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Previous research on the physical and mental health of firefighters indicates higher risk of coronary disease, stroke, cancer, hearing loss, and decreased mobility, as well as suicide risk, depression, anxiety, and substance use than in the general population. In spite of this, there is minimal research available on evidence-based interventions to reduce the impact of high-stress and high-trauma work on the mental health and well-being of firefighters. In collaboration with the Salt Lake City Fire Department, we conducted a feasibility study to understand how psychological resilience training influences the mental and social health of firefighters. A pre-intervention survey (n = 186) provided baseline data on firefighters' mental health and wellbeing. Domains measured were depression, anxiety, stress, post-traumatic stress disorder, substance use, suicide risk, willingness to attend couple's therapy, and quality of life. Three hundred firefighters then received three 90-minute training sessions on MindShield™, a newly-developed trauma-informed, mindfulness-based intervention. Analysis of measurement instrument completion rates suggests firefighters were amenable to the process, though concerns about data privacy may have inhibited response on certain instruments. Qualitative data derived from four post-intervention focus groups (n = 33) informed recommendations for future intervention delivery: shorter training sessions, leaving the training with a tangible reminder of the MindShield™ tools, embedding firefighters more into the training presentation, and clarifying data access and privacy protocols. Both the intervention and measurement tools used were generally well-received, indicating MindShield™ is a feasible intervention to mitigate the impact of high-stress, high-trauma work on firefighters. [ABSTRACT FROM AUTHOR]

In this paper, we build and test theory about the emotional cultures of prototypically masculine organizations. A qualitative study of fire stations in a major metropolitan area revealed that the emotional cultures of firefighting units were defined by two emotions: joviality and companionate love. In addition, emotion suppression, work-family conflict, risk-taking, and health problems emerged as central themes. A multirater survey study of firefighters across multiple units found that cultures characterized by both high joviality and high companionate love were associated with decreased risk-taking behavior outside of work. Additionally, emotion suppressors who experienced high work-family conflict reported more risk-taking behavior outside of work. Suppressors who experienced higher work-family conflict reported more health problems in strong cultures of joviality, but fewer health problems in strong cultures of companionate love. Longitudinal exploratory analyses of objective performance indicators revealed that, although units characterized by strong joviality had better response times, they were also more likely to have auto accidents and property loss than units weak in joviality, with some evidence that companionate love might attenuate risky behavior on the job. Our findings contribute to a more nuanced understanding of gender, emotions, and organizational culture. [ABSTRACT FROM AUTHOR]

Recent research has shown firefighters are at a higher risk for cancer diagnosis than the general population. Experts have offered six hazard adjustments that may assist in reducing the level of exposure to carcinogens. This study was conducted to better understand what motivates or deters firefighters from engaging in these hazard adjustments. The sample was firefighters who had attended or were otherwise associated with the Alabama Fire College (Alabama, USA). An internet survey was administered to collect the data. The participant recruitment email was opened by 1,539 individuals, and 358 responses were received, giving a response rate of 23%. The findings suggest that firefighters' occupational cancer risk perceptions are high. Also, response efficacy, self-efficacy, and cost of engaging in the behavior were much more reliable predictors of intention and actual hazard adjustment than risk perception, salience, and exposure. The concept of peer perception is used in this Protection Motivation Theory study, which also affects firefighters' completion of hazard adjustment. The findings of this study will assist fire service leaders in adapting education programs, policies, and procedures to better protect firefighters from occupational cancer risk. [ABSTRACT FROM AUTHOR]

Background: Exposure to carbon monoxide (CO) remains a leading occupational hazard in firefighters, but cigarette and waterpipe smoking likely contributes to the other sources of CO in such workers. The aim of this study was to estimate the contribution of self-reported active cigarette smoking, waterpipe use, and potential job-related sources of CO to the level of exhaled CO in firefighters.Methods: We surveyed the personnel of 18 fire stations (N = 842), median age 28 years, who participated at an annual screening not timed to coincide with recent firefighting. We surveyed smoking and waterpipe history, exposure to secondhand smoke (SHS), use of coal for health and biomass for cooking and time since last exposure to firefighting in the workplace. We measured exhaled CO with an instantaneous reading device (piCO Smokerlyzer). We used multivariable regression models to test the association of time since last smoked cigarette (≤12 h) and waterpipe (≤12 h) and time since last fire (≤6 h) with exhaled CO.Results: In analysis limited to men (93.5% of all surveyed), 42% were daily cigarette; 1% were waterpipe smokers; 94% were exposed to SHS, 29% used coal for heating and 4% used biomass for cooking. The median CO was 4 (interquartile range 3;8) ppm. Age (beta 0.74 per 10 years, p < 0.001), use of biomass fuel for cooking (beta 1.38, p = 0.05), cigarette smoked in the last 12 h (beta 8.22, p < 0.001), waterpipe smoked in the last 12 h (beta 23.10, p < 0.001) were statistically associated with CO, but not time since last fire (≤6 h) (beta 4.12, p = 0.12). There was a significant interaction between older age and firefighting for exhaled CO (p = 0.03).Conclusions: Cigarette and recent waterpipe smoking are associated with increased exhaled CO in firefighters. Firefighting itself was a less potent contributor to exhaled CO when measured at an annual screening, but an age interaction was manifested. [ABSTRACT FROM AUTHOR]

The article discusses the employer-funded firefighter cancer benefits under the law passed by the Florida Legislature. Also cited are the benefits like enhanced retirement disability and duty-related death benefits, the retroactive application of the law, the eligibility of firefighters to avail of the benefits, and the case Francis v. City of St. Petersburg that determined the retroactive application of the law.

Highlights • A promising index to improve firefighters' occupational safety is proposed. • Proposed index has good correlation with anaerobic metabolism threshold. • Alert threshold for "continuation of activity" is determined. Abstract Firefighting is a physically and mentally stressful activity. It is important to monitor the fatigue state of firefighters in real time in order to get a better occupational safety management though improving the efficiency of firefighting activities, preventing incidents and accidents during firefighting, and reducing human errors due to losing concentration. In general, safety management is based on the experience of the on-site leader and self-judgment of each team firefighter. We conducted two tests, a multi-step incremental load test and modified 20 m shuttle run test, and proposed an index which shows that metabolic state changed from aerobic to anaerobic. This index can be acquired noninvasively based on a frequency analysis of electrocardiographic information (RR interval). This index sensitively responds to load intensity and shows good correlation with other physiological information such as ventilatory threshold and blood lactic acid. We determined the alert threshold for "continuation of activity" based on results obtained in above mentioned two tests and verified the validity of these findings through application in other tests. One is constant load interval test and another is the standardised training test which simulates firefighting activities. It was confirmed that the alert threshold, which means the deviation from the aerobic metabolic state, can be used to estimate the degree of load on cardiopulmonary function of firefighters. By adding objective information proposed in this research to the subjective information felt by the firefighters themselves active at the firefighting site, further safety improvement of the firefighting activities can be expected. [ABSTRACT FROM AUTHOR]

Studies show significant association between cancer risk and being a firefighter. After exposure to even routine firefighting, firefighters' bunker gear often contains carcinogens that may be absorbed through contact or inhaled through off-gassing, thereby increasing cancer risk. Awareness of increased cancer risk has given rise to policies and practices focused on gear cleaning and decontamination processes to decrease risk; yet, these efforts are in their infancy and tend to be somewhat piecemeal in nature. This study presents a theory-based communication intervention tailored to the unique context of high-reliability organizations (HROs). The intervention focused on increasing postfire decontamination behaviors to reduce exposure to carcinogens among firefighters. Results of the intervention across 14 fire stations from 2 fire departments in South Florida show significant increases in attitudes, norms, and self-efficacy, decreases in perceived barriers, and increased intention to engage in decontamination processes. While the intervention was highly successful in both fire departments, there were significant differences in between organizations; attitudes perceived norms, and barriers to gear cleaning remained significantly different. This highlights the need to examine the specific context of the organization in designing interventions. In line with previous research on HROs, regression models showed that norms and self-efficacy are the strongest predictors of current behavior. However, postintervention, attitudes emerge as the strongest predictor of future behavior. The results of this study provide valuable evidence for utilizing theoretical elements in message design for interventions in HROs, and of the importance of designing communication for specific sites of intervention. [ABSTRACT FROM AUTHOR]

Background: Firefighters are at increased risk for both problematic alcohol use and suicidality. Research has found that problematic alcohol use is related to suicidality among this population; however, limited data exist regarding what might account for this association. The present two-study investigation (1) examined the association between suicidality and problematic alcohol use among two large samples of firefighters and (2) tested whether interpersonal theory of suicide constructs-perceived burdensomeness (PB) and thwarted belongingness (TB)-serve as indirect indicators of this relationship.Methods: Participants in Study 1 were 944 U.S. firefighters (12.5% female); participants in Study 2 were 241 U.S. women firefighters. Participants completed the Interpersonal Needs Questionnaire, Alcohol Use Disorders Identification Test, and the Depressive Symptom Inventory-Suicidality Subscale (Study 1) or the Self-Injurious Thoughts and Behaviors Interview-Short Form (Study 2). Bias-corrected bootstrap indirect effects path analyses were utilized.Results: In Study 1, more problematic alcohol use was significantly associated with more severe career suicidal ideation via PB but not TB. In Study 2, problematic alcohol use was associated with career suicidal ideation via both PB and TB. PB seems to account for the relationship between problematic alcohol use and career suicidal ideation among male and female firefighters.Limitations: Limitations include use of a cross-sectional design, use of retrospective measures of suicidal ideation, and our findings derived from subsamples of two existing datasets.Conclusions: Findings suggest that PB and TB may explain the relationship between problematic alcohol use and suicidal ideation, but that this effect is discrepant based on gender. [ABSTRACT FROM AUTHOR]

Musculoskeletal injuries are common in active duty firefighters. These injuries have significant medical and operational effects including increased prevalence of cardiovascular disease and excessive costs related to treatment and disability. The purpose of this study was to determine the impact of a comprehensive health, wellness, and safety initiative on overall fitness and injury prevalence in active duty firefighters. This retrospective analysis, collected data from firefighters (N=148) who participated in O2X training programs between September 2016 and March 2017. The training consisted of an initial lead-in week that included 40 hrs of lectures and supervised physical training followed by a periodized, tactical exercise training program. Demographics and performance scores from a battery of tests known as Key Performance Indicators (KPIs) were collected at baseline and at the end of each 16-wk program. The number of injuries contributing to paid time off, sick calls, salary and overtime costs, incidence of musculoskeletal injury, and incidence of disease were evaluated. KPIs improved in more than 89% of the population, depending on the fitness outcome. Overall cost savings was $6.3 million. The most impactful changes included a 19% reduction in monthly injuries and paid time off, 39% reduction in monthly sick calls, 33.3% reduction in costs related to Cardiac disease, 23.4% reduction in Cancer-related costs, and a 20% reduction in neck injury costs. These data demonstrate that the five principles of improvement established and reinforced by O2X are effective in instilling sustainable gains, functional fitness, and reducing injury in fire department personnel. [ABSTRACT FROM AUTHOR]

Inhalation exposure to smoke particles emitted from fire grounds could induce respiratory and cardiovascular diseases to firefighters and emergency responders. Understanding the detailed smoke-particle deposition distribution and dosages in nasal airway is of significant value to inhalation risk assessment. In this study, a realistic firefighter nasal airway model, accounting for facial features and external environment was employed to study the inhalation and deposition of smoke particles emitted from a composite deck fire. Particle size distribution and concentration used in the simulation were from the Underwriters Laboratories’ large-scale fire experimental data. Deposition patterns and a method for calculating particles dosimetry (in number, mass and surface area) were analyzed. The dosages in the firefighter nasal cavity, middle turbinate, middle meatus, onto the face and penetrated under various inspiration rates were discussed. The aspiration ratio was also considered in the exposure inhalation risk assessments. Three deposition hot spots were identified in the nasal cavity: nasal vestibule, nasopharynx and middle meatus. The breathing flow rate did not affect the aspiration ratio significantly, while the particle density was an obvious impact factor to aspiration ratio of larger size of micron particles (> 5 µm). Greater than 97% of number dosages were from nanoparticles in all simulated areas, yet the nanoparticle mass dosages and surface dosages only took up around 50%. In addition, majority (about 98%) of particles in composite deck fire scenario penetrated into lower airways or even into the lungs. Meanwhile, the dosages in all metrics onto the face were less than those in nasal cavity, but higher than those in the middle meatus and turbinate. Smaller sized particles (such as nanoparticles) were more likely to deposit onto the face than being inhaled into nasal cavity at high flow rate due to the intensive diffusion. Mass carrier (larger sized) particles tended to run into middle turbinate than to middle meatus. [ABSTRACT FROM AUTHOR]

Introduction: Several studies of nonfatal firefighter injuries have been conducted but are limited by the inclusion criteria used and coverage. The aim of this study was to enhance current knowledge by providing national estimates of nonfatal injuries to firefighters treated in U.S. emergency departments.Methods: Nonfatal injuries from 2003 through 2014 were extracted from the National Electronic Injury Surveillance System occupational supplement (NEISS-Work). NEISS-Work captures nonfatal occupational injuries, illnesses, and exposures treated in a sample of U.S. emergency departments. Nonfatal injury rates were calculated based on NEISS-Work counts (numerator) and counts from the National Fire Protection Association (denominator). Data were analyzed from 2016 through 2017.Results: Between 2003 and 2014, an estimated 351,800 firefighters were treated in emergency departments for nonfatal injuries. The overall rate was 260 injuries per 10,000 firefighters. Career firefighters had an annual rate of 699 injuries per 10,000 firefighters; volunteers had a rate of 39 injuries per 10,000 firefighters. Leading injury events were fires and explosions (36%) and overexertion and bodily reactions (20%). A majority (38%) of injuries occurred during firefighting activities, 7% occurred during training, and 7% occurred during patient care. Sprains and strains accounted for the largest proportion of injuries in all three of these activities: 28% firefighting activities, 32% training, and 36% patient care.Conclusions: The results demonstrate that nonfatal injuries for firefighters remained high throughout the study period. The predominance of sprains and strains in all firefighting activities suggests the need for additional research and prevention needs in areas of improved fitness, safer body postures and movements, and situational awareness. [ABSTRACT FROM AUTHOR]

Background: Workplace discrimination is associated with poor mental health. However, there is a lack of studies examining the effects of discrimination on depressive symptoms among firefighters. Methods: We analyzed a national cross‐sectional survey of 6369 firefighters in South Korea. Workplace discrimination during the past year was measured and main reasons for the discriminatory experience (gender, birth region, age, education, field/office work, job division) were identified separately by gender and job division. Depressive symptoms during the previous week were measured by the CES‐D11. Results: Overall, 30.3% of firefighters experienced workplace discrimination and the main reasons for discrimination differed by gender and job division. Firefighters who experienced workplace discrimination had a higher likelihood of depressive symptoms than those who did not after adjusting for potential confounders (PR: 1.73; 95%CI: 1.55, 1.92). Conclusions: This finding suggests that experience of workplace discrimination could aggravate the mental health of firefighters who provide an important public service. [ABSTRACT FROM AUTHOR]

Background: The goals of this study were to assess the impact of work at the World Trade Center (WTC) site in relation to new, post‐9/11/2001 (9/11) antibody to hepatitis C Virus (anti‐HCV); and, evaluate secular trends in WTC‐exposed male Fire Department of New York City (FDNY) Firefighters and Emergency Medical Services (EMS) responders. Methods: FDNY monitors responder health through physical exams and routine blood work. We used descriptive statistics to compare trans‐9/11 and post‐9/11 incidence and to assess trends in prevalence from 2000 to 2012. Results: Trans‐9/11 incidence of new anti‐HCV was 0.42 per 100 persons compared with post‐9/11 incidence of 0.34 (P = 0.68). Overall seroprevalence was 1.3%; rates declined from 1.79 per 100 to 0.49 per 100 over time (P < 0.0001). Conclusions: Work at the WTC was not associated with new infection. Biennial seroprevalence in responders declined over time, supporting the FDNY decision to discontinue routine annual testing in this cohort. [ABSTRACT FROM AUTHOR]

This study investigated the combined effect of firefighting operations and exposure to smoke on physiological responses, cognitive functions and physical performance among firefighters. Each firefighter was engaged in two experimental conditions: (a) without artificial smoke, control (NS); (b) with artificial smoke (WS). The results of data analysis revealed that heart rate and body temperature increased significantly after the firefighting activities in the two conditions relative to baseline. In addition, reaction time (RT) and correct response (CR) decreased after the activity relative to baseline and there was a significant difference in RT and CR between the NS and WS conditions. There was also a significant difference in performance time between the NS and WS conditions. These findings demonstrated that a smoke compound has an insignificant effect on physiological responses during firefighting activity. On the contrary, the smoke compound has a detrimental influence on cognitive and physical performance. [ABSTRACT FROM AUTHOR]

Activities performed by wildland firefighters are carried out wearing a personal protective equipment (PPE). Although the PPE protects workers from a wide variety of hazards, it may increase their physiological response and limit their performance. The aim of this study was to analyze the effect of the protective clothing (PPC) and the rest of the PPE elements (i.e., helmet, neck shroud, gloves, goggles, and mid-calf leather boots) on the wildland firefighters' thermophysiological response during a moderate-intense exercise. Six male wildland firefighters performed, in a counterbalanced order, a 120 min graded exercise test wearing three different clothing configurations: (i) a traditional short sports gear (SG), (ii) a PPC, and (iii) a complete firefighters' PPE. Trials were conducted on separate days at the same time of the day (12:00-15:00 h) and under climate-controlled conditions (∼30°C and ∼30% relative humidity). Heart rate, respiratory gas exchange, gastrointestinal and skin temperature, blood lactate concentration were recorded throughout the tests. Additionally, parameters of heat balance were estimated. Exercise time was shorter (p < 0.001) wearing the PPE (62.4 ± 13.3 min) than with the PPC (115.5 ± 5.0 min) and SG (118.2 ± 20.7 min). The increment of gastrointestinal temperature with the PPE (1.8 ± 0.3°C) was greater (p < 0.05) than the observed in PPC (1.2 ± 0.6°C) and SG (1.0 ± 0.2°C). The use of PPC increased (p < 0.05) subjects' metabolic demand and skin temperature versus SG during the last 20 min of the test. The sweat retention in the PPE (1,045.7 ± 214.7 g) and PPC (978.3 ± 330.6 g) was significantly higher than that obtained in the SG (510.0 ± 210.0 g). Sweat efficiency decreased (p < 0.05) in the following order: PPE (45.6 ± 18.3%), PPC (64.3 ± 7.8%), and SG (79.3 ± 7.0%). These results highlight the importance of the PPE elements in the subjects' thermal strain. The reduction in the sweat evaporation produced by the PPE, together with the ensemble mass caused a substantial increase in the subjects' thermophysiological response. As a consequence the performance was reduced by ~50%. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to examine the influence of TSD on cognitive functioning in a group of firefighters. Subjects and methods: Sixty volunteers who were active male fire brigade officers were examined with a computerized battery test that consisted of simple reaction time (SRT) (repeated three times), choice reaction time, visual attention test, and delayed matching to sample. Six series of measurements were undertaken over a period of TSD. Results: Performance in the second attempt in SRT test was significantly worse in terms of increased number of errors and, consequently, decreased number of correct responses during TSD. In contrast, the choice reaction time number of correct responses as well as the visual attention test reaction time for all and correct responses significantly improved compared to initial time points. Conclusion: The study has confirmed that subjects committed significantly more errors and, consequently, noted a smaller number of correct responses in the second attempt of SRT test. However, the remaining results showed reversed direction of TSD influence. TSD potentially leads to worse performance in a relatively easy task in a group of firefighters. Errors during repetitive tasks in firefighting routines could potentially translate into catastrophic consequences. [ABSTRACT FROM AUTHOR]

Firefighting is a hazardous occupation and the fireground is the location for many firefighter injuries, making information about firefighter injury events critical for injury prevention efforts. This study uses data collected through the National Fire Incident Reporting System and the National Fire Protection Association's annual survey of municipal fire departments to profile U.S. firefighter injuries occurring on the fireground from 2010 to 2014. The research estimates that firefighters experienced an annual average of 30,290 fireground injuries per year in this 5-year period. The findings also indicate that most injuries occurred at residential fires, that one-third resulted in lost work time and that the leading cause of injury was overexertion or strain. Other leading causes of injury were slip/trip, contact with object, falls, and struck or assaulted by person, animal, or object. The study also provides data on primary injury symptoms, place of injury, activity when injured, factors involved in the injury, and injuries by month. Efforts to reduce injury should include providing and requiring the use of appropriate personal protective equipment, establishing and enforcing stringent safety practices, providing firefighters with ongoing health and safety training opportunities, and maintaining fitness, flexibility, and other programs that reduce injury risk. [ABSTRACT FROM AUTHOR]

Introduction Firefighters represent an important population for understanding the consequences of exposure to potentially traumatic stressors. Hypothesis/Problem The researchers were interested in the effects of pre-employment disaster exposure on firefighter recruits' depression and posttraumatic stress disorder (PTSD) symptoms during the first three years of fire service and hypothesized that: (1) disaster-exposed firefighters would have greater depression and PTSD symptoms than non-exposed overall; and (2) depression and PTSD symptoms would worsen over years in fire service in exposed firefighters, but not in their unexposed counterparts.Methods: In a baseline interview, 35 male firefighter recruits from seven US cities reported lifetime exposure to natural disaster. These disaster-exposed male firefighter recruits were matched on age, city, and education with non-exposed recruits.Results: A generalized linear mixed model revealed a significant exposure×time interaction (e coef =1.04; P<.001), such that depression symptoms increased with time for those with pre-employment disaster exposure only. This pattern persisted after controlling for social support from colleagues (e coefficient=1.05; P<.001), social support from families (e coefficient=1.04; P=.001), and on-the-job trauma exposure (coefficient=0.06; e coefficient=1.11; P<.001). Posttraumatic stress disorder symptoms did not vary significantly between exposure groups at baseline (P=.61).Conclusion: Depression symptoms increased with time for those with pre-employment disaster exposure only, even after controlling for social support. Posttraumatic stress disorder symptoms did not vary between exposure groups. Pennington ML , Carpenter TP , Synett SJ , Torres VA , Teague J , Morissette SB , Knight J , Kamholz BW , Keane TM , Zimering RT , Gulliver SB . The influence of exposure to natural disasters on depression and PTSD symptoms among firefighters. Prehosp Disaster Med. 2018;33(1):102-108. [ABSTRACT FROM AUTHOR]

Firefighter wellness has become a concern across the country, in large part because a combination of poor fitness levels, excess weight, and a high-intensity work environment contributes to chronic illness as well as line-of-duty deaths. Workplace wellness programs are effective in career fire service organizations, but nationwide implementation rates are low. This study examined the barriers to implementation in career fire service organizations in the United States. Using a semistructured interview format, 18 fire service leaders from eight different geographically disparate organizations were interviewed. Results revealed themes involving barriers across categories of buy-in, financial matters, leadership support, and labor management. [ABSTRACT FROM AUTHOR]

The main objective of this study was to assess the prevalence of lower back pain (LBP) and clarify the effect of work-related psychological factors on LBP. Nationwide survey data collected from male Korean firefighters (FIFS) were used. To identify the risk factors (work-related psychological factors such as job stress and depression) affecting LBP, theχ2test and multivariate logistic regression analyses were conducted. The prevalence of LBP was 19.3% and was highest in the emergency medical service (31.8%) part of FF job types. Within job stress, an uncomfortable physical environment, high mental job demand and organizational injustice were associated with LBP. However, inadequate social support inversely associated with LBP. Depression and high-risk alcohol drinking were related to LBP. LBP was closely related to job stress, depression and alcohol intake. Proper interventions of psychological factors should therefore be addressed to control LBP in FIFS. [ABSTRACT FROM PUBLISHER]

Objectives: We conducted a systematic review and meta-analysis to evaluate potential associations between firefighting and police occupations, and prostate cancer incidence and mortality.Methods: Original epidemiological studies published from 1980 to 2017 were identified through PubMed and Web of Science. Studies were included if they contained specific job titles for ever/never firefighting and police work and associated prostate cancer risk estimates with 95% confidence intervals (CI). Study quality was assessed using a 20-point checklist. Prostate cancer meta-risk estimates (mRE) and corresponding 95% CIs were calculated for firefighting and police work separately and by various study characteristics using random effects models. Between-study heterogeneity was evaluated using the I2 score. Publication bias was assessed using Begg's and Egger's tests.Results: A total of 26 firefighter and 12 police studies were included in the meta-analysis, with quality assessment scores ranging from 7 to 19 points. For firefighter studies, the prostate cancer incidence mRE was 1.17 (95% CI = 1.08-1.28, I2 = 72%) and the mortality mRE was 1.12 (95% CI = 0.92-1.36, I2 = 50%). The mRE for police incidence studies was 1.14 (95% CI = 1.02-1.28; I2 = 33%); for mortality studies, the mRE was 1.08 (95% CI = 0.80-1.45; I2 = 0%). By study design, mREs for both firefighter and police studies were similar to estimates of incidence and mortality.Conclusion: Small excess risks of prostate cancer were observed from firefighter studies with moderate to substantial heterogeneity and a relatively small number of police studies, respectively. There is a need for further studies to examine police occupations and to assess unique and shared exposures in firefighting and police work. [ABSTRACT FROM AUTHOR]

Even though the fire service has been the subject of a growing body of academic studies since the early 1970s, no attempt has been made to discover underlying themes or the contributions and limitations of this research. As such, this article presents a systematic literature review of a representative sample of 238 fire-related academic studies drawn from peer-reviewed journals published between 1970 and 2016. Findings suggest that three themes or meta-categories define fire-related academic research during the 46-year time span. In order of importance (based on the number of studies in a meta-category) the themes or meta-categories of research are health and safety, management, and organizational culture. Results presented in this article suggest that research bridging the intersections of the meta-categories will enhance the development of a more in-depth understanding of the links among health and safety issues, managerial work, and organizational culture in the fire service. [ABSTRACT FROM AUTHOR]

The past decade of research on the health of firefighters has identified several areas of need related to morbidity and mortality risks including cancer, cardiovascular disease, and injury. Data suggest that a number of occupational risk factors push firefighters toward poor health and increase their risks for a number of diseases and premature deaths. Underlying modifiable risk factors have emerged as playing a central role in increasing risks for poor health, including obesity, poor nutrition, low fitness, binge drinking, smokeless-tobacco use, poor sleep, and behavioral-health concerns. Understanding these risks, as well as prevention and intervention techniques, are necessary components to improving occupational health among this important population. [ABSTRACT FROM AUTHOR]

Systolic (S) and diastolic (D) blood pressures (BP) [SBP and DBP] are circadian rhythmic with period (τ) in healthy persons assumed to be maintained at 24.0h. We tested this assumption in a sample of 30 healthy career (mean >12 yrs) 30-to-46 yr-old male Caucasian French firefighters (FFs) categorized into three groups according to work schedule and duties: Group A – 12 FFs working 12h day, 12h night, and occasionally 24h shifts and whose primary duties are firefighting plus paramedical and road rescue services; Group B – 9 FFs working mostly 12h day and 12h night shifts and whose duties are answering incoming emergency calls and coordinating service vehicle dispatch from fire stations with Group A personnel; Group C – 9 day shift (09:00–17:00h) FFs charged with administrative tasks. SBP and DBP, both in winter and in summer studies of the same FFs, were sampled by ambulatory BP monitoring every 1h between 06:00–23:00h and every 2h between 23:01–05:59h, respectively, their approximate off-duty wake and sleep spans, for 7 consecutive days. Activity (wrist actigraphy) was also sampled at 1-min intervals. Prominent τ of each variable was derived by a power spectrum program written for unequal-interval time series data, and between-group differences in incidence of τ≠24h of FFs were assessed by chi square test. Circadian rhythm disruption (τ≠24h) of either the SBP or DBP rhythm occurred almost exclusively in night and 24h shift FFs of Group A and B, but almost never in day shift FFs of Group C, and it was not associated with altered τ from 24.0h of the circadian activity rhythm. In summer, occurrence of τ≠24 for FFs of Group A and B differed from that for FFs of Group C in SBP (p=0.042) and DBP (p=0.015); no such differences were found in winter (p>0.10). Overall, manifestation of prominent τ≠24h of SBP or DBP time series was greater in summer than winter, 27.6% versus 16.7%, when workload of Group B FFs, i.e. number of incoming emergency telephone calls, and of Group A FFs, i.e. number of dispatches for provision of emergency services, was, respectively, two and fourfold greater and number of 12h night shifts worked by Group B FFs and number of 24h shifts worked by Group A FFs was, respectively, 92% and 25% greater. FFs of the three groups exhibited no winter-summer difference in τ≠24h of SBP or SDP; however, τ≠24h of DBP in Group B FFs was more frequent in summer than winter (p=0.046). Sleep/wake cycle disruption, sleep deprivation, emotional and physical stress, artificial light-at-night, and altered nutrient timings are hypothesized causes of τ≠24h for BP rhythms of affected Groups A and B FFs, but with unknown future health effects. [ABSTRACT FROM PUBLISHER]

Firefighting is a an extremely stressful occupation that risks exposure to traumatic events as part of the job. Despite this, the literature on stress and trauma pays little attention to this occupation and its generalization to other, high risk occupations. This study examined resilience and work locus of control as predictors of posttraumatic stress disorder (PTSD) symptoms among Nigerian firefighters. Participants were 116 paid, professional firefighters (98 males and 18 females) who completed the Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C), Resilience Scale (RS-14), and Work Locus of Control Scale (WLCS) and provided vital demographic information. Multiple regression analysis was used to analyze the data. Results showed that resilience negatively predicted PTSD symptoms such that higher resilience was associated with fewer symptoms of PTSD. Work locus of control was a positive predictor of PTSD symptoms, indicating that externality of control beliefs in the workplace was associated with more PTSD symptoms. Relevant demographic factors especially higher years of service, being a senior firefighter, and higher educational status were associated with lower PTSD symptoms. Findings underscore the potential value of resilience training and implementing behavioral health programs to modify firefighters’ external locus of control beliefs. Interventions should consider resilience and locus of control focused interventions as protective factors for PTSD. [ABSTRACT FROM AUTHOR]

Background Firefighting is a hazardous occupation and there have been numerous calls for fundamental changes in how fire service organizations approach safety and balance safety with other operational priorities. These calls, however, have yielded little systematic research. Methods As part of a larger project to develop and test a model of safety climate for the fire service, focus groups were used to identify potentially important dimensions of safety climate pertinent to firefighting. Results Analyses revealed nine overarching themes. Competency/professionalism, physical/psychological readiness, and that positive traits sometimes produce negative consequences were themes at the individual level; cohesion and supervisor leadership/support at the workgroup level; and politics/bureaucracy, resources, leadership, and hiring/promotion at the organizational level. A multi-level perspective seems appropriate for examining safety climate in firefighting. Conclusions Safety climate in firefighting appears to be multi-dimensional and some dimensions prominent in the general safety climate literature also seem relevant to firefighting. These results also suggest that the fire service may be undergoing transitions encompassing mission, personnel, and its fundamental approach to safety and risk. Practical applications These results help point the way to the development of safety climate measures specific to firefighting and to interventions for improving safety performance. [ABSTRACT FROM AUTHOR]

Objective: To explore the level of and relationship between compassion satisfaction (CS), secondary traumatic stress (STS), and burnout (BO) and to find out significant predictors of compassion satisfaction among rescuers. Methodology: This study was based on cross-sectional survey research design. It was conducted in Faisalabad Division from September to December 2016. A sample of 185 men with mean age 32.45 ±5.64 paramedics (n=100) and firefighters (n=85) working in Rescue 1122 were selected with purposive sampling technique from Faisalabad and Chiniot City. Professional Quality of Life scale developed by Stamm (2009) was used to measure the level of CS, STS and BO among paramedics and fire fighters. Results: Significant positive relationship between CS and STS and significant negative relationship between CS and BO among rescuers were observed (p <0.01). Rescuers' have moderate level of CS, STS and BO. Compassion satisfaction was significantly predicted from age group, marital status, living area, socioeconomic status, nature of job, STS and BO (F [7,177] =44.37, p =.001) R2 =.64. Conclusion: Rescuers had average level of and significant relationship with CS, STS, and BO. Compassion satisfaction was significantly predicted from age group, marital status, living area, and socioeconomic status, nature of job, STS and BO. [ABSTRACT FROM AUTHOR]

Background Little is known about the association between weight change (particularly moderate weight loss, 5-10% in initial weight) and long-term sickness absence (LSA) in working populations. Methods Three hundred and forty professional firefighters reported their current and past (1 year ago) weights in a cross-sectional survey, along with their LSA experience due to a severe accident, injury, or illness during the previous 12 months. Results The prevalence of LSA was 14.7%. In the non-smoking male firefighters, the prevalence of LSA was 3.4% in those with moderate weight loss over the past year; 13.3% in those who maintained their weight; and 21.7% in those who gained their weight moderately: gamma coefficient, 0.44 (95%CI: 0.05, 0.66). The linear association remained significant after further controlling for age and alcohol consumption. And it was similar across the adiposity strata (normal weight, overweight, and obesity) of the firefighters 1 year ago. Conclusions One-year weight loss was associated with decreased risk of LSA in professional firefighters. [ABSTRACT FROM AUTHOR]

Objectives: Rescuers work in 24-h shifts and the demanding nature of the occupation requires adequate recovery between work shifts. The purpose of this study has been to find out what kind of changes in autonomic control may be seen during work shift and its recovery period in the case of rescuers. An additional interest has been to see if aerobic fitness is associated with recovery from work shifts.Material and Methods: Fourteen male rescuers (aged 34±9 years old) volunteered to participate in the study. Heart rate variability (HRV) was recorded for 96 h to study stress and recovery, from the beginning of a 24-h work shift to the beginning of the next shift. Aerobic fitness assessment included maximal oxygen uptake (VO2max) estimation with a submaximal bicycle ergometer test. Salivary cortisol samples were collected 0 min, 15 min, and 30 min after awakening on the 3 resting days.Results: Some HRV parameters showed enhanced autonomic control after the work shift. Stress percentage decreased from the working day to the 2nd rest day (p < 0.05). However, maximal oxygen uptake was not associated with enhanced parasympathetic cardiac control (p > 0.05). Cortisol awakening response was attenuated right after the work shift.Conclusions: The HRV findings show that recovery after a long work shift takes several days. Thus, rescuers should pay attention to sufficient recovery before the next work shift, and an integrated model of perceived and physiological measurements could be beneficial to assess cardiovascular strain among rescuers with long work shifts. Int J Occup Med Environ Health 2017;30(3):433-444. [ABSTRACT FROM AUTHOR]

Background: Firefighters for difficult activities and rescue of damaged people must be in appropriate physical ability. Maximal oxygen capacity is an indicator for diagnosis of physical ability of workers. This study aimed to assess the cardiorespiratory system and its related factors in firefighters. Methods: This study was conducted on 110 firefighters from various stations. An self-administered questionnaire (respiratory disorders questionnaire, Tuxworth-Shahnavaz step test, and pulmonary function test) was used to collection of required data. Average of humidity and temperature was 52% and 17°C, respectively. Background average noise levels were between 55 and 65 dB. Data were analyzed using SPSS software (version 19). Results: The mean age of the study participants was 32 ± 6.2 years. The means of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC were 92% ±9.4%, 87% ±9.2%, and 80% ±6.1%, respectively. The participants' mean VO2-max was 2.79 ± 0.29 L/min or 37.34 ± 4.27 ml/kg body weight per minute. The results revealed that weight has a direct association with vital capacity (VC), FVC, and peak expiratory flow. In addition, height was directly associated with VC, FVC, and VO2-max (P < 0.05). However, there was an inverse and significant association between height and FEV1/FVC (r = −0.23,P< 0.05). Height, weight, body mass index, and waist circumference were directly associated with VO2-max. Conclusions: The findings of this study showed that the amount of maximum oxygen consumption is close with the proposed range of this parameter among firefighters in other studies. Furthermore, the results of the study revealed that individuals had normal amounts of lung volume index. This issue can be attributed to the appropriate usage of respiratory masks. [ABSTRACT FROM AUTHOR]

Wildland firefighting exposes personnel to combinations of occupational and environmental stressors that include physical activity, heat and sleep restriction. However, the effects of these stressors on sleep have rarely been studied in the laboratory, and direct comparisons to field scenarios remain problematic. The aim of this study was to examine firefighters’ sleep during a three-day, four-night simulated wildfire suppression that included sleep restriction and physical activity circuits representative of firefighting wildfire suppression tasks in varied temperatures. Sixty-one volunteer firefighters (37.5 ± 14.5 years of age, mean ± SD) were assigned to one of three conditions: control ( n = 25; 8 h sleep opportunities and 18–20 °C), awake ( n = 25; 4 h sleep opportunities and 18–20 °C) or awake/hot ( n = 11; 4 h sleep opportunities and 33–35 °C during the day and 23–25 °C during the night). Results demonstrated that amounts of N1, N2 and R sleep, TST, SOL and WASO declined, whilst sleep efficiency increased significantly in the awake and awake/hot conditions compared to the control condition. Results also demonstrated that SWS sleep remained relatively stable in the awake and awake/hot conditions compared to control values. Most importantly, no significant differences were found for any of the sleep measures between the awake and awake/hot conditions. Thus, working in hot daytime temperatures in combination with sleep restriction during the night did not affect patterns of sleep compared to working in temperate conditions in combination with sleep restriction during the night. However, the effects on sleep of high (>25 °C) night-time temperatures with sleep restriction in addition to physical activity remains to be studied. [ABSTRACT FROM AUTHOR]

Wildland fire fighters use many tools and equipment that produce noise levels that may be considered hazardous to hearing. This study evaluated 174 personal dosimetry measurements on 156 wildland fire fighters conducting various training and fire suppression tasks. Noise exposures often exceeded occupational exposure limits and suggest that wildland fire fighters may be at risk of developing noiseinduced hearing loss, particularly those operating chainsaws, chippers, and masticators. The authors recommend a comprehensive approach to protecting these fire fighters that includes purchasing quieter equipment, noise and administrative controls, and enrolling these fire fighters into a hearing conservation program. [ABSTRACT FROM AUTHOR]

The fitness of firefighters is regularly evaluated using exercise tests. We aimed to compare, with respect to age and body composition, two test modalities for the assessment work capacity. A total of 424 Swedish firefighters with cycle ergometer (CE) and treadmill (TM) tests available from Jan 2004 to Dec 2010 were included. We compared results from CE (6 min at 200 W, 250 W or incremental ramp exercise) with TM (6 min at 8° inclination, 4·5 km h−1 or faster, wearing 24-kg protective equipment). Oxygen requirements were estimated by prediction equations. It was more common to pass the TM test and fail the supposedly equivalent CE test (20%), than vice versa (0·5%), P<0·001. Low age and tall stature were significant predictors of passing both CE and TM tests ( P<0·05), while low body mass predicted accomplishment of TM test only ( P = 0·006). Firefighters who passed the TM but failed the supposedly equivalent CE test within 12 months had significantly lower body mass, lower BMI, lower BSA and shorter stature than did those who passed both tests. Calculated oxygen uptake was higher in TM tests compared with corresponding CE tests ( P<0·001). Body constitution affected approval differently depending on the test modality. A higher approval rate in TM testing suggests lower cardiorespiratory requirements compared with CE testing, even though estimated oxygen uptake was higher during TM testing. The relevance of our findings in relation to the occupational demands needs reconsidering. [ABSTRACT FROM AUTHOR]

Adult stem cells represent a potentially renewable and autologous source of cells to regenerate skin and improve wound healing. Firefighters are at risk of sustaining a burn and potentially benefiting from a split thickness skin graft (STSG). This mixed methods study examined firefighter willingness to participate in a future stem cell clinical trial, outcome priorities and factors associated with this decision.Methods: A sequential explanatory mixed methods design was used. The quantitative phase (online questionnaire) was followed by the qualitative phase (semi-structured interviews). A sample of 149 firefighters completed the online survey, and a purposeful sample of 15 firefighters was interviewed.Results: A majority (74%) reported they would participate in a future stem cell clinical trial if they experienced burn benefiting from STSG. Hypothetical concerns related to receiving a STSG were pain, itch, scarring/redness and skin durability. Participants indicated willingness to undergo stem cell therapy if the risk of no improvement was 43% or less. Risk tolerance was predicted by perceived social support and having children. Interviews revealed four main themes: a desire to help others, improving clinical outcomes, trusting relationships, and a belief in scientific investigation. Many participants admitted lacking sufficient knowledge to make an informed decision regarding stem cell therapies.Conclusions: Firefighters indicated they were largely willing to participate in a stem cell clinical trial but also indicated a lack of knowledge upon which to make a decision. Public education of the role of stem cells in STSG will be increasingly important as clinical trials are developed. [ABSTRACT FROM AUTHOR]

The association between cumulative exposure to suicide attempts and deaths and suicidal behavior was examined in a sample of 61 professional firefighters. On average, firefighters reported 13.1 (SD = 16.6) exposures over the course of their lifetime. Cumulative exposure to suicide attempts and deaths was positively correlated with suicidal behavior (r = .38, p = .004). Moreover, firefighters with 12+ exposures were more likely to screen positive for risk of suicidal behavior (OR = 7.885, p = .02). Additional research on the potential impact of cumulative exposure to suicide attempts and deaths on firefighters' health and safety is needed. [ABSTRACT FROM AUTHOR]

Background: The leading cause of death among firefighters in the United States (U.S.) is cardiovascular events (CVEs) such as sudden cardiac arrest and myocardial infarction. This study compared the cost-effectiveness of three strategies to prevent CVEs among firefighters. Methods: We used a cost-effectiveness analysis model with published observational and clinical data, and cost quotes for physiologic monitoring devices to determine the cost-effectiveness of three CVE prevention strategies. We adopted the fire department administrator perspective and varied parameter estimates in one-way and two-way sensitivity analyses. Results: A wellness-fitness program prevented 10% of CVEs, for an event rate of 0.9% at $1440 over 10-years, or an incremental cost-effectiveness ratio of $1.44 million per CVE prevented compared to no program. In one-way sensitivity analyses, monitoring was favored if costs were < $116/year. In two-way sensitivity analyses, monitoring was not favored if cost was ≥ $399/year. A wellness-fitness program was not favored if its preventive relative risk was >0.928. Conclusions: Wellness-fitness programs may be a cost-effective solution to preventing CVE among firefighters compared to real-time physiologic monitoring or doing nothing. [ABSTRACT FROM AUTHOR]

Background: Firefighting is a highly stressful occupation with unique physical challenges, apparel and environments that increase the potential for dehydration. Dehydration leaves the firefighter at risk of harm to their health, safety and performance. The purpose of this review was to critically analyse the current literature investigating the impact of fighting 'live' fires on firefighter hydration. Methods: A systematic search was performed of four electronic databases for relevant published studies investigating the impact of live fire suppression on firefighter hydration. Study eligibility was assessed using strict inclusion and exclusion criteria. The included studies were critically appraised using the Downs and Black protocol and graded according to the Kennelly grading system. Results: Ten studies met the eligibility criteria for this review. The average score for methodological quality was 55 %, ranging from 50 % ('fair' quality) to 61 % ('good' quality) with a 'substantial agreement' between raters (k = .772). Wildfire suppression was considered in five studies and structural fire suppression in five studies. Results varied across the studies, reflecting variations in outcome measures, hydration protocols and interventions. Three studies reported significant indicators of dehydration resulting from structural fire suppression, while two studies found mixed results, with some measures indicating dehydration and other measures an unchanged hydration status. Three studies found non-significant changes in hydration resulting from wildfire firefighting and two studies found significant improvements in markers of hydration. Ad libitum fluid intake was a common factor across the studies finding no, or less severe, dehydration. Conclusions: The evidence confirms that structural and wildfire firefighting can cause dehydration. Ad libitum drinking may be sufficient to maintain hydration in many wildfire environments but possibly not during intense, longer duration, hot structural fire operations. Future high quality research better quantifying the effects of these influences on the degree of dehydration is required to inform policies and procedures that ensure firefighter health and safety. [ABSTRACT FROM AUTHOR]

The concentrations of six urinary monohydroxyl metabolites (OH-PAHs) of polycyclic aromatic hydrocarbons, namely 1-hydroxynaphthalene, 1-hydroxyacenaphthene, 2-hydroxyfluorene, 1-hydroxyphenanthrene, 1-hydroxypyrene (1OHPy), and 3-hydroxybenzo[a]pyrene, were assessed in the post-shift urine of wildland firefighters involved in fire combat activities at six Portuguese fire corporations, and compared with those of non-exposed subjects. Overall, median levels of urinary individual and total OH-PAHs (ΣOH-PAHs) suggest an increased exposure to polycyclic aromatic hydrocarbons during firefighting activities with ΣOH-PAH levels in exposed firefighters 1.7-35 times higher than in non-exposed ones. Urinary 1-hydroxynaphthalene and/or 1-hydroxyacenapthene were the predominant compounds, representing 63-98% of ΣOH-PAHs, followed by 2-hydroxyfluorene (1-17%), 1-hydroxyphenanthrene (1-13%), and 1OHPy (0.3-10%). A similar profile was observed when gender discrimination was considered. Participation in fire combat activities promoted an increase of the distribution percentage of 1-hydroxynaphthalene and 1-hydroxyacenaphthene, while contributions of 1-hydroxyphenanthrene and 1OHPy decreased. The detected urinary 1OHPy concentrations (1.73×10-2 to 0.152μmol/mol creatinine in exposed subjects versus 1.21×10-2 to 5.44×10-2μmol/mol creatinine in non-exposed individuals) were lower than the benchmark level (0.5μmol/mol creatinine) proposed by the American Conference of Governmental Industrial Hygienists. This compound, considered the biomarker of exposure to PAHs, was the less abundant one from the six analyzed biomarkers. Thus the inclusion of other metabolites, in addition to 1OHPy, in future studies is suggested to better estimate firefighters' occupational exposure to PAHs. Moreover, strong to moderate Spearman correlations were observed between individual compounds and ΣOH-PAHs corroborating the prevalence of an emission source. [ABSTRACT FROM AUTHOR]

Background After the World Trade Center (WTC) attacks on September 11, 2001, the Fire Department of the City of New York (FDNY) instituted a WTC medical monitoring and treatment program and established a data center to document health outcomes in the WTC-exposed workforce of ∼16,000 firefighters and EMS workers. Methods FDNY schedules routine monitoring exams every 12-18 months and physical and mental health treatment appointments, as required. Results FDNY research studies have consistently found that early arrival to work and/or prolonged work at the WTC-site increased the risks for adverse physical and mental health outcomes. To date, a substantial proportion has been diagnosed with obstructive airways disease, chronic rhinosinusitis, and gastroesophageal reflux disease; a quarter has two or more of these conditions. Conclusions While much has been learned, the entire spectrum and trajectory of WTC-related disorders and their mechanisms of onset and persistence remain to be fully described. Am. J. Ind. Med. 59:695-708, 2016. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background We previously reported a modest excess of cancer in World Trade Center (WTC)-exposed firefighters versus the general population. This study aimed to separate the potential carcinogenic effects of firefighting and WTC exposure by comparing to a cohort of non-WTC-exposed firefighters. Methods Relative rates (RRs) for all cancers combined and individual cancer subtypes from 9/11/2001 to 12/31/2009 were modeled using Poisson regression comparing 11,457 WTC-exposed firefighters to 8,220 urban non-WTC-exposed firefighters. Results Compared with non-WTC-exposed firefighters, there was no difference in the RR of all cancers combined for WTC-exposed firefighters (RR = 0.96, 95%CI: 0.83-1.12). Thyroid cancer was significantly elevated (RR = 3.82, 95%CI: 1.07-20.81) from 2001 to 2009; this was attenuated (RR = 3.43, 95%CI: 0.94-18.94) and non-significant when controlling for possible surveillance bias. Prostate cancer was elevated during the latter half (2005-2009; RR = 1.38, 95%CI: 1.01-1.88). Conclusions Further follow-up is needed to assess the relationship between WTC exposure and cancers with longer latency periods. Am. J. Ind. Med. 59:722-730, 2016. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: The treatment and prevention of the metabolic syndrome (MetS) is currently one of the major challenges in medicine. The impact of working conditions on metabolic risk has not been adequately studied. Our objective was to compare the prevalence of MetS and metabolic risk in two extremely different occupational groups: firefighters and office workers. Methods: A total of 143 male subjects (97 firefighters and 46 office workers) from Germany participated in the study. Anthropometric characteristics, metabolic risk parameters as well as laboratory parameters were collected. MetS was diagnosed according to criteria of the International Diabetes Federation. Results: Sedentary occupation showed a significant tendency towards obesity. Abdominal waist circumference was significantly greater in office workers than in firefighters [5.08 CI (1.44-8.71), p = 0.007]. Concerning metabolic risk factors, abnormal HDL, triglycerides, BMI, blood pressure and waist circumference values were more frequently found in office workers than in firefighters. The MetS was detected in almost 33% of office workers as compared with only 14% in firefighters (p = 0.015). Regarding MetS in an international comparison, the prevalence of MetS in German office workers was high and in firefighters it was extremely low. Conclusions: Sedentary occupation as an office worker is associated with a high risk of MetS. Both groups need to be made aware of the metabolic risks, and health promoting concepts such as corporate sports activities or education in healthy nutrition need to be implemented to counteract the development of the MetS and cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Background: Obesity compromises firefighter safety, yet more than 70% of firefighters are overweight. Though healthcare professionals are encouraged to counsel overweight patients, the effectiveness of weight counseling is not consistent across studies.Objective: Examine longitudinal changes in cardiovascular risk factors and determine the role of healthcare professional weight loss advice on six-month weight changes among a national sample of male, overweight and obese firefighters.Methods: This study included baseline and six-month assessments of 757 firefighters. Medical and demographic data were collected using questionnaires. Investigators collected height, weight, percent body fat, waist circumference, blood pressure, and fasting serum samples (total cholesterol, high-density lipoprotein, low-density lipoprotein, glucose). Multilevel linear regression assessed the association between weight advice and outcomes.Results: Participants lost an average of 0.55 kg (95%CI: 0.17-0.93), and experienced significant improvements in systolic blood pressure (mean: 3.75 mm Hg; 95% CI: 2.35-5.14) and non-significant improvements in other clinical outcomes. Healthcare professional weight advice was not significantly associated with weight loss or other outcomes.Conclusion: Similar to other studies, results show little benefit of low intensity weight loss counseling. Additional research is needed to identify effective and feasible weight management strategies to address firefighter obesity. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate factors associated with heart rate variability in firefighters working in a metropolitan city in South Korea. Methods: Self-administered questionnaires including Korean Occupational Stress Scale (KOSS) as well as surveys collecting socio-demographic characteristics and work-related factors were given to 962 firefighters. After exclusion for missing data, 645 firefighters were included, and analysis of covaiance adjusted for the general risk factors and job characteristics were used to assess the relationship between heart rate variability and associated factors. Results: SDNN and RMSSD and were decreased in the area of occupational climate of the group with high job stress (p = 0.027, p = 0.036). HF(ln) was decreased in the area of organizational system and occupational climate of the group with high stress that statistically significant level (p = 0.034, p = 0.043). Conclusions: Occupational climate and organizational system are associated with reduction of heart rate variability. Preventive medical care plans for cardiovascular disease of firefighters through the analysis and evaluation of job stress factors are needed. [ABSTRACT FROM AUTHOR]

Background: World Trade Center (WTC)-exposed Fire Department of the City of New York firefighters lost, on average, 10% of lung function after September 11, 2011, and >10% developed new obstructive airways disease. There was little recovery (on average) over the first 6 years. Follow-up into the next decade allowed us to determine the longer-term exposure effects and the roles of cigarette smoking and cessation on lung function trajectories.Methods: We examined serial measurements of FEV1 from March 11, 2000, to September 10, 2014, among 10,641 WTC-exposed Fire Department of the City of New York firefighters with known smoking and body weight histories.Results: The median number of FEV1 measurements during follow-up was 9; 15% of firefighters arrived at the WTC during the morning of September 11, 2001; and 65% never smoked. Firefighters arriving the morning of September 11, 2001 averaged lower lung function than did lesser exposed firefighters; this difference remained significant during most of follow-up (P < .05). Never smokers had significantly better lung function than current smokers; former smokers fell in between, depending upon their cessation date. Those arriving the morning of September 11, 2001 were more likely to have an FEV1 < lower limits of normal compared with those arriving between September 13, 2001, and September 24, 2001 (OR = 1.70, P < .01). Current smokers were more likely to have an FEV1 < lower limits of normal compared with never smokers (OR = 2.06, P < .01), former smokers who quit before September 11, 2001 (OR = 1.96, P < .01), or those who quit between September 11, 2001 and March 10, 2008 (OR = 1.49, P < .01).Conclusions: Thirteen years after September 11, 2001, most firefighters continued to show a lack of lung function recovery, with the trajectory of decline differing by WTC exposure and smoking status. Unlike the immutable effect of WTC exposure, we demonstrated the benefit on lung function of smoking cessation in this unique occupational/environmental cohort. [ABSTRACT FROM AUTHOR]