Firefighters' Physical Activity across Multiple Shifts of Planned Burn Work

Occupational Injuries of Spanish Wildland Firefighters: A Descriptive Analysis

The work of wildland firefighters, especially of the so-called 'Brigadas de Refuerzo contra Incendios Forestales', is characterised by high physical demands and extreme operating conditions. These professionals face long workdays (12 h), walking with heavy loads (~25 kg), being exposed to high temperatures (>30 °C), and handling specialised tools in high-risk environments. This study aimed to describe the prevalence of occupational injuries among members of the 'Brigadas de Refuerzo contra Incendios Forestales' and its relationship to variables such as age and work experience. A total of 217 wildland firefighters (18 female and 199 male) correctly answered a questionnaire developed on an ad hoc basis to meet the study's objectives. A high prevalence of occupational injuries was observed among them (~76%). Age and work experience were shown to be significantly associated with injuries. Individuals over 35 years of age with more than 10 years' experience had a higher probability of injury (OR = 2.14, CI = 1.12-4.06 and OR = 2.46, CI = 1.30-4.67, respectively). Injuries occurred mainly during physical training (~46%), followed by preventive work (~33%) and forest fires (~20%). The most common injuries were tendonitis and muscle pain (~44% and ~21% respectively), followed by sprains (~21%). The results underline the need for physical activity programmes adapted to help wildland firefighters, especially older and more experienced individuals. The identification of risk factors such as age and work experience can contribute to the prevention and management of occupational injuries among this group of highly specialised forestry workers. Specific preventative measures during training are required to mitigate the risk of injury among these crews, who play a crucial role in protecting the environment and public safety.

Use of accelerometers and inertial measurement units to quantify movement of tactical athletes: A systematic review

The dynamic work environments of tactical athletes are difficult to replicate in a laboratory. Accelerometers and inertial measurement units provide a way to characterize movement in the field. This systematic review identified how accelerometers and inertial measurement units are currently being used to quantify movement patterns of tactical athletes. Seven research and military databases were searched, producing 26,228 potential articles with 78 articles included in this review. The articles studied military personnel (73.1%), firefighters (19.2%), paramedics (3.8%), and law enforcement officers (3.8%). Accelerometers were the most used type of sensor, and physical activity was the primarily reported outcome variable. Seventy of the studies had fair or poor quality. Research on firefighters, emergency medical services, and law enforcement officers was limited. Future research should strive to make quantified movement data more accessible and user-friendly for non-research personnel, thereby prompting increased use in tactical athlete groups, especially first responder agencies.

Chronic Pain in Spanish Wildland Firefighters

The work performed by wildland firefighters (WFFs) is very demanding owing to the conditions in which they have to operate. It has been reported that these professionals walk long distances over unstable and steep terrain carrying heavy loads, handle tools manually and repeatedly and are subject to a high level of thermal stress. Under such conditions, the risk of developing chronic pain (CP) is high, although despite this, there are no available data pertaining to CP among WFFs, to the best of our knowledge. As such, the aim of this study is to describe CP in Spanish helitack crews, for which purpose 221 WFFs (203 men and 18 women) completed an online self-report questionnaire. Approximately 60% of WFFs reported suffering from CP, of which 45.5% had CP in more than one body region at the same time. Age and length of service were associated with the probability of suffering from CP. Likewise, the age and height of WFFs and weight of the protective equipment used increased the prevalence of CP. Lastly, gender and job position affected CP location, with women and forepersons reporting greater prevalence of CP in the lower limbs. To conclude, the results obtained suggest the major prevalence of CP among Spanish WFFs, with current data suggesting in turn the importance that age, stature, gender, length of service, weight of protective equipment and job position have on the prevalence and location of CP.

Estimating Total Energy Expenditure for Fire-Fighters during Large Scale Disaster Response Training Using a Tri-Axial Accelerometer

The present study was conducted to estimate total energy expenditure (TEE) of fire-fighters using tri axial-accelerometers in conjunction with an activity log survey on a large number of subjects undergoing training mimicking a large-scale disaster. Subjects were 240 fire-fighters participating in a two-day fire-fighting training dedicated to large-scale natural disasters. Data was analyzed by job type of activity group and the job rank, and by comparing the average. The average TEE of the total survey training period is about 3619 (±499) kcal, which is the same value of expenditure for professional athletes during the soccer game season. From the activity group, the rescue and other teams consumed significantly more energy than the fire and Emergency Medical Team (EMS) teams. From the job rank, Fire Captain (conducting position) consumed significantly lower energy than the Fire Lieutenant and Fire Sergeant. Furthermore, it was found that a middle position rank consumed the most energy. This research supports a need to reconsider the current rescue food (and protocols) to supplement the energy expenditure of fire-fighters. In addition, since there was a significant difference between the job type and the job rank, it is necessary to examine the energy amount and shape suitable for each.

Shifted Firefighter Health Investigation by Personal Health Insurance Record in Taiwan

INTRODUCTION

Taiwan's firefighters use a shift rotation system with 2 days of work and 1 day of rest. Numerous papers have already explored the risks of shift work to the body. However, little data concern the impact of shift work on health as reflected in medical visits. This study used individuals' medical visit record in Taiwan's health insurance system. The locally called "health bank" contains individuals' medical visit record, health insurance payment points and the medicine used.

METHODS

Consent was obtained from 150 firefighters who were serving under the shift rotation system to obtain their 2015 individual "My Health Bank" medical data. Comparisons were made between national health insurance data norm.

RESULTS

Firefighters make significantly more visits for Western medicine than the annual average (firefighters 6.27 vs norm 5.24, P = 0.04142), more total number of medical visits (9.57 vs 7.75, P = 0.0102), more annual average payment points for Western medicine (4079 vs 2741, P = 0.003151), and a greater average number of total annual medical visit points (7003 vs 4940, p = 0.0003157). Firefighters had significantly higher incidents of respiratory diseases, urogenital diseases, skin and subcutaneous tissue diseases, musculoskeletal system and connective tissue diseases, injuries, and illness from poisoning than did the norm (P<0.05).

CONCLUSION

A persuasive health-survey-based method for workers in high occupational hazard industries was proposed in this study, and the result was highly correlated with risk factors of fireworkers. The proposed study method is potential to investigate risk factors of other working.

The accumulation of, and associations between, nurses' activity levels within their shift in the emergency department

The aim of this study was to examine emergency nurses' activity levels and associations between hourly activity levels within-shifts. Fifty emergency nurses (45 females, 5 males) wore ActiGraph accelerometers and completed work diaries for up to 4 weeks. A sub-group (n = 42) also wore activPALs. Multilevel analyses examined temporal associations between hourly periods. In any hourly period, increased time spent in moderate- to vigorous-intensity physical activity (MVPA) was associated with less time spent in MVPA in the following hourly period. In any afternoon hourly period, increased time spent in MVPA was associated with more time spent in light-intensity physical activity in the following hourly period. No other associations were significant. Emergency nurses maintain activity levels within-shifts, except when more time spent in MVPA was associated with less time spent in MVPA in the following hour; a potential recovery strategy. Future research should determine how emergency nurses maintain their activity levels within-shifts. Practitioner Summary: Emergency nursing is physically demanding; however, it is unknown how active they are during hourly periods within-shifts. Emergency nurses' activity levels were maintained within hourly periods of a shift. Except for an increase in MVPA in 1 h was associated with a decrease in MVPA in the following hour. Abbreviations: CPR: cardiopulmonary resusitation; LPA: light-intensity physical activity; MPA: moderate-intenisty physical activity; MVPA: moderate- to vigorous-intensity physical activity; SED: sedentary.

Bidirectional associations between emergency nurses' occupational and leisure physical activity: An observational study

Emergency nursing is a physically demanding occupation yet research suggests they do not meet current physical activity guidelines. Current interventions have had limited effectiveness increasing nurses' physical activity, possibly due to a failure to acknowledge physical activity in another domain (e.g., occupational). This study aimed to determine the bidirectional associations between emergency nurses' occupational and leisure time activity levels on work days. Data from 49 emergency nurses (44 females and five males) wearing an ActiGraph accelerometer and completing work and sleep diaries for up to four weeks were analysed. An activPAL inclinometer was simultaneously worn by 41 nurses. Time spent in different activity levels and postural positions during work and leisure time were determined. Multi-level analyses examined bidirectional associations between emergency nurses' activity levels at work and during their leisure time. Moderate- to vigorous-intensity physical activity prior to a morning shift was associated with more sedentary time and less physical activity at work. Conversely, occupational stepping time was associated with more sitting, standing and stepping time after each shift. These findings provide critical insights into how and when researchers should intervene to facilitate adequate recovery for nurses' post-shift and balance competing demands on their leisure time.

Are prolonged sitting and sleep restriction a dual curse for the modern workforce? a randomised controlled trial protocol

INTRODUCTION

Prolonged sitting and inadequate sleep are a growing concern in society and are associated with impairments to cardiometabolic health and cognitive performance. However, the combined effect of prolonged sitting and inadequate sleep on measures of health and cognitive performance are unknown. In addition, the circadian disruption caused by shiftwork may further impact workers' cardiometabolic health and cognitive performance. This protocol paper outlines the methodology for exploring the impact of simultaneous exposure to prolonged sitting, sleep restriction and circadian disruption on cardiometabolic and cognitive performance outcomes.

METHODS AND ANALYSIS

This between-subjects study will recruit 208 males and females to complete a 7-day in-laboratory experimental protocol (1 Adaptation Day, 5 Experimental Days and 1 Recovery Day). Participants will be allocated to one of eight conditions that include all possible combinations of the following: dayshift or nightshift, sitting or breaking up sitting and 5 hour or 9 hour sleep opportunity. On arrival to the laboratory, participants will be provided with a 9 hour baseline sleep opportunity (22:00 to 07:00) and complete five simulated work shifts (09:00 to 17:30 in the dayshift condition and 22:00 to 06:30 in the nightshift condition) followed by a 9 hour recovery sleep opportunity (22:00 to 07:00). During the work shifts participants in the sitting condition will remain seated, while participants in the breaking up sitting condition will complete 3-min bouts of light-intensity walking every 30 mins on a motorised treadmill. Sleep opportunities will be 9 hour or 5 hour. Primary outcome measures include continuously measured interstitial blood glucose, heart rate and blood pressure, and a cognitive performance and self-perceived capacity testing battery completed five times per shift. Analyses will be conducted using linear mixed models.

ETHICS AND DISSEMINATION

The CQUniversity Human Ethics Committee has approved this study (0000021914). All participants who have already completed the protocol have provided informed consent. Study findings will be disseminated via scientific publications and conference presentations.

TRIAL REGISTRATION DETAILS

This study has been registered on Australian New Zealand Clinical Trials Registry (12619001516178) and is currently in the pre-results stage.

Characterizing Objective and Self-Reported Levels of Physical Activity Among Florida Firefighters Across Weight Status Category: A Cross-Sectional Pilot Study

Background: Firefighters suffer from a disproportionally high burden of chronic diseases that could be prevented from regular bouts of physical activity (PA). The goal(s) of this pilot study were to (a) describe typical PA levels in professional paid firefighters, and (b) assess their ability to estimate their own levels of PA. Methods: A repeated measures study design was used to assess self-reported and objectively measured levels of PA from a non-probabilistic sample of firefighters (n = 18) over 1 week. Objective measures of PA, measured by accelerometry were defined as the number of minutes spent in sedentary, light, moderate, and vigorous PA. Firefighters completed a follow-up questionnaire recording their self-reported levels of PA. Results: Obese (body mass index [BMI] > 30 kg/m²) firefighters spent 8,033 ± 2,543 minutes/week in sedentary activity, overweight (BMI = 25-29 kg/m²) firefighters 6,533 ± 1,587 minutes/week, and healthy weight (BMI = 18.5-24.9 kg/m²) firefighters 5,846 ± 1,160 minutes/week. The difference in self-reported weekly minutes spent in light, moderate, and vigorous activity and objectively measured minutes in activity was calculated. Healthy weight firefighters reported the least difference (1,924 minutes/week), followed by the overweight (3,884 minutes/week) and obese (5,749 minutes/week). Conclusion/Application to Practice: Firefighters poorly estimated their true level of PA compared with their objectively measured PA and obese firefighters reported the greatest inconsistency. Occupational health nurses should aim to support firefighters in achieving PA levels that assist firefighters to achieve a healthy weight and educate them about what it means to be engaged in each level of PA.

Hot, Tired and Hungry: The Snacking Behaviour and Food Cravings of Firefighters During Multi-Day Simulated Wildfire Suppression

Firefighters are exposed to numerous stressors during wildfire suppression, including working in hot temperatures and sleep restricted conditions. Research has shown that when sleep restricted, individuals choose foods higher in carbohydrates, fat, and sugar, and have increased cravings for calorie dense foods. However, there is currently no research on the combined effect of heat and sleep restriction on snacking behaviour. Conducting secondary analyses from a larger study, the current study aimed to investigate the impact of heat and sleep restriction on snacking behaviour and food cravings. Sixty-six firefighters completed three days of simulated physically demanding firefighting work and were randomly allocated to either the control (n = 18, CON; 19 °C, 8 h sleep opportunity), sleep restricted (n = 16, SR; 19 °C, 4-h sleep opportunity), hot (n = 18, HOT; 33 °C, 8 h sleep opportunity), or hot and sleep restricted (n = 14 HOT + SR; 33 °C, 4-h sleep opportunity) condition. During rest periods firefighters were able to self-select sweet, savoury, or healthy snacks from a ration pack and were asked to rate their hunger, fullness, and cravings every two hours (eating block). Mixed model analyses revealed no difference in total energy intake between conditions, however there was a significant interaction between eating block and condition, with those in the CON, HOT, and HOT + SR condition consuming significantly more energy between 1230 and 1430 compared to the SR condition (p = 0.002). Sleep restriction and heat did not impact feelings of hunger and fullness across the day, and did not lead to greater cravings for snacks, with no differences between conditions. These findings suggest that under various simulated firefighting conditions, it is not the amount of food that differs but the timing of food intake, with those that are required to work in hot conditions while sleep restricted more likely to consume food between 1230 and 1430. This has potential implications for the time of day in which a greater amount of food should be available for firefighters.

Emergency nurses' activity levels across rotating shifts

BACKGROUND

Emergency nurses work consecutive, rotating shift patterns. However, how their occupational physical activity levels are associated between these shifts is unknown. This study aimed to examine the associations between emergency nurses' time spent in different activity levels across one shift and the following day's shift.

METHODS

Fifty emergency nurses (45 female, five male) wore an ActiGraph accelerometer and completed work and sleep diaries across four weeks in 2018. A sub-sample (n = 42) also wore an activPAL inclinometer. Time spent sedentary, physically active, and in postural positions was determined. Multi-level analyses examined associations between one shift and the following day's shift.

RESULTS

Additional time spent sedentary and in light-intensity physical activity during the first shift was associated with more time spent being physically active in the following day's shift for all rotations except back-to-back night shifts. However, additional time spent engaged in moderate- to vigorous-intensity physical activity during the first shift was associated with less time spent physically active in the following day's shift for afternoon-morning and morning-afternoon rotations.

CONCLUSION

These findings demonstrate that shift sequences may impact emergency nurses' physical activity across shifts. Future research should identify the strategies emergency nurses use to maintain activity levels between shifts.

The impact of anticipating a stressful task on sleep inertia when on-call

Sleep inertia, the state of reduced alertness upon waking, can negatively impact on-call workers. Anticipation of a stressful task on sleep inertia, while on-call was investigated. Young, healthy males (n = 23) spent an adaptation, control and two counterbalanced on-call nights in the laboratory. When on-call, participants were told they would be woken to a high or low stress task. Participants were not woken during the night, instead were given a 2300-0700 sleep opportunity. Participants slept ∼7.5-h in all conditions. Upon waking, sleep inertia was quantified using the Karolinska Sleepiness Scale and Psychomotor Vigilance and Spatial Configuration Tasks, administered at 15-min intervals. Compared to control, participants felt sleepier post waking when on-call and sleepiest in the low stress compared to the high stress condition (p < .001). Spatial performance was faster when on-call compared to control (p < .001). Findings suggest that anticipating a high-stress task when on-call, does not impact sleep inertia severity.

The effects of hydration on cognitive performance during a simulated wildfire suppression shift in temperate and hot conditions

The effects on dehydration and cognitive performance from heat and/or physical activity are well established in the laboratory, although have not yet been studied for personnel working in occupations such as wildland firefighting regularly exposed to these types of conditions. This study aimed to investigate the effects of temperature and dehydration on seventy-three volunteer firefighters (35.7 ± 13.7 years, mean ± standard deviation) during a simulation of wildfire suppression under either control or hot (18-20; or 33-35 °C) temperature conditions. Results showed cognitive performance on the psychomotor vigilance task declined when participants were dehydrated in the heat and Stroop task performance was impaired when dehydrated late in the afternoon. Firefighters may be at risk of deteriorations in simple cognitive functions in the heat whilst dehydrated, although may also experience impairments in complex cognitive functions if dehydrated late in the day, irrespective of the environmental temperature.

Changes in Physical Performance During 21 d of Military Field Training in Warfighters

Introduction

Few studies have reported the amount of physical activity (PA) and its associations to physical performance of warfighters during military field training (MFT). The purpose of this study was to investigate changes in neuromuscular performance and PA among male Finnish Army conscripts during a 21-d MFT and to evaluate their recovery during 4 d after MFT.

Methods

Body composition and physical performance were measured four times during the study (before MFT (PRE), after 12 d (MID), post training (POST) and after 4 d of recovery (RECO)). PA was measured throughout MFT in a group of healthy young male conscripts (n=49) by using a tri-axial accelerometer. The study was approved by the Finnish Defence Forces and was granted ethics approval by the Ethics Committee of the University of Jyväskylä.

Results

Body mass declined significantly from 73.5 ± 8.7 to 71.6 ± 8.2 kg, but it recovered close to the PRE values (73.0 ± 8.3 kg). The same trend was also found in skeletal muscle mass and fat mass. The change in body mass and in skeletal muscle mass correlated negatively with the change in vigorous physical activity (r = -0.374, p = 0.016, and r = -0.337, p = 0.031, respectively). Muscular endurance decreased significantly (p < 0.001) in sit-ups from the PRE (46 ± 9 reps/min) values compared with MID (40 ± 8 reps/min), POST (42 ± 8 reps/min), and RECO (34 ± 11 reps/min) values. Also in push-ups, the declines in the POST (34 ± 10 reps/min) and RECO (34 ± 13 reps/min) values (p < 0.001) from the PRE (40 ± 13 reps/min) and MID (39 ± 12 reps/min) values were observed. There was a significant decrease in a standing long jump in all measurement points MID (220 ± 20 cm), POST (216 ± 20 cm), and RECO (213 ± 20 cm) as compared with the PRE values (229 ± 23 cm, p < 0.001). There was no change in 3.2 km loaded march time between the PRE (23:57 ± 4:12 min:s) and POST (23:44 ± 5:02 min:s) measurement time points. In PA, the total number of steps per day was significantly (p < 0.001) greater during ST (13,722 ± 2,379 steps) and MFT (13,937 ± 2,276 steps) than during garrison days (9,550 ± 2,569 steps). In POST, there was significantly (p < 0.001) more light (1.5-3.0 metabolic equivalent) (2:34:38 ± 0:22:53 h:min:s in ST and 3:03:27 ± 0:23:24 h:min:s in MFT) and moderate (3.0-6.0 metabolic equivalent) (2:12:15 ± 0:23:14 h:min:s in ST and 2:47:59 ± 0:27:23 h:min:s in MFT) PA than in the PRE measurements.

Conclusion

This study demonstrated slight decrements in warfighter physical performance during the 21-d MFT. The conscripts were overloaded during MFT, but 4 d of recovery seemed not to be enough to obtain the PRE measurement values in physical performance. This study also showed changes in the muscular endurance levels and PA during the 21-d MFT. It is important for warfighters to have a good physical fitness level PRE training or combat. As the prolonged MFT may have adverse effects in warfighters muscular endurance and PA levels, it is important to have sufficient recovery time after long MFT to regain combat readiness.

Device-measured physical activity, sedentary behaviour and cardiometabolic health and fitness across occupational groups: a systematic review and meta-analysis

BACKGROUND

With approximately 8 hours of one's waking day spent at work, occupational tasks and environments are important influencers on an individual's physical activity (PA) and sedentary behaviours. Little research has compared device-measured physical activity, sedentary behaviour and cardiometabolic outcomes between occupational groups.

OBJECTIVE

To compare device-measured movement (sedentary time [ST], light intensity physical activity [LPA], moderate-to-vigorous intensity physical activity [MVPA], and steps) across occupations. The secondary objective was to examine whether cardiometabolic and fitness outcomes differed by occupation.

METHODS

Five bibliographic databases were searched to identify all studies which included working age, employed adults from high-income countries, and reported on device-measured movement within occupations. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses and narrative syntheses.

RESULTS

The review includes 132 unique studies with data from 15,619 participants. Working adults spent ~ 60% of their working and waking time engaged in sedentary behaviour; a very small proportion (~ 4%) of the day included MVPA. On average, workers accumulated 8124 steps/day. Office and call center workers' steps/day were among the lowest, while those of postal delivery workers were highest. Office workers had the greatest ST and the lowest time in LPA both at work and during wakeful time. However, office workers had the greatest minutes sent in MVPA during wakeful hours. Laborers had the lowest ST and spent a significantly greater proportion of their work time in LPA and MVPA. Healthcare and protective services workers had higher levels of LPA at work compared to other occupations. Workers in driving-based occupations tended to have a higher body mass index and blood pressure.

CONCLUSION

This review identifies that occupational and wakeful time PA and ST differed between occupations. Future studies are needed to assess whether patterns differ by age and sex, describe leisure-time movement and movement patterns, and the relationship with cardiometabolic health.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42017070448 .

The Impact of Heat Exposure and Sleep Restriction on Firefighters' Work Performance and Physiology during Simulated Wildfire Suppression

This study was designed to examine the effects of ambient heat on firefighters' physical task performance, and physiological and perceptual responses when sleep restricted during simulated wildfire conditions. Thirty firefighters were randomly allocated to the sleep restricted (n = 17, SR; 19 °C, 4-h sleep opportunity) or hot and sleep restricted (n = 13, HOT + SR; 33 °C, 4-h sleep opportunity) condition. Firefighters performed two days of simulated, intermittent, self-paced work circuits comprising six firefighting tasks. Heart rate, and core temperature were measured continuously. After each task, firefighters reported their rating of perceived exertion and thermal sensation. Effort sensation was also reported after each work circuit. Fluids were consumed ad libitum. Urine volume and urine specific gravity were analysed. Sleep was monitored using polysomnography. There were no differences between the SR and HOT + SR groups in firefighters' physiological responses, hydration status, ratings of perceived exertion, motivation, and four of the six firefighting tasks (charged hose advance, rake, hose rolling, static hose hold). Black out hose and lateral repositioning were adversely affected in the HOT + SR group. Working in hot conditions did not appear to consistently impair firefighters work performance, physiology, and perceptual responses. Future research should determine whether such findings remain true when individual tasks are performed over longer durations.