercise (p = 0.001), than Low CRF firefighters. Greater CRF was associated with enhanced HRR kinetics after submaximal and maximal exertion, suggesting that CRF may positively influence the ANS recovery of firefighters.
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Affiliation(s)
- David J Cornell
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, Massachusetts
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Robert J Flees
- Human Performance and Sport Physiology Laboratory, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin; and
| | - Corey M Shemelya
- Department of Electrical and Computer Engineering, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Kyle T Ebersole
- Human Performance and Sport Physiology Laboratory, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin; and
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Rynne PJ, Derella CC, McMorrow C, Dickinson RL, Donahue S, Almeida AA, Carty M, Feairheller DL. Blood pressure responses are dependent on call type and related to hypertension status in firefighters. Blood Press 2023; 32:2161997. [PMID: 36597210 PMCID: PMC11062321 DOI: 10.1080/08037051.2022.2161997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/19/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Impaired cardiovascular health is a concern for firefighters, with over 50% of line-of-duty deaths having cardiac causes. Many firefighters have hypertension and <25% have their blood pressure (BP) controlled. The alarm response could be an unidentified cardiac risk, but interestingly, the BP response to different calls and on-the-job activity is unknown. PURPOSE We aimed to measure the physiological stress resulting from different call types (fire, medical) and job activity (riding apparatus, pre-alert alarms) through ambulatory BP (ABP) monitoring in a population of firefighters. MATERIALS AND METHODS During 111 12-h work shifts firefighters wore an ABP monitor. BP was measured at 30-min intervals and manual measurements were prompted when the pager went off or whenever they felt stress. RESULTS Firefighters were hypertensive (124.3 ± 9.9/78.1 ± 6.7 mmHg), overweight (30.2 ± 4.6 kg/m2), middle-aged (40.5 ± 12.6 years) and experienced (17.3 ± 11.7 years). We calculated an average 11% increase in systolic and 10.5% increase in diastolic BP with alarm. Systolic BP (141.9 ± 13.2 mmHg) and diastolic BP (84.9 ± 11.1 mmHg) and the BP surges were higher while firefighters were responding to medical calls compared to fire calls. Between BP groups we found that medical call systolic BP (p = .001, d = 1.2), diastolic BP (p = .017, d = 0.87), and fire call systolic BP (p = .03, d = 0.51) levels were higher in the hypertensive firefighters. CONCLUSION This is the first report of BP surge responses to alarms and to occupational activities in firefighters, and medical calls elicited the largest overall responses.PLAIN LANGUAGE SUMMARYCardiovascular disease and impaired cardiovascular health are substantially more prevalent in firefighters, with over 50% of line-of-duty deaths being cardiac related.Many firefighters are diagnosed with high blood pressure (hypertension), which is known to increase the risk of heart attacks, strokes, heart disease, and other serious health complications.Upon stress, our body enacts the 'fight or flight' response where sympathetic nervous system activity triggers an immediate increase in heart rate and blood pressure. This response can be dangerous when surges reach extreme levels due to underlying impaired cardiovascular function. It is known that alarm sounds trigger a stress response.Firefighters respond to different alarms while on the job, each indicating different call types, such as a house fire or a medical emergency. Due to the prevalence of impaired cardiovascular health in firefighters, the physical stress resulting from these alerts is cause for concern.The blood pressure surge response to different call types and job activities in healthy and hypertensive firefighters had not been measured before this study.Through the ambulatory blood pressure monitoring of 111 on-duty firefighters, this study discovered that medical calls caused the greatest blood pressure and heart rate surge.Also, firefighters with hypertension experienced a greater blood pressure surge in response to alarms than their non-hypertensive co-workers.
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Affiliation(s)
- Paige J. Rynne
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | | | - Carly McMorrow
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | | | - Stephanie Donahue
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Andrew A. Almeida
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | - Megan Carty
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
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D'Isabel S, Berny LM, Frost A, Thongphok C, Jack K, Chaudhry S, Arena R, Smith DL. The effect of mild to moderate COVID-19 infection on the cardiorespiratory fitness of firefighters. Front Public Health 2023; 11:1308605. [PMID: 38106889 PMCID: PMC10724018 DOI: 10.3389/fpubh.2023.1308605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/13/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction An adequate level of cardiorespiratory fitness (CRF) is critical for firefighters to perform the strenuous and physiologically demanding work of firefighting safely and effectively. The coronavirus disease 2019 (COVID-19) has been shown to negatively impact CRF in both the acute phase and longer-term following infection. This study aimed to determine changes to the CRF of firefighters pre- to post-mild to moderate COVID-19 infection and to investigate the impact of days past COVID-19 infection on change in CRF. Methods CRF measures from cardiopulmonary exercise testing (CPET) at annual occupational health exams that occurred pre-COVID-19 infection in 2019 were obtained for firefighters from seven Arizona fire departments. Measures were compared to CPET evaluations from annual health exams the following year in a cohort of firefighters who self-reported mild to moderate illness following COVID-19 infection between exams. Results Among a cohort of 103 firefighters, mean age 40 ± 9 years, CRF [as measured by peak oxygen consumption (VO2)] declined by an average of 2.55 ml·kg-1·min-1 or 7.3% (d = -0.38, p < 0.001) following COVID-19 infection (mean time from COVID-19 infection to CPET was 110 ± 78 days). The number of days past COVID-19 infection showed a small, yet significant, relationship to peak VO2 (r = 0.250, p = 0.011). Estimated marginal effects indicated that when biological sex, age, and BMI are controlled for, predicted peak VO2 returned to pre-COVID-19 values ~300 days after COVID-19 infection. Conclusion Peak VO2 (ml·kg-1·min-1) declined 7.3% among firefighters an average of 110 days past reporting mild to moderate COVID-19 infection. This decrease has implications for the operational readiness and safety of firefighters.
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Affiliation(s)
- Susanne D'Isabel
- First Responder Health and Safety Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Lauren M. Berny
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
| | - Alex Frost
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Chanhtel Thongphok
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Kepra Jack
- HeartFit for Duty, Mesa, AZ, United States
| | | | - Ross Arena
- MET-Test, Atlanta, GA, United States
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, United States
| | - Denise L. Smith
- First Responder Health and Safety Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
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Hershey MS, Bouziani E, Chen XY(M, Lidoriki I, Hadkhale K, Huang YC, Filippou T, López-Gil JF, Gribble AK, Lan FY, Sotos-Prieto M, Kales SN. Surviving & Thriving; a healthy lifestyle app for new US firefighters: usability and pilot study protocol. Front Endocrinol (Lausanne) 2023; 14:1250041. [PMID: 37908746 PMCID: PMC10614295 DOI: 10.3389/fendo.2023.1250041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/11/2023] [Indexed: 11/02/2023] Open
Abstract
In the United States (US), new firefighters' fitness and health behaviors deteriorate rapidly after fire academy graduation. Over the long-term, this increases their risks for chronic diseases. This study protocol describes the proposed usability testing and pilot study of a newly designed and developed healthy lifestyle smartphone app, "Surviving & Thriving", tailored towards young US firefighters. "Surviving & Thriving" will provide interactive educational content on four lifestyle factors; nutrition, sleep, physical activity, and resilience, and include a personalized journey, habit tracker, and elements of gamification to promote engagement and long-term healthy behavior change. The first phase of the app development entails alpha testing by the research team and pre-beta testing by a fire service expert panel which will help refine the app into a pre-consumer version. Upon completion of the full app prototype, beta 'usability' testing will be conducted among new fire academy graduates from two New England fire academies to collect qualitative and quantitative feedback via focus groups and satisfaction surveys, respectively. A last phase of piloting the app will evaluate the app's efficacy at maintaining/improving healthy lifestyle behaviors, mental health metrics, and physical fitness metrics. We will also evaluate whether firefighters' perceived "health cultures" scores (ratings of each fire station's/fire department's environments as to encouraging/discouraging healthy behaviors) modify the changes in health metrics after utilizing the app for three to six months. This novel user-friendly app seeks to help new firefighters maintain/improve their health and fitness more effectively, reducing their risk of lifestyle-related chronic disease. Firefighters who can establish healthy habits early in their careers are more likely to sustain them throughout their lives.
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Affiliation(s)
- Maria Soledad Hershey
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Eleni Bouziani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Xin Yu (Maggie) Chen
- Harvard Faculty of Arts and Sciences, William James Hall, Cambridge, MA, United States
- Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - Irene Lidoriki
- Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - Kishor Hadkhale
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - Ya-Chin Huang
- Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
- Department of Preventive Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Occupational & Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - José Francisco López-Gil
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Anne Katherine Gribble
- Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
- Illawarra Shoalhaven Local Health District, NSW Health, Warrawong, NSW, Australia
| | - Fan-Yun Lan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mercedes Sotos-Prieto
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP) [Consorcio Centro de Investigación Biomédica en Red (CIBER) of Epidemiology and Public Health], Madrid, Spain
- Madrid Institute for Advanced Studies (IMDEA)-Food Institute, The Campus of International Excellence (CEI), The Spanish National Research Council (CSIC), The Autonomous University of Madrid (UAM), Madrid, Spain
| | - Stefanos N. Kales
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
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14
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Teixeira IG, Verzola MR, Filipini RE, Speretta GF. The effects of a firefighting simulation on the vascular and autonomic functions and cognitive performance: a randomized crossover study. Front Physiol 2023; 14:1215006. [PMID: 37811491 PMCID: PMC10551144 DOI: 10.3389/fphys.2023.1215006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction: During firefighting, physical and cognitive demands increase. However, the stress inherent to these events can decrease cognitive performance and increase the risk of cardiovascular events in firefighters. Thus, this crossover study aimed to evaluate the effects of a firefighting Simulation on cognitive performance and vascular and autonomic functions in military firefighters. Methods: Sixteen firefighters (37.8 ± 5.6 years) underwent anthropometry, mental health status, and sleep quality assessments. They randomly performed two interventions, Simulation (Firefighting tasks; 10.0 ± 1.1 min) and Control (rest for 10 min), on different days. After both interventions, cognitive performance was assessed using the Stroop Test, Paced Auditory Serial Addition Test, and Trail Making Test. Then, the vascular function was assessed using ultrasonography through the carotid artery reactivity to the cold pressor test. The arterial pressure, heart rate, and cardiac intervals were recorded before interventions. The cardiac intervals were also measured during the cold pressor test. Student's t-test and Wilcoxon were used for comparisons between Control and Simulation and the analysis of variance for repeated measures was used for comparison over time during the cold pressor test. A significance level of p < 0.05 was adopted. Results: Although the mean and maximum heart rate were higher before the Simulation (p < 0.0001), all the heart rate variability parameters (p > 0.05) and mean arterial pressure (p > 0.3795) were similar before the interventions. After Simulation, the cognitive performance was similar to Control (p > 0.05), except for the improvement in Stroop Test part B (p < 0.0001). After Simulation, carotid artery reactivity was attenuated (p < 0.0010). During the cold pressor test, the high-frequency band of the heart rate variability was lower after the Simulation (p < 0.0104). Discussion: Although firefighting Simulation did not substantially change cognitive performance, the lower carotid artery reactivity and parasympathetic modulation to the heart during the cold pressor test may contribute to greater vulnerability to cardiovascular events in firefighters on duty.
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Affiliation(s)
- Iara G. Teixeira
- Post-Graduate Program in Neurosciences, Federal University of Santa Catarina, Florianópolis, Brazil
- Department of Physiological Sciences, Biological Sciences Centre, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Marcio R. Verzola
- Military Firefighters Corps of Santa Catarina, Florianópolis, Brazil
| | - Richard E. Filipini
- Department of Physiological Sciences, Biological Sciences Centre, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Guilherme F. Speretta
- Post-Graduate Program in Neurosciences, Federal University of Santa Catarina, Florianópolis, Brazil
- Department of Physiological Sciences, Biological Sciences Centre, Federal University of Santa Catarina, Florianópolis, Brazil
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Ras J, Smith DL, Kengne AP, Soteriades ES, Leach L. Physical fitness, cardiovascular and musculoskeletal health, and occupational performance in firefighters. Front Public Health 2023; 11:1241250. [PMID: 37693709 PMCID: PMC10485367 DOI: 10.3389/fpubh.2023.1241250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction To perform their work efficiently and safely, firefighters should maintain all aspects of physical fitness. Cardiac-related incidents are the leading cause of duty-related deaths in firefighters, and many firefighters have poor musculoskeletal health (MSH) that hinder their occupational performance (OP). Establishing the relationship between physical fitness, cardiovascular health (CVH), MSH and OP may add new insight on the most significant factors influencing OP in firefighters, specifically in the City of Cape Town Fire and Rescue Service (CoCTFS), which had not been studied before. Therefore, the purpose of this study was to investigate whether physical fitness, CVH and MSH were associated with OP in firefighters, in the COCTFRS. Methods This cross-sectional study included 283 full-time firefighters aged 20-65 years from Cape Town, South Africa. A researcher-generated questionnaire was used to collect data on sociodemographic characteristics, lifestyle factors and MSH. Physical measures were used to collect information on physical fitness, CVH, and OP [using a physical ability test (PAT)]. Linear and binary logistic regressions, adjusted for age, sex, height and weekly metabolic equivalent minutes (WMETM), multivariate analysis of covariance (MANCOVA), adjusted for age, sex, height and body mass index (BMI) and backward stepwise regressions were used to investigate the associations between the various constructs. Results From multivariable analyses, age, lean body mass, body fat percentage (BF%), estimated absolute oxygen consumption (abV̇O2max), grip strength, leg strength, push-ups, sit-ups, WMETM and heart rate variability were associated with PAT completion times (all p < 0.01). The MANCOVA showed a significant difference between performance categories of the PAT based on physical fitness and CVH (both p < 0.001). WMETM, BF%, abV̇O2max, grip strength, leg strength and sit-ups explained the highest proportion (50.5%) of the variation in PAT completion times. Conclusion Younger, non-obese, fitter and stronger firefighters, with a better CVH status, performed significantly better and were most likely to pass the PAT in firefighters, in Cape Town, South Africa. Firefighters should maintain high levels of physical fitness and a good level of CVH to ensure a satisfactory level of OP.
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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
| | - Denise L. Smith
- Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Andre P. Kengne
- Non-communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Elpidoforos S. Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
- Environmental and Occupational Medicine and Epidemiology (EOME), Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - 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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Hershey MS, Chang CR, Sotos-Prieto M, Fernandez-Montero A, Cash SB, Christophi CA, Folta SC, Muegge C, Kleinschmidt V, Moffatt S, Mozaffarian D, Kales SN. Effect of a Nutrition Intervention on Mediterranean Diet Adherence Among Firefighters: A Cluster Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2329147. [PMID: 37589978 PMCID: PMC10436136 DOI: 10.1001/jamanetworkopen.2023.29147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/09/2023] [Indexed: 08/18/2023] Open
Abstract
Importance US firefighters are a working population at risk of chronic diseases, including obesity, cardiovascular disease, and cancer. This risk may be mitigated by a healthy diet. Objective To evaluate the effect of a Mediterranean nutrition intervention using a behavioral/environmental approach (firefighter/fire station/home) at the individual participant level. Design, Setting, and Participants This 12-month cluster randomized clinical trial included US career firefighters from fire stations and homes within 2 Indiana fire departments. Participants were randomized by fire station to either Mediterranean diet or control (usual care). The study was conducted from October 2016 to December 2019, and data were analyzed in November 2022. Intervention For the first 12 months of the study, firefighters located at fire stations randomized to the intervention group were provided with access to supermarket discounts and free samples of Mediterranean diet foods, online nutrition education platforms, email announcements and reminders, family and peer education and support, and chef demonstrations. Firefighters in fire stations allocated to the control group received no intervention and were instructed to follow their usual diet. Main Outcomes and Measures Change in dietary habits at 12 months as measured by a modified Mediterranean diet score (range, 0 to 51 points) at baseline and 6-month and 12-month follow-up. Cardiometabolic parameters were secondary outcomes. Results Of 485 included firefighters, 458 (94.4%) were male, and the mean (SD) age was 47 (7.5) years. A total of 241 firefighters (27 fire stations) were randomized to the Mediterranean nutrition intervention, and 244 (25 fire stations) were randomized to usual diet. Outcomes were analyzed using generalized linear mixed models for modified Mediterranean diet score at 6 months (n = 336) and 12 months (n = 260), adjusting for baseline age, sex, race and ethnicity, fire department, physical activity, and waist circumference. In the intervention group compared with the control group, the modified Mediterranean diet score significantly increased by 2.01 points (95% CI, 0.62-3.40; P = .005) at 6 months and by 2.67 points (95% CI, 1.14-4.20; P = .001) at 12 months. Among secondary outcomes, changes in cardiometabolic risk factors were not statistically significant at 1 year. Results from analyses with multilevel multiple imputation for missingness were similar. Conclusions and Relevance In this Mediterranean nutrition intervention of multicomponent behavioral/environmental changes, career firefighters had increased adherence to a Mediterranean diet. Trial Registration ClinicalTrials.gov Identifier: NCT02941757.
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Affiliation(s)
- Maria Soledad Hershey
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Chia-Rui Chang
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Mercedes Sotos-Prieto
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain
- Campus of International Excellence (CEI) Universidad Autónoma de Madrid (UAM), Spanish National Research Council (CSIC), Madrid, Spain
| | - Alejandro Fernandez-Montero
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Occupational Medicine, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Sean B. Cash
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Costas A. Christophi
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Lemesos, Cyprus
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Carolyn Muegge
- National Institute for Public Safety Health, Indianapolis, Indiana
| | | | - Steven Moffatt
- National Institute for Public Safety Health, Indianapolis, Indiana
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Stefanos N. Kales
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Occupational Medicine, Cambridge Hospital, Harvard Medical School, Cambridge, Massachusetts
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Ras J, Soteriades ES, Smith DL, Kengne AP, Leach L. Association between physical fitness and musculoskeletal health in firefighters. Front Physiol 2023; 14:1210107. [PMID: 37469568 PMCID: PMC10352848 DOI: 10.3389/fphys.2023.1210107] [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: 04/25/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction: Firefighters are often placed in situations that require high levels of physical exertion, leading to significant strain on firefighters' musculoskeletal system, predisposing them to musculoskeletal discomfort (MSD) and/or musculoskeletal injury (MSI). Physical fitness programs are often recommended and justified, in part, to prevent injuries. The aim of this study was to determine the association between physical fitness and musculoskeletal health (MSH) in firefighters. Methods: A total of 308 full-time firefighters took part in the study conducted in Cape Town, South Africa. Physical fitness tests encompassed a non-exercise estimation for cardiorespiratory fitness, grip and leg strength for upper and lower body strength, push-ups and sit-ups for muscular endurance, and sit-and-reach for flexibility. The Nordic Musculoskeletal Questionnaire and Cornell Musculoskeletal Discomfort Questionnaire were used to determine MSIs and MSD, respectively. A p-value <0.05 indicated statistical significance. Results: Every one-unit increase in AbVO2max, push-ups, sit-ups, and sit-and-reach decreased the odds of firefighters reporting MSIs by 5% (p = 0.005), 3% (p = 0.017), 3% (p = 0.006), and 3% (p = 0.034), respectively. Every one repetition increase in push-up capacity increased the odds of firefighters reporting neck, elbow and forearm, wrist and hand, and thigh discomfort by 3% (p = 0.039), 4% (p = 0.031), 5% (p = 0.002), and 5%` (p = 0.007), respectively. Every one repetition increase in sit-up capacity increased the odds of firefighters reporting upper back discomfort and thigh discomfort by 5% (p = 0.045) and 7% (p = 0.013), respectively. Conclusion: Maintenance of physical fitness is likely beneficial in reducing MSIs, which, however, may increase the feeling of MSD in firefighters. In addition, it may be noticed that there is an ideal level of physical fitness that is conducive to the reduction of MSIs and should be studied further.
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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
| | - Elpidoforos S. Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
- Environmental and Occupational Medicine and Epidemiology (EOME), Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Denise L. Smith
- Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Andre P. Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, 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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Ras J, Soteriades ES, Smith DL, Kengne AP, Leach L. Association between Cardiovascular and Musculoskeletal Health in Firefighters. J Occup Environ Med 2023; 65:e496-e505. [PMID: 37130821 PMCID: PMC10332654 DOI: 10.1097/jom.0000000000002872] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVE The aim of the study is to determine the association between cardiovascular health (CVH) and musculoskeletal health in firefighters. METHODS This cross-sectional study involved 309 full-time firefighters aged 20 to 65 years. Cardiovascular health encompassed cardiovascular disease risk factors, risk scores, CVH metrics, and heart rate variability. Musculoskeletal health was assessed using two validated questionnaires. RESULTS Increasing age ( P = 0.004), body mass index ( P < 0.001), body fat percentage ( P < 0.001), diastolic blood pressure ( P = 0.003), total cholesterol ( P = 0.006), and Framingham risk score ( P = 0.011) increased the risk of reporting musculoskeletal injuries (MSIs). Obesity ( P = 0.018), hypertension ( P = 0.034), and dyslipidemia ( P = 0.005) increased the risk of reporting MSIs. Musculoskeletal discomfort was associated with total cholesterol ( P = 0.0.34) and low-density lipoprotein ( P = 0.014). CONCLUSIONS Adverse cardiovascular disease risk profile was associated with MSIs and musculoskeletal discomfort in firefighters. Firefighters should maintain an ideal CVH profile, especially as they age.
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Achmat G, Erasmus C, Kanaley J, Leach L. Effect of physical activity on coronary heart disease risk factors among firefighters: a scoping review protocol. BMJ Open 2023; 13:e068353. [PMID: 37202132 DOI: 10.1136/bmjopen-2022-068353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
INTRODUCTION Physical activity interventions have been used for various health conditions, including cardiovascular disease. However, the literature is still limited regarding the effect of physical activity on coronary heart disease among firefighters. METHODS AND ANALYSIS The review will be conducted according to recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and PRISMA Protocol guidelines. This scoping review will provide a synthesis of current evidence on the effects of physical activity on coronary heart disease among firefighters. Search strategies will be performed in the following databases: Cochrane database, PubMed, Medline, (EbscoHost), Web of Science, Academic Search Complete, CINAHL (EBSCO), SAGE journals, ScienceDirect and Scopus. We will include literature in the English language that are full-text peer-reviewed articles from inception to November 2021. Screening of (titles, abstracts and full text of potential articles) will be done by two independent authors using EndNote V.9 software tool. A standardised data extraction form will be designed for the extraction. Two authors will independently extract the data from the selected articles and all differences will be discussed by an invited third reviewer if a consensus cannot be reached. The primary outcomes will be the impact of physical fitness on firefighters experiencing coronary artery disease. This information can assist policy-makers in decision-making related to the use of physical activity in firefighters experiencing coronary heart disease. ETHICS AND DISSEMINATION Ethical clearance has been obtained from the University ethics committee and the City of Cape Town. The findings will be disseminated through publications and the physical activity guidelines will be submitted to the Fire Departments within the City of Cape Town. Data analysis will start on 1 April 2023.
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Affiliation(s)
- Ghaleelullah Achmat
- Department of Sport, Recreation and Exercise Science, University of the Western Cape, Bellville, South Africa
| | - Charlene Erasmus
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Bellville, South Africa
| | - Jill Kanaley
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, USA
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, University of the Western Cape, Bellville, South Africa
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Ras J, Kengne AP, Smith DL, Soteriades ES, Leach L. Association between Cardiovascular Disease Risk Factors and Cardiorespiratory Fitness in Firefighters: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2816. [PMID: 36833514 PMCID: PMC9957465 DOI: 10.3390/ijerph20042816] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/26/2023] [Accepted: 02/02/2023] [Indexed: 06/12/2023]
Abstract
Approximately 45% of on-duty related mortalities were due to sudden cardiac death, with many of these fatalities related to cardiovascular disease and overexertion, while performing emergency duties. Therefore, the aim of this systematic review was to determine the association between cardiovascular disease risk factors and cardiorespiratory fitness in firefighters. A literature search of PubMed, SCOPUS, Web of Science, Embase, EBSCOHost, and ScienceDirect was conducted; the Rayyan® intelligent systematic review tool was used to screen and select studies for inclusion. The appraisal tool for cross-sectional studies and the Critical Appraisal Skills Programme toolkit were used for methodological assessment of included studies. Data were analyzed using the Review Manager 5.3 and MedCalc® statistical softwares to determine the effects of obesity (Z = 10.29, p < 0.001) and aging (Z = 4.72, p < 0.001) on cardiorespiratory fitness. Furthermore, there was a significant effect for cardiorespiratory fitness level on systolic blood pressure (Z = 5.94, p < 0.001), diastolic blood pressure (Z = 2.45, p < 0.001), total cholesterol levels (Z = 3.80, p < 0.001), low-density lipoprotein cholesterol (Z = 4.44, p < 0.001), triglycerides (Z = 3.76, p < 0.001) and blood glucose concentration (Z = 4.78, p < 0.001). Cardiovascular disease risk factors and cardiorespiratory fitness were significantly and inversely associated in firefighters. Fire service departments should adopt behavioral intervention strategies to maintain optimum cardiovascular disease risk factor profiles and cardiorespiratory fitness among firefighters to ensure their occupational well-being.
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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 7535, South Africa
| | - Andre P. Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
| | - Denise L. Smith
- Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY 12866, USA
| | - Elpidoforos S. Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia 2220, Cyprus
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town 7535, South Africa
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Gendron P, Laurencelle L, Lajoie C, Trudeau F, Houle J, Goulet ÉDB. Change in heart rate variability during two firefighting work cycles. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:453-460. [PMID: 36519506 DOI: 10.1080/10803548.2022.2159173] [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: 12/23/2022]
Abstract
This study aimed to determine whether the change in heart rate variability from pre to post firefighting is modulated by different work cycles. Thirteen male firefighters underwent two firefighting simulations that comprised two identical 25-min work bouts intercalated by a passive recovery period of either 20 min (T20) or 5 min (T5). The square root of the mean squared differences of successive R-R intervals (RMSSD) and aural temperature were measured at rest before (PRE) and after (POST) firefighting simulations. The decrease in RMSSD was different between firefighting simulations (T20: -10 ± 21.2 ms, T5: -19.9 ± 20.9 ms, interaction, p = 0.02). Post-firefighting aural temperature was greater (p = 0.05) in T5 (37.18 ± 0.53 °C) than in T20 (36.88 ± 0.49 °C). In conclusion, a shorter recovery period of 5 min between firefighting work bouts decreases post-firefighting heart rate variability, possibly attributed to a lower parasympathetic reactivation and a higher absolute value of body temperature.
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Affiliation(s)
- Philippe Gendron
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Canada
| | - Louis Laurencelle
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Canada
| | - Claude Lajoie
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Canada
| | - François Trudeau
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Canada
| | - Julie Houle
- Département des sciences infirmières, Université du Québec à Trois-Rivières, Canada
| | - Éric D B Goulet
- Faculté des sciences de l'activité physique, Université de Sherbrooke, Canada
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22
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Nogueira RM, Saint-Martin DRF, Barreto KA, Von Koenig Soares EMK, Smith DL, Molina GE, Porto LGG. Longitudinal changes in cardiorespiratory fitness among firefighters based on a fixed 12.0 MET standard and an age-adjusted fitness standard. Work 2023; 76:821-829. [PMID: 36938771 DOI: 10.3233/wor-220608] [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: 03/16/2023] Open
Abstract
BACKGROUND Firefighting is a physically demanding profession. Firefighters (FFs) need adequate physical fitness (PF) to perform duty tasks efficiently. While FFs' work demands are constant throughout their career, there is an expected age-related decline in PF. OBJECTIVE To describe longitudinal changes in cardiorespiratory fitness (CRF) based on a fixed (12.0 METs) and an age-adjusted standard and compare the prevalence of fit/unfit firefighters (FFs) over eight years. METHODS 297 Brazilian male firefighters were randomly selected. CRF was assessed by the 12-minute Cooper test. To compare the prevalence's of fit/unfit FFs depending on the standard (12 METs vs. age-adjusted), the McNemar test was used. RESULTS The reduction in the prevalence of fit firefighters was 4.4-fold higher when the analysis did not consider age. CONCLUSION After eight years, the prevalence of fit FFs decreased by 30.5% based on the fixed standard, while this reduction was only 7% when using an age-adjusted standard.
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Affiliation(s)
- Rosenkranz Maciel Nogueira
- Universidade de Brasılia, Faculdade de Educação Física, Brasılia, Brazil
- Universidade de Brasılia, Grupo de Estudos em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), Brasılia, Brazil
- Federal District Military Firefighter Brigade CBMDF, Brasilia, Brazil
| | - Daniel Rodrigues Ferreira Saint-Martin
- Universidade de Brasılia, Faculdade de Educação Física, Brasılia, Brazil
- Universidade de Brasılia, Grupo de Estudos em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), Brasılia, Brazil
| | - Kevin Alves Barreto
- Universidade de Brasılia, Faculdade de Educação Física, Brasılia, Brazil
- Universidade de Brasılia, Grupo de Estudos em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), Brasılia, Brazil
| | - Edgard M K Von Koenig Soares
- Universidade de Brasılia, Faculdade de Educação Física, Brasılia, Brazil
- Universidade de Brasılia, Grupo de Estudos em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), Brasılia, Brazil
| | - Denise L Smith
- First Responder Health and Safety Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA
| | - Guilherme E Molina
- Universidade de Brasılia, Faculdade de Educação Física, Brasılia, Brazil
- Universidade de Brasılia, Grupo de Estudos em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), Brasılia, Brazil
| | - Luiz Guilherme Grossi Porto
- Universidade de Brasılia, Faculdade de Educação Física, Brasılia, Brazil
- Universidade de Brasılia, Grupo de Estudos em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), Brasılia, Brazil
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23
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Saari A, Ma X, Clasey J, Bollinger L, Abel M. Heart rate dynamics during a simulated fireground test: The influence of physical characteristics and fitness1. Work 2023; 76:251-262. [PMID: 36806532 DOI: 10.3233/wor-220216] [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] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Firefighting is a physiologically demanding occupation and there is a need to evaluate physical and fitness characteristics that are related to attenuated physiological stress during fireground tasks. Previous studies have not measured associations between heart rate responses during simulated fireground tasks with a standardized work rate. OBJECTIVE The purpose of this study was to examine associations between heart rate during a standardized pace simulated fireground test (SFGT) and heart rate recovery and variability following the SFGT. In addition, this study sought to evaluate associations between heart rate measures versus physical and fitness characteristics in structural firefighter recruits. METHODS Twenty-one fire academy recruits performed a standardized pace SFGT while mean heart rate reserve (HRRes) during the SFGT, change in heart rate variability from rest to post-SFGT (LnRMSSDRest-Post), and 60-second post-SFGT heart rate recovery (HRR60) were measured. Regression analyses were conducted between HRRes, LnRMSSDRest-Post and HRR60 and between heart rate measures versus physical and fitness characteristics while accounting for differences in SFGT completion time. RESULTS HRRes was associated with LnRMSSDRest-Post, but not HRR60. Height and pull-ups explained most of the variance in HRRes, height explained most of the variance in LnRMSSDRest-Post and push-ups and 1.5-mile run explained most of the variance in HRR60. CONCLUSION Greater cardiovascular stress during fireground tasks is associated with greater depression of post-SFGT heart rate variability, but not heart rate recovery. Physical and fitness characteristics are important to consider in relation to firefighters' ability to cope with physical stress on the fireground.
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Affiliation(s)
- Anssi Saari
- Finnish Institute of High Performance Sport KIHU, Jyväskylä, Finland
| | - Xin Ma
- College of Education, University of Kentucky, Lexington, KY, USA
| | - Jody Clasey
- College of Education, University of Kentucky, Lexington, KY, USA
| | - Lance Bollinger
- College of Education, University of Kentucky, Lexington, KY, USA
| | - Mark Abel
- College of Education, University of Kentucky, Lexington, KY, USA
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24
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Lockie RG, Dulla JM, Higuera D, Ross KA, Orr RM, Dawes JJ, Ruvalcaba TJ. Body Composition and Fitness Characteristics of Firefighters Participating in a Health and Wellness Program: Relationships and Descriptive Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15758. [PMID: 36497832 PMCID: PMC9736830 DOI: 10.3390/ijerph192315758] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
This study investigated body composition and fitness test relationships from firefighters participating in a health and wellness program and categorized firefighters according to population norms relative to sex and age. Data from 270 firefighters (men = 258, women = 12) were analyzed, including body composition (body mass index [BMI], body fat percentage [BF%], waist circumference [WC], waist-to-hip ratio) and fitness (sit-and-reach, grip strength, leg press, crunches, push-ups, maximal aerobic capacity [V̇O2max]) tests. Mann-Whitney U-test analysis (p < 0.05) showed that male firefighters had a greater WC, WHR, grip strength and leg press. Female firefighters had a greater BF% and better sit-and-reach. Partial correlations controlling for sex indicated 22/24 correlations between body composition and fitness were significant (r = -0.143--0.640). ~52% of firefighters were overweight, and 25% were Obesity Class I-III. ~76% had an increased risk of cardiovascular disease (CVD) considering BMI and WC. ~22% were fatter than average-to-overfat considering BF%. Most firefighters (73-94%) were good-to-excellent in sit-and-reach, grip strength, and push-ups; average-to-well above average in crunches; average-to-above average in leg press; and had good-to-superior V̇O2max. Although most firefighters had better fitness compared to the general population, many had increased CVD risk. The data highlighted the need for comprehensive approaches to improving firefighter health and decreasing CVD risk.
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Affiliation(s)
- Robert G Lockie
- Department of Kinesiology, California State University, Fullerton, CA 92831, USA
| | - Joseph M Dulla
- Tactical Research Unit, Bond University, Robina, QLD 4229, Australia
| | - Daniel Higuera
- Fire Technology Department, Santa Ana College, Santa Ana, CA 92706, USA
- Human and Sport Performance, Rocky Mountain University, Provo, UT 84606, USA
| | - Kristina A Ross
- Fire Technology Department, Santa Ana College, Santa Ana, CA 92706, USA
| | - Robin M Orr
- Tactical Research Unit, Bond University, Robina, QLD 4229, Australia
| | - J Jay Dawes
- Tactical Fitness and Nutrition Lab, Oklahoma State University, Stillwater, OK 74078, USA
| | - Tomas J Ruvalcaba
- Fire Technology Department, Santa Ana College, Santa Ana, CA 92706, USA
- Human and Sport Performance, Rocky Mountain University, Provo, UT 84606, USA
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25
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Ras J, Smith DL, Soteriades ES, Kengne AP, Leach L. A Pilot Study on the Relationship between Cardiovascular Health, Musculoskeletal Health, Physical Fitness and Occupational Performance in Firefighters. Eur J Investig Health Psychol Educ 2022; 12:1703-1718. [PMID: 36421326 PMCID: PMC9689559 DOI: 10.3390/ejihpe12110120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
Firefighters’ face life threatening situations and are frequently exposed to numerous physical, chemical, biological, ergonomic and psychosocial hazards. The purpose of this pilot study was to investigate the feasibility of conducting a large-scale study on cardiovascular and musculoskeletal health, physical fitness and occupational performance of firefighters. We conducted a cross-sectional pilot study by recruiting 36 firefighters. A researcher-generated questionnaire and physical measures were used to collect data on sociodemographic characteristics, cardiovascular and musculoskeletal health, physical fitness and occupational performance using a physical ability test (PAT). We documented a high equipment and intra-assessor reliability (r > 0.9). The potential logistic and/or administrative obstacles in the context of a larger study were discerned. Data were successfully retrieved using available equipment and survey instruments. Hypertension (30.6%) dyslipidaemia (33.3%), obesity (36.1%) and physical inactivity (66.7%) were the most prevalent cardiovascular disease risk factors. A significant difference between genders in total PAT completion time was also seen (p < 0.001). Cardiorespiratory fitness, lean body mass, grip strength and leg strength were significantly associated with occupational performance (p < 0.001). The pilot study supports the larger study feasibility and verified equipment and assessors’ reliability for research. Cardiovascular health, musculoskeletal health and physical fitness may be related to PAT performance.
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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 7535, South Africa
- Correspondence:
| | - Denise L. Smith
- Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, New York, NY 12866, USA
| | - Elpidoforos S. Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, 2200 Nicosia, Cyprus
- Environmental and Occupational Medicine and Epidemiology (EOME), Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| | - Andre P. Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7500, South Africa
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town 7535, South Africa
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Cardiometabolic Biomarkers and Habitual Caffeine Consumption Associate with the Adverse Ambulatory Blood Pressure Response to Strenuous Physical Exertion among Firefighters. Nutrients 2022; 14:nu14194025. [PMID: 36235676 PMCID: PMC9572770 DOI: 10.3390/nu14194025] [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: 07/21/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Caffeine has beneficial effects on firefighter job performance reducing fatigue and improving psychomotor vigilance. However, excessive caffeine intake may raise blood pressure (BP) following a bout of acute exercise among adults with elevated BP. The influence of caffeine intake on the ambulatory BP (ABP) response to vigorous physical exertion among firefighters has not been studied. In this sub-study we conducted secondary statistical analyses from a larger clinical trial (NCT04514354) that included examining the influence of habitual caffeine intake, and cardiometabolic biomarkers shown to influence BP, on the ABP response following a bout of sudden vigorous exertion over 19 h among firefighters. Previously, we found high amounts of calcium and sodium intake raised BP following a bout of acute exercise among adults with elevated BP. Thus, other secondary aims were to examine the influence of habitual calcium and sodium intake, and cardiometabolic biomarkers have shown to influence BP, on the ABP response following sudden vigorous exertion over 19 h among firefighters. Firefighters (n = 15) completed a Food-Frequency Questionnaire assessing habitual dietary intake over the past year. They randomly completed a maximal graded exercise stress test (GEST) and non-exercise CONTROL on separate non-workdays leaving the laboratory wearing an ABP monitor for 19 h. Prior to and immediately after the GEST, fasting venous blood was collected to measure lipid-lipoproteins, c-reactive protein, and blood glucose. Height and weight were taken to calculate body mass index. Repeated measures ANCOVA tested if the ABP response differed after GEST vs. CONTROL. Linear mixed models examined the relationships among caffeine, calcium, sodium, cardiometabolic biomarkers, and the ABP response following GEST vs. CONTROL. Firefighters were middle-aged (40.2 ± 9.5 year), overweight (29.0 ± 3.9 kg/m2) men with elevated BP (124.1 ± 10.3/79.6 ± 11.5 mmHg) who consumed 542.0 ± 348.9 mg of caffeine/day, about ~50% more than the dietary reference intake. Unexpectedly, systolic ABP was higher by 18.0 ± 6.7 mmHg and diastolic ABP by 9.1 ± 5.4 mmHg (ps < 0.01) over 19 h following GEST vs. CONTROL. We found 24% of the variance in the adverse ABP response to maximal physical exertion was explained by caffeine intake, and when combined with c-reactive protein, non-high-density lipoprotein-cholesterol, body mass index, blood glucose, and resting heart rate, up to 74% of the variability in the ABP response was explained. Additionally, we found calcium (ps < 0.001) and sodium (p < 0.0001) intake each explained up to 24% of the ABP response. Further investigation is needed in a larger, more diverse sample of firefighters to better establish how caffeine contributes to the adverse BP response to strenuous physical exertion.
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27
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Ras J, Kengne AP, Smith DL, Soteriades ES, November RV, Leach L. Effects of Cardiovascular Disease Risk Factors, Musculoskeletal Health, and Physical Fitness on Occupational Performance in Firefighters-A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11946. [PMID: 36231242 PMCID: PMC9564707 DOI: 10.3390/ijerph191911946] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/16/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
Background: Firefighting is a strenuous occupation, which necessitates that firefighters stay in good physical condition and maintain adequate cardiovascular and musculoskeletal fitness to perform their duties with minimal health and safety risks. The aim of this review is to determine the effects of cardiovascular disease risk factors, musculoskeletal health, and physical fitness on the occupational performance of firefighters. Methods: PubMed/Medline, SCOPUS, Web of Science, EBSCOHost, and ScienceDirect were searched without time-restriction. The appraisal tool for cross-sectional studies and the Critical Appraisal Skills Programme toolkit were used to conduct the methodological assessment. Data were analyzed using Review Manager 5.3, and MedCalc® statistical software. Results: Age had a moderate effect on occupational performance (Z = 5.15, p < 0.001), whereas gender had a large effect size on occupational performance (Z = 4.24, p < 0.001). A significant moderate negative correlation was found between cardiorespiratory fitness and occupational performance (R = -0.584, p < 0.001). Significant low negative correlations were found between upper body endurance (R = -0.344, p < 0.001), abdominal endurance (R = -0.308, p < 0.001), grip strength (R = -0.421, p < 0.001), upper body strength (R = -0.318, p < 0.001), and lower body strength (R = -0.216, p = 0.020) and occupational performance. Conclusions: Aged firefighters with poor body composition and lower levels of physical fitness performed worse on all occupational performance tasks.
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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 7535, South Africa
| | - Andre P. Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
| | - Denise L. Smith
- Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, New York, NY 12866, USA
| | - Elpidoforos S. Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia 2220, Cyprus
| | - Rucia V. November
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town 7535, South Africa
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town 7535, South Africa
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28
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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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McMorrow C, Feairheller DL. Blood Pressure Responses in Firefighters: A Review. Curr Hypertens Rev 2022; 18:145-152. [PMID: 34979891 DOI: 10.2174/1573402118666220103094201] [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: 08/04/2021] [Revised: 11/02/2021] [Accepted: 12/13/2021] [Indexed: 01/27/2023]
Abstract
Blood pressure (BP) responses are controlled by various factors and understanding how BP changes is important to occupational health. This paper presents a review of the literature that reports BP responses in the firefighter population. Hypertension is one of the main risk factors underlying the pathophysiology of cardiovascular disease (CVD), and cardiac incidents remain the leading cause of line-of-duty deaths in firefighters. Risk factors for line-of-duty deaths include obesity, previous or underlying heart disease, and hypertension. The occupation of firefighting is one of the most hazardous and dangerous jobs, yet over 50 % of firefighters are volunteers. Tactical operations and the hazardous nature of firefighting are exposures that influence stress responses and, therefore, affect BP. In fact, hypertension in firefighters often remains undocumented or undiagnosed. CVD risk and elevated BP in tactical populations, like firefighters, maybe a combination of physical and emotional stress due to the nature of the job. Cross-sectional studies have reported that firefighters have higher levels of BP and higher rates of hypertension compared to civilians. Interestingly, there is a limited amount of research that reports BP values before and after firefighting- related activities, and very few studies on interventional changes in BP. Here, we synthesize the literature on firefighting and provide a summary of the studies that report pre- and post- BP levels that relate to CVD risk factors, occupational factors, firefighting activities, and the data on exercise training and BP. More studies are needed that examine BP in firefighters and report on the changes in BP with occupational activities.
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Affiliation(s)
- Carly McMorrow
- Department of Kinesiology, University of New Hampshire, Durham NH, USA
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30
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Coehoorn CJ, Neary JP, Krigolson OE, Service TW, Stuart-Hill LA. Firefighter salivary cortisol responses following rapid heat stress. J Therm Biol 2022; 108:103305. [DOI: 10.1016/j.jtherbio.2022.103305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 07/10/2022] [Accepted: 08/02/2022] [Indexed: 10/15/2022]
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Ras J, Kengne AP, Smith D, Soteriades ES, Leach L. Effects of cardiovascular health, musculoskeletal health and physical fitness on occupational performance of firefighters: protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e061435. [PMID: 35863825 PMCID: PMC9310163 DOI: 10.1136/bmjopen-2022-061435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Firefighting is a hazardous occupation, where firefighters are involved in life-threatening situations, being placed under tremendous physical strain, while wearing heavy and insulated equipment to protect them from chemicals, fumes and high temperatures. This necessitates that firefighter stay in good physical condition and maintain adequate cardiovascular fitness to cope with these stressors and perform their duties with minimal health risks. The aim of this systematic review and meta-analysis is to determine the effect of cardiovascular health, musculoskeletal health and physical fitness on the occupational performance of firefighters. METHODS AND ANALYSIS All study types and designs will be included and appraised. The following electronic databases will be searched: PubMed/Medline, Scopus, Web of Science, Embase, EBSCOHost and CINAHL, with no restrictions on publication date. The literature search will be conducted comprehensively to enable the capturing of as many relevant articles as possible but will be limited to English-language papers only. A combination of the appropriate terms (search string) will be used to ensure the inclusion of the relevant components of the participants, exposure, comparison and outcome. A researcher-generated form with the key characteristics of each study will be used to retrieve all relevant details from the selected studies for initial eligibility screening. The Rayyan Intelligent Systematic Review tool will be used to screen and select studies for inclusion, and information from the included studies will be captured on the researcher-generated data extraction form. The The appraisal tool for cross-sectional studies (AXIS) checklist and the Critical Appraisal Skills Programme toolkit will be used to conduct the methodological assessment of each study. Data will be analysed using Review Manager V.5.3. Generated results will be presented using a combination of figures, graphs and tables. The synthesis of quantitative data (using a meta-analysis methodology) will involve the integration of quantitative findings from multiple studies to achieve coherence. ETHICS AND DISSEMINATION This study obtained ethical clearance from the University of the Western Cape Biomedical Research Ethics Committee (BM21/10/9). We will disseminate the findings of in peer-reviewed journals and at national and international conferences. The protocol will form part of a chapter for a doctoral thesis. PROSPERO REGISTRATION NUMBER CRD42021258898.
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Affiliation(s)
- Jaron Ras
- Department of Sport, Recreation and Exercise Science, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Andre Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Denise Smith
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, New York, USA
| | - Elpidoforos Soterakis Soteriades
- School of Economics and Management, Healthcare Management Program, Open University of Cyprus, Nicosia, Cyprus
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, University of the Western Cape, Bellville, South Africa
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MacDonald HV, Colster EC, Mulholland AM, Holmes CJ, Bentley BC, Robinson JB, Wingo JE. Physical demands and physiological strain of American football referees while officiating. PHYSICIAN SPORTSMED 2022:1-10. [PMID: 35708121 DOI: 10.1080/00913847.2022.2090869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Certain occupations are associated with greater risk of triggering a sudden cardiac event because of high levels of physical exertion and extreme thermal environments in which they occur. The extent to which sports officials--particularly high school (HS) American football referees--experience these conditions is unknown. Forty-six male HS officials (72% White/Caucasian; age = 48 ± 12 years, body mass index = 31.7 ± 6.6 kg·m-2) were studied to quantify the physiological strain and physical demands of officiating. METHODS Referee demographics (e.g., experience, habitual exercise), pre-game urine specific gravity (USG), thermal (peak core temperature [Tcore]) and cardiovascular (average heart rate [HR]) strain, kinematic activity (e.g., total distance, speed, mechanical intensity), and environmental conditions were measured during 10 regular season varsity HS football games (≈2.5 h each) in the Southeastern United States (average wet bulb globe temperature and relative humidity: 18.9 ± 6.0 °C and 78.2% ± 12.1%). Analyses included descriptive statistics, bivariate correlations, and linear regression. RESULTS Referees covered 5.2 ± 1.2 km per game, eliciting average HR and peak Tcore of 71.5% ± 8.0% HRmax and 38.3 ± 0.5 °C, respectively; 38% began games dehydrated (USG = 1.026 ± 0.004). Multiple regression analyses revealed that obesity (β = 0.34), not participating in regular exercise (β = -0.36), and officiating at lower mechanical intensity (β = -0.33) predicted greater cardiovascular strain (all p ≤ 0.03). White/Caucasian race/ethnicity (β = 0.59), younger age (β = -0.46), and obesity (β = 0.28) predicted greater thermal strain (all p ≤ 0.01). CONCLUSION HS football referees experienced elevated levels of physiological strain while officiating, with individual factors modulating the magnitude of strain. Strategies aimed at reducing obesity, increasing exercise participation, and improving cardiovascular health should be emphasized to mitigate strain and prevent cardiac events.
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Affiliation(s)
- Hayley V MacDonald
- Department of Kinesiology, the University of Alabama, Tuscaloosa, AL, USA
| | - Emily C Colster
- Department of Kinesiology, the University of Alabama, Tuscaloosa, AL, USA
| | - Anne M Mulholland
- Department of Kinesiology, the University of Alabama, Tuscaloosa, AL, USA
| | - Clifton J Holmes
- Department of Kinesiology, the University of Alabama, Tuscaloosa, AL, USA.,Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO
| | - Brett C Bentley
- Department of Family, Internal, and Rural Medicine, The University of Alabama, Tuscaloosa, AL, USA
| | - James B Robinson
- Department of Family, Internal, and Rural Medicine, The University of Alabama, Tuscaloosa, AL, USA
| | - Jonathan E Wingo
- Department of Kinesiology, the University of Alabama, Tuscaloosa, AL, USA
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Gao H, Deaton AS, Barker R, Fang X, Watson K. Relationship between Heat Loss Indexes and Physiological Indicators of Turnout Related Heat Strain in Mild and Hot Environments. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2022; 29:562-572. [PMID: 35341451 DOI: 10.1080/10803548.2022.2058746] [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: 10/18/2022]
Abstract
A validated physiological manikin method was used to qualify environmentally dependent correlations between firefighter turnout THL (total heat loss) and Ref (intrinsic evaporative resistance) heat strain indexes and core temperature rise in stressful work conducted in mild (25 °C, 65% RH) and in hot (35 °C, 40% RH; 40 °C, 28% RH) conditions. Five turnout suit constructions representing a wide range of breathability were selected. The observed correlations between measured material heat loss and core temperature showed that the THL heat strain index accurately forecast thermal burden in mild environments (< 25 °C); while the Ref index provided accurate prediction in hot environments (> 35 °C). They showed that the THL index did not predict heat strain in hot work environments. The findings of this study support incorporating both the Ref and THL heat strain indexes as dual metrics for characterizing the heat strain performance of turnout clothing fabrics.
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Affiliation(s)
- Huipu Gao
- Textile Protection and Comfort Center, North Carolina State University, USA
| | - A Shawn Deaton
- Textile Protection and Comfort Center, North Carolina State University, USA
| | - Roger Barker
- Textile Protection and Comfort Center, North Carolina State University, USA
| | - Xiaomeng Fang
- Textile Protection and Comfort Center, North Carolina State University, USA
| | - Kyle Watson
- Textile Protection and Comfort Center, North Carolina State University, USA
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Fullagar H, Notley SR, Fransen J, Richardson A, Stadnyk A, Lu D, Brown G, Duffield R. Cooling strategies for firefighters: Effects on physiological, physical, and visuo-motor outcomes following fire-fighting tasks in the heat. J Therm Biol 2022; 106:103236. [DOI: 10.1016/j.jtherbio.2022.103236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/21/2022] [Accepted: 03/26/2022] [Indexed: 11/25/2022]
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Hemostatic Responses to Multiple Bouts of Firefighting Activity: Female vs. Male Differences in a High Demand, High Performance Occupation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042124. [PMID: 35206312 PMCID: PMC8872043 DOI: 10.3390/ijerph19042124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/27/2022] [Accepted: 02/01/2022] [Indexed: 11/17/2022]
Abstract
While the fire service has long been a male-dominated occupation, women's participation in this strenuous, high risk, high performance activity has increased in recent years. Firefighting induces significant cardiovascular strain, including hemostatic disruption; however, the effect of sex on hemostatic responses has not been investigated despite evidence that there are sex-related differences in hemostatic variables at rest and following exercise. Thus, we investigated hemostatic responses in age- and BMI-matched male and female firefighters who performed 3-4 evolutions of firefighting drills over a 3 h period. Venous blood samples were collected before and after the firefighting training drills and hemostatic variables were assessed. Firefighting significantly increased platelet count and factor VIII, tissue plasminogen activator (t-PA) antigen, and t-PA activity, and decreased activated partial thromboplastin time and plasminogen activator inhibitor (PAI-1) activity. Females had lower values for epinephrine-induced platelet closure time, antithrombin III, PAI-1 activity, and PAI-1 antigen. There were no interactions between sex and time for any variables assessed. In conclusion, multiple bouts of firefighting activity resulted in a procoagulatory state. Although there were sex differences for several hemostatic variables, male and female firefighters did not differ in their hemostatic response to multiple bouts of firefighting.
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Horn GP, Madrzykowski D, Neumann DL, Mayer AC, Fent KW. Airborne contamination during post-fire investigations: Hot, warm and cold scenes. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2022; 19:35-49. [PMID: 34762010 PMCID: PMC10074475 DOI: 10.1080/15459624.2021.2002343] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Fire investigators may be occupationally exposed to many of the same compounds as the more widely studied fire suppression members of the fire service but are often tasked with working in a given exposure for longer periods ranging from hours to multiple days and may do so with limited personal protective equipment. In this study, we characterize the area air concentrations of contaminants during post-fire investigation of controlled residential fires with furnishings common to current bedroom, kitchen and living room fires in the United States. Area air sampling was conducted during different investigation phases including when investigations might be conducted immediately after fire suppression and extended out to 5 days after the fire. Airborne particulate over a wide range of dimensions, including sub-micron particles, were elevated to potentially unhealthy levels (based on air quality index) when averaged over a 60 min investigation period shortly after fire suppression with median PM2.5 levels over 100 µg/m3 (range 16-498 µg/m3) and median peak transient concentrations of 1,090 µg/m3 (range 200-23,700 µg/m3) during drywall removal or shoveling activities. Additionally, airborne aldehyde concentrations were elevated compared to volatile organic compounds with peak values of formaldehyde exceeding NIOSH ceiling limits during the earliest investigation periods (median 356 µg/m3, range: 140-775 µg/m3) and occasionally 1 day post-fire when the structure was boarded up before subsequent investigation activities. These results highlight the need to protect investigators' airways from particulates when fire investigation activities are conducted as well as during post-fire reconstruction activities. Additionally, vapor protection from formaldehyde should be strongly considered at least through investigations occurring 3 days after the fire and personal formaldehyde air monitoring is recommended during investigations.
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Affiliation(s)
- Gavin P. Horn
- Fire Safety Research Institute, Underwriters Laboratories Inc.; Columbia, MD
| | - Daniel Madrzykowski
- Fire Safety Research Institute, Underwriters Laboratories Inc.; Columbia, MD
| | | | | | - Kenneth W. Fent
- National Institute for Occupational Safety & Health; Cincinnati, OH
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Marciniak RA, Wahl CA, Ebersole KT. Autonomic Nervous System Response to Far-Infrared Sauna Exposure in Firefighters. Ann Work Expo Health 2021; 66:356-367. [PMID: 34632485 DOI: 10.1093/annweh/wxab088] [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] [Received: 05/24/2021] [Revised: 08/26/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Fire departments have employed far-infrared sauna (FIRS) use as part of post-fire call protocols to address concerns related to carcinogens. The inability of the autonomic nervous system (ANS) to fully recover following an emergency call, as demonstrated by heightened sympathetic nervous system activity and delayed parasympathetic nervous system reactivation, has been implicated as a potential factor related to sudden cardiac death. The use of a sauna post-fire call, which has been demonstrated to elevate body temperature, may interfere with the ability of the ANS to fully recover. The purpose of this study was to examine ANS responses to FIRS exposure in firefighters (FFs) with (EX) and without (NONEX) prior maximal exercise. METHODS Sixteen career FFs participated in this study. Body temperature (TEMP), heart rate (HR), heart rate variability (HRV), blood pressure (BP), and blood lactate (La─) were measured at the start of each testing session, following a maximal exercise test (EX only), and immediately after a 15-min FIRS exposure for NONEX and EX. RESULTS In NONEX, TEMP increased (P < 0.001); however, there was no change in HR, HRV, BP, or La─. In EX, BP remained unchanged while TEMP, HR, and La─ were significantly (P < 0.001) greater than baseline following FIRS exposure and HRV was significantly (P = 0.018) lower than baseline. CONCLUSIONS These findings indicate that FIRS following maximal exercise did support some ANS recovery, but may interfere with restoration of body temperature and parasympathetic nervous system reactivation, potentially influencing post-call cardiovascular risk in FFs.
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Affiliation(s)
- Rudi A Marciniak
- Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Suite 350, 3409 N. Downer Ave, Milwaukee, WI, USA
| | - Carly A Wahl
- Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Suite 350, 3409 N. Downer Ave, Milwaukee, WI, USA
| | - Kyle T Ebersole
- Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Suite 350, 3409 N. Downer Ave, Milwaukee, WI, USA
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Marcel-Millet P, Groslambert A, Gimenez P, Grosprêtre S, Ravier G. Psychophysiological responses of firefighters to day and night rescue interventions. APPLIED ERGONOMICS 2021; 95:103457. [PMID: 33984583 DOI: 10.1016/j.apergo.2021.103457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 04/29/2021] [Accepted: 04/29/2021] [Indexed: 06/12/2023]
Abstract
This study aimed 1) to assess the psychophysiological responses throughout a rescue intervention performed during the day and at night and 2) to determine if a vibrating alarm influences these psychophysiological responses at night. Sixteen male firefighters completed a simulated intervention under three different conditions: 1) during the day with a sound alarm signal (DaySA), 2) during the night with a sound alarm signal (NightSA), 3) during the night with a vibrating alarm signal (NightVA). Cardiovascular and psychological stress were recorded throughout the interventions. During the alarm signal, HR reactivity was greater in NightSA than in DaySA (p < 0.01). Parasympathetic reactivation and self-confidence were significantly lower in NightSA than in DaySA (p < 0.05). HR reactivity was decreased in NightVA in comparison to NightSA (p < 0.05). Overall, the rescue intervention had a greater impact on the psychophysiological variables during the night than during the day, and the type of alarm had a minor effect.
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Affiliation(s)
- Philémon Marcel-Millet
- University of Bourgogne-Franche-Comte, Laboratory C3S (EA 4660), Department Sport and Performance, UFR STAPS, 31 Chemin de l'Epitaphe, 25000, Besançon, France.
| | - Alain Groslambert
- University of Bourgogne-Franche-Comte, Laboratory C3S (EA 4660), Department Sport and Performance, UFR STAPS, 31 Chemin de l'Epitaphe, 25000, Besançon, France.
| | - Philippe Gimenez
- University of Bourgogne-Franche-Comte, Laboratory C3S (EA 4660), Department Sport and Performance, UFR STAPS, 31 Chemin de l'Epitaphe, 25000, Besançon, France.
| | - Sidney Grosprêtre
- University of Bourgogne-Franche-Comte, Laboratory C3S (EA 4660), Department Sport and Performance, UFR STAPS, 31 Chemin de l'Epitaphe, 25000, Besançon, France.
| | - Gilles Ravier
- University of Bourgogne-Franche-Comte, Laboratory C3S (EA 4660), Department Sport and Performance, UFR STAPS, 31 Chemin de l'Epitaphe, 25000, Besançon, France.
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Abstract
OBJECTIVE To address which body composition (BC) measures best correlate with cardiorespiratory fitness (CRF) in firefighters and develop a model for accurate CRF estimation compared with traditional methods. METHODS Career firefighters had body mass index (BMI) and waist circumference (WC) measured in addition to body fat percentage (FM%) by dual-energy x-ray absorptiometry (DXA). CRF as maximum oxygen uptake (VO2max) was estimated by rowing machine and measured by indirect calorimetry in a treadmill exercise test. RESULTS Fifty two firefighters participated (92.3% men). Univariate correlations with BMI were best with WC. Univariate correlations with VO2max were best with FM%. Obesity classifications by BC measures agreed weakly at best. Multivariate analysis of several variables yielded an improved VO2max estimate (R2 = 0.70). CONCLUSIONS Fire departments may benefit from more sophisticated measures of BC and CRF to evaluate firefighter fitness.
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40
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Graham EL, Khaja S, Caban-Martinez AJ, Smith DL. Firefighters and COVID-19: An Occupational Health Perspective. J Occup Environ Med 2021; 63:e556-e563. [PMID: 34138822 PMCID: PMC8327761 DOI: 10.1097/jom.0000000000002297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | - Saeed Khaja
- Advocate Lutheran General Hospital, Park Ridge, IL
- Hanover Park Fire Department, Hanover Park, IL
| | - Alberto J Caban-Martinez
- Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
- Sylvester Comprehensive Cancer Center, Miami, FL
| | - Denise L Smith
- First Responder Health and Safety Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY
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42
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Moffatt SM, Stewart DF, Jack K, Dudar MD, Bode ED, Mathias KC, Smith DL. Cardiometabolic health among United States firefighters by age. Prev Med Rep 2021; 23:101492. [PMID: 34354906 PMCID: PMC8322457 DOI: 10.1016/j.pmedr.2021.101492] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/07/2021] [Accepted: 07/10/2021] [Indexed: 01/10/2023] Open
Abstract
Cardiometabolic health in male firefighters was lowest among 45–50 year olds. Cardiometabolic health continually decreased with age among female firefighters. Firefighters have similar or better cardiometabolic health than the US population. Cardiometabolic risk factors were prevalent in firefighters and the US population.
Firefighting is strenuous work that results in considerable cardiovascular strain. Sudden cardiac events are the leading cause of duty-related death in the fire service. This cross-sectional study examined cardiometabolic measures and prevalence of risk factors in firefighters by age and sex and compare these data to the general population. Data obtained at medical exams (2015–2018) from 4279 male and 234 female career firefighters at four occupational health clinics in the United States were analyzed. Estimates for the general population were obtained using the 2015–16 National Health and Nutrition Examination Survey fasting subsample. Linear regression models stratified by sex with age modelled as a continuous variable were used to examine general trends. Point estimates across age groups (20–29, 30–39, 40–49, and 50–59 year olds) for cardiometabolic measures were reported. Among the total sample, 36% were obese and 25% had low HDL cholesterol. Females had significantly lower body mass index (BMI), LDL cholesterol, triglycerides and blood glucose than males. A significant quadratic relationship of age with BMI, total cholesterol, LDL cholesterol, and triglycerides was found in males with increasing values peaking between 45 and 50 years. Total cholesterol and LDL cholesterol increased with age among females. Blood glucose increased with age in both sexes. Firefighters had similar or better cardiometabolic health profiles than the US general population; however, both samples had a concerning prevalence of cardiometabolic risk factors among individuals ≥ 40 years of age. Health professionals and fire service members alike should consider prevention efforts among young firefighters and better treatment among older firefighters.
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Affiliation(s)
- Steven M Moffatt
- Public Safety Medical, 6612 East 75th Street 2nd Floor, Indianapolis, IN 46250, USA
| | - Donald F Stewart
- Public Safety Occupational Health Center, 12099 Government Center Parkway, Fairfax, VA 22035, USA
| | - Kepra Jack
- HeartFit For Duty, LLC, 5432 E Southern Ave Suite 101, Mesa, AZ 85206, USA
| | - Monique D Dudar
- Health and Human Physiological Sciences, Skidmore College, Sports and Recreation Center # 241, Saratoga Springs, NY 12866, USA
| | - Emilie D Bode
- Health and Human Physiological Sciences, Skidmore College, Sports and Recreation Center # 241, Saratoga Springs, NY 12866, USA
| | - Kevin C Mathias
- Health and Human Physiological Sciences, Skidmore College, Sports and Recreation Center # 241, Saratoga Springs, NY 12866, USA
| | - Denise L Smith
- Health and Human Physiological Sciences, Skidmore College, Sports and Recreation Center # 241, Saratoga Springs, NY 12866, USA
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Ranadive SM, Lofrano-Porto A, Soares EMKVK, Eagan L, Porto LGG, Smith DL. Low testosterone and cardiometabolic risks in a real-world study of US male firefighters. Sci Rep 2021; 11:14189. [PMID: 34244582 PMCID: PMC8270893 DOI: 10.1038/s41598-021-93603-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
Low serum total testosterone (TT) is associated with increased cardiovascular risk and metabolic derangements, with fatty liver (FL) emerging as an additional cardiometabolic threat. We investigated the associations between TT and cardiometabolic (CM) health in 298 US male firefighters. Cross-sectional data from occupational health examination were analyzed. TT was categorized as low (< 264 ng/dL), borderline (264-399 ng/dL), and reference (400-916 ng/dL). Conventional CM risk factors were compared among TT categories, and between firefighters with and without FL. 81% of firefighters were obese/overweight; almost 40% had FL. In the low-TT group, only 3.1% had normal BMI, while 78.1% had FL. The low-TT group had a worse CM profile, independently of age and BMI, and a fourfold higher adjusted odds of having FL. FL was associated with lower TT, regardless of age, BMI and HbA1c. Having a FL, HbA1c ≥ 5.7% or triglycerides ≥ 150 mg/dL increased the odds for low-TT by 4.1, 2.7 and 6.6 times, respectively. These real-world data reveal strong associations between low-TT and CM risk factors and support a call for action towards screening for low-TT and FL, regardless of age, BMI or dysmetabolic conditions in firefighters. Recognizing cardiometabolic risks in firefighters provides an opportunity to lessen cardiovascular diseases burden.
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Affiliation(s)
- Sushant M Ranadive
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
| | - Adriana Lofrano-Porto
- Adrenal and Gonadal Diseases Clinic, Section of Endocrinology and Metabolism of the University Hospital, Graduate Program in Health Sciences, University of Brasilia, UnB, Brasília, Brazil
| | - Edgard M K V K Soares
- Study Group on Exercise and Physical Activity Physiology and Epidemiology (GEAFS), Exercise Physiology Laboratory, Faculty of Physical Education, University of Brasilia, UnB, Brasília, Brazil
| | - Lauren Eagan
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
| | - Luiz Guilherme Grossi Porto
- Study Group on Exercise and Physical Activity Physiology and Epidemiology (GEAFS), Exercise Physiology Laboratory, Faculty of Physical Education, University of Brasilia, UnB, Brasília, Brazil
| | - Denise L Smith
- First Responder Health and Safety Lab, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA.
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Bode ED, Mathias KC, Stewart DF, Moffatt SM, Jack K, Smith DL. Cardiovascular Disease Risk Factors by BMI and Age in United States Firefighters. Obesity (Silver Spring) 2021; 29:1186-1194. [PMID: 34060241 PMCID: PMC8362202 DOI: 10.1002/oby.23175] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/24/2021] [Accepted: 03/06/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study examined cardiovascular disease risk factors by BMI category in firefighters, the association of BMI and age with risk factor prevalence, and the prevalence of risk factors by BMI category within age groups. METHODS Cardiovascular measures from the medical evaluations of 4,453 firefighters, performed between 2015 and 2018 at four occupational health clinics in the United States (South-West Cohort, Mid-Atlantic Cohort, South-East Cohort, and Mid-West Cohort), were analyzed cross-sectionally by BMI and age categories. RESULTS Among female firefighters with normal weight, 25% had high blood pressure, 8% had low high-density lipoprotein cholesterol, and 0% had high glucose, whereas the prevalence in female firefighters with obesity was 57%, 45%, and 11%, respectively. Among male firefighters, there were independent and significant associations of BMI and age for the prevalence of high blood pressure, high cholesterol, high triglycerides, and high glucose. Higher BMI category was associated with a higher prevalence of high blood pressure, high triglycerides, and low high-density lipoprotein cholesterol within all age groups and with a higher prevalence of high glucose and high cholesterol within ages 40 to 49 and 50 to 59 years. CONCLUSIONS An increasing prevalence of risk factors with older age and higher BMI suggests that preventive strategies should be initiated in younger firefighters and aggressively promoted or mandated throughout firefighters' careers.
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Affiliation(s)
- Emilie D. Bode
- Health and Human Physiological SciencesSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Kevin C. Mathias
- Health and Human Physiological SciencesSkidmore CollegeSaratoga SpringsNew YorkUSA
| | | | - Steven M. Moffatt
- Public Safety Health SystemsAscension St. VincentIndianapolisIndianaUSA
| | | | - Denise L. Smith
- Health and Human Physiological SciencesSkidmore CollegeSaratoga SpringsNew YorkUSA
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45
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Lefferts EC, Rosenberg AJ, Grigoriadis G, Wee SO, Kerber S, Fent KW, Horn GP, Smith DL, Fernhall B. Firefighter hemodynamic responses to different fire training environments. Vasc Med 2021; 26:240-246. [PMID: 33606968 PMCID: PMC8170364 DOI: 10.1177/1358863x20987608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Firefighting is associated with an increased risk for a cardiovascular (CV) event, likely due to increased CV strain. The increase in CV strain during firefighting can be attributed to the interaction of several factors such as the strenuous physical demand, sympathetic nervous system activation, increased thermal burden, and the environmental exposure to smoke pollutants. Characterizing the impact of varying thermal burden and pollutant exposure on hemodynamics may help understand the CV burden experienced during firefighting. The purpose of this study was to examine the hemodynamic response of firefighters to training environments created by pallets and straw; oriented strand board (OSB); or simulated fire/smoke (fog). Twenty-three firefighters had brachial blood pressure measured and central blood pressure and hemodynamics estimated from the pressure waveform at baseline, and immediately and 30 minutes after each scenario. The training environment did not influence the hemodynamic response over time (interaction, p > 0.05); however, OSB scenarios resulted in higher pulse wave velocity and blood pressure (environment, p < 0.05). In conclusion, conducting OSB training scenarios appears to create the largest arterial burden in firefighters compared to other scenarios in this study. Environmental thermal burden in combination with the strenuous exercise, and psychological and environmental stress placed on firefighters should be considered when designing fire training scenarios and evaluating CV risk.
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Affiliation(s)
- Elizabeth C Lefferts
- Department of Kinesiology &
Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Alexander J Rosenberg
- Department of Kinesiology &
Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Georgios Grigoriadis
- Department of Kinesiology &
Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Sang Ouk Wee
- Department of Kinesiology, California
State University San Bernardino, San Bernardino, CA, USA
| | - Stephen Kerber
- UL Firefighter Safety Research
Institute, Columbia, MD, USA
| | - Kenneth W Fent
- National Institute for Occupational
Safety & Health, Cincinnati, OH, USA
| | - Gavin P Horn
- UL Firefighter Safety Research
Institute, Columbia, MD, USA
- Fire Service Institute, University of
Illinois, Urbana-Champaign, IL, USA
| | - Denise L Smith
- Fire Service Institute, University of
Illinois, Urbana-Champaign, IL, USA
- Department of Health and Human
Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA
| | - Bo Fernhall
- Department of Kinesiology &
Nutrition, University of Illinois at Chicago, Chicago, IL, USA
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Ebersole KT, Cornell DJ, Flees RJ, Shemelya CM, Noel SE. Contribution of the Autonomic Nervous System to Recovery in Firefighters. J Athl Train 2021; 55:1001-1008. [PMID: 32841323 DOI: 10.4085/1062-6050-0426.19] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Sudden cardiac deaths (SCDs) have accounted for nearly half of the line-of-duty deaths among US firefighters over the past 10 years. In 2018, 33% of all SCDs occurred after the end of a fire service call. Researchers have suggested that an imbalance in autonomic nervous system (ANS) regulation of heart rate postcall may interfere with recovery in firefighters. OBJECTIVE To use heart-rate recovery (HRR) and heart-rate variability (HRV), 2 noninvasive markers of ANS function, to examine the ANS recovery profiles of firefighters. DESIGN Cross-sectional study. SETTING Firehouse and research laboratory. PATIENTS OR OTHER PARTICIPANTS Thirty-seven male career active-duty firefighters (age = 39 ± 9 years, height = 178.8 ± 5.4 cm, mass = 87.9 ± 11.2 kg). MAIN OUTCOME MEASURE(S) Percentage of maximal HR (%MHR) and HRV (natural log of the square root of the mean sum of the squared differences [lnRMSSD]) were collected after both submaximal and maximal exercise protocols during a 10-minute seated recovery. The HRR profiles were examined by calculating the asymptote, amplitude, and decay parameters of the monoexponential HRR curve for each participant. RESULTS Differences in HRR parameters after 10 minutes of seated recovery were identified after submaximal versus maximal exercise (P < .001). In addition, although ANS was more suppressed after maximal exercise, HRV indicated incomplete recovery, and regardless of the test, recovery %MHR and lnRMSSD values did not return to pretest %MHR and lnRMSSD values. CONCLUSIONS Our results suggest that the ANS contributions to recovery in active-duty firefighters are exercise-intensity specific, and this is likely an important factor when establishing best-practice recovery guidelines.
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Affiliation(s)
- Kyle T Ebersole
- Department of Kinesiology, University of Wisconsin-Milwaukee
| | - David J Cornell
- Department of Physical Therapy and Kinesiology, University of Massachusetts, Lowell
| | - Robert J Flees
- Department of Kinesiology, University of Wisconsin-Milwaukee
| | - Corey M Shemelya
- Department of Electrical and Computer Engineering, University of Massachusetts, Lowell
| | - Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell
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Heart rate response to alarm tones in firefighters. Int Arch Occup Environ Health 2021; 94:783-789. [PMID: 33423092 DOI: 10.1007/s00420-020-01646-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To examine cardiovascular responses to medical (MED) and fire (FIRE) alarm tones in firefighters. METHODS Heart rate was collected throughout 24-h shifts (N = 41). Call logs were utilized post hoc to identify heart rate at the time the alarm sounded (TIMETONE), peak heart rate following the alarm (TIMEPEAK), and heart rate at the time of station departure (TIMEDEPART) for MED and FIRE calls. A 2X3 (TONE x TIME) split-plot mixed-model repeated-measures analysis of variance (ANOVA) and least significant differences tests examined the influence of tone type on heart rate, expressed as a percent of age estimated maximum. Bivariate Pearson correlations examined the relationship between body mass index (BMI) and TIMEPEAK and TIMEDEPART. An alpha of 0.05 determined statistical significance and Bonferroni Corrections were applied to post hoc comparisons (p < 0.017). RESULTS Follow-up analyses for the significant 2 × 3 repeated-measures ANOVA (p = 0.035) indicated differences in heart rate for MED (p < 0.001) and FIRE (p < 0.001) where TIMETONE < TIMEPEAK, TIMETONE < TIMEDEPART, and TIMEPEAK > TIMEDEPART. There was a non-significant simple effect of time for MED and FIRE at TIMETONE (p = 0.259), but significant effects of tone type where FIRE > MED at TIMEPEAK (p < 0.001) and TIMEDEPART (p = 0.002). There was a significant small positive relationship between BMI and TIMEPEAK (p = 0.002) and TIMEDEPART (p < 0.001) for MED only. CONCLUSIONS Alarms increased heart rates to a greater extent in FIRE than MED calls. Higher BMI was related to greater heart rate responses in MED but was unrelated to FIRE response.
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Cornell DJ, Noel SE, Zhang X, Ebersole KT. Influence of Body Composition on Post-Exercise Parasympathetic Reactivation of Firefighter Recruits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E339. [PMID: 33466351 PMCID: PMC7795331 DOI: 10.3390/ijerph18010339] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/02/2021] [Accepted: 01/03/2021] [Indexed: 11/16/2022]
Abstract
Firefighters have a sustained risk for experiencing a sudden cardiac event after completing a fire call. Heart rate recovery (HRR) can be utilized to characterize autonomic nervous system (ANS) recovery and has been linked to cardiac events. Research suggests that body composition influences post-exercise HRR responses in non-firefighter populations. The purpose of this study was to examine the influence of body mass index (BMI), waist circumference (WC), and percent body fat (BF) on the HRR response of firefighter recruits. BMI (kg·m-2), WC (cm), and BF (%) data from 57 firefighter recruits were collected. HRR (b·min-1) data were collected at completion (HR0), as well as 15 (HR15), 30 (HR30), 45 (HR45), 60 (HR60), 120 (HR120), and 180 (HR180) seconds following a submaximal step test, and commonly utilized clinical HRR indices were calculated (ΔHRR30, ΔHRR60, ΔHRR120, and ΔHRR180). After controlling for sex, linear mixed regression models did not identify significant interactions between body composition (ps > 0.05) and HRR response across time. However, significant (ps < 0.05) indirect semi-partial correlations were identified between BF and ΔHRR30 (rsp = -0.31) and ΔHRR60 (rsp = -0.27), respectively. Reducing overall BF (vs. BMI or WC) should be prioritized to improve the post-exercise ANS recovery of firefighter recruits.
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Affiliation(s)
- David J. Cornell
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Center for Population Health, University of Massachusetts Lowell, Lowell, MA 01854, USA;
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Sabrina E. Noel
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Center for Population Health, University of Massachusetts Lowell, Lowell, MA 01854, USA;
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA;
| | - Xiyuan Zhang
- Center for Population Health, University of Massachusetts Lowell, Lowell, MA 01854, USA;
| | - Kyle T. Ebersole
- Human Performance and Sport Physiology Laboratory, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
- Department of Occupational Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
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Cornell DJ, Noel SE, Zhang X, Ebersole KT. Influence of a Training Academy on the Parasympathetic Nervous System Reactivation of Firefighter Recruits-An Observational Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E109. [PMID: 33375223 PMCID: PMC7795559 DOI: 10.3390/ijerph18010109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022]
Abstract
Sudden cardiac death (SCD) is the leading type of line-of-duty death among firefighters. An inability to restore parasympathetic nervous system (PSNS) control after activity is associated with SCD. Post-exercise heart rate recovery (HRR) provides unique insight into reactivation of the PSNS. Thus, the purpose of this study was to examine longitudinal changes in HRR responses of 25 male firefighter recruits. HR data were collected after submaximal exercise at week 1 (W1), week 6 (W6), and week 15 (W15) of their training at an academy. Percent maximal heart rate (%MHR) measures were computed at each HRR time point (%MHR0, %MHR15, %MHR30, %MHR45, %MHR60, %MHR120, %MHR180) and absolute HRR values were calculated at 30 s (ΔHRR30), 60 s (ΔHRR60), 120 s (ΔHRR120), and 180 s (ΔHRR180). After controlling for age and percent body fat, there was no statistically significant interaction between Week × HRR (p = 0.730), and there were no changes in ΔHRR30, ΔHRR60, and ΔHRR120, and ΔHRR180 indices across time. However, %MHR at W6 and W15 was significantly lower than %MHR at W1 at every HRR time point (ps < 0.001). Therefore, although the firefighter recruit training academy elicited positive training adaptations, changes in PSNS reactivation after submaximal activity were not identified.
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Affiliation(s)
- David J. Cornell
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA;
- Center for Population Health, University of Massachusetts Lowell, Lowell, MA 01854, USA;
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Sabrina E. Noel
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA;
- Center for Population Health, University of Massachusetts Lowell, Lowell, MA 01854, USA;
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Xiyuan Zhang
- Center for Population Health, University of Massachusetts Lowell, Lowell, MA 01854, USA;
| | - Kyle T. Ebersole
- Human Performance and Sport Physiology Laboratory, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
- Department of Occupational Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
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Firefighting Induces Acute Inflammatory Responses that are not Relieved by Aspirin in Older Firefighters. J Occup Environ Med 2020; 61:617-622. [PMID: 31090673 DOI: 10.1097/jom.0000000000001626] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Sudden cardiac events account for 40% to 50% of firefighter line-of-duty deaths. Inflammatory proteins are strong biomarkers of cardiovascular inflammation. The present study investigated the effects of aspirin supplementation on inflammatory biomarkers following firefighting. METHODS Using a randomized, placebo-controlled, double-blind crossover design, 24 male firefighters (48.2 ± 5.9 years) were allocated into four conditions: acute (81 mg; single-dose) aspirin and placebo supplementation, and chronic (81 mg; 14 days) aspirin and placebo supplementation. Inflammatory proteins [interleukin (IL)-6, C-reactive protein (CRP), intracellular adhesion molecule (ICAM)-1, P-selectin, matrix metalloproteinase-9 (MMP-9)] and antioxidant potential [total antioxidant capacity (TAC)] were measured pre- and post-structural firefighting drills. RESULTS Firefighting activities significantly increased IL-6, MMP-9, and P-Selectin; however, no changes in TAC and ICAM-1 were detected. Neither acute nor chronic aspirin supplementation attenuated this inflammatory response. CONCLUSION Firefighting significantly increases inflammatory biomarkers and neither acute nor chronic low-dose aspirin mitigates this response.
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