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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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Barros B, Paiva AM, Oliveira M, Alves S, Esteves F, Fernandes A, Vaz J, Slezakova K, Costa S, Teixeira JP, Morais S. Baseline data and associations between urinary biomarkers of polycyclic aromatic hydrocarbons, blood pressure, hemogram, and lifestyle among wildland firefighters. Front Public Health 2024; 12:1338435. [PMID: 38510349 PMCID: PMC10950961 DOI: 10.3389/fpubh.2024.1338435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Available literature has found an association between firefighting and pathologic pathways leading to cardiorespiratory diseases, which have been linked with exposure to polycyclic aromatic hydrocarbons (PAHs). PAHs are highlighted as priority pollutants by the European Human Biomonitoring Initiative in occupational and non-occupational contexts. Methods This cross-sectional study is the first to simultaneously characterize six creatinine-adjusted PAHs metabolites (OHPAHs) in urine, blood pressure, cardiac frequency, and hemogram parameters among wildland firefighters without occupational exposure to fire emissions (> 7 days), while exploring several variables retrieved via questionnaires. Results Overall, baseline levels for total OHPAHs levels were 2 to 23-times superior to the general population, whereas individual metabolites remained below the general population median range (except for 1-hydroxynaphthalene+1-hydroxyacenaphtene). Exposure to gaseous pollutants and/or particulate matter during work-shift was associated with a 3.5-fold increase in total OHPAHs levels. Firefighters who smoke presented 3-times higher total concentration of OHPAHs than non-smokers (p < 0.001); non-smoker females presented 2-fold lower total OHPAHs (p = 0.049) than males. 1-hydroxypyrene was below the recommended occupational biological exposure value (2.5 μg/L), and the metabolite of carcinogenic PAH (benzo(a)pyrene) was not detected. Blood pressure was above 120/80 mmHg in 71% of subjects. Firefighters from the permanent intervention team presented significantly increased systolic pressure than those who performed other functions (p = 0.034). Tobacco consumption was significantly associated with higher basophils (p = 0.01-0.02) and hematocrit (p = 0.03). No association between OHPAHs and blood pressure was found. OHPAHs concentrations were positively correlated with monocyte, basophils, large immune cells, atypical lymphocytes, and mean corpuscular volume, which were stronger among smokers. Nevertheless, inverse associations were observed between fluorene and pyrene metabolites with neutrophils and eosinophils, respectively, in non-smokers. Hemogram was negatively affected by overworking and lower physical activity. Conclusion This study suggests possible associations between urinary PAHs metabolites and health parameters in firefighters, that should be further assessed in larger groups.
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Affiliation(s)
- Bela Barros
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
| | - Ana Margarida Paiva
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
| | - Marta Oliveira
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
| | - Sara Alves
- Instituto Politécnico de Bragança, UICISA: E, Unidade de Investigação em Ciências da Saúde: Enfermagem, Instituto Politécnico de Bragança Campus de Santa Apolónia, Bragança, Portugal
| | - Filipa Esteves
- Environmental Health Department, National Institute of Health Dr. Ricardo Jorge, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical School, Faculty of Medicine, University of Porto, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Adília Fernandes
- Instituto Politécnico de Bragança, UICISA: E, Unidade de Investigação em Ciências da Saúde: Enfermagem, Instituto Politécnico de Bragança Campus de Santa Apolónia, Bragança, Portugal
| | - Josiana Vaz
- CIMO, Instituto Politécnico de Bragança, Bragança, Centro de Investigação de Montanha Campus Santa Apolónia, Bragança, Portugal
- SusTEC, Instituto Politécnico de Bragança, Bragança, Sustec – Associate Laboratory for Sustainability and Technology in Inland Regions – Campus Santa Apolónia, Bragança, Portugal
| | - Klara Slezakova
- LEPABE-ALiCE, Departamento de Engenharia Química, Faculdade de Engenharia, Rua Dr. Roberto Frias, Porto, Portugal
| | - Solange Costa
- Environmental Health Department, National Institute of Health Dr. Ricardo Jorge, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - João Paulo Teixeira
- Environmental Health Department, National Institute of Health Dr. Ricardo Jorge, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Simone Morais
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
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Gonzalez DE, Lanham SN, Martin SE, Cleveland RE, Wilson TE, Langford EL, Abel MG. Firefighter Health: A Narrative Review of Occupational Threats and Countermeasures. Healthcare (Basel) 2024; 12:440. [PMID: 38391814 PMCID: PMC10888326 DOI: 10.3390/healthcare12040440] [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: 12/29/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
Structural firefighters are responsible for protecting properties and saving lives during emergency operations. Despite efforts to prepare firefighters for these hazardous occupational demands, the unfortunate reality is that the incidence of health morbidities is increasing within the fire service. Specifically, cardiovascular disease, cancer, and mental health disorders are among the most documented morbidities in firefighters. Pubmed and Google Scholar search engines were used to identify peer-reviewed English language manuscripts that evaluated firefighters' occupational health threats, allostatic factors associated with their occurrence, and evidence-based strategies to mitigate their impact. This narrative review provides fire departments, practitioners, and researchers with evidence-based practices to enhance firefighters' health.
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Affiliation(s)
- Drew E Gonzalez
- Department of Kinesiology and Sport Management, Texas A&M University, College Station, TX 77845, USA
| | - Sarah N Lanham
- First Responder Research Laboratory, Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA
| | - Steven E Martin
- Department of Kinesiology and Sport Management, Texas A&M University, College Station, TX 77845, USA
| | - Richard E Cleveland
- Department of Leadership, Technology, and Human Development, Georgia Southern University, Statesboro, GA 30458, USA
| | - Thad E Wilson
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY 40536, USA
| | - Emily L Langford
- First Responder Research Laboratory, Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA
- Department of Health and Human Sciences, University of Montevallo, Montevallo, AL 35115, USA
| | - Mark G Abel
- First Responder Research Laboratory, Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, 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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Ras J, Smith DL, Soteriades ES, Kengne AP, Leach L. Association between Physical Fitness and Cardiovascular Health in Firefighters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5930. [PMID: 37297534 PMCID: PMC10252711 DOI: 10.3390/ijerph20115930] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 06/12/2023]
Abstract
Firefighters perform strenuous work in dangerous and unpredictable environments requiring optimal physical conditioning. The aim of this study was to investigate the association between physical fitness and cardiovascular health (CVH) in firefighters. This cross-sectional study systematically recruited 309 full-time male and female firefighters between the ages of 20 to 65 years in Cape Town, South Africa. Physical fitness was assessed using absolute (abV̇O2max) and relative oxygen consumption (relVO2max), grip and leg strength, push-ups and sit-ups, sit-and-reach for flexibility and lean body mass (LBM). CVH encompassed age, smoking, blood pressure (BP), blood glucose, lipid profile, body mass index, body fat percentage (BF%), and waist circumference. Linear regressions and logistic regressions were applied. Multivariable analysis indicated that relVO2max was associated with systolic BP (p < 0.001), diastolic BP (p < 0.001), non-fasting blood glucose (p < 0.001), and total cholesterol (p = 0.037). Poor CVH index was negatively associated with relV̇O2max (p < 0.001), leg strength (p = 0.019), and push-ups (p = 0.012). Furthermore, age was inversely associated with V̇O2max (p < 0.001), push-up and sit-up capacity (p < 0.001), and sit-and-reach (p < 0.001). BF% was negatively associated with abV̇O2max (p < 0.001), grip and leg strength (p < 0.001), push-ups (p = 0.008), sit-ups (p < 0.001), and LBM (p < 0.001). Cardiorespiratory fitness, muscular strength, and muscular endurance were significantly associated with a better overall CVH profile.
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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;
| | - 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;
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Boston, MA 02115, USA
| | - Andre P. Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, 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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