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Kaufman CC, McHugh RK, Drury M, Merrill JG, Rosmarin DH. Spirituality/Religion Among First Responders With and Without Posttraumatic Stress Disorder and Alcohol Misuse. J Dual Diagn 2024:1-12. [PMID: 38560884 DOI: 10.1080/15504263.2024.2330619] [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] [Indexed: 04/04/2024]
Abstract
Objective: To examine the co-occurrence of alcohol misuse and posttraumatic stress disorder (PTSD) and potential sources of coping (e.g., spirituality/religion) and clinically relevant variables among first responders (e.g., firefighters, law enforcement corrections officers, paramedics). Method: We assessed rates of independent and co-occurring alcohol misuse and PTSD among a national online sample of 320 first responders as well as the prevalence and salience of S/R, guilt, shame, moral injury, aspects of S/R, and treatment interest. Results: In our sample, 46.88% (n = 150) met criteria for comorbid alcohol misuse and probable PTSD and individuals with these comorbid conditions reported significantly greater negative religious coping, moral injury, and shame than all other diagnostic groups (i.e., independent alcohol misuse, independent PTSD, and neither). Correlations also revealed significant relationships between alcohol misuse and PTSD symptomatology with positive and negative religious coping, moral injury, shame, guilt, interest in treatment, and interest in spiritually integrated treatment. Conclusions: Findings highlight the high rates of independent and co-occurring alcohol misuse and PTSD among first responders as well as the salience of S/R in this population.
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Affiliation(s)
- Caroline C Kaufman
- Department of Psychiatry, Harvard Medical School, Belmont, Massachusetts, USA
- Spirituality and Mental Health Program, McLean Hospital, Belmont, Massachusetts, USA
| | - R Kathryn McHugh
- Department of Psychiatry, Harvard Medical School, Belmont, Massachusetts, USA
- McLean Hospital Stress, Anxiety, and Substance Use Laboratory, Belmont, Massachusetts, USA
| | - Mia Drury
- Spirituality and Mental Health Program, McLean Hospital, Belmont, Massachusetts, USA
| | - Julia G Merrill
- Department of Geriatrics, McLean Hospital, Belmont, Massachusetts, USA
| | - David H Rosmarin
- Department of Psychiatry, Harvard Medical School, Belmont, Massachusetts, USA
- Spirituality and Mental Health Program, McLean Hospital, Belmont, Massachusetts, USA
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Kaufman CC, Rosmarin DH. Spiritually Integrated Group Psychotherapy for First Responders: Forgiveness, Trauma, and Alcohol Use. Int J Group Psychother 2024; 74:217-243. [PMID: 38502106 PMCID: PMC11062829 DOI: 10.1080/00207284.2024.2322500] [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] [Indexed: 03/20/2024]
Abstract
First responders (e.g. firefighters, law enforcement, paramedics, corrections officers) experience high rates of comorbid posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Despite the relevance of both spirituality and forgiveness to PTSD and AUD among first responders, spiritually integrated group interventions for this population are rare. This article discusses a forgiveness session of a spiritually integrated group psychotherapy protocol for first responders (SPIRIT-FR) in acute psychiatric care. This brief group psychotherapy intervention includes (a) psychoeducation about the intersection of PTSD, AUD, and forgiveness (b) discussion of the relevance of forgiveness to PTSD and AUD, and (c) the integration of spiritual beliefs and behaviors to move toward forgiveness. We discuss relevant clinical theory as well as the potential clinical application of this protocol.
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Affiliation(s)
- Caroline. C. Kaufman
- Spirituality and Mental Health Program, McLean Hospital
- Department of Psychiatry, Harvard Medical School
| | - David H. Rosmarin
- Spirituality and Mental Health Program, McLean Hospital
- Department of Psychiatry, Harvard Medical School
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3
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Zhang X, Tian M, Li J. Investigating the influencing factors and prediction models of skin burns for firefighters' occupational safety. Int J Occup Saf Ergon 2024:1-14. [PMID: 38516740 DOI: 10.1080/10803548.2024.2327869] [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: 03/23/2024]
Abstract
Relevant studies in the fields of fire safety, occupational health and firefighter clothing were analyzed in this study to address the high injury rate among firefighters during fire rescue and the complexity of factors affecting skin burns. The findings indicate that the degree of skin burns in firefighters is primarily influenced by the heat source (heat flux, type), firefighter clothing (fabric, pattern) and the under-clothing air gap (thickness, characteristics). Since skin burns cannot be directly measured, internal skin heat transfer and burn prediction models are commonly employed to assess the impact of external factors on skin burns. These models can predict the safe working distance or time for firefighters. Investigating the influencing factors and prediction models of skin burns among firefighters holds significant value in enhancing operating procedures, optimizing firefighter clothing design and effectively preventing skin burns.
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Affiliation(s)
- Xinyu Zhang
- College of Fashion and Design, Donghua University, People's Republic of China
| | - Miao Tian
- College of Fashion and Design, Donghua University, People's Republic of China
- Protective Clothing Research Center, Donghua University, People's Republic of China
- Key Laboratory of Clothing Design and Technology, Donghua University, People's Republic of China
| | - Jun Li
- College of Fashion and Design, Donghua University, People's Republic of China
- Protective Clothing Research Center, Donghua University, People's Republic of China
- Key Laboratory of Clothing Design and Technology, Donghua University, People's Republic of China
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4
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Dzikowicz DJ, Saoji SB, Tam WC, Brunner WM, Carey MG. The Effect of Mandatory Fitness Requirements on Cardiovascular Events: A State-by-State Analysis Using a National Database. Workplace Health Saf 2024; 72:101-107. [PMID: 38217417 DOI: 10.1177/21650799231221575] [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: 01/15/2024]
Abstract
BACKGROUND Cardiovascular events are known to be the leading cause of death among on-duty firefighters. Implementing fitness standards may help reduce the incidence of cardiovascular deaths; however, standards vary between firefighter type and states. We aimed to investigate the rate of cardiovascular events among firefighters across states. METHODS Using publicly available data from the United States Fire Administration, we explored the rates of cardiovascular deaths between firefighter type (e.g., career, volunteer, and wildland) and state. Specifically, we examined rates of cardiovascular deaths between California and Tennessee, which have fitness standards for all firefighters, and New York, which does not have fitness standards for volunteer firefighters. We used descriptive statistics and trend analysis to examine the data. FINDINGS Most cardiovascular events occur among volunteer firefighters (60.6%, n = 877). Volunteer firefighters had 7.5 (95% CI = [4.8, 11.7], p < .001) greater odds of cardiovascular events compared to wildland firefighters, who had the lowest incidence of cardiovascular events (1.7%, n = 24). New York reported the most cardiovascular events (n = 161), primarily among volunteer firefighters (73.9%, n = 119). After the passage of legislation mandating fitness standards in California, a downtrend in the number of volunteer firefighter fatalities is observed. However, a null effect was observed in Tennessee after the passage of similar fitness standards as in California. CONCLUSIONS/APPLICATIONS TO PRACTICE Volunteer firefighters are significantly more likely to die of a cardiovascular event than career and wildland firefighters, both of which have stricter fitness standards. However, the effect of legislation mandating stricter fitness standards among volunteers did not produce a clear benefit for preventing fatalities. Nurses need to promote cardiovascular health among volunteer firefighters.
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Affiliation(s)
- Dillon J Dzikowicz
- School of Nursing, University of Rochester
- University of Rochester Medical Center
- Clinical Cardiovascular Research Center
| | | | - Wai Cheong Tam
- Fire Research Division, National Institute of Standards and Technology
| | | | - Mary G Carey
- School of Nursing, University of Rochester
- University of Rochester Medical Center
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5
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Jo J, Park H. Fit of fire boots: exploring internal morphology using computed tomography. Int J Occup Saf Ergon 2024; 30:90-99. [PMID: 37596795 DOI: 10.1080/10803548.2023.2247765] [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: 08/20/2023]
Abstract
Fit of fire boots is a crucial factor in the safety and performance of firefighters on the hostile fireground. Firefighters have reported that ill-fitting fire boots restrict their lower body movement and sometimes cause very dangerous situations by falling off behind the wearer. By using computed tomography, this study demonstrates the potential to quantify and visualize the fit of fire boots, which previously relied on subjective feedback from the wearers. The high-resolution three-dimensional (3D) models of two fire boot products allowed a detailed observation and measurement of the internal space of the boots. Also, the boot's internal dimension was compared to the foot measurement of local firefighters, showing the significant differences between the two boots. Lastly, simulation wrapping the 3D scanned foot with the boot revealed large void spaces around the toe box and ankle, as well as the narrower ball width of the boot than the foot.
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Affiliation(s)
- Jeyeon Jo
- Department of Human Centered Design, Cornell University, USA
- Department of Textiles, Merchandising and Interiors, University of Georgia, USA
| | - Huiju Park
- Department of Human Centered Design, Cornell University, USA
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6
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Karnick A, Caulfield NM, Buerke M, Stanley I, Capron D, Vujanovic A. Clinical and psychological implications of post-traumatic stress in firefighters: a moderated network study. Cogn Behav Ther 2024; 53:171-189. [PMID: 37960947 DOI: 10.1080/16506073.2023.2282374] [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: 05/26/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023]
Abstract
Firefighters are frequently exposed to trauma and may experience a unique symptom presentation of post-traumatic stress. Prior research has identified stronger associations between certain post-traumatic stress symptoms (e.g. detachment, intrusions, physiological reactivity) using network analysis. However, little is known about the effects of symptom severity and emergency work-related trauma on symptom networks. The present study probed the network structure of post-traumatic stress symptoms in trauma-exposed firefighters (N = 871) to model the dynamic interactions of psychological symptoms. We developed a network of post-traumatic stress symptoms and a network of post-traumatic stress with clinical covariates and used moderated network modelling to assess the effects of having PTSD and experiencing work-related trauma on the networks. We identified high edge correlations between several nodes (e.g. startle/hypervigilance, internal/external cue avoidance, detachment/lack of interest) and high centrality of detachment, external cue avoidance, and flashbacks. Additionally, having PTSD moderated positive network associations between risk-taking and suicidality and between distorted blame and post-traumatic cognitions. Work-related trauma moderated negative associations between appetite gain and loss and appetite loss and suicidality. Findings suggest that targeting specific symptoms of detachment, external cue avoidance, and flashbacks could allow for the development of effective trauma-informed interventions for these populations.
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Affiliation(s)
- Aleksandr Karnick
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | | | | | - Ian Stanley
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Center for COMBAT Research, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Daniel Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Anka Vujanovic
- Department of Psychology, University of Houston, Houston, TX, USA
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7
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Lanham SN, Nagel TR, Rochani H, Melton BF, Cleveland RE. Strengthening First Responders' Coaching Proficiency through a Peer Fitness Leader Workshop: A Preliminary Efficacy Trial. Int J Exerc Sci 2024; 17:298-307. [PMID: 38665685 PMCID: PMC11042847] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
First responders require physical fitness to perform dangerous tasks in unpredictable environments. To promote physical fitness among first responders, many agencies use a peer fitness leader (PFL) approach; however, resources for the fitness, wellness, and health of PFLs are often minimal. This study's purpose was to investigate the effectiveness of a training workshop to increase PFL's training knowledge and coaching comfort (CC). Thirty-six PFLs (Experience: 14.6 ± 9.1 yrs; Age: 41.0 ± 9.8 yrs; BMI: 28.9 ± 7.0 kg·m-2) attended a one-day workshop. Paired samples t-tests assessed for differences between baseline and post-assessment knowledge scores. Pearson correlations described the bivariate relationship between baseline and post-assessment knowledge scores. Wilcoxon's Signed Rank Test determined associations between baseline and post-workshop CC variables. Spearman's Rho correlations described bivariate relationships between baseline and post-assessment values for each CC category. Kendall's Rank correlations investigated relationships between knowledge scores and total perceived CC for pre- and post-workshops. Statistical significance was set at p < 0.05. Results indicated an improvement from the baseline knowledge score (6.08 ± 1.46 points) and post-workshop knowledge score (7.03 ± 0.94 points); (t (25) = 3.85; p < 0.001). Similar trends were observed for all CC measures (Z > -3.42; p < 0.001). Differences were not observed between pre-workshop total CC and knowledge scores (τ = -0.03; p = 0.81) or following workshop completion (τ = -0.04; p = 0.76). Participants demonstrated varying exercise knowledge and CC, highlighting inconsistencies in exercise standards within first responder occupations. This investigation suggests the proposed pedagogy design may be a solution for agencies with limited budgets.
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Affiliation(s)
- Sarah N Lanham
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, Georgia
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY
| | - Thomas R Nagel
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, Georgia
| | - Haresh Rochani
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Georgia Southern University, Statesboro, GA
| | - Bridget F Melton
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, Georgia
| | - Richard E Cleveland
- Department of Counselor Education, Georgia Southern University, Statesboro, GA
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8
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ODare K, Dillard D, King E, Dilks J, Herzog J, Rotunda R, Close F, Hartman M. The 2nd Alarm Project: Bridging Social Work and Public Health to Improve Mental Wellness in the Fire Service. Soc Work Public Health 2024; 39:93-104. [PMID: 38367222 DOI: 10.1080/19371918.2024.2318382] [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] [Indexed: 02/19/2024]
Abstract
Firefighters are trained to respond to a wide range of emergencies, and over the course of responding to emergencies, are exposed to a variety of potentially traumatic events. Repeated exposure to traumatic events may adversely impact firefighters' mental health. Combined with stigma surrounding help-seeking, lack of systematic resources and referral programs, and other barriers to care, firefighters do not routinely receive a continuum of trauma informed, assessment and treatment services from trained professionals. The purpose of this paper is to describe an evidence-informed approach to a reciprocal, collaborative model among social work and public health practice, policy, and research; and to offer a framework for researchers, clinicians, and policy advocates to more effectively achieve goals of preventing and treating trauma exposure in firefighters. This paper provides a comprehensive literature review, as well as describes a case study of a successful public health intervention for mitigating exposure to trauma among a population of firefighters. The significant contribution of mental health issues to the burden of disease among our firefighters is a matter of considerable public health concern. Effective approaches to mitigating behavioral health needs must bridge both mental health disciplines and public health to minimally, include access to evidence-based assessment and treatment, peer support capacity building, widely available mental health education, and leadership development to promote culture change. When considering a model for services with firefighters, reciprocal collaboration among researchers, health care professionals, first responder organizations, families, and other relevant community stakeholders is essential for success.
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Affiliation(s)
- Kellie ODare
- Institute of Public Health, Florida A & M University, Tallahassee, FL, USA
| | - Dana Dillard
- Social Work Program, Mississippi State University, Starkville, MS, USA
| | - Erin King
- Department of Social Work, University of West Florida, Pensacola, FL, USA
| | - John Dilks
- Department of Social Work, University of West Florida, Pensacola, FL, USA
| | - Joseph Herzog
- Department of Social Work, University of West Florida, Pensacola, FL, USA
| | - Robert Rotunda
- Department of Psychology, University of West Florida, Pensacola, FL, USA
| | - Fran Close
- Institute of Public Health, Florida A & M University, Tallahassee, FL, USA
| | - Megan Hartman
- Department of Social Work, University of West Florida, Pensacola, FL, USA
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9
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Wilkinson MS, Guy JH, Obst SJ. Isokinetic Shoulder Strength and its Associations to Injury in Tactical Populations: A Critical Review. Int J Exerc Sci 2024; 17:235-251. [PMID: 38665688 PMCID: PMC11042902] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
The aim of this review is to evaluate existing isokinetic testing protocols for the shoulder in tactical occupations, document their shoulder strength profiles, and determine any associations to shoulder injury. Four electronic databases were searched (Medline/Pubmed, Ovid/Emcare, CINAHL/Ebsco and Embase) using the keywords police OR law enforcement, firefighter, military, AND isokinetic. Articles were eligible if they had at least one cohort of a tactical population and included isokinetic testing of the glenohumeral joint. The search yielded 275 articles. After screening for duplicates and inclusion criteria, 19 articles remained for review, six of which assessed injury correlation. 17 articles evaluated military personnel and two examined firefighters. Articles were categorized by study design, population, isokinetic protocols, strength outcome measures and statistical measures. Concentric internal rotation (IR) and external rotation (ER) strength at 60 degrees/second were reported most frequently (84% of cases). There was a paucity of testing speeds, repetition ranges and contraction types evaluated when compared to existing literature in other populations with high shoulder injury occurrence such as overhead and collision athletes. Outside of military cohorts, there is limited data available to characterise the isokinetic strength profile of the shoulder in tactical occupations. Meta-analysis for injury association was unable to be performed due to independent variable and statistical heterogeneity. However, a best evidence synthesis suggested conflicting evidence to support the association of injury with isokinetic strength testing in tactical populations. Future studies should prioritise prospective designs utilising variable speeds, repetition schemes and contraction types to better capture the dynamic occupational demands in tactical groups.
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Affiliation(s)
- Michael S Wilkinson
- School of Health, Medical, and Applied Sciences, Central Queensland University, Cairns, QLD, AUSTRALIA
| | - Joshua H Guy
- School of Health, Medical, and Applied Sciences, Central Queensland University, Cairns, QLD, AUSTRALIA
| | - Steven J Obst
- School of Health, Medical, and Applied Sciences, Central Queensland University, Bundaberg, QLD, AUSTRALIA
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10
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Eastman AQ, Rous B, Langford EL, Tatro AL, Heebner NR, Gribble PA, Lanphere R, Abel MG. Etiology of Exercise Injuries in Firefighters: A Healthcare Practitioners' Perspective. Healthcare (Basel) 2023; 11:2989. [PMID: 37998481 PMCID: PMC10671663 DOI: 10.3390/healthcare11222989] [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] [Received: 10/29/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
The purpose of this study was to query healthcare practitioners (HCPs) who treat firefighter injuries to identify risk factors and mechanisms associated with musculoskeletal injuries during exercise. A phenomenological design was utilized to understand the experiences of HCPs while treating firefighters' musculoskeletal injuries due to exercise. Semi-structured interviews were conducted with 14 HCPs. Two interviews were pilot-tested with HCPs to ensure reliability and validity. Interviews were transcribed and uploaded to a qualitative analysis software program. Although the study inquired about injuries incurred by any exercise modality (e.g., endurance and resistance training), injuries induced during resistance training were prominent among HCPs as resistance training emerged as a primary exercise injury mechanism. HCPs indicated that the back and shoulder were prevalent anatomical exercise injury locations. Risk factors for exercise injuries included age, immobility, movement proficiency, and factors associated with fatigue. Exercise injury mechanisms included poor resistance training technique and overexertion. These findings could guide exercise program design, use of movement assessments, and the identification of other countermeasures to decrease the risk of resistance training exercise injuries among firefighters.
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Affiliation(s)
- Alyssa Q. Eastman
- First Responder Research Laboratory, University of Kentucky, Lexington, KY 40506, USA
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA;
- Department of Clinical Genomics Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Beth Rous
- Department of Educational Leadership Studies, University of Kentucky, Lexington, KY 40508, USA;
| | - Emily L. Langford
- First Responder Research Laboratory, University of Kentucky, Lexington, KY 40506, USA
- Department of Health and Human Sciences, University of Montevallo, Montevallo, AL 35115, USA
| | - Anne Louise Tatro
- First Responder Research Laboratory, University of Kentucky, Lexington, KY 40506, USA
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA;
| | - Nicholas R. Heebner
- Sports Medicine Research Institute, University of Kentucky, Lexington, KY 40536, USA
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY 40536, USA
| | - Phillip A. Gribble
- Sports Medicine Research Institute, University of Kentucky, Lexington, KY 40536, USA
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY 40536, USA
| | - Rosie Lanphere
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA;
| | - Mark G. Abel
- First Responder Research Laboratory, University of Kentucky, Lexington, KY 40506, USA
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA;
- Sports Medicine Research Institute, University of Kentucky, Lexington, KY 40536, USA
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11
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Jahnke SA, Watson P, Leto F, Jitnarin N, Kaipust CM, Hollerbach BS, Haddock CK, Poston WSC, Gist R. Evaluation of the Implementation of the NFFF Stress First Aid Intervention in Career Fire Departments: A Cluster Randomized Controlled Trial. Int J Environ Res Public Health 2023; 20:7067. [PMID: 37998298 PMCID: PMC10671183 DOI: 10.3390/ijerph20227067] [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: 09/20/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/25/2023]
Abstract
Firefighting is inherently dangerous, though recently concerns have shifted from traditional fireground injuries (burns and asphyxiation) to a focus on mental and behavioral health. Although firefighters are remarkably resilient, research suggests many suffer negative psychological consequences from repeated exposures to trauma. While the Stress First Aid (SFA) model has gained increased attention and adoption among fire departments as a model for behavioral health training, it has not been formally evaluated. This cluster randomized controlled trial used a crossover design comparing the immediate SFA group to delayed SFA control to test the impact of the SFA on firefighters' mental and behavioral health changes after 10-12 months (n = 400; Mage = 37.6, 4.8% women). A convenience sample of 79 firefighters (Mage = 41.4; 8.7% women) provided evaluations on one or more of the training modules. Participants reported satisfaction with all training components (Peer team training 97.6%, Online SFA 94.9%, Curbside Manner 88.4%, After Action Review 89.4%) and reported success in changing personnel's perception of their department's ability to respond to behavioral health issues (SFA M = 3.93, Control 3.50; t = 2.52, p = 0.042). Future work should focus on additional resources and training to augment existing efforts to help departments continue their efforts.
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Affiliation(s)
- Sara A. Jahnke
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA; (S.A.J.); (N.J.); (C.M.K.); (C.K.H.); (W.S.C.P.)
| | - Patricia Watson
- National Center for PTSD, White River Junction, VT 05009, USA;
| | - Frank Leto
- FDNY, Counseling Services Unit, Fort Totten, NY 10314, USA;
| | - Nattinee Jitnarin
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA; (S.A.J.); (N.J.); (C.M.K.); (C.K.H.); (W.S.C.P.)
| | - Christopher M. Kaipust
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA; (S.A.J.); (N.J.); (C.M.K.); (C.K.H.); (W.S.C.P.)
| | - Brittany S. Hollerbach
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA; (S.A.J.); (N.J.); (C.M.K.); (C.K.H.); (W.S.C.P.)
| | - Christopher K. Haddock
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA; (S.A.J.); (N.J.); (C.M.K.); (C.K.H.); (W.S.C.P.)
| | - W. S. Carlos Poston
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA; (S.A.J.); (N.J.); (C.M.K.); (C.K.H.); (W.S.C.P.)
| | - Richard Gist
- KCMO Fire Department, Kansas City, MO 64106, USA;
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12
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Fernandez AR, Treichel A, Myers JB, Bourn SS, Crowe RP, Gardner B. Evaluating Firefighter On-Scene Decontamination Practices Using a National Fire Records Management System. J Occup Environ Med 2023; 65:931-936. [PMID: 37550953 PMCID: PMC10662600 DOI: 10.1097/jom.0000000000002927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
OBJECTIVE This study describes firefighters' on-scene decontamination procedure use post-working fire and frequency of adherence to best practice. METHODS This retrospective analysis of working fires was conducted using records from the ESO Data Collaborative (Austin, TX) national research database from January 1, 2021, to December 31, 2021. Documentation of decontamination procedures was examined among records with smoke or combustion products exposure. Firefighter and incident characteristics were evaluated. Descriptive statistics and univariable odds ratios were calculated. RESULTS Among the 31,281 firefighters included in the study, 8.0% documented a fire-related exposure. Of those, 82% performed at least one on-scene decontamination procedure; 5% documented all decontamination procedures defined as best practices. The odds of documenting any decontamination procedure were significantly decreased among firefighters responding to incidents in rural areas compared with urban areas (odds ratio, 0.70). CONCLUSIONS Fire personnel may not be taking all necessary decontamination steps post-working fires.
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13
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Kuehl K, Elliot D, DeFrancesco C, McGinnis W, Ek S, Garg B. A Web-Based Total Worker Health Intervention for Those Fighting Wildland Fires: Mixed Methods Development and Effectiveness Trial. J Med Internet Res 2023; 25:e47050. [PMID: 37878362 PMCID: PMC10632911 DOI: 10.2196/47050] [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: 03/09/2023] [Revised: 04/24/2023] [Accepted: 08/30/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Fire seasons are longer, with more and larger wildfires, placing increased demands and risks on those fighting wildland fires. There are multiple agencies involved with fighting wildland fires and unique worksite conditions make meeting these workers' needs a challenge. OBJECTIVE The aim of the study is to develop and establish the effectiveness of a web-based safety and health program for those fighting wildland fires. METHODS This mixed methods project had 3 phases. The initial qualitative phase assessed the needs of 150 diverse firefighters through interviews and focus groups across 11 US sites to establish and prioritize program content. Interview transcripts were read for thematic content with iterative readings used to identify, code, and rank health and safety issues. The second phase used that information to build a comprehensive Total Worker Health program for those fighting wildfires. The program content was based on the qualitative interview data and consisted of 6 core and 8 elective 30-minute, web-based modules primarily done individually on a smartphone or computer. The final, third phase evaluated the program with a quantitative prospective proof-of-concept, usability, and effectiveness trial among wildland firefighter participants. Effectiveness was assessed with paired 2-tailed t tests for pre- and post-Likert agreement scale survey items, adjusted for multiple comparisons. In addition to assessing mean and SD at baseline and postsurvey, observed effect sizes were calculated (Cohen d). Usability and reaction to the program among firefighters who responded to postsurvey were also assessed. RESULTS The qualitative themes and subthemes were used to inform the program's content. For the effectiveness trial, 131 firefighters completed the presurvey, and 50 (38.2%) completed the postsurvey. The majority of the participants were White (n=123, 93.9%), male (n=117, 89.3%), with an average age of 41 (SD 12.9) years. Significant increases in knowledge and desired health and safety behaviors were found for both cancer (P<.001) and cardiovascular risk (P=.01), nutrition behaviors (P=.01), hydration or overheating (P=.001), binge drinking (P=.002), and getting medical checkups (P=.001). More than 80% (n=40) of postsurvey respondents agreed or strongly agreed that the program was easy to use and would recommend it to others. CONCLUSIONS An innovative web-based safety and health promotion program for those fighting wildland fires was feasible, scalable, and usable. It improved the health and safety of those fighting wildland fires. TRIAL REGISTRATION ClinicalTrials.gov NCT05753358; https://classic.clinicaltrials.gov/ct2/show/NCT05753358.
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Affiliation(s)
- Kerry Kuehl
- Oregon Health & Science University, Portland, OR, United States
| | - Diane Elliot
- Oregon Health & Science University, Portland, OR, United States
| | | | - Wendy McGinnis
- Oregon Health & Science University, Portland, OR, United States
| | - Susanna Ek
- Oregon Health & Science University, Portland, OR, United States
| | - Bharti Garg
- Oregon Health & Science University, Portland, OR, United States
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14
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Noël-Peyronnet J. [The advantages of the fire department nurse in managing a CBRN event]. Soins 2023; 68:41-44. [PMID: 37778854 DOI: 10.1016/j.soin.2023.08.010] [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] [Indexed: 10/03/2023]
Abstract
Nuclear, radiological, biological and chemical hazards are caused by agents of very different origins. They can be blatant or insidious, difficult to detect, accidental or intentional. In all cases, in addition to treating victims, the aim is to avoid contamination of hospital services. Faced with these risks, which are often seen as unlikely or too complex, the firefighter nurse represents an asset for his or her establishment, in terms of both crisis anticipation and management.
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Affiliation(s)
- Jérôme Noël-Peyronnet
- Service départemental d'incendie et de secours de Seine-et-Marne (Sdis 77), 56 avenue de Corbeil, 77000 Melun, France.
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15
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Pendergrast C, Boyle T, Crockett AJ, Eston R, Johnston KN. Perceptions of lung function surveillance in urban firefighters. Ann Work Expo Health 2023; 67:926-937. [PMID: 37499229 PMCID: PMC10516620 DOI: 10.1093/annweh/wxad040] [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: 12/08/2022] [Accepted: 06/27/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Workplace health and safety (WHS) is an important responsibility falling on both employers and employees and is most effective when the perspectives of all stakeholders are considered. This study aimed to explore the facilitators and barriers to a voluntary workplace lung function surveillance program from the perspective of urban firefighters and describe their perceptions of its value. METHODS Using a qualitative, descriptive methodology, firefighters who had participated in a longitudinal lung function surveillance study were invited to participate in semi-structured interviews. Purposeful, maximum variation sampling was used to achieve diversity in those firefighters invited to participate. We used inductive content analysis to identify themes. RESULTS Interviews with 15 firefighters identified 3 main themes: (i) practical experience of surveillance (administration, communication, workplace culture change, convenience, acceptability, and appeal); (ii) value of surveillance (lung health efficacy and control, social support, workplace management support/motivations, contribution to global firefighter health); and (iii) contribution of surveillance to health (occupational risk, relevance in the context of total health, workability, and fitness and future value). CONCLUSION Practical and psychosocial facilitators and barriers to providing lung function surveillance in the fire service were identified. In addition to the personal benefits of detecting adverse lung health and allowing for medical intervention, factors known to positively influence firefighter workplace wellbeing, such as providing peace of mind, feedback on good work practices, motivation to utilize control measures, management commitment to health, and providing data to assist with global knowledge were valued aspects of longitudinal lung function surveillance.
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Affiliation(s)
- Catherine Pendergrast
- Innovation, Implementation and Clinical Translation in Health (IIMPACT) Research Concentration, University of South Australia, Corner of North Terrace and Frome Road, Adelaide, South Australia, 5001, Australia
| | - Terry Boyle
- Australian Centre for Precision Health, Allied Health and Human Performance, University of South Australia, Corner of North Terrace and Frome Road, Adelaide, South Australia, 5001, Australia
| | - Alan J Crockett
- Allied Health and Human Performance, University of South Australia, Corner of North Terrace and Frome Road, Adelaide, South Australia, 5001, Australia
| | - Roger Eston
- Alliance for Research in Exercise, Nutrition and Performance (ARENA), University of South Australia, Corner of North Terrace and Frome Road, Adelaide, South Australia, 5001, Australia
| | - Kylie N Johnston
- Innovation, Implementation and Clinical Translation in Health (IIMPACT) Research Concentration, University of South Australia, Corner of North Terrace and Frome Road, Adelaide, South Australia, 5001, Australia
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16
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Navarro KM, Fent K, Mayer AC, Brueck SE, Toennis C, Law B, Meadows J, Sammons D, Brown S. Characterization of inhalation exposures at a wildfire incident during the Wildland Firefighter Exposure and Health Effects (WFFEHE) Study. Ann Work Expo Health 2023; 67:1011-1017. [PMID: 37597244 PMCID: PMC10616911 DOI: 10.1093/annweh/wxad046] [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: 12/14/2022] [Accepted: 07/26/2023] [Indexed: 08/21/2023] Open
Abstract
Wildland firefighters (WFFs) are exposed to many inhalation hazards working in the wildland fire environment. To assess occupational exposures and acute and subacute health effects among WFFs, the wildland firefighter exposure and health effects study collected data for a 2-year repeated measures study. This manuscript describes the exposure assessment from one Interagency Hotshot Crew (N = 19) conducted at a wildfire incident. Exposures to benzene, toluene, ethylbenzene, xylene isomers, formaldehyde, acetaldehyde, and naphthalene were measured through personal air sampling each work shift. Biological monitoring was done for creatinine-adjusted levoglucosan in urine pre- and post-shift. For 3 days sampling at the wildfire incident, benzene, toluene, ethylbenzene, xylene isomers (m and p, and o) exposure was highest on day 1 (geometric mean [GM] = 0.015, 0.042, 0.10, 0.42, and 0.15 ppm, respectively) when WFFs were not exposed to smoke but used chainsaws to remove vegetation and prepare fire suppression breaks. Exposure to formaldehyde and acetaldehyde was highest on day 2 (GM = 0.03 and 0.036 ppm, respectively) when the WFFs conducted a firing operation and were directly exposed to wildfire smoke. The greatest difference of pre- and post-shift levoglucosan concentrations were observed on day 3 (pre-shift: 9.7 and post-shift: 47 μg/mg creatinine) after WFFs conducted mop up (returned to partially burned area to extinguish any smoldering vegetation). Overall, 65% of paired samples (across all sample days) showed a post-shift increase in urinary levoglucosan and 5 firefighters were exposed to benzene at concentrations at or above the National Institute for Occupational Safety and Health (NIOSH) recommended exposure limit. Our findings further demonstrate that exposure to inhalation hazards is one of many risks that wildland firefighters experience while suppressing wildfires.
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Affiliation(s)
- Kathleen M. Navarro
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Western States Division, P.O. Box 25226, Denver, CO 80225-0226, United States
| | - Kenneth Fent
- Centers for Disease Control and Prevention, Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, 1090 Tusculum Ave, Cincinnati, OH 45226, United States
| | - Alexander C. Mayer
- Centers for Disease Control and Prevention, Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, 1090 Tusculum Ave, Cincinnati, OH 45226, United States
| | - Scott E. Brueck
- Centers for Disease Control and Prevention, Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, 1090 Tusculum Ave, Cincinnati, OH 45226, United States
| | - Christine Toennis
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Effects Laboratory Division, 1090 Tusculum Ave, Cincinnati, OH 45226, United States
| | - Brandon Law
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Effects Laboratory Division, 1090 Tusculum Ave, Cincinnati, OH 45226, United States
| | - Juliana Meadows
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Effects Laboratory Division, 1090 Tusculum Ave, Cincinnati, OH 45226, United States
| | - Deborah Sammons
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Effects Laboratory Division, 1090 Tusculum Ave, Cincinnati, OH 45226, United States
| | - Skylar Brown
- United States Forest Service, National Technology and Development Program, 5785 Hwy 10 West, Missoula, MT 59808, United States
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17
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Wohlgemuth K, Sekiguchi Y, Mota J. Overexertion and heat stress in the fire service: a new conceptual framework. Am J Ind Med 2023; 66:705-709. [PMID: 37062940 DOI: 10.1002/ajim.23482] [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: 02/06/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/18/2023]
Abstract
From the year 2000, the United States Fire Administration (USFA) has been recording all line-of-duty deaths in the fire service. Stress or overexertion caused 1096 out of 2598 total line-of-duty deaths in the United States from 2000 to 2021. Those deaths due to stress or overexertion were further classified as myocardial infarction (90%), cerebrovascular accident (6.8%), other (2.6%), and heat exhaustion (0.6%). Environmental heat exposure is a concern in firefighting, as firefighters work in extreme conditions, such as high ambient temperatures, while wearing protective clothing. Heat stress is not only hazardous to the cardiovascular system, but may accentuate muscle fatigue and overexertion. In addition, overexertion itself is related to increased incidence of musculoskeletal injuries, usually to the lower extremities. Further, there is a strong physiological mechanistic link to suggest that the increased occupational heat exposure and thermoregulatory strain firefighters experience may be a stressor that increases the risk of injuries. This commentary hopes to show the need for further research on the effects of occupational exposures and physiological strain in the fire service.
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Affiliation(s)
- Kealey Wohlgemuth
- Neuromuscular and Occupational Performance Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Yasuki Sekiguchi
- Sports Performance Lab, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Jacob Mota
- Neuromuscular and Occupational Performance Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
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18
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Kearney JW, Weyden MNSVD, Cortes N, Fernandes O, Martin JR. Effect of the Law Enforcement Duty Belt on Muscle Activation during Hip Hinging Movements in Young, Healthy Adults. J Funct Morphol Kinesiol 2023; 8:99. [PMID: 37489312 PMCID: PMC10366834 DOI: 10.3390/jfmk8030099] [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: 06/17/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 07/26/2023] Open
Abstract
Sixty percent of all law enforcement officers (LEOs) experience low back pain (LBP), with the LEO duty belt (LEODB) commonly reported to be a contributing factor. The primary purpose of the study was to investigate the LEODB's effect on muscular activity and compare it to a tactical vest, which is a commonly used alternative to an LEODB. In total, 24 participants (13 male, 11 female; mass, 73.0 ± 11.1 kg; height, 169.0 ± 10.0 cm; age, 24.0 ± 5.8 years) completed a progressive series of hip hinge tasks in a single testing session. All participants completed four conditions (no belt, leather belt, nylon belt, and weight VEST) in a randomized order. Surface electromyography (sEMG) sensors were placed bilaterally on the rectus abdominus, multifidus, biceps femoris, and rectus femoris. Across all tasks, no significant effects of load on muscle activity were found for any of the muscles. Participants rated the VEST condition as more comfortable (p < 0.05) and less restrictive (p < 0.05) than either LEODB. The findings suggest an LEODB does not alter muscle activity during bodyweight hip hinging or lifting objects from the ground. Future research should examine whether changes in muscle activity occur with durations of LEODB wear more similar to an actual work shift duration for LEOs (≥8 h).
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Affiliation(s)
- James W Kearney
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA 20110, USA
| | - Megan N Sax van der Weyden
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA 20110, USA
| | - Nelson Cortes
- School of Sport, Rehabilitation, and Exercise Science, University of Essex, Colchester CO4 3WA, UK
- Department of Bioengineering, George Mason University, Fairfax, VA 22030, USA
| | - Orlando Fernandes
- Sport and Health Department, School of Science and Technology, University of Évora, 7004-516 Évora, Portugal
| | - Joel R Martin
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA 20110, USA
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19
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Stanley IH, Lebeaut A, Betz ME, Wright A, Vujanovic AA. Firearm ownership and storage practices among United States firefighters and emergency medical services personnel. Psychol Serv 2023:2023-76315-001. [PMID: 37261761 PMCID: PMC10689572 DOI: 10.1037/ser0000780] [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: 06/02/2023]
Abstract
Compared with the general U.S. population, firefighters (FF) and emergency medical services (EMS) workers (FF + EMS personnel) are at increased risk for firearm suicide. Although secure firearm storage is associated with reduced risk of firearm suicide, no study has examined the prevalence and sociodemographic correlates of firearm ownership and storage practices among U.S. FF + EMS personnel. A total of 141 U.S. FF + EMS personnel completed a structured, web-based self-report questionnaire. Overall, 76.6% (n = 108) of FF + EMS personnel in our sample reported owning a personal firearm, among whom 85.2% (n = 92) reported owning more than one firearm. Among firearm owners, 42.6% (n = 46) reported secure firearm storage (i.e., unloaded and locked) and 57.4% (n = 62) reported nonsecure firearm storage (i.e., loaded and/or unlocked). FF + EMS personnel who cited personal safety as the only reason for firearm ownership, as opposed to reporting other or multiple reasons for ownership (e.g., hunting), were at increased odds of reporting nonsecure storage practices (69.4% vs. 47.5%; OR = 2.51, 95% CI [1.14, 5.55], p = .023). Most FF + EMS personnel in our sample reported firearm ownership, and approximately half of the firearm owners reported nonsecure firearm storage practices. Promoting secure firearm storage practices among FF + EMS personnel might decrease risk of firearm suicide and other forms of firearm-related injuries. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Ian H. Stanley
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
- Center for COMBAT Research, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Antoine Lebeaut
- Department of Psychology, University of Houston, Houston, TX
| | - Marian E. Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
- VA Eastern Colorado Geriatric Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO
| | - Angela Wright
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
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20
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Boggi A, do Amaral J, Bacchi A, Nascimento V, Voegels R, dos Santos J, Grimaldi G, Basseto de Oliveira Araújo K, Pavão V, Passaretti D, Aldred A, Gomes G, Pezato R. Evaluation of the Impact of Exposure To Heat and to By-Products of Combustion on the Health of Firefighters. Ann Burns Fire Disasters 2023; 36:100-110. [PMID: 38681946 PMCID: PMC11041887] [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] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/02/2022] [Indexed: 05/01/2024]
Abstract
Firefighters are often exposed to high temperatures and by-products of combustion, which can affect their health. In this study, we assessed the impact of acute exposure of firefighters in fire simulators. Twenty male firefighters were exposed to fire simulators, and observed in four phases: pre-exposure (group 0, control) and after the end of the first (group 1), second (group 2), and fourth (group 3) weeks of training. Blood samples were collected and dosed to evaluate the response of the immune, inflammatory (C-reactive protein, IL6, and IL10), and endocrine systems (cortisone, total testosterone, free testosterone, SHBG, bioavailable testosterone, TSH, and free T4). In groups 0, 1, and 3, a thermographic evaluation was also carried out to study the temperature and body heat flow of the participants. Regarding the inflammatory process, an increase in C-reactive protein and a reduction in IL-10 were observed. With respect to hormonal markers, an increase in cortisol and reduced levels of free T4 and bioavailable testosterone were found after exposure, with recovery of testosterone levels in the final week of training. Thermoregulatory adaptation of the organism has been associated with changes in heat flow in the organism in people subjected to extreme temperatures, with emphasis on the performance of the lower limbs. Our findings demonstrate an inflammatory response with hormonal changes after exposure to fire and an adaptive response of thermal balance, which could aid understanding of the physiology of the human body in extreme situations.
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Affiliation(s)
- A.C. Boggi
- ENT Research Lab, Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil
- Fire Department, Escola Superior de Bombeiros -– Polícia Militar do Estado de São Paulo, Franco da Rocha, Brazil
| | - J.B. do Amaral
- ENT Research Lab, Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil
| | - A.L.L. Bacchi
- ENT Research Lab, Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo, Brazil
| | - V.M. Nascimento
- Fire Department, Escola Superior de Bombeiros -– Polícia Militar do Estado de São Paulo, Franco da Rocha, Brazil
| | - R.L. Voegels
- Department of Ophthalmology and Otorhinolaryngology, University of São Paulo, São Paulo, Brazil
| | - J.M.B. dos Santos
- ENT Research Lab, Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil
- Post-Graduation Program in Science of Human and Rehabilitation, Federal University of São Paulo (UNIFESP), Santos, Brazil
| | - G. Grimaldi
- Hospital da Polícia Militar, Polícia Militar do Estado de São Paulo, São Paulo, Brazil
| | | | - V. Pavão
- Fire Department, Escola Superior de Bombeiros -– Polícia Militar do Estado de São Paulo, Franco da Rocha, Brazil
| | - D.A. Passaretti
- Fire Department, Escola Superior de Bombeiros -– Polícia Militar do Estado de São Paulo, Franco da Rocha, Brazil
| | - A. Aldred
- Predikta Soluções em Pesquisa LTDA, São Paulo, Brazil
| | - G. Gomes
- Predikta Soluções em Pesquisa LTDA, São Paulo, Brazil
| | - R. Pezato
- ENT Research Lab, Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil
- Department of Ophthalmology and Otorhinolaryngology, University of São Paulo, São Paulo, Brazil
- Centre of Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
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21
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Han SW, Jung HO. Factors Influencing Infection Anxiety in Korean Male Firefighters Due to COVID-19 Infection Status. Healthcare (Basel) 2023; 11:healthcare11111623. [PMID: 37297762 DOI: 10.3390/healthcare11111623] [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: 05/07/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
This paper describes descriptive research to identify the effects of job stress, COVID-19 self-care behavior, and COVID-19 vaccination status according to the infection and non-infection of COVID-19 on anxiety about the COVID-19 infection among firefighters in South Korea. Data from 205 firefighters working at 10 fire stations were collected from 26 January to 16 February 2023. The variables used were job stress, COVID-19 self-care behavior, COVID-19 vaccination status, and COVID-19 infection anxiety. The collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple linear regression. In subjects who were infected with COVID-19, the factors that significantly affected infection anxiety were job stress (β = 0.247, p = 0.011) and self-care behavior (β = 0.343, p = 0.011). In subjects who were not infected with COVID-19, the factors that significantly affected infection anxiety were marriage status (unmarried) (β = -0.260, p = 0.005) and self-care behavior (β = 0.374, p = 0.001). These results demonstrate that the infection anxiety of firefighters should be prevented, and their physical and mental health should be promoted by considering job stress, self-care behavior, and personal environment.
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Affiliation(s)
- Seung-Woo Han
- Department of Nursing, Kwangju Women's University, Gwangsan-gu, Gwangju 62396, Republic of Korea
| | - Hyun-Ok Jung
- The Research Institute of Nursing Science, College of Nursing, Daegu Catholic University, Daegu 42472, Republic of Korea
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Mendelson BJ, Marciniak RA, Wahl CA, Ebersole KT. Body Composition Is Related to Maximal Effort Treadmill Test Time in Firefighters. Healthcare (Basel) 2023; 11:healthcare11111607. [PMID: 37297747 DOI: 10.3390/healthcare11111607] [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] [Received: 04/14/2023] [Revised: 05/19/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
Firefighting tasks may require near maximal levels of cardiorespiratory fitness. Previous research has indicated that body fat percentage (BF%) and aerobic capacity (VO2peak) are related to the performance of firefighting tasks. Since a standard submaximal treadmill test for firefighters is terminated at 85% of maximal heart rate (MHR), key performance information relating to maximal cardiorespiratory effort may not be measured in a submaximal test. The purpose of this study was to examine the relationships between body composition and time spent running at intensities greater that 85% MHR. Height, weight, body mass index (BMI; kg/m2), BF%, MHR (bpm), VO2peak (mL/kg/min), predicted VO2peak (P-VO2peak; mL/kg/min), submaximal treadmill test time (WFIsub Test Time; min), and maximal treadmill test time (WFImax Test Time; min) were collected in fifteen active-duty firefighters. The results indicated that significant relationships (p < 0.05) existed between BF% and VO2peak, BF% and WFImax Test Time, BF% and Tdiff, and VO2peak and WFImax Test Time. P-VO2peak was not significantly different than VO2peak, and the WFImax Test Time was significantly longer than the WFIsub Test Time. These results indicate that a submaximal treadmill test may reasonably predict VO2peak, but key information about physiological work at intensities greater than 85% MHR may be missed when using submaximal effort tests.
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Affiliation(s)
- Benjamin J Mendelson
- Human Performance & Sport Physiology Laboratory, Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Rudi A Marciniak
- Human Performance & Sport Physiology Laboratory, Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Carly A Wahl
- Department of Kinesiology, Sport, & Recreation, Eastern Illinois University, Charleston, IL 61920, USA
| | - Kyle T Ebersole
- Human Performance & Sport Physiology Laboratory, Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
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23
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Martin J, Sax van der Weyden M, Fyock-Martin M. Effects of Law Enforcement Load Carriage Systems on Muscle Activity and Coordination during Walking: An Exploratory Study. Sensors (Basel) 2023; 23:4052. [PMID: 37112391 PMCID: PMC10141999 DOI: 10.3390/s23084052] [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] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/11/2023] [Accepted: 04/15/2023] [Indexed: 06/19/2023]
Abstract
Law enforcement officers (LEOs) commonly wear a duty belt (DB) or tactical vest (TV) and from prior findings, these forms of load carriage (LC) likely alter muscular activity. However, studies on the effects of LEO LC on muscular activity and coordination are limited in the current literature. The present study examined the effects of LEO load carriage on muscular activity and coordination. Twenty-four volunteers participated in the study (male = 13, age = 24.5 ± 6.0 years). Surface electromyography (sEMG) sensors were placed on the vastus lateralis, biceps femoris, multifidus, and lower rectus abdominus. Participants completed treadmill walking for two load carriage conditions (duty belt and tactical vest) and a control condition. Mean activity, sample entropy and Pearson correlation coefficients were computed for each muscle pair during the trials. The duty belt and tactical vest resulted in an increase in muscle activity in several muscles; however, no differences between the duty belt and tactical vest were found. Consistently across the conditions, the largest correlations were observed between the left and right multifidus (r = 0.33-0.68) and rectus abdominus muscles (0.34-0.55). There were statistically small effects (p < 0.05, η2 = 0.031 to 0.076) of the LC on intermuscular coordination. No effect (p > 0.05) of the LC on sample entropy was found for any muscle. The findings indicate that LEO LC causes small differences in muscular activity and coordination during walking. Future research should incorporate heavier loads and longer durations.
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Raposa ME, Mullin G, Murray RM, Shepler LJ, Castro KC, Fisher AB, Gallogly VH, Davis AL, Resick CJ, Lee J, Allen JA, Taylor JA. Assessing the Mental Health Impact of the COVID-19 Pandemic on US Fire-Based Emergency Medical Services Responders: A Tale of Two Samples (The RAPID Study I). J Occup Environ Med 2023; 65:e184-e194. [PMID: 36730580 PMCID: PMC10090321 DOI: 10.1097/jom.0000000000002745] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study aimed to examine the COVID-19 pandemic's impact on fire service safety culture, behavior and morale, levers of well-being, and well-being outcomes. METHODS Two samples (Stress and Violence against fire-based EMS Responders [SAVER], consisting of 3 metropolitan departments, and Fire service Organizational Culture of Safety [FOCUS], a geographically stratified random sample of 17 departments) were assessed monthly from May to October 2020. Fire department-specific and pooled scores were calculated. Linear regression was used to model trends. RESULTS We observed concerningly low and decreasing scores on management commitment to safety, leadership communication, supervisor sensegiving, and decision-making. We observed increasing and concerning scores for burnout, intent to leave the profession, and percentage at high risk for anxiety and depression. CONCLUSIONS Our findings suggest that organizational attributes remained generally stable but low during the pandemic and impacted well-being outcomes, job satisfaction, and engagement. Improving safety culture can address the mental health burden of this work.
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Pendergrast C, Boyle T, Crockett AJ, Eston R, Johnston KN. Longitudinal lung function in urban firefighters: A group-based multi-trajectory modelling approach. Respirology 2023; 28:247-253. [PMID: 36180416 DOI: 10.1111/resp.14382] [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: 06/07/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Urban firefighters are routinely exposed to both physical and chemical hazards that can negatively impact lung health, but it is unclear if firefighters experience accelerated decline in spirometry parameters due to chronic exposure and acute insults. This study aimed to describe sub-groups of firefighters with differing spirometry trajectories and examine the relationship between the identified trajectories and demographic, lifestyle and occupational characteristics. METHODS Data from six waves of the Respiratory Function Measurement and Surveillance for South Australian Metropolitan Fire Service Study (2007-2019) were used to identify spirometry parameter z-score trajectories, using group-based multi-trajectory modelling (GBMTM). Analysis of variance and chi-square statistics were used to assess trajectory group differences in baseline self-reported demographic, lifestyle and occupational characteristics. RESULTS In the 669 included firefighters, we identified five trajectories for the combination of Forced Expiratory Volume in the first second z-score (FEV1 z), Forced Vital Capacity z-score (FVCz) and the ratio of FEV1 and FVC z-score (FEV1 /FVCz). There were three stable trajectories of low, average and very high lung function and two declining trajectories of average and high lung function. Analysis of subgroup characteristics revealed no significant differences between expected and actual group proportions for the occupational characteristics of years of service and respiratory protection use. Significant differences were seen in respiratory health and body mass index. CONCLUSION GBMTM defined distinct, plausible spirometry trajectory sub-groups. Firefighter longitudinal spirometry trajectory group membership was associated with BMI and respiratory disease or symptoms but not with self-reported smoking history or occupational factors.
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Affiliation(s)
- Catherine Pendergrast
- Innovation, Implementation and Clinical Translation in Health (IIMPACT) Research Concentration, University of South Australia, Adelaide, South Australia, Australia
| | - Terry Boyle
- Australian Centre for Precision Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Alan J Crockett
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Roger Eston
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Kylie N Johnston
- Innovation, Implementation and Clinical Translation in Health (IIMPACT) Research Concentration, University of South Australia, Adelaide, South Australia, Australia
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Jagim AR, Luedke JA, Dobbs WC, Almonroeder T, Markert A, Zapp A, Askow AT, Kesler RM, Fields JB, Jones MT, Erickson JL. Physiological Demands of a Self-Paced Firefighter Air-Management Course and Determination of Work Efficiency. J Funct Morphol Kinesiol 2023; 8:jfmk8010021. [PMID: 36810505 PMCID: PMC9944468 DOI: 10.3390/jfmk8010021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
Firefighters often complete air management courses (AMC) to assess the ability to tolerate personal protective equipment, appropriately manage the breathing system and assess occupational performance. Little information is known relative to the physiological demands of AMCs, nor how to assess work efficiency in order to characterize occupational performance and evaluate progress. PURPOSE To assess the physiological demands of an AMC and examine differences across BMI categories. A secondary aim was to develop an equation to assess work efficiency in firefighters. METHODS Fifty-seven firefighters (Women, n = 4; age: 37.2 ± 8.4 yr.; height: 182.0 ± 6.9 cm; body mass: 90.8 ± 13.1 kg; BMI: 27.8 ± 3.6 kg·m-2) completed an AMC per routine evaluation while wearing a department issued self-contained breathing apparatus and full protective gear. Course completion time, starting pounds per square inch (PSI) on the air cylinder, changes in PSI, and distance traveled were recorded. All firefighters were equipped with a wearable sensor integrated with a triaxial accelerometer and telemetry to assess movement kinematics, heart rate, energy expenditure, and training impulse. The AMC consisted of an initial section involving a hose line advance, rescue (body drag), stair climb, ladder raise, and forcible entry. This section was followed by a repeating loop, which consisted of a stair climb, search, hoist, and recovery walk. Firefighters repeated the course loop until the self-contained breathing apparatus air supply pressure reached 200 PSI, at which time they were instructed to lay down until the PSI reached zero. RESULTS Average completion time was 22.8 ± 1.4 min, with a mean distance of 1.4 ± 0.3 km and an average velocity of 2.4 ± 1.2 m·s-1. Throughout the AMC, the mean heart rate was 158.7 ± 11.5 bpm equating to 86.8 ± 6.3% of the age-predicted max heart rate and a training impulse of 55 ± 3 AU. Mean energy expenditure was 464 ± 86 kcals and work efficiency was 49.8 ± 14.9 km·PSI-1·s. Regression analysis determined that fat-free mass index (R2 = 0.315; β = -5.069), body fat percentage (R2 = 0.139; β = -0.853), fat-free mass (R2 = 0.176; β = -0.744), weight (R2 = 0.329; β = -0.681), and age (R2 = 0.096; β = -0.571) were significant predictors of work efficiency. CONCLUSIONS The AMC is a highly aerobic task with near-maximal heart rates reached throughout the course. Smaller and leaner individuals achieved a higher degree of work efficiency during the AMC.
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Affiliation(s)
- Andrew R. Jagim
- Sports Medicine, Mayo Clinic Health System, La Crosse, WI 54650, USA
- Exercise & Sport Science Department, University of Wisconsin—La Crosse, La Crosse, WI 54601, USA
- Correspondence: ; Tel.: +1-608-392-5013
| | - Joel A. Luedke
- Sports Medicine, Mayo Clinic Health System, La Crosse, WI 54650, USA
| | - Ward C. Dobbs
- Exercise & Sport Science Department, University of Wisconsin—La Crosse, La Crosse, WI 54601, USA
| | | | - Adam Markert
- La Crosse Fire Department, La Crosse, WI 54603, USA
| | | | - Andrew T. Askow
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | | | - Jennifer B. Fields
- Exercise Science and Athletic Training, Springfield College, Springfield, MA 01109, USA
| | - Margaret T. Jones
- Patriot Performance Laboratory, Frank Pettrone Center for Sports Performance, George Mason University, Fairfax, VA 22030, USA
| | - Jacob L. Erickson
- Sports Medicine, Mayo Clinic Health System, La Crosse, WI 54650, USA
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Paris-Davila T, Gaines LGT, Lucas K, Nylander-French LA. Occupational exposures to airborne per- and polyfluoroalkyl substances (PFAS)-A review. Am J Ind Med 2023; 66:393-410. [PMID: 36719301 DOI: 10.1002/ajim.23461] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are a group of synthetically-made chemicals with diverse functional properties that have become ubiquitous in our environment because of their widespread use. PFAS exposure has been associated with adverse health effects, and it is therefore vital to know how exposure may occur. Many studies have focused on environmental exposure from drinking water, but there is a paucity of data on inhalation exposure, especially in occupational settings. METHODS In this study, through a comprehensive literature search, measured airborne (i.e., aerosols, volatiles, and dust) inhalation exposure and area levels were compiled for various occupations to compare reported levels of PFAS exposure. Airborne PFAS levels measured in various occupations such as ski waxing, textile manufacturing, firefighting, and floor waxing were analyzed and compared. RESULTS Results of this review demonstrate that workers experience varying levels of PFAS exposure contingent on the workplace and industry and the work tasks performed within the workplace. Out of all occupations, ski waxing exhibited the highest total PFAS airborne concentrations when compared to all other reported occupational and residential exposures. CONCLUSIONS Further research is recommended to estimate the risk of PFAS exposures in the occupations reviewed and to identify other potential occupations at risk of PFAS exposure. In addition, informed recommendations to implement safety measures ought to be developed to protect workers from adverse health effects.
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Affiliation(s)
- Tamara Paris-Davila
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Linda G T Gaines
- Office of Superfund Remediation and Technology Innovation, Office of Land and Emergency Management, US Environmental Protection Agency, The United States Environmental Protection Agency, Washington, District of Columbia, USA
| | - Katherine Lucas
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Leena A Nylander-French
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Deng A, Yang Y, Li Y, Huang M, Li L, Lu Y, Chen W, Yuan R, Ju Y, Liu B, Zhang Y. Using machine learning algorithm to predict the risk of post-traumatic stress disorder among firefighters in Changsha. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2023; 48:84-91. [PMID: 36935181 PMCID: PMC10930560 DOI: 10.11817/j.issn.1672-7347.2023.220067] [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] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Indexed: 03/21/2023]
Abstract
OBJECTIVES Firefighters are prone to suffer from psychological trauma and post-traumatic stress disorder (PTSD) in the workplace, and have a poor prognosis after PTSD. Reliable models for predicting PTSD allow for effective identification and intervention for patients with early PTSD. By collecting the psychological traits, psychological states and work situations of firefighters, this study aims to develop a machine learning algorithm with the aim of effectively and accurately identifying the onset of PTSD in firefighters, as well as detecting some important predictors of PTSD onset. METHODS This study conducted a cross-sectional survey through convenient sampling of firefighters from 20 fire brigades in Changsha, which were evenly distributed across 6 districts and Changsha County, with a total of 628 firefighters. We used the synthetic minority oversampling technique (SMOTE) to process data sets and used grid search to finish the parameter tuning. The predictive capability of several commonly used machine learning models was compared by 5-fold cross-validation and using the area under the receiver operating characteristic curve (ROC-AUC), accuracy, precision, recall, and F1 score. RESULTS The random forest model achieved good performance in predicting PTSD with an average AUC score at 0.790. The mean accuracy of the model was 90.1%, with an F1 score of 0.945. The three most important predictors were perseverance, forced thinking, and reflective deep thinking, with weights of 0.165, 0.158, and 0.152, respectively. The next most important predictors were employment time, psychological power, and optimism. CONCLUSIONS PTSD onset prediction model for Changsha firefighters constructed by random forest has strong predictive ability, and both psychological characteristics and work situation can be used as predictors of PTSD onset risk for firefighters. In the next step of the study, validation using other large datasets is needed to ensure that the predictive models can be used in clinical setting.
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Affiliation(s)
- Aoqian Deng
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha 410011.
| | - Yanyi Yang
- Health Management Center, Second Xiangya Hospital, Central South University, Changsha 410011, China.
| | - Yunjing Li
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Mei Huang
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Liang Li
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Yimei Lu
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Wentao Chen
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Rui Yuan
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Yumeng Ju
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha 410011.
| | - Bangshan Liu
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha 410011.
| | - Yan Zhang
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha 410011
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Gendron P, Laurencelle L, Lajoie C, Trudeau F, Houle J, Goulet ÉDB. Change in heart rate variability during two firefighting work cycles. Int J Occup Saf Ergon 2023; 29:453-460. [PMID: 36519506 DOI: 10.1080/10803548.2022.2159173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This study aimed to determine whether the change in heart rate variability from pre to post firefighting is modulated by different work cycles. Thirteen male firefighters underwent two firefighting simulations that comprised two identical 25-min work bouts intercalated by a passive recovery period of either 20 min (T20) or 5 min (T5). The square root of the mean squared differences of successive R-R intervals (RMSSD) and aural temperature were measured at rest before (PRE) and after (POST) firefighting simulations. The decrease in RMSSD was different between firefighting simulations (T20: -10 ± 21.2 ms, T5: -19.9 ± 20.9 ms, interaction, p = 0.02). Post-firefighting aural temperature was greater (p = 0.05) in T5 (37.18 ± 0.53 °C) than in T20 (36.88 ± 0.49 °C). In conclusion, a shorter recovery period of 5 min between firefighting work bouts decreases post-firefighting heart rate variability, possibly attributed to a lower parasympathetic reactivation and a higher absolute value of body temperature.
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Affiliation(s)
- Philippe Gendron
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Canada
| | - Louis Laurencelle
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Canada
| | - Claude Lajoie
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Canada
| | - François Trudeau
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Canada
| | - Julie Houle
- Département des sciences infirmières, Université du Québec à Trois-Rivières, Canada
| | - Éric D B Goulet
- Faculté des sciences de l'activité physique, Université de Sherbrooke, Canada
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30
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Lee WR, Lee H, Nam EW, Noh JW, Yoon JH, Yoo KB. Comparison of the risks of occupational diseases, avoidable hospitalization, and all-cause deaths between firefighters and non-firefighters: A cohort study using national health insurance claims data. Front Public Health 2023; 10:1070023. [PMID: 36726614 PMCID: PMC9884821 DOI: 10.3389/fpubh.2022.1070023] [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: 10/14/2022] [Accepted: 12/27/2022] [Indexed: 01/17/2023] Open
Abstract
Objectives National Health Insurance claims data were used to compare the incidence of occupational diseases, avoidable hospitalization, and all-cause death standardized incidence ratio and hazard ratio between firefighters and non-firefighters. Methods The observation period of the study was from 2006 to 2015 and a control group (general workers and national and regional government officers/public educational officers) and a firefighter group was established. The dependent variables were occupational diseases, avoidable hospitalization (AH), and all-cause death. The analysis was conducted in three stages. First, the standardized incidence ratios were calculated using the indirect standardization method to compare the prevalence of the disease between the groups (firefighter and non-firefighter groups). Second, propensity score matching was performed for each disease in the control group. Third, the Cox proportional hazards model was applied by matching the participants. Results The standardized incidence ratio and Cox regression analyses revealed higher rates of noise-induced hearing loss, ischemic heart disease, asthma, chronic obstructive pulmonary disease, cancer, back pain, admission due to injury, mental illness, depression, and AH for firefighters than general workers. Similarly, the rates of noise-induced hearing loss, ischemic heart disease, asthma, chronic obstructive pulmonary disease, back pain, admission due to injury, mental illness, depression, and AH were higher in the firefighter group than in the national and regional government officer/public educational officer group. Conclusions The standardized incidence ratios and hazard ratios for most diseases were high for firefighters. Therefore, besides the prevention and management of diseases from a preventive medical perspective, management programs, including social support and social prescriptions in the health aspect, are needed.
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Affiliation(s)
- Woo-Ri Lee
- Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
| | - Haejong Lee
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju-si, Republic of Korea
| | - Eun Woo Nam
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju-si, Republic of Korea
| | - Jin-Won Noh
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju-si, Republic of Korea
| | - Jin-Ha Yoon
- Department of Preventive Medicine and Institute of Occupational Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea,*Correspondence: Jin-Ha Yoon ✉
| | - Ki-Bong Yoo
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju-si, Republic of Korea,Ki-Bong Yoo ✉
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Cheng P, Wang L, Zhou Y, Ma W, Zhao G, Zhang L, Li W. Post-traumatic stress disorder and depressive symptoms among firefighters: a network analysis. Front Public Health 2023; 11:1096771. [PMID: 37213609 PMCID: PMC10193951 DOI: 10.3389/fpubh.2023.1096771] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/04/2023] [Indexed: 05/23/2023] Open
Abstract
Background Firefighters, as first responders with a high risk of occupational exposure to traumatic events and heavy working stress, have a high prevalence of PTSD symptoms and depressive symptoms. But no previous studies analyzed the relationships and hierarchies of PTSD and depressive symptoms among firefighters. Network analysis is a novel and effective method for investigating the complex interactions of mental disorders at the symptom level and providing a new understanding of psychopathology. The current study was designed to characterize the PTSD and depressive symptoms network structure in the Chinese firefighters. Method The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) and the Self-Rating Depression Scale (SDS) were applied to assess PTSD and depressive symptoms, respectively. The network structure of PTSD and depressive symptoms was characterized using "expected influence (EI)" and "bridge EI" as centrality indices. The Walktrap algorithm was conducted to identify communities in the PTSD and depressive symptoms network. Finally, Network accuracy and stability were examined using the Bootstrapped test and the case-dropping procedure. Results A total of 1,768 firefighters were enrolled in our research. Network analysis revealed that the relationship between PTSD symptoms, "Flashback" and "Avoidance," was the strongest. "Life emptiness" was the most central symptom with the highest EI in the PTSD and depression network model. Followed by "Fatigue" and "Interest loss." Bridge symptoms connecting PTSD and depressive symptoms in our study were "Numb," "High alertness," "Sad mood," and "Compunction and blame," successively. The data-driven community detection suggested the differences in PTSD symptoms in the clustering process. The reliability of the network was approved by both stability and accuracy tests. Conclusion To the best of our knowledge, the current study first demonstrated the network structure of PTSD and depressive symptoms among Chinese firefighters, identifying the central and bridge symptoms. Targeting interventions to the symptoms mentioned above may effectively treat firefighters suffering from PTSD and depressive symptoms.
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Affiliation(s)
- Peng Cheng
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Lirong Wang
- Xiangya School of Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Ying Zhou
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Wenjing Ma
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Guangju Zhao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Li Zhang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Weihui Li
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- *Correspondence: Weihui Li,
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Valek SA, Rousseau MA, Nelson KC, Kannler C, Tran T. Melanoma risk among career firefighters: A systematic review of case-control studies. J Am Acad Dermatol 2022; 88:1189-1192. [PMID: 36592739 DOI: 10.1016/j.jaad.2022.11.058] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 01/02/2023]
Affiliation(s)
- Stephanie A Valek
- University of Texas Health Science Center at Houston John P. and Katherine G. McGovern Medical School, Houston, Texas
| | - Morgan A Rousseau
- University of Texas Health Science Center at Houston John P. and Katherine G. McGovern Medical School, Houston, Texas
| | - Kelly C Nelson
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Christine Kannler
- Massachusetts Department of Fire Services, Boston Fire Department and the Professional Firefighter Union of Massachusetts, Northeast Dermatology Associates, North Andover, Massachusetts
| | - Tiffaney Tran
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Cheng CY, Sun JT, Chang HP, Chen YL, Pei D, Liang YJ. Investigation of Psychological Stress and Sleep Quality of Emergency Medical Technicians in Taiwan Fire Department during the COVID-19 Pandemic. Int J Environ Res Public Health 2022; 20:137. [PMID: 36612456 PMCID: PMC9819878 DOI: 10.3390/ijerph20010137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
When the coronavirus disease 2019 (COVID-19) began to ravage the world in 2019, the World Health Organization became concerned. The epidemic has a high mortality and contagion rate, with severe health and psychological impacts on frontline emergency medical service system practitioners. There are many hospital staff surveys, but few have covered the stress among emergency medical technicians. DASS-21, PSQI, and AUDIT questionnaires were used to evaluate the sources of psychological stress factors of firefighters in Taiwan. Multiple logistic regression was used to analyze the questionnaire content. We conducted questionnaire surveys from May 2022 to July 2022. Our sample comprised 688 participants. The odds ratios of increased depression, anxiety, and stress levels due to reduced family or peer understanding and support were 2.72 (95% CI: 1.50−4.92), p = 0.001; 2.03 (95% CI: 1.11−3.68), p = 0.021; and 3.27 (95% CI: 1.83−5.86), p < 0.001, respectively. The odds ratios of poor sleep quality due to depression, anxiety, and increased stress levels were 5.04 (3.18−7.99), p < 0.001; 2.44 (95% CI: 1.57−3.81), p < 0.001; and 4.34 (95% CI: 2.76−6.82), p-value < 0.001, respectively. During the COVID-19 pandemic, poor sleep quality and a lack of understanding and support from the Taiwan firefighting agency staff, family, or peers resulted in increased depression, anxiety, and stress levels.
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Affiliation(s)
- Chiao-Yin Cheng
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei 220, Taiwan
- Graduate Institute of Applied Science and Engineering, Fu Jen Catholic University, New Taipei 242, Taiwan
| | - Jen-Tang Sun
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei 220, Taiwan
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Yilan 266, Taiwan
| | - Hung-Pin Chang
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei 220, Taiwan
| | - Yen-Lin Chen
- Department of Pathology, Tri-Service General Hospital, Medical Defense Medical Center, Taipei 114, Taiwan
| | - Dee Pei
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei 242, Taiwan
| | - Yao-Jen Liang
- Graduate Institute of Applied Science and Engineering, Fu Jen Catholic University, New Taipei 242, Taiwan
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Kuklane K, Eggeling J, Kemmeren M, Heus R. A Database of Static Thermal Insulation and Evaporative Resistance Values of Dutch Firefighter Clothing Items and Ensembles. Biology (Basel) 2022; 11:biology11121813. [PMID: 36552322 PMCID: PMC9775573 DOI: 10.3390/biology11121813] [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] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022]
Abstract
The rescue operations' environment can impair firefighters' performance and increase the risk of injuries, e.g., burns and hyperthermia. The bulk and carried weight of heavy protection contributes to lower physical performance, higher metabolic load and internal body heat production. For recommending optimal protection for the tasks and incident scenarios, knowledge of clothing thermal properties is needed. However, detailed data on firefighter protective clothing systems are not available. The aim of the study was to provide scientific background and a dataset that would allow for validation of thermo-physiological models for task-specific conditions of rescue work. Thermal insulation of 37 single items and their variations and 25 realistic protective clothing ensembles were measured on a thermal manikin. Twelve (12) ensembles that evenly covered the whole insulation range were selected for evaporative resistance testing. The equations for summing up individual item's insulation to ensemble insulation and calculating clothing area factor were derived from the dataset. The database of a firefighter clothing system was created. In addition, the local and regional thermal properties of the clothing ensembles were provided for use in future validation of advanced thermo-physiological models for rescue worker exposure predictions and for designing decision aid tools.
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Affiliation(s)
- Kalev Kuklane
- Team Fire Service Science, Netherlands Academy of Crisis Management and Fire Service Science, Netherlands Institute for Public Safety, Zilverstraat 91, 2718 RP Zoetermeer, The Netherlands
| | - Jakob Eggeling
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Box 118, 22100 Lund, Sweden
| | - Maurice Kemmeren
- Team COLS, Netherlands Institute for Public Safety, Zilverstraat 91, 2718 RP Zoetermeer, The Netherlands
| | - Ronald Heus
- Team Fire Service Science, Netherlands Academy of Crisis Management and Fire Service Science, Netherlands Institute for Public Safety, Zilverstraat 91, 2718 RP Zoetermeer, The Netherlands
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Haddock CK, Jitnarin N, Caetano R, Jahnke SA, Hollerbach BS, Kaipust CM, Poston WS. Norms about Alcohol Use among US Firefighters. Saf Health Work 2022; 13:387-393. [PMID: 36579011 PMCID: PMC9772477 DOI: 10.1016/j.shaw.2022.08.008] [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: 04/13/2022] [Revised: 08/24/2022] [Accepted: 08/28/2022] [Indexed: 12/31/2022] Open
Abstract
Background Problem drinking is a perennial concern in the US fire service. A large literature has documented the importance of addressing alcohol norms in intervention research. The purpose of this study was to explore alcohol norms in a national cohort of firefighters (FFs) to inform intervention development in this occupational group. Methods Data were from a national online survey of career and volunteer FFs (N = 674). Participants were recruited through national fire service listservs and a database of FFs who had agreed to be contacted for research. Results When asked about "acceptable" levels of alcohol consumption, FFs on average suggested levels which exceeded public health guidelines. Further, approximately half of career and volunteer FFs believed that, at least under some circumstances, drinking until intoxicated was normative. When asked how long should elapse between a FFs last drink and reporting for duty, the average suggested lag was 11.2 hours (sd = 4.6). However, among male volunteer FFs who reported heavy drinking, the average was 6.68 hours (sd = 4.77). Conclusions Given the high prevalence of heavy and binge drinking in the fire service, it is not surprising that the alcohol norms found in this study were consistent with a culture of drinking. Participants' reports of alcohol use among their peers were consistent with the actual prevalence of problem drinking. Thus, education and prevention efforts in this occupation should focus on changing norms about alcohol use, including linking heavy drinking to other health and safety issues they face.
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Affiliation(s)
- Christopher K. Haddock
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, 1920 West 143rd Street, Suite 120, Leawood, KS 66224, USA,Corresponding author. Center for Fire, Rescue and EMS Health Research, NDRI-USA, Inc., 1920 West 143rd Street, Suite 120, Leawood, KS 66224, USA.
| | - Nattinee Jitnarin
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, 1920 West 143rd Street, Suite 120, Leawood, KS 66224, USA
| | - Raul Caetano
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704, USA
| | - Sara A. Jahnke
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, 1920 West 143rd Street, Suite 120, Leawood, KS 66224, USA
| | - Brittany S. Hollerbach
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, 1920 West 143rd Street, Suite 120, Leawood, KS 66224, USA
| | - Christopher M. Kaipust
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, 1920 West 143rd Street, Suite 120, Leawood, KS 66224, USA
| | - Walker S.C. Poston
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, 1920 West 143rd Street, Suite 120, Leawood, KS 66224, USA
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Noll L, Moran J, Mallows A. Inter-Rater and Intra-Rater Reliability of Return-to-Work Screening Tests for UK Firefighters Following Injury. Healthcare (Basel) 2022; 10:healthcare10122381. [PMID: 36553905 PMCID: PMC9778182 DOI: 10.3390/healthcare10122381] [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: 11/07/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to assess the inter-rater and intra-rater reliability of a return-to-work (RTW) screening test to be used on UK firefighters following injury. The inter rater and intra-rater reliability of eight tasks involved in a screening test was used to assess readiness to RTW for UK firefighters following injury. These tasks included the following: (1) putting on and removing a breathing apparatus set (BA), (2) a ladder lift simulation, (3) a ladder carry simulation, (4) a light portable pump (LPP) lift and carry simulation, (5) a hose run, (6) a ladder climb with leg lock, (7) a casualty evacuation and (8) a confined space crawl simulation. The inter-rater reliability between each individual screening task was interpreted as Excellent (ICC = 0.94-1.00) for eleven (68.75%) of the screening task videos and as Good (ICC = 0.75-0.88) for five (31.25%) of the screening task videos. Intra-rater reliability was interpreted as Excellent (ICC = 1) for twenty-six participants (74.3%), Good (ICC = 0.76-0.88) for eight participants (22.9%) and Moderate for one participant (2.8%). Due to the reliability of this screening test, it allows conclusions to be made from the results which can inform a RTW decision for a firefighter.
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Harries ME, Allen DT, Adetona O, Bell ML, Black MS, Burgess JL, Dryer FL, Holder AL, Mascareñas A, Rosario-Ortiz FL, Stec AA, Turpin BJ, Zelikoff JT. A Research Agenda for the Chemistry of Fires at the Wildland-Urban Interface: A National Academies Consensus Report. Environ Sci Technol 2022; 56:15189-15191. [PMID: 36288208 PMCID: PMC9670845 DOI: 10.1021/acs.est.2c07015] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Megan E. Harries
- National
Academies of Sciences, Engineering, and Medicine, Washington, District of
Columbia 20001, United
States
| | - David T. Allen
- University
of Texas at Austin, Austin, Texas 78712, United States
| | - Olorunfemi Adetona
- Division
of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio 43210, United States
| | - Michelle L. Bell
- Yale
University, School of the Environment, New Haven, Connecticut 06511, United States
| | - Marilyn S. Black
- Chemical
Insights Research Institute, Underwriters
Laboratories Inc., Marietta, Georgia 30067, United States
| | - Jefferey L. Burgess
- Mel and Enid
Zuckerman College of Public Health, University
of Arizona, Tucson, Arizona 85724, United States
| | - Frederick L. Dryer
- Department
of Mechanical Engineering, University of
South Carolina, Columbia, South Carolina 29208, United States
| | - Amara L. Holder
- Office
of Research and Development, US Environmental
Protection Agency, Research Triangle
Park, North Carolina 27711, United States
| | - Ana Mascareñas
- Independent
Consultant, Washington, District of Columbia 20010, United States
| | - Fernando L. Rosario-Ortiz
- Department
of Civil, Environmental, and Architectural Engineering, University of Colorado Boulder, Boulder, Colorado 80309, United States
- Environmental
Engineering Program, University of Colorado
Boulder, Boulder, Colorado 80309, United States
| | - Anna A. Stec
- Centre
for Fire and Hazards Sciences, University
of Central Lancashire, Preston, PR1 2HE, United Kingdom
| | - Barbara J. Turpin
- Department
of Environmental Sciences and Engineering, Gillings School of Global
Public Health, University of North Carolina
at Chapel Hill, Chapel
Hill, North Carolina 27599, United States
| | - Judith T. Zelikoff
- Division
of Environmental Medicine, NYU Grossman
School of Medicine, New York, New York 10010, United States
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Horn GP, Fent KW, Kerber S, Smith DL. Hierarchy of contamination control in the fire service: Review of exposure control options to reduce cancer risk. J Occup Environ Hyg 2022; 19:538-557. [PMID: 35853136 PMCID: PMC9928012 DOI: 10.1080/15459624.2022.2100406] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Indexed: 06/01/2023]
Abstract
The international fire service community is actively engaged in a wide range of activities focused on development, testing, and implementation of effective approaches to reduce exposure to contaminants and the related cancer risk. However, these activities are often viewed independent of each other and in the absence of the larger overall effort of occupational health risk mitigation. This narrative review synthesizes the current research on fire service contamination control in the context of the National Institute for Occupational Safety and Health (NIOSH) Hierarchy of Controls, a framework that supports decision making around implementing feasible and effective control solutions in occupational settings. Using this approach, we identify evidence-based measures that have been investigated and that can be implemented to protect firefighters during an emergency response, in the fire apparatus and at the fire station, and identify several knowledge gaps that remain. While a great deal of research and development has been focused on improving personal protective equipment for the various risks faced by the fire service, these measures are considered less effective. Administrative and engineering controls that can be used during and after the firefight have also received increased research interest in recent years. However, less research and development have been focused on higher level control measures such as engineering, substitution, and elimination, which may be the most effective, but are challenging to implement. A comprehensive approach that considers each level of control and how it can be implemented, and that is mindful of the need to balance contamination risk reduction against the fire service mission to save lives and protect property, is likely to be the most effective.
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Affiliation(s)
- Gavin P Horn
- Fire Safety Research Institute, UL Research Institutes, Columbia, Maryland
- Illinois Fire Service Institute, Champaign, Illinois
| | - Kenneth W Fent
- National Institute for Occupational Safety & Health, Cincinnati, Ohio
| | - Steve Kerber
- Fire Safety Research Institute, UL Research Institutes, Columbia, Maryland
| | - Denise L Smith
- Illinois Fire Service Institute, Champaign, Illinois
- Skidmore College, Saratoga Springs, New York
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Abstract
OBJECTIVES The effects of personal protective clothing (PPC) on firefighters' gait were investigated to develop high-performance PPC. METHODS Thirteen participants participated in human trials with three types of PPC (firefighter protective clothing (FPC); semi-enclosed chemical protective clothing (CPC_semi); full-enclosed chemical protective clothing (CPC_full)) and T-shirt (CON). A 3D motion capture system was used to obtain gait parameters (step length, step width, stride frequency, gait speed, and toe-out angle) and the range of motion (ROM) of the joints (hip, knee, and ankle). RESULTS PPCs produced an increase in step width (23.4%, p > 0.05), but the gait speed (9.1%) and stride frequency (6.4%) decreased compared with the CON results. ROM is affected by the PPC type and joint. FPC and CPC_semi had no significant effect in terms of the ROM of the hip and knee besides the landing angle of the knee. However, CPC_full had a significant effect on the maximum extension angle of the hip and maximum flexion angle of the knee, which reached up to 27.2%. CONCLUSION The ROM of the firefighter's lower limbs were limited by PPC. This study offers insights into next-generation PPC design and development, as well as guidelines for training and firefighting.
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Affiliation(s)
- Jikun Liu
- College of Safety Science and Engineering, Xi'an University of Science and Technology, Xi'an, 710054, China
| | - Yiming Huang
- College of Safety Science and Engineering, Xi'an University of Science and Technology, Xi'an, 710054, China
| | - Yiwen Zhang
- College of Safety Science and Engineering, Xi'an University of Science and Technology, Xi'an, 710054, China
| | - Xingming Wang
- College of Safety Science and Engineering, Xi'an University of Science and Technology, Xi'an, 710054, China
| | - Jie Yang
- College of Safety Science and Engineering, Xi'an University of Science and Technology, Xi'an, 710054, China
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Hwang J, Xu C, Grunsted P, Agnew RJ, Malone TR, Clifton S, Thompson K, Xu X. Urinary Metabolites of Polycyclic Aromatic Hydrocarbons in Firefighters: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2022; 19:8475. [PMID: 35886320 PMCID: PMC9318785 DOI: 10.3390/ijerph19148475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 02/04/2023]
Abstract
Firefighters are intermittently exposed to complex, mixed pollutants in random settings. Of those pollutants, PAHs (polycyclic aromatic hydrocarbons) are the most commonly studied and best understood. PAH exposure can occur via multiple routes; therefore, the levels of hydroxylated metabolites of PAHs in urine have been used as a biomonitoring tool for risk assessment. We performed a systematic review and meta-analysis of the literature to estimate the levels of urinary hydroxylated PAH (OHPAH) among firefighters, determine risk attributions, and, finally, evaluate the scope of preventive efforts and their utility as diagnostic tools. The meta-regression confirmed increases in OHPAH concentrations after fire activities by up to 1.71-times (p-values: <0.0001). Samples collected at a time point of 2−4 h after a fire suppression showed a consistent, statistically significant pattern as compared with baseline samples. The National Fire Protection Association (NFPA) standard 1582 Standard on Comprehensive Occupational Medical Program for Fire Departments lists various health examinations, including a urinalysis for occupational chemical exposure if indicated and medical screening for cancers and cardiovascular diseases. Biomonitoring is a valuable screening tool for assessing occupational exposure and the results of this meta-analysis support their inclusion in regular health screenings for firefighters.
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Affiliation(s)
- Jooyeon Hwang
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Chao Xu
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (C.X.); (P.G.)
| | - Paul Grunsted
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (C.X.); (P.G.)
| | - Robert J. Agnew
- Fire Protection & Safety Engineering Technology Program, College of Engineering, Architecture and Technology, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Tara R. Malone
- Department of Health Sciences Library and Information Management, Graduate College, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (T.R.M.); (S.C.)
| | - Shari Clifton
- Department of Health Sciences Library and Information Management, Graduate College, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (T.R.M.); (S.C.)
| | - Krista Thompson
- Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX 75390, USA;
| | - Xin Xu
- Shanghai Anti-Doping Laboratory, Shanghai University of Sport, Shanghai 200438, China;
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Jeung DY, Hyun DS, Kim I, Chang SJ. Effects of Emergency Duties on Cardiovascular Diseases in Firefighters: A 13-Year Retrospective Cohort Study. J Occup Environ Med 2022; 64:510-514. [PMID: 35081586 PMCID: PMC9275837 DOI: 10.1097/jom.0000000000002490] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to examine the effects of firefighters' emergency duties on the incidence of cardiovascular disease (CVD). METHODS We used a 13-year follow-up in a nationwide retrospective cohort study. A total of 363,137 employees were recruited. The sex-and age-specific incidence of CVD (hypertension, angina pectoris, and acutemyocardial infarction [AMI]) in firefighters and public officials was estimated. RESULTS The overall age-specific sex-based incidence of CVD, except for hypertension, was higher in firefighters than in public officials. The age-stratified hazard ratios for the three types of CVD in male firefighters were also higher. AMI was more common in younger firefighters, whereas angina pectoris and hypertension were common in older firefighters. CONCLUSIONS Firefighters' duties are more likely to increase the risk of CVD, and preventive strategies with proven benefits are required.
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Affiliation(s)
- Da-Yee Jeung
- From the Department of Dental Hygiene, Hanyang Women's University (Dr Jeung); Task Force for Launching Non-benefit Service Reporting, National Health Insurance Service (Dr Hyun); Department of Occupational and Environmental Medicine, Hanyang University College of Medicine (Dr Kim), Seoul; Department of Preventive Medicine & Institute of Occupational Environmental Medicine, Yonsei University Wonju College of Medicine (Dr Chang), Wonju, Republic of Korea
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Chin DL, Kyung M, Li J, Phelps S, Hong O. The short form effort-reward imbalance: Measure of occupational stress for firefighters. Am J Ind Med 2022; 65:492-499. [PMID: 35411620 DOI: 10.1002/ajim.23355] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 10/20/2021] [Revised: 03/01/2022] [Accepted: 03/22/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE The original effort-reward imbalance (ERI) questionnaire has been widely used as a measure of occupational stress. The need for brief measurement of psychosocial stress at work has risen. This study examined the psychometric properties of a 16-item short form ERI (S-ERI) questionnaire. METHODS A cross-sectional study was conducted with a convenience sample of 247 career firefighters in the United States. An internet-based survey contained the S-ERI questionnaire, and assessed perceived health, demographics, and work characteristics. Internal consistency was tested by item-total correlation and Cronbach's α coefficients. Factorial validity was assessed by confirmatory factor analysis (CFA), and criterion validity was examined by testing the S-ERI's association with perceived health, controlling for other factors. RESULTS The study participants were primarily young and mid-aged White males (mean age = 42 years, 75% White non-Hispanic, 93% males). The S-ERI questionnaire showed satisfactory internal consistency, with Cronbach α coefficients above 0.80 for all three scales: effort 0.82, reward 0.83, and overcommitment 0.81. CFA showed all the S-ERI components had a good fit (goodness-of-fit index = 0.99, comparative fit index = 0.92, root mean square error of approximation = 0.06). In terms of criterion validity, significantly increased odds ratios (ORs) for perceived health (those indicating they were less healthy) were found in firefighters in the lowest tertile of reward (OR = 7.06, 95% confidence interval [CI]: 2.86-17.43), and highest tertile of overcommitment (OR = 2.29, 95% CI: 1.00-5.22), after controlling for other factors. CONCLUSION The S-ERI questionnaire is a reliable and valid measure to assess occupational stress. We recommend the use of S-ERI as a measure of occupational stress when initiating efforts to improve firefighters' wellness.
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Affiliation(s)
- Dal Lae Chin
- Occupational and Environmental Health Nursing Graduate Program, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - MinJung Kyung
- Occupational and Environmental Health Nursing Graduate Program, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, California, USA
| | - Stephanie Phelps
- Occupational and Environmental Health Nursing Graduate Program, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - OiSaeng Hong
- Occupational and Environmental Health Nursing Graduate Program, School of Nursing, University of California San Francisco, San Francisco, California, USA
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Leonard SJ, Zegel M, Venta A, Vujanovic AA. Insecure Adult Attachment Style and PTSD Symptom Severity among Firefighters: The Role of Distress Tolerance. J Aggress Maltreat Trauma 2022; 32:592-610. [PMID: 37377579 PMCID: PMC10292721 DOI: 10.1080/10926771.2022.2078681] [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] [Received: 08/13/2021] [Revised: 03/07/2022] [Accepted: 05/01/2022] [Indexed: 06/29/2023]
Abstract
Trauma exposure and posttraumatic stress disorder (PTSD) symptoms among firefighters are prevalent and well-documented. Insecure adult attachment style (AAS) and distress tolerance (DT) present two factors with demonstrated relevance to the etiology and maintenance of PTSD. Few studies have examined these constructs in relation to PTSD symptomatology among firefighter populations. The present investigation examined the indirect effect of insecure romantic AAS (i.e., anxious AAS, avoidant AAS) on PTSD symptom severity through DT among firefighters. Exploratory analyses examined this model with each of the PTSD symptom clusters as outcomes. The sample was comprised of 105 firefighters (Mage=40.43, SD=9.15, 95.2% male) recruited from various departments in the southern U.S. An indirect effect was calculated using 10,000 bootstrapped samples. Indirect effects models in the primary analyses were significant when both anxious AAS (β=.20, SE=.10, CI=.06-.43) and avoidant AAS (β=.28, SE=.12, CI=.08-.54) were evaluated as predictors. Effects were evident after accounting for gender, relationship status, years of fire service, and trauma load (i.e., number of potentially traumatic event types experienced). Exploratory analyses revealed that anxious and avoidant AAS are both indirectly related to the PTSD intrusion, negative alterations in cognitions and mood, and alterations in arousal and reactivity symptom clusters through DT. Anxious AAS also demonstrated an indirect association with PTSD avoidance symptoms through DT. Attachment styles may influence PTSD symptoms among firefighters through a firefighter's perceived ability to withstand emotional distress. This line of inquiry has potential to inform specialized intervention programs for firefighters. Clinical and empirical implications are discussed.
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Vanchiere C, Thirumal R, Hendrani A, Dherange P, Bennett A, Shi R, Gopinathannair R, Olshansky B, Smith DL, Dominic P. Association Between Atrial Fibrillation and Occupational Exposure in Firefighters Based on Self-Reported Survey Data. J Am Heart Assoc 2022; 11:e022543. [PMID: 35319223 PMCID: PMC9075462 DOI: 10.1161/jaha.121.022543] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Exposure to inhaled smoke, pollutants, volatile organic compounds, and polycyclic aromatic hydrocarbons in the firefighting environment has been associated with detrimental respiratory and cardiovascular effects, making firefighters a unique population with both personal and occupational risk factors for cardiovascular disease. Some of these exposures are also associated with development of atrial fibrillation. We aimed to study the association of atrial fibrillation and occupational exposure in firefighters. Methods and Results A cross-sectional survey was conducted between October 2018 and December 2019. Data were gathered electronically and stored in a secure REDCap database through Louisiana State University Health Shreveport. Firefighters who were members of at least 1 of 5 preselected professional organizations were surveyed via electronic links distributed by the organizations. The survey queried the number of fires fought per year as a measure of occupational exposure, as well as self-reported cardiovascular disease. A total of 10 860 active firefighters completed the survey, of whom 93.5% were men and 95.5% were aged ≤60 years. Firefighters who fought a higher number of fires per year had a significantly higher prevalence of atrial fibrillation (0-5 fires per year 2%, 6-10 fires per year 2.3%, 11-20 fires per year 2.7%, 21-30 fires per year 3%, 31 or more fires per year 4.5%; P<0.001). Multivariable logistic regression showed that a higher number of fires fought per year was associated with an increased risk of atrial fibrillation (odds ratio 1.14 [95% CI, 1.04-1.25]; P=0.006). Conclusions Firefighters may have an increased risk of atrial fibrillation associated with the number of fires they fight per year. Further clinical and translational studies are needed to explore causation and mechanisms.
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Affiliation(s)
- Catherine Vanchiere
- Department of Internal Medicine Temple University Health System Philadelphia PA.,Louisiana State University Health ShreveportSchool of Medicine Shreveport LA
| | - Rithika Thirumal
- Louisiana State University Health ShreveportSchool of Medicine Shreveport LA.,Department of Internal Medicine University of Cincinnati Cincinnati OH
| | - Aditya Hendrani
- Louisiana State University Health ShreveportCenter for Cardiovascular Diseases and Sciences Shreveport LA.,Department of Cardiology University of Pittsburgh Medical Center Somerset Somerset PA
| | - Parinita Dherange
- Louisiana State University Health ShreveportCenter for Cardiovascular Diseases and Sciences Shreveport LA.,Department of Electrophysiology Brigham and Women's Hospital Boston MA
| | - Angela Bennett
- Louisiana State University Health ShreveportCenter for Cardiovascular Diseases and Sciences Shreveport LA.,Overton Brooks VA Medical Center Shreveport LA
| | - Runhua Shi
- Louisiana State University Health ShreveportSchool of Medicine Shreveport LA.,Louisiana State University Health ShreveportFeist-Weiller Cancer Center Shreveport LA
| | | | - Brian Olshansky
- Department of Internal Medicine University of Iowa Health CareCardiovascular Medicine Iowa City IA
| | - Denise L Smith
- Department of Health and Human Physiological Sciences Skidmore College Saratoga Springs NY
| | - Paari Dominic
- Louisiana State University Health ShreveportSchool of Medicine Shreveport LA.,Louisiana State University Health ShreveportCenter for Cardiovascular Diseases and Sciences Shreveport LA
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Smith E, Holmes L, Larkin B, Mills B, Dobson M. Supporting Volunteer Firefighter Well-Being: Lessons from the Australian "Black Summer" Bushfires. Prehosp Disaster Med 2022; 37:1-4. [PMID: 35232517 DOI: 10.1017/s1049023x22000322] [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: 11/05/2022]
Abstract
INTRODUCTION The 2019-2020 "Black Summer" bushfires in Australia focused the attention of the nation on the critical role that volunteer firefighters play in the response to such a disaster, spurring a national conversation about how to best support those on the frontline. The objective of this research was to explore the impact of the Black Summer bushfires on volunteer firefighter well-being and to investigate how to deliver effective well-being support. METHODS An explorative qualitative design underpinned by a phenomenological approach was applied. Participant recruitment followed a multi-modal sampling strategy and data were collected through semi-structured, in-depth interviews. RESULTS Qualitative data were collected from 58 participants aged from 23 to 61-years-of-age (average age of 46 years). All self-reported as volunteer firefighters who had responded to the Black Summer bushfires in Australia. Just over 80% of participants were male and the majority lived in the Australian states of New South Wales (65%) and Victoria (32%). All participants reported impact on their well-being, resulting from cumulative trauma exposure, responding to fires in local communities, intense work demands, minimal intervals between deployments, and disruption to primary employment. In regard to supporting well-being, four key themes emerged from data analysis: (1) Well-being support needs to be both proactive and reactive and empower local leaders to "reach in" while encouraging responders to "reach out;" (2) Employee Assistance Programs (EAPs) should not be the only well-being support option available; (3) The sharing of lived experience is important; and (4) Support programs need to address self-stigmatization. CONCLUSION Participants in this research identified that effective well-being support needs to be both proactive and reactive and holistic in approach.
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Affiliation(s)
- Erin Smith
- Edith Cowan University, School of Medical and Health Sciences, Joondalup, Perth, Western Australia
- DART Centre Asia Pacific, C/O Phoenix Australia Centre for Posttraumatic Mental Health Carlton, Victoria, Australia
| | - Lisa Holmes
- Edith Cowan University, School of Medical and Health Sciences, Joondalup, Perth, Western Australia
| | - Brigid Larkin
- Edith Cowan University, School of Medical and Health Sciences, Joondalup, Perth, Western Australia
| | - Brennen Mills
- Edith Cowan University, School of Medical and Health Sciences, Joondalup, Perth, Western Australia
| | - Mark Dobson
- Fire and Rescue NSW, Sydney South, New South Wales, Australia
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Park HS, Ham S, Jeong JH, Kim SJ, Woo H. Examination of Factors Influencing SCBA Washing Behavior among Firefighters in Metropolitan. Int J Environ Res Public Health 2022; 19:2240. [PMID: 35206426 DOI: 10.3390/ijerph19042240] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/04/2022] [Accepted: 02/13/2022] [Indexed: 02/05/2023]
Abstract
Field-washing decontamination of equipment is an effective way for firefighters to reduce their risk of secondary contamination. No study has yet clarified the factors influencing effective field decontamination of equipment such as self-contained breathing apparatuses (SCBAs). This study sought to examine factors that influence the SCBA washing and decontamination behavior of firefighters. We conducted a questionnaire using the web-based Seoul Metropolitan Electronic Questionnaire System. As of May 2021, the survey had been sent to 3626 of 7198 Seoul career firefighters, and 1940 subjects were selected to participate in the study. Binomial logistic regression and χ2-test analyses were performed. We confirmed that previous training in SCBA washing was an important factor in effective field decontamination of SCBAs. Firefighters should be trained to perform field decontamination procedures systematically and regulations to perform field decontamination before leaving the scene of a fire should be introduced.
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Paterson JL, Aisbett B, Kovac K, Ferguson SA. Informal management of health and safety risks associated with alarm response by Australian firefighters. Ergonomics 2022; 65:233-241. [PMID: 34429036 DOI: 10.1080/00140139.2021.1967460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/12/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
Fire-fighters use informal strategies to manage risks to health and safety during operations. It is not known whether such strategies are used during the high-risk alarm response period. The aim of this study was to determine if informal risk management strategies are employed by Australian firefighters during the alarm response procedure, and if these strategies differ between salaried and retained personnel. Forty-six metropolitan firefighters (all male; mean age 38 years ± 10 years; 22 salaried; 24 retained) participated in semi-structured group interviews. A general inductive data analysis approach revealed that firefighters use multiple informal risk management strategies. Some similar themes were reported by both salaried and retained personnel, for example leveraging team dynamics, communication about sleep and fatigue, stress adaptation, informal debriefs, and enhancing physical preparedness. These findings could be used by fire services to tailor risk management approaches during the alarm response period. Practitioner summary: Identifying informal risk management strategies firefighters use during alarm response will allow their development, refinement and dissemination, and may help other firefighters and emergency service workers to manage these risks. This qualitative study reveals multiple informal strategies that firefighters employ during alarm response to keep themselves and their team-mates safe.
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Affiliation(s)
| | - Brad Aisbett
- Centre for Physical Activity Research, Deakin University, Burwood, Australia
| | - Katya Kovac
- Appleton Institute, Central Queensland University, Goodwood, Australia
| | - Sally A Ferguson
- Appleton Institute, Central Queensland University, Goodwood, Australia
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Wang X, Chen J, Yu R. Exploring the comfort of head personal protective equipment for Chinese firefighters: An interview study. Int J Occup Saf Ergon 2021; 28:2686-2693. [PMID: 34970947 DOI: 10.1080/10803548.2021.2024359] [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: 10/19/2022]
Abstract
Head personal protective equipment (HPPE), such as helmets and masks, are protective equipment worn by firefighters to protect their head, neck, and face when they are performing tasks. As a wearable device, HPPE significantly affects firefighters' occupational safety and health along with job performance. This study aims to explore the influential factors of HPPE comfort and collect corresponding functional requirements. A semi-structured interview was conducted among 5 focus groups comprising 31 Chinese firefighters. Through a qualitative analysis of the interview results, eight dimensions of HPPE comfort were proposed: perceived change, movement, attachment, harm, emotion, anxiety, thermal comfort, and comfort of vision and hearing. The aspects of weight and size matching are the important reasons behind the comfort problems of the current HPPE. Four aspects of functional requirements were summarized: communication tools, goggles, full-face helmets, and lighting. The study findings will provide references for improving HPPE design.
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Affiliation(s)
- Xuanzhi Wang
- Department of Industrial Engineering, Tsinghua University, Beijing, China,
| | - Jianwu Chen
- Institute of Occupational Health, China Academy of Safety Science and Technology, Beijing, China,
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Chizewski A, Box A, Kesler RM, Petruzzello SJ. High Intensity Functional Training (HIFT) Improves Fitness in Recruit Firefighters. Int J Environ Res Public Health 2021; 18:13400. [PMID: 34949008 DOI: 10.3390/ijerph182413400] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/15/2021] [Accepted: 12/18/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Firefighting is a strenuous profession requiring adequate levels of fitness for effective job performance. Providing firefighters with a safe and effective fitness program is essential for optimal performance. The purpose of this project was to examine changes in various parameters of physical fitness and firefighter ability following a 7-week high intensity functional training (HIFT) program. METHODS Participants were male firefighter recruits (N = 89; age = 27.1 ± 4.2 years, height = 1.78 ± 0.1 m, BMI = 28.1 ± 4.2) enrolled in a Basic Operations Firefighter Academy. Fitness and firefighting ability (via the Academy Firefighter Challenge) were assessed at Weeks 1 and 7 of the Academy. RESULTS Significant improvements in both fitness and firefighter ability were seen following the HIFT program. Specifically, fitness (BMI, cardiovascular fitness, muscular endurance) improved significantly [Hotelling's T2 = 8.98, F(5, 84) = 150.92, p < 0.001, η2p = 0.90]. Firefighter ability also improved significantly [Hotelling's T2 = 3.95, F(7, 88) = 46.26, p < 0.001, η2p = 0.80]. CONCLUSIONS Following a 7-week Basic Operations Firefighter Academy that included daily HIFT, significant increases in fitness and firefighting ability were observed. These findings suggest that HIFT appears to be an effective means of improving fitness and firefighting ability in recruit firefighters.
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Barr KL, Sturdivant RX, Williams DN, Harris D. Bacteria Associated with Healthcare-Associated Infections on Environmental Samples Obtained from Two Fire Departments. Int J Environ Res Public Health 2021; 18:ijerph182211885. [PMID: 34831638 PMCID: PMC8621870 DOI: 10.3390/ijerph182211885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 12/14/2022]
Abstract
(1) Background: Firefighters spend about 64% of their time responding to medical emergencies and providing medical care without a patient history, which can render them vulnerable to healthcare-associated infections (HAI). Infection prevention, control, and surveillance systems have been instituted at hospitals. However, the prevalence of firefighters’ exposure to HAI is unknown. The objective of this study was to document evidence of HAI on surfaces in fire stations and engines to inform disinfection procedures and identify which pathogens might contribute to occupational exposures. (2) Methods: High-touch or high-use surfaces of two fire departments were sampled during five separate occasions. One fire station from one fire department was sampled over a 4-week period, whereas four fire stations were sampled from a different fire department only once. Sampled surfaces included: entryway floor, washing machine, medical bag, back seat of engine, keyboard of reporting computer, engine console, and uniform pants. (3) Results: Multiple statistical models determined that bacterial contamination was similar between the two fire departments and their stations. Keyboards were the most contaminated surface for all fire stations and departments, E. coli was the most common bacteria detected, and C. difficile was the least detected bacteria. Adjustments for rates of contamination found that contamination rates varied between fire stations. (4) Conclusions: Comprehensive environmental sampling and clinical studies are needed to better understand occupational exposures of firefighters to HAI.
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Affiliation(s)
- Kelli L. Barr
- Center for Global Health Infectious Disease Research, College of Public Health, University of South Florida, Tampa, FL 10921, USA;
| | | | - Denise N. Williams
- Department of Human Sciences and Design, College of Health and Human Science, Baylor University, Waco, TX 76798, USA;
| | - Debra Harris
- Department of Human Sciences and Design, College of Health and Human Science, Baylor University, Waco, TX 76798, USA;
- Correspondence: ; Tel.: +1-254-710-7255
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