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Hwang J, Peng Z, Najar FZ, Xu C, Agnew RJ, Xu X, Yang Z, Ahsan N. Urine proteome profile of firefighters with exposure to emergency fire-induced smoke: A pilot study to identify potential carcinogenic effects. Sci Total Environ 2024; 927:172273. [PMID: 38583625 DOI: 10.1016/j.scitotenv.2024.172273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
Firefighters are frequently exposed to a variety of chemicals formed from smoke, which pose a risk for numerous diseases, including cancer. Comparative urine proteome profiling could significantly improve our understanding of the early detection of potential cancer biomarkers. In this study, for the first time, we conducted a comparative protein profile analysis of 20 urine samples collected from ten real-life firefighters prior to and following emergency fire-induced smoke. Using a label-free quantitative proteomics platform, we identified and quantified 1325 unique protein groups, of which 45 proteins showed differential expressions in abundance in response to fire-smoke exposure (post) compared to the control (pre). Pathway analysis showed proteins associated with epithelium development (e.g., RHCG, HEG1, ADAMTSL2) and Alzheimer's disease (SORL1) were significantly increased in response to smoke exposure samples. A protein-protein-network study showed a possible link between these differentially abundant proteins and the known cancer gene (TP53). Moreover, a cross-comparison analysis revealed that seven proteins-ALDH1A1, APCS, POMC, COL2A1, RDX, DDAH2, and SDC4 overlapped with the previously published urine cancer proteome datasets, suggesting a potential cancer risk. Our findings demonstrated that the discovery proteomic platform is a promising analytical technique for identifying potential non-invasive biomarkers associated with fire-smoke exposure in firefighters that may be related to cancer.
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Affiliation(s)
- Jooyeon Hwang
- Department of Environmental & Occupational Health Sciences, School of Public Health, University of Texas Health Science Center, Houston, TX, USA; Southwest Center for Occupational and Environmental Health, University of Texas Health Science Center, Houston, TX, USA; Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences, Oklahoma City, OK, USA.
| | - Zongkai Peng
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, USA
| | - Fares Z Najar
- High-Performance Computing Center, Oklahoma State University, Stillwater, OK, USA
| | - Chao Xu
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
| | - Robert J Agnew
- Fire Protection & Safety Engineering Technology Program, College of Engineering, Architecture and Technology, Oklahoma State University, Stillwater, OK, USA
| | - Xin Xu
- Shanghai Anti-doping Laboratory, Shanghai University of Sport, Shanghai, China
| | - Zhibo Yang
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, USA
| | - Nagib Ahsan
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, USA; Mass Spectrometry, Proteomics and Metabolomics Core Facility, Stephenson Life Sciences Research Center, The University of Oklahoma, Norman, OK, USA.
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Kim JI, Min B, Lee JH, Park H, Kim JH. Patterns of comorbid PTSD, depression, alcohol use disorder, and insomnia symptoms in firefighters: A latent profile analysis. J Affect Disord 2024; 356:338-345. [PMID: 38583597 DOI: 10.1016/j.jad.2024.03.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Firefighters are an at-risk population for multiple psychiatric conditions, including posttraumatic stress disorder (PTSD), depression, alcohol use disorders (AUDs), and insomnia. These disorders are likely to co-occur; however, patterns of comorbidity have scarcely been investigated in firefighters. We aimed to identify subgroups of comorbidity of PTSD, depression, AUDs, and insomnia in a nationwide population of firefighters in South Korea. METHODS A total of 54,054 firefighters responded to an online survey. Latent classes of comorbidity were categorized using latent profile analysis (LPA) based on the symptom scores of PTSD, depression, AUDs, and insomnia. Analysis of variance was performed to compare the characteristics of the identified classes, and multinomial logistic regression was conducted to examine whether anger reactions, resilience, and number of traumatic events predicted class membership. RESULTS The LPA identified four subgroups: minimal symptoms (n = 42,948, 79.5 %), predominant PTSD (n = 2858, 5.3 %), subthreshold symptoms and comorbidity (n = 7003, 13.0 %), and high symptoms and comorbidity (n = 1245, 2.3 %). Three comorbidity classes were defined based on severity and one class showed predominant PTSD symptoms. Number of traumatic exposures predicted predominant PTSD, while resilience and anger reactions predicted severity of comorbidities. LIMITATIONS The cross-sectional design and usage of self-reported questionnaires are limitations of this study. CONCLUSIONS The severity of PTSD, depression, AUDs and insomnia tend to correlate and co-occur in firefighters. Our findings highlight the need to assess comorbid symptoms in firefighters and need to reduce anger reactions and enhance resilience in those with multiple comorbidities.
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Affiliation(s)
- Johanna Inhyang Kim
- Department of Psychiatry, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, Republic of Korea
| | - Beomjun Min
- Chung Psychiatry Clinic, Seocho-daero 77-gil 17 Block 77, Seoul, Republic of Korea
| | - Ji-Hye Lee
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Heyeon Park
- Division of General Studies & Teaching Profession, Dongduk Women's University, Seoul, Republic of Korea
| | - Jeong-Hyun Kim
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea; Department of Psychiatry, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
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Kander MC, Mayer AC, Wilkinson AF, Bertke S, Kesler RM, Smith DL, Horn GP, Fent KW. Evaluating workplace protection factors (WPFs) of different firefighter PPE interface control measures for select volatile organic compounds (VOCs). J Occup Environ Hyg 2024:1-12. [PMID: 38560919 DOI: 10.1080/15459624.2024.2323109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Structural firefighters are exposed to a complex set of contaminants and combustion byproducts, including volatile organic compounds (VOCs). Additionally, recent studies have found structural firefighters' skin may be exposed to multiple chemical compounds via permeation or penetration of chemical byproducts through or around personal protective equipment (PPE). This mannequin-based study evaluated the effectiveness of four different PPE conditions with varying contamination control measures (incorporating PPE interface design features and particulate blocking materials) to protect against ingress of several VOCs in a smoke exposure chamber. We also investigated the effectiveness of long-sleeve base layer clothing to provide additional protection against skin contamination. Outside gear air concentrations were measured from within the smoke exposure chamber at the breathing zone, abdomen, and thigh heights. Personal air concentrations were collected from mannequins under PPE at the same general heights and under the base layer at abdomen and thigh heights. Sampled contaminants included benzene, toluene, styrene, and naphthalene. Results suggest that VOCs can readily penetrate the ensembles. Workplace protection factors (WPFs) were near one for benzene and toluene and increased with increasing molecular weight of the contaminants. WPFs were generally lower under hoods and jackets compared to under pants. For all PPE conditions, the pants appeared to provide the greatest overall protection against ingress of VOCs, but this may be due in part to the lower air concentrations toward the floor (and cuffs of pants) relative to the thigh-height outside gear concentrations used in calculating the WPFs. Providing added interface control measures and adding particulate-blocking materials appeared to provide a protective benefit against less-volatile chemicals, like naphthalene and styrene.
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Affiliation(s)
- M Christina Kander
- Department of Environmental & Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Alexander C Mayer
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, Ohio, USA
| | - Andrea F Wilkinson
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, Ohio, USA
| | - Stephen Bertke
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, Ohio, USA
| | - Richard M Kesler
- Fire Safety Research Institute, UL Research Institutes, Columbia, Maryland, USA
| | - Denise L Smith
- Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, New York, USA
- Illinois Fire Service Institute, University of Illinois, Urbana-Champaign, Illinois, USA
| | - Gavin P Horn
- Fire Safety Research Institute, UL Research Institutes, Columbia, Maryland, USA
| | - Kenneth W Fent
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, Ohio, USA
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Hong JS, Lee D, Han DH, Sim M. Development and validation of the trauma-specific emotional counting Stroop paradigm for fMRI study. J Affect Disord 2024; 350:118-124. [PMID: 38163567 DOI: 10.1016/j.jad.2023.12.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The emotional-counting Stroop (ecStroop) is a cognitive task to evaluate emotional information processing. This study aimed to develop a trauma-specific ecStroop protocol for firefighters and assess its validity as a functional magnetic resonance imaging (fMRI) activation paradigm. METHODS To develop the ecStroop protocol, trauma-related words for firefighters were selected from previous studies, and general negative and neutral words were matched corresponding to the number of letters and syllables, parts of speech, and frequency in the Korean language. The negative emotional valence of whole words was investigated in 520 healthy participants. To compare brain activation between three categories, 25 healthy individuals underwent fMRI during the ecStroop task. RESULTS Eight trauma-related words, eight general negative words, and sixteen neutral words were selected by emotional valence scores. The general negative words were related to increased activation in the right inferior and middle temporal gyrus, right medial frontal gyrus, and left superior frontal gyrus compared to the neutral words. When exposed to the trauma-related words, participants' brain activation was increased in the right inferior temporal gyrus, right medial frontal gyrus, left superior temporal gyrus, and left inferior frontal gyrus as compared to when exposed to the neutral words. LIMITATIONS The fact that all participants in the phase 2 fMRI study were male could limit generalization to all genders. CONCLUSIONS These findings suggest that the ecStroop paradigm successfully activated the brain regions for emotional processing. This paradigm could be valuable in assessing the trauma-specific neural changes in firefighters.
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Affiliation(s)
- Ji Sun Hong
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Dayoung Lee
- National Center for Disaster and Trauma, National Center for Mental Health, Seoul, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
| | - Minyoung Sim
- National Center for Disaster and Trauma, National Center for Mental Health, Seoul, Republic of Korea.
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Lee NM, Tadesse AW, Ekpe OD, Lee SY, Kwon JW, Kim W, Cho YH, Oh JE. Assessment of PAH exposure and health risks among South Korean firefighters based on urinary PAH metabolites. Chemosphere 2024; 353:141429. [PMID: 38364917 DOI: 10.1016/j.chemosphere.2024.141429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 02/18/2024]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) comprise a group of compounds resulting from the incomplete combustion of organic matter. Firefighters engaged in fire suppression are highly exposed to PAHs. This study centered on evaluating the exposure levels and health risks of PAHs in South Korean firefighters involved in firefighting activities. The concentrations of 10 PAH metabolites in the urine of firefighters were measured immediately after, and two weeks post their engagement in extinguishing a large tire factory fire. The levels of OH-PAHs in urine samples immediately after fire suppression were elevated by a factor of 1.01-1.84 compared to urine samples from non-exposed period. The median concentration of total PAH metabolites (OH-PAHs) was higher in urine samples immediately after fire suppression (5910 ng/g creatinine) than in urine samples from non-exposed periods (5020 ng/g creatinine). However, the ∑OH-PAH levels in firefighters' urine were related to personal habits such as smoking. The concentrations of all individual OH-PAHs in the urine samples of nonsmokers exhibited a substantial increase, ranging from 1.37 to 2.3 times, clearly demonstrating that firefighting activities were a substantial source of PAH exposure. The calculated values associated with the health risks stemming from exposure to PAHs, including carcinogenic risk, total estimated daily intake (TEDI), and hazard quotients/index (HQs/HI), all fell within acceptable limits, indicating negligible risk. However, the HQ/HI values and TEDI for individual and total PAH exposures, except those for naphthalene, were 1.36-2.00 times higher in firefighters' samples taken after firefighting operations compared to those during regular duty. This underscores the need for more comprehensive investigations to comprehend the singular impact of firefighting activities due to the diverse sources of PAH emissions in the environment.
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Affiliation(s)
- Na Mi Lee
- Department of Civil and Environmental Engineering, Pusan National University, Busan, 46241, Republic of Korea
| | - Ababo Workineh Tadesse
- Department of Civil and Environmental Engineering, Pusan National University, Busan, 46241, Republic of Korea; Ambo University, Ambo, Ethiopia
| | - Okon Dominic Ekpe
- Department of Civil and Environmental Engineering, Pusan National University, Busan, 46241, Republic of Korea
| | - So Yun Lee
- National Fire Research Institute of Korea, Asan, 31555, Republic of Korea
| | - Ji Woon Kwon
- National Fire Research Institute of Korea, Asan, 31555, Republic of Korea
| | - Won Kim
- Wonjin Institute for Occupational and Environmental Health, Seoul, 02221, Republic of Korea
| | - Young Hwan Cho
- Wonjin Institute for Occupational and Environmental Health, Seoul, 02221, Republic of Korea
| | - Jeong-Eun Oh
- Department of Civil and Environmental Engineering, Pusan National University, Busan, 46241, Republic of Korea; Institute for Environment and Energy, Pusan National University, Busan, 46241, Republic of Korea.
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Khoshakhlagh AH, Al Sulaie S, Mirzahosseininejad M, Yazdanirad S, Orr RM, Laal F, Bamel U. Occupational stress and musculoskeletal disorders in firefighters: the mediating effect of depression and job burnout. Sci Rep 2024; 14:4649. [PMID: 38409336 PMCID: PMC10897186 DOI: 10.1038/s41598-024-55468-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 02/23/2024] [Indexed: 02/28/2024] Open
Abstract
The firefighting profession carries a heightened risk of musculoskeletal disorders. A firefighter's job is physically demanding and includes activities such as running, climbing, dragging, and lifting. Often, these tasks are unpredictable, performed in harsh environments, and have been found to cause psychological stress. The purpose of this study was to investigate the effects of occupational stress on work-related musculoskeletal disorders (WRMSD) in firefighters. In addition, the mediating effects of depression and job burnout on proposed relationships were examined. Data informing this study were collected using a survey questionnaire. The survey questionnaire included the Beck Depression Inventory, the Center for Epidemiological Studies Depression Scale (CES-D), the Maslach Burnout Inventory, the Post Traumatic Stress Disorder Inventory (PCL), and the Nordic Musculoskeletal Questionnaire. Collected data were analyzed using structural equation modeling approach in AMOS. The results of the 2339 responding firefighters suggest that work related stress is positively related to WRMSDs in firefighters and can lead to musculoskeletal symptoms through four paths, being emotional exhaustion, personal accomplishment, CES-D total score, and depersonalization. Through depersonalization, job stress had the most significant impact on musculoskeletal symptoms (coefficient = 0.053). Furthermore, the results showed that post-traumatic stress disorders (PTSD) can affect musculoskeletal symptoms through ten paths, again through depersonalization, PTSD had the most significant impact on musculoskeletal symptoms (coefficient = 0.141). The results of this study suggest that organizations should design interventions and policies to prevent and manage occupational stress, depression, and job burnout to negate its undesired consequences on firefighters' health (i.e. WRMSD).
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Affiliation(s)
- Amir Hossein Khoshakhlagh
- Department of Occupational Health, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Saleh Al Sulaie
- Department of Mechanical and Industrial Engineering, College of Engineering and Computers in Al-Qunfudah, Umm Al-Qura University, 21955, Makkah, Saudi Arabia
| | - Marziyeh Mirzahosseininejad
- Fire Safety Section of Department of Health, Safety and Environment of Sarcheshmeh Copper Complex, National Iranian Copper Industries Co, Rafsanjan, Kerman, Iran
| | - Saeid Yazdanirad
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Robin Marc Orr
- Tactical Research Unit, Bond University, Gold Coast, Australia
| | - Fereydoon Laal
- Department of Occupational Health Engineering, Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.
| | - Umesh Bamel
- OB & HRM Group, International Management Institute New Delhi, New Delhi, India
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Faghihi A, Naderi Z, Keshtkar MM, Nikrouz L, Bijani M. A comparison between the effects of simulation of basic CPR training and workshops on firefighters' knowledge and skills: experimental study. BMC Med Educ 2024; 24:178. [PMID: 38395870 PMCID: PMC10893681 DOI: 10.1186/s12909-024-05165-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND One of the most common causes of death worldwide is cardiopulmonary arrest. Firefighters are among the first responders at the scenes of accidents and can, therefore, play a key part in performing basic cardiopulmonary resuscitation (CPR) for victims who need it. The present study was conducted to compare the effects of simulation training against workshops on the CPR knowledge and skills of firefighters in the south of Iran. METHODS This experimental (Interventional) study was conducted on 60 firefighters of south of Fars province, Iran. The study was undertaken from March to July 2023. Through random allocation, the participants were divided into two groups: simulation-based training (30 members) and traditional workshop training (30 members). The participants' CPR knowledge and practical skills were measured before, immediately after, and three months after intervention. RESULTS The findings of the study revealed a statistically significant difference between the pretest and posttest CPR knowledge and skill mean scores of the simulation groups as compared to the workshop group (p < 0.001). As measured three months after the intervention, the firefighters' knowledge and skill mean scores were still significantly different from their pretest mean scores (p < 0.001); however, they had declined, which can be attributed to the fact that the study population did not frequently exercise CPR. CONCLUSION Based on the findings of the study, even though both methods of education were effective on enhancing the firefighters' CPR knowledge and skill, simulation training had a far greater impact than training in workshops. In view of the decline in the participants' knowledge and skill scores over time, it is recommended that short simulation training courses on CPR should be repeated on a regular basis.
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Affiliation(s)
- Amir Faghihi
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Zeinab Naderi
- Department of Medical Surgical Nursing, Sirjan School of Medical Sciences, Sirjan, Iran
| | | | - Leila Nikrouz
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran.
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Martin J, Toczko M, Sax van der Weyden M, Lockie R. Effects of implementing a mandatory and consequential annual fitness assessment in a fire department over the initial 4-year period. Work 2024:WOR230378. [PMID: 38339952 DOI: 10.3233/wor-230378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Despite the physical nature of the occupation many firefighters have low levels of physical fitness which is associated with poor performance of occupational tasks and increased injury rates. For many fire departments an initial step in promoting health and wellness within the department is to conduct annual fitness testing. OBJECTIVE To examine the effects of implementing a consequential fitness assessment within a fire department. METHODS A retrospective repeated measures design was used to analyze annual fitness assessment data of professional firefighters (n = 1415) from 2019 to 2022 within a large urban fire department located in the mid-Atlantic region of the United States. The fitness tests included assessments of pull-ups, push-ups, sit-ups, aerobic capacity, and body composition. Repeated measure analyses of variances (ANOVAs) assessed the effect of year and a 2-way ANOVA was conducted to investigate the effects of sex and age on fitness measures on 2022 data. RESULTS All fitness measures were found to be maintained over the 4-year period. Significant main effects of age and sex across all fitness measures, but no significant interactions were found. Older firefighters (50 + years) exhibited lower performance (p < 0.001, d > 0.80) on muscular fitness assessments than young firefighters (20-29 years). A large effect of sex (males > females) was found for pull-ups (d = 1.04), push-ups (d = 1.23), and aerobic capacity (d = 1.38). CONCLUSIONS The results suggest that implementing a consequential fitness assessment could help maintain firefighters' fitness levels over a multi-year period.
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Affiliation(s)
- Joel Martin
- Sports Medicine Assessment Research & Testing (SMART) Laboratory; George Mason University, Virginia, USA
| | - Michael Toczko
- Sports Medicine Assessment Research & Testing (SMART) Laboratory; George Mason University, Virginia, USA
| | - Megan Sax van der Weyden
- Sports Medicine Assessment Research & Testing (SMART) Laboratory; George Mason University, Virginia, USA
| | - Robert Lockie
- Department of Kinesiology, California State University, Fullerton, Fullerton, CA, USA
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Dos Santos V, Son C. Identifying firefighters' situation awareness requirements for fire and non-fire emergencies using a goal-directed task analysis. Appl Ergon 2024; 114:104136. [PMID: 37716079 DOI: 10.1016/j.apergo.2023.104136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/02/2023] [Accepted: 09/07/2023] [Indexed: 09/18/2023]
Abstract
A firefighter's situation awareness (SA) is considered crucial to making effective tactical decisions and actions at the scene. Despite the importance of the firefighter's SA, there have been limited research efforts to understand what cues and information firefighters use to assess ongoing situations and predict future conditions. In addition to fire events, contemporary firefighters respond to an increasing volume of non-fire incidents. Thus, this study aims to identify firefighters' SA during three fire incidents (single house fire, vehicle fire, and passenger aircraft fire) and three non-fire incidents (medical emergency, hazardous materials, and urban search and rescue). A goal-directed task analysis was conducted via focus group discussions with eight career firefighters. Findings indicate that firefighters build their SA by processing various cues from hazards (e.g., fire, ignition source), humans (e.g., occupants, bystanders, drivers, passengers), spatial elements (e.g., building structure, location of hazards), and surrounding conditions (e.g., traffic, weather). Our findings provide insights into SA measurement, SA-oriented work processes, training for SA, and designing technologies to support firefighters' SA during all-hazard responses.
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Affiliation(s)
- Viviana Dos Santos
- Department of Industrial, Manufacturing, & Systems Engineering, Texas Tech University, Lubbock, TX, USA
| | - Changwon Son
- Department of Industrial, Manufacturing, & Systems Engineering, Texas Tech University, Lubbock, TX, USA.
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10
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Piyachaiseth N, Sithisarankul P, Ratanachina J. Sleep Quality and Associated Factors Among Firefighters in Bangkok, Thailand: A Cross-sectional Study. J Prev Med Public Health 2024; 57:83-90. [PMID: 38147823 PMCID: PMC10861332 DOI: 10.3961/jpmph.23.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/20/2023] [Accepted: 11/30/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVES Professional firefighters face various health hazards and are required to maintain both physical and mental fitness to effectively mitigate crises and respond to emergencies. Moreover, the long working hours and shift work of this profession impact sleep quality. This study investigated the quality of sleep and its associated factors among firefighters in Bangkok, Thailand. METHODS This was a cross-sectional study of firefighters affiliated with the Bangkok Fire and Rescue Department, Bangkok Metropolitan Administration, Thailand between January 2023 and March 2023. A cluster random sampling technique was utilized to distribute 600 questionnaires to firefighters in 15 fire stations. The questionnaire addressed demographic, work-related, and environmental factors. Sleep quality was assessed using the Thai version of the Pittsburgh Sleep Quality Index (PSQI). Data analysis involved both descriptive and inferential statistics. Bivariate and multiple logistic regressions were performed. RESULTS The response rate was 78.7% (n=472), and 44.1% of the firefighters reported poor sleep quality (PSQI score >5). Sleep quality was statistically associated with conflicting family relationships (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1 to 2.9), additional part-time jobs (daytime, OR, 2.4; 95% CI, 1.3 to 4.4; or nighttime, OR, 4.3; 95% CI, 1.1 to 16.7), noisy sleeping areas (OR, 1.7; 95% CI, 1.1 to 2.8), and the availability of adequate bedding (OR, 3.0; 95% CI, 1.8 to 4.9). CONCLUSIONS Poor sleep quality among firefighters was associated with various personal, work-related, and environmental factors. Organizations should promote policies that improve sleep quality through good sleep hygiene practices and facilities.
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Affiliation(s)
- Nunnapat Piyachaiseth
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pornchai Sithisarankul
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jate Ratanachina
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- National Heart and Lung Institute, Imperial College London, London, UK
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11
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Bralewska K. Air pollution inside fire stations: State-of-the-art and future challenges. Int J Hyg Environ Health 2024; 255:114289. [PMID: 37976582 DOI: 10.1016/j.ijheh.2023.114289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
Firefighters are frequently exposed to products of combustion and pyrolysis. Exposure to these substances occurs not only during fires but also at fire stations, particularly where fire equipment and fire uniforms are stored after firefighting operations. The aims of this study were to review the research on the concentrations of various air pollutants in fire stations, identify the limitations and strengths of such research, identify research gaps and related future challenges, and highlight potential solutions for reducing firefighter exposure to air pollution at fire stations. A total of 32 articles published in international journals during 1987-2023 were selected for analysis. The most frequently studied pollutants in fire stations were polycyclic aromatic hydrocarbons, particulate matter, and diesel particulate matter. Research was most often conducted on changing rooms and garages. Firefighting equipment, personal protective equipment, fire trucks, and combustion tools were identified as the main sources of pollution at fire stations. Recommendations aimed at reducing the concentration of pollutants in fire stations were mainly concerned with the systematic decontamination of equipment and the introduction of ventilation solutions that would remove exhaust fumes from garages. This in-depth literature review indicates a lack of comprehensive research on the state and quality of air at fire stations. It also highlights the emerging need for more knowledge on the concentrations of air pollutants in fire stations, health exposure related to these substances, and an analysis of the effectiveness of the proposed solutions.
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Affiliation(s)
- Karolina Bralewska
- Institute of Safety Engineering, Fire University (formerly Main School of Fire Service), 52/54 Slowackiego Street, Warsaw, 01-629, Poland.
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12
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Keir JLA, Papas W, Wawrzynczak A, Aranda-Rodriguez R, Blais JM, White PA. Use of silicone wristbands to measure firefighters' exposures to polycyclic aromatic hydrocarbons (PAHs) during live fire training. Environ Res 2023; 239:117306. [PMID: 37797669 DOI: 10.1016/j.envres.2023.117306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/30/2023] [Accepted: 10/03/2023] [Indexed: 10/07/2023]
Abstract
Firefighters experience exposures to carcinogenic and mutagenic substances, including polycyclic aromatic hydrocarbons (PAHs). Silicone wristbands (SWBs) have been used as passive samplers to assess firefighters' exposures over the course of a shift but their utility in measuring short term exposures, source of exposure, and correlations with other measurements of exposure have not yet been investigated. In this study, SWBs were used to measure the concentrations of 16 priority PAHs inside and outside of firefighters' personal protective equipment (PPE) while firefighting. SWBs were placed on the wrist and jacket of 20 firefighters conducting live fire training. Correlations were made with matching data from a sister project that measured urinary concentrations of PAH metabolites and PAH concentrations from personal air samples from the same participants. Naphthalene, acenaphthylene and phenanthrene had the highest geometric mean concentrations in both jacket and wrist SWB, with 1040, 320, 180 ng/g SWB for jacket and 55.0, 4.9, and 6.0 ng/g SWB for wrist, respectively. Ratios of concentrations between the jacket and wrist SWBs were calculated as worker protection factors (WPFs) and averaged 40.1 for total PAHs and ranged from 2.8 to 214 for individual PAHs, similar to previous studies. Several significant correlations were observed between PAHs in jacket SWBs and air samples (e.g., total and low molecular weight PAHs, r = 0.55 and 0.59, p < 0.05, respectively). A few correlations were found between PAHs from SWBs worn on the wrist and jacket, and urinary concentrations of PAH metabolites and PAH concentrations in air samples. The ability of the SWBs to accurately capture exposures to various PAHs was likely influenced by short sampling time, high temperatures, and high turbulence. Future work should further examine the limitations of SWBs for PAH exposures in firefighting, and other extreme environments.
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Affiliation(s)
- Jennifer L A Keir
- Department of Biology, University of Ottawa, 30 Marie Curie, Ottawa, Ontario, K1N 6N5, Canada; Environmental Health Science and Research Bureau, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, Ontario, K1A 0K9, Canada
| | - William Papas
- Environmental Health Science and Research Bureau, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, Ontario, K1A 0K9, Canada
| | - Adam Wawrzynczak
- Environmental Health Science and Research Bureau, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, Ontario, K1A 0K9, Canada
| | - Rocio Aranda-Rodriguez
- Environmental Health Science and Research Bureau, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, Ontario, K1A 0K9, Canada.
| | - Jules M Blais
- Department of Biology, University of Ottawa, 30 Marie Curie, Ottawa, Ontario, K1N 6N5, Canada.
| | - Paul A White
- Department of Biology, University of Ottawa, 30 Marie Curie, Ottawa, Ontario, K1N 6N5, Canada; Environmental Health Science and Research Bureau, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, Ontario, K1A 0K9, Canada
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13
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Wang S, Feng C, Chen X, Shan M, Niu W. A biomechanical evaluation of firefighters' musculoskeletal loads when carrying self-contained breathing apparatus in walking and running. J Safety Res 2023; 87:1-14. [PMID: 38081685 DOI: 10.1016/j.jsr.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 04/24/2023] [Accepted: 08/03/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Musculoskeletal loading data are needed to design ergonomic intervention for firefighters. This study aimed to quantify the firefighters' musculoskeletal loads during self-contained breathing apparatus (SCBA) carriage and evaluate the effectiveness of shoulder strap length variation for the prevention of SCBA-related injuries. METHOD Twelve firefighters (height: 174.6 ± 2.4 cm, mass: 67 ± 3.5 kg, BMI = 22 ± 1 kg/m2) participated the walking and running protocols with no SCBA equipped and three varying-strapped SCBAs conditions. Joint range of motion and surface electromyography (sEMG) were synchronously measured. Subsequently, joint kinematics was inputted for subject-specific musculoskeletal modeling to estimate muscle forces and joint reaction forces, while the sEMG was used to validate the model. Repeated measures analysis of variance was used for the main effects (p < 0.05). Independent samples t-test was performed to determine differences between walking and running. RESULTS Walking with SCBA increased the rectus femoris force and hip reaction force by 34.92% [F = 53.629; p < 0.001; η2 = 0.317] and 34.71% [F = 53.653; p < 0.001; η2 = 0.517], the growth rate was 54.2% [F = 76.487; p < 0.001; η2 = 0.418] and 51.19% [F = 69.201; p < 0.001; η2 = 0.652] during running, respectively. Running with SCBA significantly increased the knee reaction force by 63.04% [F = 83.960; p < 0.001; η2 = 0.797], while only 18.49% increase during walking. Adjusting SCBA shoulder strap length significantly altered the rectus abdominis force and L4/L5 reaction force during walking and running. CONCLUSIONS Results revealed that rectus femoris activity, hip and knee exertion was sensitive to SCBA carriage. The variation of shoulder strap length has potential to influence the risk of low back pain (LBP). PRACTICAL APPLICATIONS The findings suggest that fire services promote targeting physical training at firefighters' hip and knee regions. Test firefighters in this study were not advisable to adjust their shoulder strap at loose-fitting condition. The compatibility design of the trunk morphology and SCBA back-mounted frame was suggested for the management of LBP.
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Affiliation(s)
- Shitan Wang
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 201619, China; Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai 200092, China
| | - Chenglong Feng
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 201619, China; Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai 200092, China
| | - Xinpeng Chen
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 201619, China
| | - Mianjia Shan
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 201619, China; Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai 200092, China
| | - Wenxin Niu
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 201619, China; Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai 200092, China.
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14
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Pennington ML, Ylitalo KR, Thomas KL, Coe E, Humphries M, Gulliver SB. Suicides among American Indian/Alaska Native firefighters: Data from the National Violent Death Reporting System, 2003 - 2017. Psychiatry Res 2023; 330:115593. [PMID: 37951031 DOI: 10.1016/j.psychres.2023.115593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 11/13/2023]
Abstract
Suicide is a significant public health problem in the United States and disproportionally affects male American Indian/Alaska Natives (AI/AN). Suicide is particularly problematic among AI/AN firefighters who are more likely to report suicide ideation, planning, attempts, and risk compared to non-Hispanic white (NHW) firefighters. The aim of the current study was to compare non-Hispanic AI/AN firefighter and NHW firefighter suicide decedents by demographics and risk/precipitating factors using National Violent Death Reporting System data for 45 male non-Hispanic AI/AN firefighter and 588 male NHW firefighter decedents who died by suicide. Compared to NHW firefighter decedents, AI/AN firefighter decedents were significantly younger and had significantly higher odds of experiencing alcohol use problems and a recent death/suicide of a family member/friend. AI/AN firefighter decedents had significantly lower odds of documented mental health problems, documented diagnosis of depression/dysthymia, receipt of mental health treatment, or leaving a suicide note compared to NHW firefighter decedents. Results from this study may inform tailored suicide prevention and screening efforts among first responders with the goal of lowering suicide mortality among AI/AN firefighters and fire service as a whole.
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Affiliation(s)
- Michelle L Pennington
- Department of Public Health, Baylor University, Waco, TX, USA; Warriors Research Institute, Baylor Scott & White Health, Waco, TX, USA.
| | - Kelly R Ylitalo
- Department of Public Health, Baylor University, Waco, TX, USA
| | | | - Elizabeth Coe
- Warriors Research Institute, Baylor Scott & White Health, Waco, TX, USA
| | - Mariah Humphries
- George W. Truett Theological Seminary, Baylor University, Waco, TX, USA
| | - Suzy B Gulliver
- Warriors Research Institute, Baylor Scott & White Health, Waco, TX, USA; Department of Psychiatry and Behavioral Science, Texas A&M Health Science Center, Temple, TX, USA
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15
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Mazumder NUS, Lu J, Hall AS, Kasebi A, Girase A, Masoud F, Stull JO, Ormond RB. Toward the future of firefighter gear: Assessing fluorinated and non-fluorinated outer shells following simulated on-the-job exposures. J Ind Text 2023; 53:10.1177/15280837231217401. [PMID: 38529520 PMCID: PMC10962281 DOI: 10.1177/15280837231217401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
In 2022, the occupation of firefighting was categorized as a "Group 1" carcinogen, meaning it is known to be carcinogenic to humans. The personal protective equipment that structural firefighters wear is designed to safeguard them from thermal, physical, and chemical hazards while maintaining thermo-physiological comfort. Typically, the outer layer of structural turnout gear is finished with a durable water and oil-repellent (DWR) based on per- and polyfluoroalkyl substances (PFAS) that helps limit exposure to water and hazardous liquids. The PFAS-based aqueous emulsion typically used in DWR finishes is highly persistent and can cause various health problems if absorbed into the body through ingestion, inhalation, and/or dermal absorption. In response, the U.S. Fire Service has begun using non-PFAS water repellants in firefighter turnout gear. This study aims to evaluate the performance of both traditional PFAS-based and alternative non-PFAS outer shell materials. The study involved exposing both PFAS-based and non-PFAS DWR outer shell materials in turnout composites to simulated job exposures (i.e., weathering, thermal exposure, and laundering) that artificially aged the materials. After exposures, samples were evaluated for repellency, durability, thermal protection, and surface chemistry analysis to determine any potential performance trade-offs that may exist. Non-PFAS outer shell fabrics were found not to be diesel/oil-repellent, posing a potential flammability hazard if exposed to diesel and subsequent flame on an emergency response. Both PFAS-based and non-PFAS sets of fabrics performed similarly in terms of thermal protective performance, tearing strength, and water repellency. The surface analysis suggests that both PFAS and non-PFAS chemistries can degrade and shed from fabrics during the aging process. The study indicates that firefighters should be educated and trained regarding the potential performance trade-offs, such as oil absorption and flammability concerns when transitioning to non-PFAS outer shell materials.
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Affiliation(s)
- Nur-Us-Shafa Mazumder
- Textile Protection and Comfort Center, Wilson College of Textiles, North Carolina State University, Raleigh, NC, USA
| | - Jingtian Lu
- Textile Protection and Comfort Center, Wilson College of Textiles, North Carolina State University, Raleigh, NC, USA
| | - Andrew Stephen Hall
- Textile Protection and Comfort Center, Wilson College of Textiles, North Carolina State University, Raleigh, NC, USA
| | - Arash Kasebi
- Textile Protection and Comfort Center, Wilson College of Textiles, North Carolina State University, Raleigh, NC, USA
| | - Arjunsing Girase
- Textile Protection and Comfort Center, Wilson College of Textiles, North Carolina State University, Raleigh, NC, USA
| | - Farzaneh Masoud
- Illinois Fire Service Institute, University of Illinois at Urbana Champaign, Champaign, IL, USA
| | | | - R. Bryan Ormond
- Textile Protection and Comfort Center, Wilson College of Textiles, North Carolina State University, Raleigh, NC, USA
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16
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Marjerrison N, Grimsrud TK, Hansen J, Martinsen JI, Nordby KC, Olsen R, Veierød MB, Kjærheim K. Occupational exposures of firefighting and urinary tract cancer risk among men in the Norwegian Fire Departments Cohort. Occup Environ Med 2023; 80:659-666. [PMID: 37863650 DOI: 10.1136/oemed-2023-109003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 09/22/2023] [Indexed: 10/22/2023]
Abstract
OBJECTIVES Increased risks of bladder cancer and mesothelioma were the strongest evidence for the recent reclassification of firefighting as carcinogenic (Group 1) by the International Agency for Research on Cancer. Our study aim was to develop indicators for specific firefighting exposures and examine associations with urinary tract cancer (UTC), including bladder cancer. METHODS We developed indicators for exposure from employment at a fire department or in firefighting jobs, to fire and smoke, and to diesel exhaust for men in the Norwegian Fire Departments Cohort (n=4250). Incident UTC cases were obtained from the Cancer Registry of Norway (1960-2021). Poisson regression was used to estimate incidence rate ratios (IRR) with cumulative exposures grouped into tertiles (reference: lowest exposed tertile) with 0-year, 10-year and 15-year lagging of exposures. RESULTS During 125 090 person-years of follow-up, there were 76 cases of UTC. IRRs were mostly non-significantly increased in the middle tertile and at or below 1 in the highest tertile for total duration of employment, number of fires attended and fire exposure score with and without lags. In the middle tertile for diesel exhaust exposure, UTC risk was elevated over twofold with 10-year (IRR 2.27, 95% CI 1.22 to 4.20) and 15- year (2.21, 1.18 to 4.16) lags, and near 1 in the highest tertile. Findings for bladder cancer were similar to those for UTC. CONCLUSIONS Dose-response associations between the exposure indicators and UTC were not observed. Future studies using the indicators with more cases are needed.
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Affiliation(s)
- Niki Marjerrison
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Tom K Grimsrud
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Johnni Hansen
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | | | | | - Raymond Olsen
- National Institute of Occupational Health (STAMI), Oslo, Norway
| | - Marit B Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Killip SC, MacDermid JC, Thayalan N, Lomotan M, Gewurtz RE, Sinden KE. Exploring Canadian Career Firefighters' Understanding of the Return-to-Work Process After Musculoskeletal Injuries. J Occup Rehabil 2023:10.1007/s10926-023-10147-x. [PMID: 37938435 DOI: 10.1007/s10926-023-10147-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE Firefighters perform dangerous and physically demanding work, increasing their risk of musculoskeletal injuries that can lead to work absences. Return-to-work procedures can help firefighters return-to-work sooner and safely. The purpose of this study was to explore what firefighters understand about return-to-work procedures in their workplaces, and what firefighters believe the facilitators and barriers to return-to-work are. METHODS Thirty-eight Canadian career firefighters were recruited for semi-structured interviews. Qualitative descriptive methods were used to analyze the transcripts. Two researchers performed the inductive coding and thematic analysis. RESULTS Five themes were identified: 1. Variation in the return-to-work process knowledge among firefighters based on their experiences; 2. Accessible medical resources and treatments to support injury recovery; 3. Light duties must be meaningful and suitable; 4. Pressures to return-to-work too soon may lead to negative consequences; and 5. Heavy physical demands of firefighting may become a barrier for return-to-work. 'Factors affecting RTW depended on personal experiences and context' was the overarching theme identified, as many reported facilitators for return-to-work were also reported as barriers in different contexts. There was a variation in the experiences and understanding of return-to-work. CONCLUSION There is a lack of knowledge of the return-to-work processes. Firefighters require access to clear return-to-work policies and procedures and treatments that are targeted to firefighting duties to support recovery from injuries and regain physical abilities after an injury. Firefighters must be able to perform all essential duties before returning to firefighting work, as returning to work too soon can lead to further injury.
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Affiliation(s)
- Shannon C Killip
- School of Rehabilitation Science, McMaster University, 1400 Main Street West IAHS 403, Hamilton, ON, L8S 1C7, Canada.
| | - Joy C MacDermid
- School of Rehabilitation Science, McMaster University, 1400 Main Street West IAHS 403, Hamilton, ON, L8S 1C7, Canada
- Physical Therapy and Surgery, Western University, London, ON, Canada
- Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada
| | - Nijaanth Thayalan
- Department of Kinesiology, McMaster University, 1280 Main Street West Ivor Wynne Centre, Hamilton, ON, L8S 4K1, Canada
| | - Margaret Lomotan
- School of Rehabilitation Science, McMaster University, 1400 Main Street West IAHS 403, Hamilton, ON, L8S 1C7, Canada
| | - Rebecca E Gewurtz
- School of Rehabilitation Science, McMaster University, 1400 Main Street West IAHS 403, Hamilton, ON, L8S 1C7, Canada
| | - Kathryn E Sinden
- School of Kinesiology, Lakehead University, 955 Oliver Rd, Thunder Bay, ON, P7B 5E1, Canada
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18
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Gulliver SB, Pennington ML, Cardenas M, Lewis JE, Cammarata CM, Leto F, Ostiguy WJ, Meyer EC, Kimbrel NA. Stamp Out Stigma: a national campaign to decrease stigma and increase behavioral health in fire service. Cogn Behav Ther 2023; 52:625-640. [PMID: 37489115 DOI: 10.1080/16506073.2023.2233695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/27/2023] [Indexed: 07/26/2023]
Abstract
Firefighters are at risk for behavioral health problems; however, mental health stigma is a barrier to seeking treatment. Although effective treatments exist, many firefighters report that internal stigma prohibits presentation for effective care. This study aimed to decrease stigma about behavioral health in fire service through the development and delivery of a peer-led anti-stigma intervention campaign called Stamp Out Stigma (SOS). SOS consisted of three related phases. During Phase 1 (n = 12), we produced testimonials and piloted the videos with firefighters to determine which were most compelling. During Phase 2 (n = 23), we beta-tested our training curriculum with two departments, resulting in a significant decrease in internalized stigma but not in self-stigma. During Phase 3 (n = 73), we presented the curriculum to two cohorts of firefighters. Participation in the SOS workshop was associated with a significant decrease in firefighters' self-stigma from pre-, M = 22.7, SD = 6.3, to post-workshop, M = 20.8, SD = 5.5, t(66) = 3.2, p = 0.002. Participation in the SOS workshop was associated with a significant decrease in firefighters' internalized stigma, M = 2.0, SD = 0.5, to post-workshop, M = 1.8, SD = 0.4, t(66) = 2.8, p = 0.007. The SOS approach to stigma reduction is promising for modifying negative attitudes toward mental health and treatment seeking among professional firefighters.
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Affiliation(s)
- Suzy B Gulliver
- Baylor Scott & White Warriors Research Institute, Waco, TX, USA
- Department of Psychiatry & Behavioral Science, Texas A&M University Health Science Center, Temple, TX, USA
| | | | - Megan Cardenas
- Baylor Scott & White Warriors Research Institute, Waco, TX, USA
| | - Jordan E Lewis
- Baylor Scott & White Warriors Research Institute, Waco, TX, USA
| | - Claire M Cammarata
- New York City Fire Department Counseling Services Unit, New York, NY, USA
| | - Frank Leto
- New York City Fire Department Counseling Services Unit, New York, NY, USA
| | | | - Eric C Meyer
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nathan A Kimbrel
- Durham Veterans Affairs Medical Center, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
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Soltani E, Mirzaei Aliabadi M. Risk assessment of firefighting job using hybrid SWARA-ARAS methods in fuzzy environment. Heliyon 2023; 9:e22230. [PMID: 38053856 PMCID: PMC10694163 DOI: 10.1016/j.heliyon.2023.e22230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 11/01/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
Identification and risk assessment of hazards using classic methods have various flaws, such as ambiguity and uncertainty in the data, inability to correctly reflect the human thinking style, failure to assign weight to criteria, use of predetermined data and tables, and the evaluator's role in the results of the risk assessment process. Therefore, developing these methods and creating approaches with higher accuracy and sensitivity is necessary. This study utilized a developed method that integrated SWARA's weighting methods and ARAS prioritization using Fine-Kinney criteria in a fuzzy environment to evaluate the risks of the firefighting job. The sensitivity analysis results confirmed the accuracy and applicability of the proposed method. Based on the study's results, the inhalation of harmful gases and smoke (R3) was identified as the most critical risk, while concern about the optimal operation (R21) was considered the least dangerous risk in firefighting.
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Affiliation(s)
- Edris Soltani
- Student Research Committee, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mostafa Mirzaei Aliabadi
- Center of Excellence for Occupational Health, Occupational Health and Safety Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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20
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Beattie E, Thomas K, Ponder WN, Meyer EC, Kimbrel NA, Cammarata C, Coe E, Pennington ML, Sacco A, Nee B, Leto F, Ostiguy W, Yockey RA, Carbajal J, Schuman DL, Gulliver SB. Network analysis of posttraumatic stress disorder in a treatment-seeking sample of US firefighters and emergency medical technicians. J Affect Disord 2023; 340:686-693. [PMID: 37595896 DOI: 10.1016/j.jad.2023.08.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND First responders, including firefighters and emergency medical technicians (EMTs), are under extreme stress from repeated exposure to potentially traumatic events. To optimize treatment for this population, it is critical to understand how the various posttraumatic stress disorder (PTSD) symptom factors are associated with one another so these relations may be targeted in treatment. METHOD Using a sample of treatment-seeking firefighters/EMTs (N = 342), we conducted a partial correlation network analysis of the eight-factor model. A Bayesian directed acyclic graph (DAG) was used to estimate causal associations between clusters. RESULTS Approximately 37 % of the sample screened positive for probable PTSD. Internal re-experiencing and external re-experiencing had the strongest edges. In the DAG, internal re-experiencing was the parent node and was potentially predictive of external re-experiencing, negative affect, dysphoric arousal, and avoidance. LIMITATIONS Data were drawn from a treatment-seeking sample that may not generalize to all firefighters/EMTs. CONCLUSIONS The current findings are consistent with prior research suggesting re-experiencing plays a critical role in developing and maintaining PTSD symptoms. Future research should investigate non-treatment-seeking first responders, as well as EMTs and firefighters as individual populations.
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Affiliation(s)
- Emily Beattie
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA.
| | - Katharine Thomas
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA
| | | | - Eric C Meyer
- Department of Counseling and Behavioral Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nathan A Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Claire Cammarata
- New York City Office of Labor Relations Employee Assistance Program, USA
| | - Elizabeth Coe
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA
| | | | - Angelo Sacco
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA
| | - Brian Nee
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA
| | - Frank Leto
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA
| | - William Ostiguy
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA
| | - R Andrew Yockey
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Jose Carbajal
- Stephen F. Austin State University, Nacogdoches, TX, USA
| | | | - Suzy B Gulliver
- Trauma Research Consortium at Baylor Scott & White Health, Waco, TX, USA; Texas A&M University Health Science Center, College of Medicine, College Station, TX, USA
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Peixoto JPJ, Costa DG, Portugal P, Vasques F. A geospatial dataset of urban infrastructure for emergency response in Portugal. Data Brief 2023; 50:109593. [PMID: 37767125 PMCID: PMC10520295 DOI: 10.1016/j.dib.2023.109593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/23/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Emergency response plays a critical role in mitigating the impact of disasters and ensuring public safety. Understanding a city's capability for emergency response is vital for effective disaster management and urban planning. This paper describes a comprehensive geospatial dataset that assesses the emergency response capability of cities in Portugal based on their urban infrastructure, accounting for the number of hospitals, police stations, fire department units, and metro/railway stations. These infrastructures are essential for attending to victims, mitigating emergency situations, and performing rescue operations. Besides that, the GeoJSON definitions of all Portuguese cities are also provided in the dataset, which were used to compute the number of the target facilities based on data from OpenStreetMap. The potential applications of this dataset are numerous, ranging from urban planning and resource allocation to disaster response strategy development. Moreover, it indicates where public investments are most required, especially when combined with others continuously updated public datasets with incidents in urban areas.
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Affiliation(s)
- João Paulo Just Peixoto
- IFBA, Federal Institute of Education, Science and Technology of Bahia, Valença, Brazil
- PPGM-UEFS, State University of Feira de Santana, Feira de Santana, Brazil
| | - Daniel G. Costa
- INEGI, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Paulo Portugal
- INESC-TEC, Faculty of Engineering, University of Porto, Porto, Portugal
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22
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Lim JE, Kang H, Lee J, Kim S, Bae M, Moon HB, Choi K, Kim C, Kim KT. Urinary concentrations of organophosphate esters and associated health outcomes in Korean firefighters. Chemosphere 2023; 339:139641. [PMID: 37495049 DOI: 10.1016/j.chemosphere.2023.139641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/17/2023] [Accepted: 07/22/2023] [Indexed: 07/28/2023]
Abstract
Although firefighters are at an increased risk of occupational exposure to chemicals, such as flame retardants, research on the exposure of Korean firefighters to organophosphate esters (OPEs)-a group of emerging flame retardants-remains limited. Therefore, in the present study, OPE metabolite concentrations in the urine samples of 149 former and current Korean firefighters were measured. Based on the data obtained, the estimated daily intakes (EDIs) of OPEs were calculated. Subsequently, the association between the urinary concentrations of OPE metabolites and the potential determinants of OPE exposure and health outcomes (e.g., obesity and serum lipids) was investigated. We found that bis(1-chloro-2-propyl) phosphate (BCIPP) and bis(2-chloroethyl) phosphate (BCEP) were the most prevalent urinary OPE metabolites, with median concentrations of 2.33 and 1.80 ng/mL, respectively; these concentrations were higher than those reported previously in other countries, such as the USA and China. Moreover, their parent compounds-tris(1-chloro-2-propyl) phosphate (TCIPP) and tris(2-chloroethyl) phosphate (TCEP)-exhibited EDIs of 126 and 94.8 ng/kg bw/day, respectively. Unlike the high detection rate of bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) in other populations, its detection rate in this study was low (6.7%), suggesting regional differences in the exposure pattern of OPEs among countries. Furthermore, occupational characteristics, such as recent participation in firefighting activity, were identified as determinants of the urinary concentrations of OPE metabolites. Total OPE metabolites were inversely associated with body mass index and positively associated with high-density lipoprotein cholesterol. Overall, our findings demonstrate that Korean firefighters are highly exposed to several occupation-related OPEs. Further prospective studies will help elucidate the potential health implications of occupational exposure to OPEs among firefighters.
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Affiliation(s)
- Jae-Eun Lim
- Department of Marine Sciences and Convergent Technology, College of Science and Convergence Technology, Hanyang University, Ansan, 15588, Republic of Korea.
| | - Habyeong Kang
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea; Institute of Health Sciences, College of Health Science, Korea University, Seoul, 02841, Republic of Korea
| | - Jiwon Lee
- Department of Environmental Engineering, Seoul National University of Science and Technology, Seoul, 01811, Republic of Korea
| | - Sunmi Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea; Chemical Analysis Center, Chemical Platform Technology Division, Korea Research Institute of Chemical Technology, Daejeon, 34114, Republic of Korea
| | - Munjoo Bae
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Hyo-Bang Moon
- Department of Marine Sciences and Convergent Technology, College of Science and Convergence Technology, Hanyang University, Ansan, 15588, Republic of Korea
| | - Kyungho Choi
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Ki-Tae Kim
- Department of Environmental Engineering, Seoul National University of Science and Technology, Seoul, 01811, Republic of Korea.
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23
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Crombez-Bequet N, Schiffler F, Legrand F. Assessment of the condition of psychic health of French firefighters: Burnout. Encephale 2023:S0013-7006(23)00137-9. [PMID: 37718201 DOI: 10.1016/j.encep.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/28/2023] [Accepted: 06/08/2023] [Indexed: 09/19/2023]
Abstract
To date, there has been little research on burnout in firefighters despite the acknowledged impact of occupational stress on both individuals and society. According to a survey conducted by the French National Research and Security Institute, the annual cost to society of occupational stress in France is 2-3 billion euros. The aim of the present study was to assess the prevalence of occupational burnout in a large and representative sample of French firefighters. A nationwide survey was conducted in 2021, targeting all categories of firefighters (except for military firefighters in Paris and Marseille) both in metropolitan France and in its overseas departments and territories. This survey came in two parts: questions eliciting basic sociodemographic and job-related data, followed by the Burnout Assessment Tool which assesses the intensity of job-related burnout. We collated results for 3038 firefighters: 2418 men (79.59%), 619 women (20.38%), and 1 gender neutral (0.03%). Findings revealed that while 2455 respondents (80.8%) did not meet the criteria for burnout, 345 (11.4%) reported mild/moderate symptoms of burnout, and 238 (7.8%) could be deemed to have severe burnout symptoms. Further research is warranted into the causes of burnout and its prevention in this specific population.
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Affiliation(s)
- Natacha Crombez-Bequet
- Laboratoire cognition santé société (EA 6291), université Reims-Champagne-Ardenne, 51100 Reims, France.
| | | | - Fabien Legrand
- Laboratoire cognition santé société (EA 6291), 51100 Reims, France
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24
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Chung S, Lee HS, Jang S, Shin YW, Kim JH, Jun JY. Pandemic Grief Reaction and Intolerance of Uncertainty on the Cognitive-Behavioral Model of COVID-Related Hypochondriasis Among Firefighters. Psychiatry Investig 2023; 20:826-833. [PMID: 37794664 PMCID: PMC10555506 DOI: 10.30773/pi.2023.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/18/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE This study aimed to explore the feasibility of cognitive-behavioral model hypochondriasis regarding coronavirus disease-2019 (COVID-19) among firefighters. In addition, we examined the possible role of their grief reaction and intolerance of uncertainty in the model of COVID-related hypochondriasis. METHODS An anonymous online survey was done on October 27-28, 2022, among firefighters who witnessed people's death. Demographic characteristics were collected, and their psychological states were assessed using rating scales such as the Obsession with COVID-19 Scale (OCS), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Fear of COVID-19 Scale (FCV-19S), Pandemic Grief Scale (PGS), and Intolerance of Uncertainty Scale-12 (IUS-12). RESULTS Their OCS score was expected by the CRBS (β=0.30, p<0.001), FCV-19S (β=0.10, p<0.001), PGS (β=0.29, p<0.001), and IUS12 (β=0.04, p=0.024) (F=134.5, p<0.001). The COVID-related cognitive-behavioral model of hypochondriasis was feasible among firefighters who witnessed people's death. Their pandemic grief reaction and intolerance of uncertainty directly influenced their preoccupation with coronavirus, and viral anxiety and coronavirus reassurance-seeking behavior mediated the relationship. CONCLUSION Firefighters' viral anxiety and coronavirus reassurance-seeking behavior mediated the influence of pandemic grief reaction or intolerance of uncertainty on the preoccupation with coronavirus.
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Affiliation(s)
- Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Han-Sung Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soomin Jang
- Department of Psychiatry, SMG-SNU (Seoul National University) Boramae Medical Center, Seoul, Republic of Korea
| | - Yong-Wook Shin
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong-Hyun Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jin Yong Jun
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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25
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Blekić W, Ben Taieb S, Kandana Arachchige KG, Rossignol M, Schultebraucks K. Stress response and experiential avoidance among firefighters: Preliminary insights from network analyses. J Psychiatr Res 2023; 165:132-139. [PMID: 37499484 PMCID: PMC10546386 DOI: 10.1016/j.jpsychires.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 07/29/2023]
Abstract
Firefighters are at increased risk of developing posttraumatic stress disorder (PTSD) due to exposure to potentially traumatic events during their careers. However, little is known about the prevalence of PTSD among this population, particularly when taking moderating variables into account. Using Gaussian Graphical Models and Directed Acyclic Graphs, we conducted network analyses to examine the interactions between clusters of PTSD symptoms, perceived stress, hardiness, and experiential avoidance among 187 firefighters. The data and code are published with the paper. Experiential avoidance, as part of psychological inflexibility, was found to be the only variable that interacted with PTSD symptomatology. Strong positive associations were observed between experiential avoidance and the "negative mood and cognitions" subscale of the PTSD Checklist for DSM-5 (PCL-5). Through this association, other PTSD symptoms were activated, particularly avoidance and arousal. Our findings suggest that experiential avoidance and negative mood and cognition symptoms are particularly important in the expression of PTSD symptomatology in firefighters. In addition, experiential avoidance may be used as a coping strategy to reduce perceived stress during potentially traumatic events. Therefore, experiential avoidance may be a prime target for future interventions and training focused on flexible self-regulation strategies in this population.
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Affiliation(s)
- Wivine Blekić
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA.
| | - Souhaib Ben Taieb
- Department of Computer Science, University of Mons, Mons, Belgium; Big Data and Machine Learning Lab, University of Mons, Mons, Belgium
| | | | - Mandy Rossignol
- Department of Cognitive Psychology and Neuropsychology, University of Mons, Belgium
| | - Katharina Schultebraucks
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
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26
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Ohayon JL, Rasanayagam S, Rudel RA, Patton S, Buren H, Stefani T, Trowbridge J, Clarity C, Brody JG, Morello-Frosch R. Translating community-based participatory research into broadscale sociopolitical change: insights from a coalition of women firefighters, scientists, and environmental health advocates. Environ Health 2023; 22:60. [PMID: 37649086 PMCID: PMC10466827 DOI: 10.1186/s12940-023-01005-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/17/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND We report on community-based participatory research (CBPR) initiated by women firefighters in order to share successful elements that can be instructive for other community-engaged research. This CBPR initiative, known as the Women Worker Biomonitoring Collaborative (WWBC) is the first we are aware of to investigate links between occupational exposures and health outcomes, including breast cancer, for a cohort of exclusively women firefighters. METHODS In order to be reflective of the experiences and knowledge of those most intimately involved, this article is co-authored by leaders of the research initiative. We collected leaders' input via recorded meeting sessions, emails, and a shared online document. We also conducted interviews (N = 10) with key research participants and community leaders to include additional perspectives. RESULTS Factors contributing to the initiative's success in enacting broadscale social change and advancing scientific knowledge include (1) forming a diverse coalition of impacted community leaders, labor unions, scientists, and advocacy organizations, (2) focusing on impacts at multiple scales of action and nurturing different, yet mutually supportive, goals among partners, (3) adopting innovative communication strategies for study participants, research partners, and the broader community, (4) cultivating a prevention-based ethos in the scientific research, including taking early action to reduce community exposures based on existing evidence of harm, and (5) emphasizing co-learning through all the study stages. Furthermore, we discuss external factors that contribute to success, including funding programs that elevate scientist-community-advocacy partnerships and allow flexibility to respond to emerging science-policy opportunities, as well as institutional structures responsive to worker concerns. CONCLUSIONS While WWBC shares characteristics with other successful CBPR partnerships, it also advances approaches that increase the ability for CBPR to translate into change at multiple levels. This includes incorporating partners with particular skills and resources beyond the traditional researcher-community partnerships that are the focus of much CBPR practice and scholarly attention, and designing studies so they support community action in the initial stages of research. Moreover, we emphasize external structural factors that can be critical for CBPR success. This demonstrates the importance of critically examining and advocating for institutional factors that better support this research.
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Affiliation(s)
| | - Sharima Rasanayagam
- California Breast Cancer Research Program, University of California, Office of the President, Oakland, CA, USA
| | - Ruthann A Rudel
- Silent Spring Institute, 320 Nevada Street, Suite 302, Newton, MA, 02460, USA
| | - Sharyle Patton
- Commonweal Biomonitoring Resource Center, Bolinas, CA, USA
| | | | - Tony Stefani
- San Francisco Firefighters Cancer Prevention Foundation, San Francisco, CA, USA
| | - Jessica Trowbridge
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, Berkeley, CA, USA
| | - Cassidy Clarity
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, Berkeley, CA, USA
| | - Julia Green Brody
- Silent Spring Institute, 320 Nevada Street, Suite 302, Newton, MA, 02460, USA
| | - Rachel Morello-Frosch
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, Berkeley, CA, USA.
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27
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Martin J, Toczko M, Lockie RG. Individual responses to the implementation of mandatory fitness testing within a fire department. Occup Environ Med 2023; 80:455-461. [PMID: 37258271 DOI: 10.1136/oemed-2023-108828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/22/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To examine the effects of implementing a consequential fitness assessment (pull-ups, curl-ups, push-ups, 3 min step test) in a fire department on an individual level. METHODS We used a repeated-measures design to analyse fitness assessment data from 2019 to 2020 in Northern Virginia. A total of 631 professional firefighters completed the fitness assessment in both years. Repeated measures analysis of variances (ANOVAs) and multiple regression modelling were used to examine the effects of the fitness assessment and factors associated with changes in fitness, respectively. RESULTS Overall all aspects of fitness improved over the first year of implementation with a majority of firefighters improved on all components of the fitness assessment except for pull-ups (16.1% improved). Greater levels of baseline fitness and being female were negatively associated with changes in all fitness measures. Older firefighters had smaller changes in pull-up, curl-up and push-up performance. CONCLUSIONS During the first year of fitness assessment implementation, the fire department generally improved. The findings suggest that fire departments which enforce mandatory fitness assessments must establish policies for dealing with inadequate performance and offer resources to aid individual firefighters.
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Affiliation(s)
- Joel Martin
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Fairfax, Virginia, USA
| | - Michael Toczko
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Fairfax, Virginia, USA
| | - Robert G Lockie
- Department of Kinesiology, California State University Fullerton, Fullerton, California, USA
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28
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Park H, Oh S, Min B, Kim JI, Jeon H, Kim JH. Nonsuicidal Self-Injury and Its Mediation Effect on the Association Between Posttraumatic Stress Disorder, Depression, and Suicidal Behavior in Firefighters. Psychiatry Investig 2023:pi.2023.0006. [PMID: 37409368 PMCID: PMC10397779 DOI: 10.30773/pi.2023.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/16/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the prevalence, clinical characteristics, and the correlates of nonsuicidal self-injury (NSSI) in firefighters. We also investigated the mediating role of NSSI frequency in the association between posttraumatic stress disorder (PTSD), depression, and suicidal behavior. METHODS A total of 51,505 Korean firefighters completed a web-based self-reported survey, including demographic and occupational characteristics, NSSI, PTSD, depression, and suicidal behavior. Multivariable logistic regression analyses and serial mediation analyses were performed. RESULTS The 1-year prevalence of NSSI was 4.67% in Korean firefighters. Female gender, the presence of recent traumatic experience, and PTSD and depression symptoms were correlated with NSSI. Serial mediation analyses revealed that NSSI frequency mediated the association between PTSD, depression, and suicidal behavior; it indicates more severe PTSD was sequentially associated with more severe depression symptoms and more frequent NSSI, leading to higher risk of suicidal behavior. CONCLUSION NSSI is prevalent and may play a significant mediating role when PTSD is associated with suicidal behavior in firefighters. Our results imply the need for screening and early intervention of NSSI in firefighters.
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Affiliation(s)
- Heyeon Park
- Division of General Studies & Teaching Profession, Dongduk Women's University, Seoul, Republic of Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Beomjun Min
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Johanna Inhyang Kim
- Department of Psychiatry, Hanyang University Hospital, Seoul, Republic of Korea
| | - Hankaram Jeon
- Department of Psychiatry, Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - Jeong-Hyun Kim
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Mental Health & Behavioral Medicine Services for Clinical Departments, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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29
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Pálešová N, Maitre L, Stratakis N, Řiháčková K, Pindur A, Kohoutek J, Šenk P, Bartošková Polcrová A, Gregor P, Vrijheid M, Čupr P. Firefighters and the liver: Exposure to PFAS and PAHs in relation to liver function and serum lipids (CELSPAC-FIREexpo study). Int J Hyg Environ Health 2023; 252:114215. [PMID: 37418783 DOI: 10.1016/j.ijheh.2023.114215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/09/2023]
Abstract
INTRODUCTION Firefighting is one of the most hazardous occupations due to exposure to per- and polyfluoroalkyl substances (PFAS) and polycyclic aromatic hydrocarbons (PAHs). Such exposure is suspected to affect the cardiometabolic profile, e.g., liver function and serum lipids. However, only a few studies have investigated the impact of this specific exposure among firefighters. METHODS Men included in the CELSPAC-FIREexpo study were professional firefighters (n = 52), newly recruited firefighters in training (n = 58), and controls (n = 54). They completed exposure questionnaires and provided 1-3 samples of urine and blood during the 11-week study period to allow assessment of their exposure to PFAS (6 compounds) and PAHs (6 compounds), and to determine biomarkers of liver function (alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and total bilirubin (BIL)) and levels of serum lipids (total cholesterol (CHOL), low-density lipoprotein cholesterol (LDL) and triglycerides (TG)). The associations between biomarkers were investigated both cross-sectionally using multiple linear regression (MLR) and Bayesian weighted quantile sum (BWQS) regression and prospectively using MLR. The models were adjusted for potential confounders and false discovery rate correction was applied to account for multiplicity. RESULTS A positive association between exposure to PFAS and PAH mixture and BIL (β = 28.6%, 95% CrI = 14.6-45.7%) was observed by the BWQS model. When the study population was stratified, in professional firefighters and controls the mixture showed a positive association with CHOL (β = 29.5%, CrI = 10.3-53.6%) and LDL (β = 26.7%, CrI = 8.3-48.5%). No statistically significant associations with individual compounds were detected using MLR. CONCLUSIONS This study investigated the associations between exposure to PFAS and PAHs and biomarkers of cardiometabolic health in the Czech men, including firefighters. The results suggest that higher exposure to a mixture of these compounds is associated with an increase in BIL and the alteration of serum lipids, which can result in an unfavourable cardiometabolic profile.
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Affiliation(s)
- Nina Pálešová
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic
| | - Léa Maitre
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Nikos Stratakis
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Katarína Řiháčková
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic
| | - Aleš Pindur
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic; Faculty of Sports Studies, Masaryk University, Kamenice 753/5, 625 00, Czech Republic; Training Centre of Fire Rescue Service, Fire Rescue Service of the Czech Republic, Ministry of the Interior, Trnkova 85, 628 00, Brno, Czech Republic
| | - Jiří Kohoutek
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic
| | - Petr Šenk
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic
| | | | - Petr Gregor
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pavel Čupr
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic.
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30
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Riccardi E, Fontana L, Pacella D, Fusco F, Marinaro I, Costanzo G, Vassallo F, Triassi M, Iavicoli I. Impact of Covid-19 pandemic on psychological well-being of firefighters. Saf Health Work 2023:S2093-7911(23)00036-7. [PMID: 37361372 PMCID: PMC10268815 DOI: 10.1016/j.shaw.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/26/2023] [Accepted: 06/10/2023] [Indexed: 06/28/2023] Open
Abstract
Background Covid-19 pandemic represented a unique stressful event that affected the physical health and the psychological well-being (PWB) of individuals and communities. Monitoring PWB is essential to clarify the burden on mental health effects but also to define targeted psychological-supporting measures. This cross-sectional study evaluated the PWB of Italian firefighters during the pandemic. Methods Firefighters recruited during the pandemic period filled out a self-administered questionnaire the Psychological General Well-Being Index during the health surveillance medical examination. This tool is usually used to assess the global PWB and explores six subdomains: anxiety, depressed mood, positive well-being, self-control, general health, and vitality. The influencing role of age, gender, working activities, Covid-19 and pandemic restrictive measures was also explored. Results A total of 742 firefighters completed the survey. The aggregate median PWB global score was in the "no distress" range (94.3±10.3) resulting higher than that observed in studies conducted using the same tool in the Italian general population during the same pandemic period. Similar findings were observed in the specific subdomains thus suggesting that investigated population was in good PWB condition. Interestingly, significantly better outcomes were detected in the younger firefighters. Conclusion Our data showed a satisfactory PWB situation in firefighters that could be related to different professional factors such as work organization, mental and physical training. In particular, our results would suggest the hypothesis that in firefighters, the maintaining of a minimum/moderate level of physical activity (consisting of even just going to work) might had a profoundly positive impact on psychological health and well-being.
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Affiliation(s)
- Elisabetta Riccardi
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Luca Fontana
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Fabio Fusco
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Ilaria Marinaro
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Giovanna Costanzo
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Francesco Vassallo
- Regional Direction of Campania Firefighters, Via del Sole 10, 80138 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Ivo Iavicoli
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
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31
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Teixeira J, Sousa G, Morais S, Delerue-Matos C, Oliveira M. Assessment of coarse, fine, and ultrafine particulate matter at different microenvironments of fire stations. Chemosphere 2023:139005. [PMID: 37245598 DOI: 10.1016/j.chemosphere.2023.139005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/17/2023] [Accepted: 05/20/2023] [Indexed: 05/30/2023]
Abstract
The concentrations of respirable particulate matter (PM) and the impact on indoor air quality in occupational settings remains poorly characterized. This study assesses, for the first time, the cumulative and non-cumulative concentrations of 14 fractions of coarse (3.65-9.88 μm), fine (0.156-2.47 μm), and ultrafine (0.015-0.095 μm) PM inside the garage of heavy vehicles, firefighting personal protective equipment' storage room, bar, and a common area of seven Portuguese fire stations. Sampling campaigns were performed during a regular work week at the fire stations. Levels of daily total cumulative PM ranged from 277.4 to 413.2 μg/m3 (maximum values of 811.4 μg/m3), with the bar (370.1 μg/m3) and the PPE' storage room (361.3 μg/m3) presenting slightly increased levels (p > 0.05) than the common area (324.8 μg/m3) and the garage (339.4 μg/m3). The location of the sampling site, the proximity to local industries and commercial activities, the layout of the building, the heating system used, and indoor sources influenced the PM concentrations. Fine (193.8-301.0 μg/m3) and ultrafine (41.3-78.2 μg/m3) particles were predominant in the microenvironments of all fire stations and accounted for 71.5% and 17.8% of daily total cumulative levels, respectively; coarse particles (23.3-47.1 μg/m3) represented 10.7% of total PM. The permissible exposure limit (5.0 mg/m3) defined by the Occupational Safety and Health Organization for respirable dust was not overcome in the evaluated fire stations. Results suggest firefighters' regular exposure to fine and ultrafine PM inside fire stations which will contribute to cardiorespiratory health burden. Further studies are needed to characterize firefighters' exposure to fine and ultrafine PM inside fire stations, identify main emission sources, and evaluate the contribution of exposures at fire stations to firefighters' occupational health risks.
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Affiliation(s)
- Joana Teixeira
- REQUIMTE/LAQV, Instituto Superior de Engenharia Do Porto, Instituto Politécnico Do Porto, R. Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal
| | - Gabriel Sousa
- REQUIMTE/LAQV, Instituto Superior de Engenharia Do Porto, Instituto Politécnico Do Porto, R. Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal
| | - Simone Morais
- REQUIMTE/LAQV, Instituto Superior de Engenharia Do Porto, Instituto Politécnico Do Porto, R. Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal
| | - Cristina Delerue-Matos
- REQUIMTE/LAQV, Instituto Superior de Engenharia Do Porto, Instituto Politécnico Do Porto, R. Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal
| | - Marta Oliveira
- REQUIMTE/LAQV, Instituto Superior de Engenharia Do Porto, Instituto Politécnico Do Porto, R. Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal.
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Tochihara Y, Lee JY, Son SY, Bakri I. Heat strain of Japanese firefighters wearing personal protective equipment: a review for developing a test method. Ergonomics 2023; 66:676-689. [PMID: 35959644 DOI: 10.1080/00140139.2022.2113150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
The aim of this review was to develop a test method for the evaluation of heat strain for structural firefighters wearing personal protective equipment (PPE) in Japan. We analysed a series of our laboratory's questionnaires and experimental studies and reviewed international standards on test methods. We investigated the actual average working conditions (total firefighting time on one incidence, working time with full PPE, maximum temperature and humidity during firefighting) at structural firefighting site in Japan by conducting a large-scale questionnaire survey of Japanese firefighters. We discussed test subjects (firefighters vs. non-firefighters; body size; physical fitness), exercise intensity (absolutes vs. relative; light vs. heavy) and duration, experimental temperature and relative humidity, experimental clothing items including station uniforms (shorts vs. long), and measurement variables (physiological and subjective responses), and suggested a standard test method to evaluate the heat strain of firefighters in hot and humid environments.Practitioner summary: We reviewed studies on human wear trials of firefighting personal protective equipment (PPE) in hot environments and suggested a standard test method to evaluate the heat strain of firefighters. The test method can be internationally utilised to examine the comfort functions and heat stress of PPE in hot, humid environments.
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Affiliation(s)
- Yutaka Tochihara
- Department of Human Science, Faculty of Design, Kyushu University, Fukuoka, Japan
| | - Joo-Young Lee
- Department of Textiles, Merchandising and Fashion Design College of Human Ecology, Seoul National University, Seoul, Korea
- Graphene Research Center for Convergence Technology, Advanced Institute of Convergence Technology, Suwon, Korea
| | - Su-Young Son
- Department of Home Economics Education Teachers College, Kyungpook National University, Daegu, Korea
| | - Ilham Bakri
- Industrial Engineering Department, Hasanuddin University, Makassar, Indonesia
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Řiháčková K, Pindur A, Komprdová K, Pálešová N, Kohoutek J, Šenk P, Navrátilová J, Andrýsková L, Šebejová L, Hůlek R, Ismael M, Čupr P. The exposure of Czech firefighters to perfluoroalkyl substances and polycyclic aromatic hydrocarbons: CELSPAC - FIREexpo case-control human biomonitoring study. Sci Total Environ 2023; 881:163298. [PMID: 37054786 DOI: 10.1016/j.scitotenv.2023.163298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/13/2023] [Accepted: 04/01/2023] [Indexed: 04/15/2023]
Abstract
The CELSPAC - FIREexpo biomonitoring study investigates the long-term effects of chemical exposure on firefighters' wellness and fitness. It aims to provide science-based measures to minimize the health risks of the firefighting occupation. Here, we present the study design, cohort profile, and first results with respect to internal per- and polyfluoroalkyl substances (PFAS) and polycyclic aromatic hydrocarbons (PAH) levels in study participants. Participants (n = 166) were divided into three subcohorts: i) newly recruited firefighters, ii) professional firefighters with several years' experience, and iii) the control group. Participants underwent physical performance tests, provided information on their lifestyle and diet, and urine and blood samples 1-4 times within an 11-week period. 12 serum PFAS and 10 urinary hydroxylated PAH (OH-PAH) levels were determined using HPLC-MS/MS and compared between subcohorts and samplings. The association of internal exposure with reported lifestyles and occupational factors was investigated using Spearman's correlation, principal component analysis, and multivariate regression analysis. ΣPFAS levels in firefighters were significantly higher than in the control group and were mostly associated with the length of firefighting career, age, blood donation, and population size. 10.9 % and 7.6 % of measurements exceeded the HBM-I or HBM-II value for PFOS and PFOA, respectively. Urinary ΣPAH levels increased significantly after training with burning wooden pallets, but none of them exceeded the no observed genotoxic effect level. Firefighters' occupational exposure, its sources, and pathways, need to be systematically monitored and investigated on a long-term and individual basis. The CELSPAC - FIREexpo study helps to clarify the degree of occupational exposure to the given compounds and the subsequent risks to firefighters.
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Affiliation(s)
- Katarína Řiháčková
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
| | - Aleš Pindur
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; Faculty of Sports Studies, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; Training Center of Fire Rescue Service, General Directorate of Fire Rescue Service of the Czech Republic, Ministry of the Interior of the Czech Republic, Trnkova 85, 628 00 Brno, Czech Republic.
| | - Klára Komprdová
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
| | - Nina Pálešová
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
| | - Jiří Kohoutek
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
| | - Petr Šenk
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
| | - Jana Navrátilová
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
| | - Lenka Andrýsková
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
| | - Ludmila Šebejová
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
| | - Richard Hůlek
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
| | - Mazen Ismael
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
| | - Pavel Čupr
- RECETOX, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic.
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Huang RS, Chen YC, Tsai SY, Huang YE, Guo YL. Incomplete off-duty work hours and sleep quality among firefighters: a cross-sectional study, Taiwan. Int Arch Occup Environ Health 2023; 96:247-57. [PMID: 36063231 DOI: 10.1007/s00420-022-01918-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/24/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE We examined whether firefighters in Taiwan have a sleep problem and investigated the related factors of poor sleep quality. METHODS In this cross-sectional study, 2123 male shift firefighters in the Greater Taipei area were invited, and 37.7% of them satisfactorily completed the questionnaire online. The Chinese version of Pittsburgh sleep quality index (PSQI) was used to evaluate sleep quality. Multiple logistic and linear regression analyses were used to determine the associations among demographic characteristics, work-related characteristics, and poor sleep quality. RESULTS As revealed by 801 valid questionnaires, 77.2% were poor sleepers (PSQI cutoff score > 6), and 61.2% reported incomplete off-duty in the past month. Moreover, 42.6% of incomplete off-duty workers reported extended overtime of more than 5 h on off-duty days in the past month. Poor sleep quality was associated with the following factors: (1) demographic characteristics: age, working tenure, having children, and chronotype and (2) work-related characteristics: shift schedule and incomplete off-duty. The final model for poor sleep quality as per PSQI included age, chronotype, shift schedule, and incomplete off-duty hours in the past month. Longer hours of incomplete off-duty work were associated with increased risks of overall poor sleep quality and of poor subjective sleep quality, long sleep latency, sleep disturbances, and daytime dysfunction. CONCLUSION Firefighters are advised to have a complete off-duty day to avoid poor sleep quality, long sleep latency, short sleep duration, sleep disturbances, and daytime dysfunction. Our results confirm the need for implementing appropriate shift schedules to ensure adequate rest time for firefighters.
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Rosenfeld PE, Spaeth KR, Remy LL, Byers V, Muerth SA, Hallman RC, Summers-Evans J, Barker S. Perfluoroalkyl substances exposure in firefighters: Sources and implications. Environ Res 2023; 220:115164. [PMID: 36584840 DOI: 10.1016/j.envres.2022.115164] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
Firefighters are at risk of occupational exposure to long-chain per- and poly-fluoroalkyl substances (PFASs), most notably from PFASs present in Class B aqueous film-forming foam (AFFF). Firefighters have been found to have elevated serum levels of long-chain PFASs. Due to the persistence of PFAS chemicals in the human body and their ability to bioaccumulate, firefighters experience the latent and cumulative effects of PFAS-containing AFFF exposure that occurs throughout their careers. This article summarizes the history of AFFF use by firefighters and current AFFF use practices. In addition, this paper describes PFAS levels in firefighter serum, PFAS serum removal pathways, PFAS exposure pathways, and occupational factors affecting PFAS levels in firefighters. International, national, and state agencies have concluded that PFOA, a long-chain PFAS, is potentially carcinogenic and that carcinogens have an additive effect. From the cancer types that may be associated with PFAS exposure, studies on cancer risk among firefighters have shown an elevated risk for thyroid, kidney, bladder, testicular, prostate, and colon cancer. Thus, exposure to PFAS-containing AFFF may contribute to firefighter cancer risk and warrants further research.
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Affiliation(s)
- Paul E Rosenfeld
- Soil Water Air Protection Enterprise (SWAPE), 2656 29th Street, Suite 201, Santa Monica, CA, 90405, USA.
| | - Kenneth R Spaeth
- Division of Occupational and Environmental Medicine, Zucker School of Medicine at Hofstra/Northwell, NY, USA.
| | - Linda L Remy
- Family Health Outcomes Project, Family and Community Medicine, School of Medicine, University of California San Francisco, 500 Parnassus Ave. Room MU-337, San Francisco, CA, 94143-0900, USA.
| | - Vera Byers
- Immunology Inc. PO Box 4703, Incline Village, NV, 89450, USA.
| | - Stuart A Muerth
- Soil Water Air Protection Enterprise (SWAPE), 2656 29th Street, Suite 201, Santa Monica, CA, 90405, USA.
| | - Ryan C Hallman
- Soil Water Air Protection Enterprise (SWAPE), 2656 29th Street, Suite 201, Santa Monica, CA, 90405, USA.
| | - Jasmine Summers-Evans
- University of California, Los Angeles, Institute of the Environment and Sustainability. LaKretz Hall, 619 Charles E Young Dr E #300, Los Angeles, CA, 90024, USA.
| | - Sofia Barker
- Soil Water Air Protection Enterprise (SWAPE), 2656 29th Street, Suite 201, Santa Monica, CA, 90405, USA.
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Cuenca-Lozano MF, Ramírez-García CO. Occupational Hazards in Firefighting: Systematic Literature Review. Saf Health Work 2023; 14:1-9. [PMID: 36941942 PMCID: PMC10024222 DOI: 10.1016/j.shaw.2023.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/19/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Background Firefighting involves exposure of firefighters to risks related to this activity, serious injuries, and occupational diseases are recorded. There are other consequences such as thermal and emotional stress. This systematic review is proposed in order to analyze the risks and consequences faced by these workers and thus provide elements to improve safety management systems in institutions. Method A descriptive observational study of systematic literature review on the risks and consequences of exposure to firefighters' activity was proposed, and the information was analyzed and described based on the available data and according to the variables determined. Results The studies showed data on mechanical, physical, chemical, psychosocial risks, workers' perception and resilience, and epidemiological data. Information related to firefighters' activity on falls and slips, exposure to noise, and high concentrations of carbon monoxide is detailed. In addition, the relationship between burnout, cognitive, and physical fatigue as adverse effects on health and performance is mentioned. Conclusions Among the preventive measures, the use of personal protective equipment is suggested, incorporation in prevention programs of information on exposure to risk factors, as well as the implementation of models that can predict the perception of workers, additionally, the generation of management systems with safety climate models for fire departments.
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Jung AM, Beitel SC, Gutenkunst SL, Billheimer D, Jahnke SA, Littau SR, White M, Hoppe-Jones C, Cherrington NJ, Burgess JL. Excretion of polybrominated diphenyl ethers and AhR activation in breastmilk among firefighters. Toxicol Sci 2023; 192:kfad017. [PMID: 36856729 PMCID: PMC10109531 DOI: 10.1093/toxsci/kfad017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Excretion of toxicants accumulated from firefighter exposures through breastmilk represents a potential hazard. We investigated if firefighting exposures could increase the concentration of polybrominated diphenyl ethers (PBDEs) and aryl hydrocarbon receptor (AhR) activation in excreted breastmilk. Firefighters and non-firefighters collected breastmilk samples prior to any firefighting responses (baseline) and at 2, 8, 24, 48, and 72 hours after a structural fire (firefighters only). Five PBDE analytes (BDEs 15, 28, 47, 99, and 153) detected in at least 90% of samples were summed for analyses. The AhR in vitro DR CALUX® bioassay assessed the mixture of dioxin-like compounds and toxicity from breastmilk extracts. Baseline PBDEs and AhR response were compared between firefighters and non-firefighters. Separate linear mixed models assessed changes in sum of PBDEs and AhR response among firefighters over time and effect modification by interior or exterior response was assessed. Baseline PBDE concentrations and AhR responses did not differ between the 21 firefighters and 10 non-firefighters. There were no significant changes in sum of PBDEs or AhR response among firefighters over time post-fire, and no variation by interior or exterior response. Plots of sum of PBDEs and AhR response over time demonstrated individual variation but no consistent pattern. Currently, our novel study results do not support forgoing breastfeeding after a fire exposure. However, given study limitations and the potential hazard of accumulated toxicants from firefighter exposures excreted via breastfeeding, future studies should consider additional contaminants and measures of toxicity by which firefighting may impact maternal and child health.
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Affiliation(s)
- Alesia M Jung
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
| | - Shawn C Beitel
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
| | - Shannon L Gutenkunst
- Statistics Consulting Lab, BIO5 Institute, University of Arizona, Tucson, Arizona 85721, USA
- Southwest Environmental Health Sciences Center, University of Arizona, Tucson, Arizona 85721, USA
| | - Dean Billheimer
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
- Statistics Consulting Lab, BIO5 Institute, University of Arizona, Tucson, Arizona 85721, USA
- Southwest Environmental Health Sciences Center, University of Arizona, Tucson, Arizona 85721, USA
| | - Sara A Jahnke
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, Leawood, Kansas 66224, USA
| | - Sally R Littau
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
| | - Mandie White
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
| | | | - Nathan J Cherrington
- Southwest Environmental Health Sciences Center, University of Arizona, Tucson, Arizona 85721, USA
- Department of Pharmacology and Toxicology, R. Ken Coit College of Pharmacy, University of Arizona, Tucson, Arizona 85721, USA
| | - Jefferey L Burgess
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
- Southwest Environmental Health Sciences Center, University of Arizona, Tucson, Arizona 85721, USA
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Goldfarb DG, Prezant DJ, Zeig-Owens R, Schwartz T, Liu Y, Kavouras IG. Development of a job-exposure matrix (JEM) for exposure to smoke particle mass among firefighters of the Fire Department of the City of New York (FDNY). Occup Environ Med 2023; 80:104-110. [PMID: 36635097 DOI: 10.1136/oemed-2022-108549] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/15/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVES A refined job exposure matrix (JEM) based on incident types and severities and response characteristics was developed for firefighters to estimate quantities of smoke particles emitted during structural and non-structural fire incidents from 2010 to 2021. METHODS The cohort included a subset of 3237 Fire Department of the City of New York firefighters who responded to at least one incident between 2010 and 2021, prior to retirement. Fire incident data included dates, type, severity (alarm level) and location. Response data included dates worked, firehouse, position titles and shift lengths for each firefighter. The quantity of smoke particle mass generated during structural and non-structural fires adjusted by individual firefighter engagement was computed using the United States Environmental Protection Agency AP-42 emissions framework. Correlations between years of employment, fire responses and career total particle mass concentration by firefighter were examined. Linear regression models were fit and corresponding R2 values were calculated. RESULTS Firefighters responded to a median of 424.7 (IQR=202.3-620.0) annual incidents/person; 17.6% were fire incidents (median=77.1; IQR=40.4-114.0). Structural fires were the most common type of fire incident (72.5% of annual incidents/person; median=55.9; IQR=29.6-85.5). Incident severity (alarm level) and firefighter engagement (position title) appeared to differentiate between high and low exposure regimes (R2=0.43). Incident severity explained most of the variability of particle exposures (R2=0.90). CONCLUSIONS Using the JEM, job-related smoke particle concentrations were estimated to vary by incident type, incident severity and firefighter engagement, highlighting the importance of using refined measures, so that future studies can more accurately evaluate associations between firefighting and health outcomes.
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Affiliation(s)
- David G Goldfarb
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA .,Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA.,Department of Medicine, Montefiore Medical Center, Brooklyn, New York, USA
| | - David J Prezant
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Rachel Zeig-Owens
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA.,Department of Medicine, Montefiore Medical Center, Brooklyn, New York, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Theresa Schwartz
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA.,Department of Medicine, Montefiore Medical Center, Brooklyn, New York, USA
| | - Yang Liu
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Ilias G Kavouras
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
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Jung AM, Jahnke SA, Dennis LK, Bell ML, Burgess JL, Farland LV. Firefighter occupational factors and the risk of preterm birth: results from a survey of women firefighters in the USA. Occup Environ Med 2023; 80:77-85. [PMID: 36564180 PMCID: PMC9887375 DOI: 10.1136/oemed-2022-108332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/17/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Previous research has suggested that women firefighters may have a greater risk of adverse reproductive outcomes compared with non-firefighting women. In this study, we investigated the association between firefighter occupational factors and risk of preterm birth. METHODS This cross-sectional analysis of US firefighters surveyed in 2017 compared preterm birth among firefighters to non-firefighters using age-at-pregnancy-standardised prevalence ratios. Generalised estimating equations estimated relative risks and 95% CIs between firefighter occupational factors (career or volunteer, wildland status, shift schedule, fire responses, work restriction) and preterm birth risk. We adjusted for age-at-pregnancy, education, gravidity, BMI, and smoking and considered effect modification by age-at-pregnancy and career versus volunteer status. RESULTS Among 934 women who reported 1356 live births, 12% were preterm (n=161). Preterm birth prevalence among firefighters was 1.41 times greater than non-firefighters (95% CI 1.18 to 1.68). Among wildland and combination wildland/structural firefighters, volunteers had 2.82 times the risk of preterm birth (95% CI 1.19 to 6.67) compared with career firefighters. Firefighters who started restricting their work in the 2nd trimester had a nonsignificant 0.67 times lower risk of preterm birth than those who started in the 3rd trimester or did not restrict work at all (95% CI 0.43 to 1.03). CONCLUSIONS Firefighters may have greater risk of preterm birth than non-firefighters, which could be influenced by roles in the fire service and work restrictions taken.
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Affiliation(s)
- Alesia M Jung
- Department of Epidemiology and Biostatistics, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA .,Department of Community, Environment and Policy, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Sara A Jahnke
- Center for Fire Rescue and EMS Health Research, NDRI-USA, Inc, Leawood, Kansas, USA
| | - Leslie K Dennis
- Department of Epidemiology and Biostatistics, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Melanie L Bell
- Department of Epidemiology and Biostatistics, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Jefferey L Burgess
- Department of Community, Environment and Policy, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Leslie V Farland
- Department of Epidemiology and Biostatistics, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA,Department of Obstetrics and Gynecology, The University of Arizona College of Medicine Tucson, Tucson, Arizona, USA
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Khoshakhlagh AH, Al Sulaie S, Yazdanirad S, Orr RM, Dehdarirad H, Milajerdi A. Global prevalence and associated factors of sleep disorders and poor sleep quality among firefighters: A systematic review and meta-analysis. Heliyon 2023; 9:e13250. [PMID: 36798763 PMCID: PMC9925976 DOI: 10.1016/j.heliyon.2023.e13250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/13/2023] [Accepted: 01/24/2023] [Indexed: 01/30/2023] Open
Abstract
Lack of sleep can affect the health and performance of firefighters. This systematic review and meta-analysis estimated the global prevalence of sleep disorders and poor sleep quality among firefighters and reported associated factors. Four academic databases (Scopus, PubMed, Web of Science, and Embase) were systematically searched from January 1, 2000 to January 24, 2022. These databases were selected as they are known to index studies in this field. The search algorithm included two groups of keywords and all possible combinations of these words. The first group included keywords related to sleep and the second group keywords related to the firefighting profession. The relevant Joanna Briggs Institute checklist was used to evaluate study quality. Data from eligible studies were included in a meta-analysis. In total, 47 articles informed this review. The pooled prevalence of sleep disorders and poor sleep quality in firefighters were determined as 30.49% (95% CI [25.90, 35.06]) and 51.43% (95% CI [42.76, 60.10]), respectively. The results of a subgroup analysis showed that individuals in low- and middle-income countries (LMICs) had a higher prevalence of sleep disorders than those in high-income countries (HICs) but HICs had a higher prevalence of poor sleep quality than LMICs. Various factors, including shift work, mental health, injuries and pain, and body mass index were associated with sleep health. The findings of this review highlight the need for sleep health promotion programs in firefighters.
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Affiliation(s)
- Amir Hossein Khoshakhlagh
- Department of Occupational Health, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Saleh Al Sulaie
- Department of Industrial Engineering, College of Engineering in Al-Qunfudah, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Saeid Yazdanirad
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran,School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran,Corresponding author. Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Robin Marc Orr
- Tactical Research Unit, Bond University, Gold Coast, Australia
| | - Hossein Dehdarirad
- Medical Library & Information Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Milajerdi
- Research Center of Biochemistry and Nutrition in Metabolic Diseases, Institude for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
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Jasani GN, Cavaliere GA, Tian L, Liang SY, Lawner BJ. Terrorist Attacks Against Firefighters, 1970-2019. Health Secur 2023; 21:141-145. [PMID: 36629863 DOI: 10.1089/hs.2022.0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Firefighters are a critical component of the emergency response system and therefore a potential target for organizations seeking to disrupt this system. Terrorist organizations may deliberately attack firefighters to both increase the devastation of an attack and impair the affected community's ability to respond to an attack. We performed a focused search of the Global Terrorism Database to identify terrorist attacks against firefighters worldwide. The database includes incidents from 1970 through 2019, with a total of 201,183 entries. These entries were searched for incidents involving firefighters or fire trucks. We analyzed trends in the number of incidents occurring per year, regions of the world impacted, methods employed, and number of casualties inflicted. A total of 42 attacks involving firefighters were identified in the Global Terrorism Database resulting in 26 deaths and 95 wounded. Of the 42 attacks, 12 (28.6%) were secondary attacks, where firefighters responding to an initial attack were themselves targeted. The most common method for both primary and secondary attacks was the use of a bomb or explosive. Although attacks against firefighters are uncommon, they highlight both the strategic value and vulnerability of firefighters to terrorist attacks. Increased efforts must be made to protect firefighters from future terrorist attacks.
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Affiliation(s)
- Gregory N Jasani
- Gregory N. Jasani, MD, is an Assistant Professor; Department of Emergency Medicine, University of Maryland School of Medicine, and Medical Director, Maryland ExpressCare Critical Care Transport Program; both in Baltimore, MD
| | - Garrett A Cavaliere
- Garrett A. Cavaliere, DO, NRP, is an Emergency Medicine Physician, Emergency Department, Robert Wood Johnson Barnabas Health, and an Emergency Medical Services Fellow, Department of Emergency Medicine, Rutgers New Jersey School of Medicine; both in Newark, NJ
| | - LinLin Tian
- LinLin Tian, PhD, is a Staff Scientist, Department of Neurology; Division of Infectious Diseases and Division of Emergency Medicine; both at Washington University School of Medicine, St. Louis, MO
| | - Stephen Y Liang
- Stephen Y. Liang, MD, MPHS, is an Associate Professor, Division of Infectious Diseases and Division of Emergency Medicine; both at Washington University School of Medicine, St. Louis, MO
| | - Benjamin J Lawner
- Benjamin J. Lawner, DO, EMT-P, is an Assistant Professor, Department of Emergency Medicine, University of Maryland School of Medicine, and Medical Director, Maryland ExpressCare Critical Care Transport Program; both in Baltimore, MD
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Engelsman M, Toms LML, Wang X, Banks APW. Firefighter undergarments: Assessing contamination and laundering efficacy. Environ Res 2023; 216:114344. [PMID: 36115416 DOI: 10.1016/j.envres.2022.114344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/06/2022] [Accepted: 09/11/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Michelle Engelsman
- QAEHS, Queensland Alliance for Environmental Health Sciences, The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland, 4102, Australia; Fire & Rescue NSW, 1 Amarina Avenue, Greenacre, NSW, 2194, Australia.
| | - Leisa-Maree L Toms
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Australia
| | - Xianyu Wang
- QAEHS, Queensland Alliance for Environmental Health Sciences, The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland, 4102, Australia; Minderoo Centre - Plastics and Human Health, The University of Queensland, Woolloongabba, QLD, 4102, Australia
| | - Andrew P W Banks
- QAEHS, Queensland Alliance for Environmental Health Sciences, The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland, 4102, Australia
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Li Y, Han Q, Chen S, Cui G, Bai K, Cui L. Assessment of firefighter-training effectiveness in China based on human-factor parameters and machine learning. Technol Health Care 2023; 31:2165-2192. [PMID: 37302054 DOI: 10.3233/thc-230071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The emergency rescue ability of firefighters is particularly important in the event of major disasters or accidents. Therefore, an assessment of the firefighter-training effectiveness is necessary. OBJECTIVE This paper aims to achieve a scientific and effective assessment of the firefighter-training effectiveness in China. An assessment method based on human factor parameters and machine learning was proposed. METHOD The model is constructed by collecting the corresponding human factor parameters such as electrocardiographic signals, electroencephalographic signals, surface electromyographic signals, and photoplethysmographic signals through wireless sensors and using them as constraint indicators. For the problems of weak human factor parameters and high noise proportion, an improved flexible analytic wavelet transform algorithm is used to denoise and extract the corresponding feature values. To overcome the limitations of traditional assessment methods, improved machine learning algorithms are used to comprehensively assess the training effectiveness of firefighters and provide targeted training suggestions. RESULTS The effectiveness of this study's evaluation method is verified by comparing it with the expert scoring method and considering firefighters from a special fire station in Xhongmen, Daxing District, Beijing, as an example. CONCLUSION This study can effectively guide the scientific training of firefighters and the method is more objective and accurate than the traditional method.
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Affiliation(s)
- Yang Li
- School of Safety Engineering, Beijing Institute of Petrochemical Technology, Beijing, China
- Beijing Academy of Safety Engineering and Technology, Beijing, China
| | - Qinglin Han
- School of Safety Engineering, Beijing Institute of Petrochemical Technology, Beijing, China
| | - Simeng Chen
- School of Safety Engineering, Beijing Institute of Petrochemical Technology, Beijing, China
| | - Gaozhi Cui
- School of Safety Engineering, Beijing Institute of Petrochemical Technology, Beijing, China
| | - Ke Bai
- School of Safety Engineering, Beijing Institute of Petrochemical Technology, Beijing, China
| | - Linqi Cui
- School of Safety Engineering, Beijing Institute of Petrochemical Technology, Beijing, China
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Holtkamp C, Schöler L, Anastasiou OE, Brune B, Fessmann K, Elsner C, Möhlendick B, Čiučiulkaitė I, Dudda M, Trilling M, Dittmer U, Spors J, Le-Trilling VTK. Antibody responses elicited by mRNA vaccination in firefighters persist six months and correlate inversely with age and directly with BMI. Heliyon 2023; 9:e12746. [PMID: 36597483 PMCID: PMC9801692 DOI: 10.1016/j.heliyon.2022.e12746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 08/18/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
Knowledge regarding the sustainability of immune responses after COVID-19 vaccination is important, e.g., to decide whom and when to booster. Thus, we analyzed antibody titers in firefighters six months after vaccination with the mRNA-based vaccine Comirnaty. SARS-CoV-2 spike-binding antibodies (bAb) were quantified and compared to peak responses determined in healthcare workers (HCW). For the firefighters, neutralizing antibodies (nAb) were also analyzed. Six months after the second vaccine dose, all analyzed firefighters had detectable bAb, and 91% exhibited nAb titers above 1:16. However, actual titers six months after vaccination were over 12-fold lower than in the HCW control group four weeks after vaccination. bAb and nAb responses showed a significant correlation, and age correlated inversely with antibody responses. Unexpectedly, participants with a body mass index over 25 had higher neutralization titers after six months. All participants with very low neutralization titers were offered booster vaccination. The booster vaccination improved the extent and sustainability of antibody responses.
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Affiliation(s)
- Caroline Holtkamp
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lara Schöler
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Olympia E. Anastasiou
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Bastian Brune
- Emergency Medical Services, Fire Brigade Essen, Essen, Germany,Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Kai Fessmann
- Emergency Medical Services, Fire Brigade Essen, Essen, Germany,Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Carina Elsner
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Birte Möhlendick
- Institute of Pharmacogenetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ieva Čiučiulkaitė
- Institute of Pharmacogenetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Marcel Dudda
- Emergency Medical Services, Fire Brigade Essen, Essen, Germany,Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mirko Trilling
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jörg Spors
- Emergency Medical Services, Fire Brigade Essen, Essen, Germany
| | - Vu Thuy Khanh Le-Trilling
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany,Corresponding author. University Hospital Essen, University of Duisburg-Essen, Institute for Virology, Virchowstr. 179, 45147 Essen, Germany
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45
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Li Y, Li N, Zhang L, Liu Y, Zhang T, Li D, Bai D, Liu X, Li L. Predicting PTSD symptoms in firefighters using a fear-potentiated startle paradigm and machine learning. J Affect Disord 2022; 319:294-299. [PMID: 36162659 DOI: 10.1016/j.jad.2022.09.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/19/2022] [Accepted: 09/20/2022] [Indexed: 10/14/2022]
Abstract
This study develops a fear-potentiated startle paradigm (FPS) and a machine learning approach to accurately predict PTSD symptoms using electrogram data. A three-phase fear-potentiated startle paradigm was designed to assess the conditioning, generalization, and extinction of fear. Electrooculogram and electrocardiogram signals were collected during the FPS. A total of 1107 Chinese firefighters participated in the study. The Chinese version PCL-C was administered to all subjects. A cutoff of 38 or higher is used to indicate PTSD symptoms. Electrogram features were extracted and selected to build a machine learning model to classify individuals. The machine learning model was 5-fold cross validated. The importance of the selected features was calculated. Classification performance metrics were evaluated for the machine learning model. The machine learning model can identify firefighters with a PCL-C score of 38 or above with sensitivity and specificity both above 0.85 when 5-fold cross validated on a 1107-person sample. The area under the receiver operating characteristic curve of the model is 0.93. Features related to fear generalization are found to be the most important. The proposed fear-potentiated startle paradigm and machine learning approach can accurately predict PTSD symptoms in Chinese firefighters, which can improve the screening and diagnosis of PTSD.
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Affiliation(s)
- Yuanhui Li
- Adai Technology (Beijing) Co., Ltd., Beijing, China
| | - Nan Li
- Department of Industrial Engineering, Tsinghua University, Beijing, China
| | - Liqun Zhang
- Adai Technology (Beijing) Co., Ltd., Beijing, China
| | - Yanru Liu
- Adai Technology (Beijing) Co., Ltd., Beijing, China
| | | | - Dai Li
- Adai Technology (Beijing) Co., Ltd., Beijing, China
| | | | - Xiang Liu
- Department of Industrial Engineering, Tsinghua University, Beijing, China.
| | - Lingjiang Li
- Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, China.
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46
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Russell A, Jenkins JL, Zhang A, Wilson LM, Bass EB, Hsu EB. A review of infectious disease epidemiology in emergency medical service clinicians. Am J Infect Control 2022:S0196-6553(22)00846-X. [PMID: 36509183 DOI: 10.1016/j.ajic.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/02/2022] [Accepted: 12/03/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND The emergency medical service (EMS) workforce is at high risk of occupationally-acquired infections. This review synthesized existing literature on the prevalence, incidence, and severity of infections in the EMS workforce. METHODS We searched PubMed, Embase, CINAHL, and SCOPUS from January 1, 2006 to March 15, 2022 for studies in the US that involved EMS clinician or firefighter populations and reported 1 or more health outcomes related to occupationally-acquired infections. RESULTS Of the 25 studies that met the inclusion criteria, most focused on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with prevalence rates ranging from 1.1% to 36.2% (median 6.7%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in 4 studies ranged from 1.9% to 6.4%, and the prevalence of Hepatitis C in 1 study was 1.3%. Few studies reported incidence rates. The prevalence or incidence of these infections generally did not differ by age or gender, but 4 studies reported differences by race or ethnicity. In the 4 studies that compared infection rates between EMS clinicians and firefighters, EMS clinicians had a higher chance of hospitalization or death from SAR-CoV-2 (odds ratio 4.23), a higher prevalence of Hepatitis C in another study (odds ratio 1.74), and no significant difference in MRSA colonization in a separate study. CONCLUSIONS More research is needed to better characterize the incidence and severity of occupationally-acquired infections in the EMS workforce.
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Affiliation(s)
- Anna Russell
- Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - J Lee Jenkins
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Allen Zhang
- Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Lisa M Wilson
- Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
| | - Eric B Bass
- Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Edbert B Hsu
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
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Michinov E. The Moderating Role of Emotional Intelligence on the Relationship Between Conflict Management Styles and Burnout among Firefighters. Saf Health Work 2022; 13:448-55. [PMID: 36579009 DOI: 10.1016/j.shaw.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 12/31/2022] Open
Abstract
Background While the organizational factors that account for firefighters' burnout have been extensively explored, the individual factors related to how they regulate interpersonal conflicts and emotions remain to be investigated. Previous research has demonstrated the association between emotional intelligence and conflict management styles and burnout, but no study has looked at the interrelationships among these factors in high-risk sectors. The present exploratory study aimed to fill this research gap by investigating the relationships between conflict management style, emotional intelligence and burnout in a sample of firefighters. Methods A cross-sectional study was conducted with 240 French firefighters. Measures comprised validated scales of conflict management styles, emotional intelligence and burnout. Results Results showed that the integrating conflict style reduced burnout. They also revealed the effects of emotion regulation on burnout, whereby the awareness and management of one's own emotions reduced burnout. Moreover, awareness of one's own emotions moderated the relationship between integrating conflict resolution style and burnout, whereby the effect of integrating style on reduced burnout was higher when awareness of one's own emotions was high. Conclusion These results reveal that strategies used by firefighters to regulate their emotions in order to meet the emotional demands specific to their job are important for reducing the emotional exhaustion component of burnout. Training programs for conflict and emotion management are needed to preserve the mental health of firefighters and ensure the safety of interventions.
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48
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Kim JA, Song SY, Jeong W, Jun JK. Non-cancer health risks in firefighters: a systematic review. Epidemiol Health 2022; 44:e2022109. [PMID: 36397239 PMCID: PMC10396521 DOI: 10.4178/epih.e2022109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/16/2022] [Indexed: 08/04/2023] Open
Abstract
osFirefighters are occupationally exposed to hazardous factors that may increase their risk of disease. However, non-cancer disease risk in firefighters has not been systematically examined. This systematic review aimed to identify non-cancer disease risk in firefighters and determine whether the risk differs according to job characteristics. We searched the Cochrane Library, Embase, PubMed, and KoreaMed databases using relevant keywords from their inception to April 30, 2021. The Risk of Bias Assessment Tool for Non-randomized Studies version 2.0 was used to assess the quality of evidence. Due to study heterogeneity, a narrative synthesis was presented. The systematic literature search yielded 2,491 studies, of which 66 met the selection and quality criteria. We confirmed that the healthy worker effect is strong in firefighters as compared to the general population. We also identified a significant increase in the incidence of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder (PTSD) in firefighters compared to other occupational groups. Contradictory results for the risk of PTSD and anxiety disorders related to rank were reported. Sufficient evidence for increased risk of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and PTSD was available. The risk of non-cancer diseases varied depending on job type, years of service, and rank. However, caution should be exercised when interpreting the results because the classification criteria for firefighters' jobs and ranks differ by country.
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Affiliation(s)
- Jeong Ah Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Soo Yeon Song
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Wonjeong Jeong
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
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49
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Jeon YE, Kim MJ, Chung I, Ha JC. The effect of blood cadmium levels on hypertension in male firefighters in a metropolitan city. Ann Occup Environ Med 2022; 34:e37. [PMID: 36544887 DOI: 10.35371/aoem.2022.34.e37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/23/2022] [Accepted: 10/08/2022] [Indexed: 11/11/2022] Open
Abstract
Background This study investigated the effect of dispatch frequency on blood cadmium levels and the effect of blood cadmium levels on hypertension in male firefighters in a metropolitan city. Methods We conducted a retrospective longitudinal study of male firefighters who completed the regular health checkups, including a health examination survey and blood cadmium measurements. We followed them for 3 years. To investigate the effect of dispatch frequency on blood cadmium levels and the effect of blood cadmium levels on hypertension, we estimated the short-term (model 1) and long-term (model 2) effects of exposure and hypothesized a reversed causal pathway model (model 3) for sensitivity analysis. Sequential conditional mean models were fitted using generalized estimating equations, and the odds ratios (ORs) and the respective 95% confidence intervals (CIs) were calculated for hypertension for log-transformed (base 2) blood cadmium levels and quartiles. Results Using the lowest category of dispatch frequency as a reference, we observed that the highest category showed an increase in blood cadmium levels of 1.879 (95% CI: 0.673, 3.086) μg/dL and 0.708 (95% CI: 0.023, 1.394) μg/dL in models 2 and 3, respectively. In addition, we observed that doubling the blood cadmium level significantly increased the odds of hypertension in model 1 (OR: 1.772; 95% CI: 1.046, 3.003) and model 3 (OR: 4.288; 95% CI: 1.110, 16.554). Using the lowest quartile of blood cadmium levels as a reference, the highest quartile showed increased odds of hypertension in model 1 (OR: 2.968; 95% CI: 1.121, 7.861) and model 3 (OR: 33.468; 95% CI: 1.881, 595.500). Conclusions We found that dispatch frequency may affect blood cadmium levels in male firefighters, and high blood cadmium levels may influence hypertension in a dose-response manner.
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Oh HJ, Sim CS, Jang TW, Ahn YS, Jeong KS. Association between sleep quality and type of shift work in Korean firefighters. Ann Occup Environ Med 2022; 34:e27. [PMID: 36452253 DOI: 10.35371/aoem.2022.34.e27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/16/2022] [Accepted: 09/16/2022] [Indexed: 11/07/2022] Open
Abstract
Background Shift work that interferes with normal sleep patterns, is known to be a cause of sleep disturbance and has been studied through various occupational groups. However, it is not known which shift type is better for sleep health. Methods This study included 568 firefighters. Sleep quality was evaluated using Pittsburgh Sleep Quality Index. Sleep quality was categorized into 2 groups; good quality (≤ 5 points) and poor quality (≥ 6 points). Demographic variables, depression, anxiety, type of shift, and job were collected by self-reported questionnaires. The χ2 test, t-test, and multiple logistic regression analysis were used to evaluate the effect of shift type on the sleep quality of firefighters. Results Three hundred thirty-seven firefighters (59.3%) have poor sleep quality. Compared to day workers, the odds ratios (ORs) of poor sleep quality were 2.169 (95% confidence interval: 1.137-4.134) in 6-day cycle, 2.161 (1.150-4.062) in 9-day cycle, 1.805 (1.087-2.997) in 21-day cycle, and 1.485 (0.718-3.069) in 3-day cycle. The ORs of poor sleep quality were 1.697(1.021-2.823) in fire suppression and 2.325 (1.213-4.455) in emergency medical service compared to administration. Conclusions All shift work type except for the 3-day cycle was associated with poor sleep quality compared to day work.
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