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Shah NN, Steinberg MB, Calkins MM, Caban-Martinez AJ, Burgess JL, Austin E, Hollerbach BS, Edwards DL, Black TM, Black K, Hinton KM, Kubiel BS, Graber JM. Prevalence and predictors of colon and prostate cancer screening among volunteer firefighters: The United States Firefighter Cancer Assessment and Prevention Study. Am J Ind Med 2024; 67:483-495. [PMID: 38530105 PMCID: PMC11022136 DOI: 10.1002/ajim.23582] [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: 12/05/2023] [Revised: 03/01/2024] [Accepted: 03/11/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Although firefighters have increased risk for colon and prostate cancer, limited information exists on screening practices for these cancers in volunteer firefighters who compose two-thirds of the US fire service. We estimated the prevalence of colon and prostate cancer screening among volunteer firefighters using eligibility criteria from 4 evidence-based screening recommendations and evaluated factors influencing screening. METHODS We evaluated colon (n = 569) and prostate (n = 498) cancer screening prevalence in a sample of US volunteer firefighters using eligibility criteria from the US Preventive Services Taskforce (USPSTF), National Fire Protection Association, American Cancer Society, and National Comprehensive Cancer Network. We assessed associations with fire service experience, demographics, and cancer risk perception based on USPSTF guidelines. RESULTS For those eligible based on USPSTF guidelines, colon and prostate cancer screening prevalence was 51.7% (95% CI: 45.7, 57.8) and 48.8% (95% CI: 40.0, 57.6), respectively. Higher odds of colon and prostate cancer screening were observed with older age and with some college education compared to those with less education. Fire service experience and cancer risk perception were not associated with screening practices. CONCLUSION This is the first large study to assess colon and prostate cancer screening among US volunteer firefighters based on different screening guidelines. Our findings suggest gaps in cancer prevention efforts in the US volunteer fire service. Promoting cancer screening education and opportunities for volunteer firefighters by their fire departments, healthcare professionals, and public health practitioners, may help to address the gaps.
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Affiliation(s)
- Nimit N. Shah
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Michael B. Steinberg
- Division of General Internal Medicine; Robert Wood Johnson Medical School; Rutgers, The State University of New Jersey; New Brunswick, New Jersey, USA
| | - Miriam M. Calkins
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Jefferey L. Burgess
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Elena Austin
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Washington, USA
| | | | | | - Taylor M. Black
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Kathleen Black
- Rutgers Environmental and Occupational Health Sciences Institute, Rutgers the State University of New Jersey, Piscataway, New Jersey, USA
| | - Kaleigh M. Hinton
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Brian S. Kubiel
- Toms River Board of Fire Commissioners, District #1, Toms River, New Jersey, USA
| | - Judith M. Graber
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
- Rutgers Environmental and Occupational Health Sciences Institute, Rutgers the State University of New Jersey, Piscataway, New Jersey, USA
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Marmis R, McGoldrick-Ruth L, Kelly MR, Haynes PL. Comparing actigraphy and diary to measure daily and average sleep in firefighters: a Bland-Altman analysis. J Clin Sleep Med 2024; 20:497-503. [PMID: 37950454 PMCID: PMC10985296 DOI: 10.5664/jcsm.10916] [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: 06/02/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/12/2023]
Abstract
STUDY OBJECTIVES This study sought to examine the relationship between actigraphy and the Consensus Sleep Diary to contribute information on their concurrent validity in a sample of career firefighters. METHODS Sixty firefighters were recruited from a large, urban fire department in the southwest United States that utilizes a fire-based emergency medical services system and a 5/6 shift schedule. A total of 329 differences were recorded during participants' 6-day between-shift recovery period. Data was collected utilizing the two most common forms of sleep analysis in an outpatient setting, wrist actigraphy (Actiwatch-2) and the Consensus Sleep Diary. Nine major sleep indices were computed: wake time after sleep onset, total sleep time, sleep onset latency, sleep offset, in-bed time, lights-off time, out-of-bed time, wake time, and sleep efficiency. RESULTS Firefighters overestimated sleep efficiency and underestimated wake after sleep onset by values that were greater than the American Academy of Sleep Medicine a priori clinical significance thresholds. All indices showed very broad limits of agreement. For example, the 95% confidence interval for diary and actigraphic total sleep time estimates fell within a 4.7-hour range. CONCLUSIONS Firefighters receiving recovery sleep between tours demonstrated significantly large disagreements between their daily self-reported sleep and measured actigraphic sleep. Sleep findings from actigraphic and Consensus Sleep Diary sleep assessments in this population should be interpreted cautiously until each method is compared against other reliable sleep analysis methods. Currently it is unclear if clinicians are using properly validated tools when diagnosing shift work disorder or other sleep disorders in firefighters. CITATION Marmis R, McGoldrick-Ruth L, Kelly MR, Haynes PL. Comparing actigraphy and diary to measure daily and average sleep in firefighters: a Bland-Altman analysis. J Clin Sleep Med. 2024;20(4):497-503.
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Affiliation(s)
- Ryan Marmis
- Department of Physiology, University of Arizona, Tucson, Arizona
| | | | - Monica R. Kelly
- Department of Psychology, University of Arizona, Tucson, Arizona
- Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California
- Department of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Patricia L. Haynes
- Department of Health Promotion Sciences, University of Arizona, Tucson, Arizona
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3
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Pinheiro PS, Koru-Sengul T, Zhao W, Hernandez DR, Hernandez MN, Kobetz EN, Caban-Martinez AJ, Lee DJ. Distinct Prostate Cancer Survival Outcomes in Firefighters: A Population-Based Study. Cancers (Basel) 2024; 16:1305. [PMID: 38610983 PMCID: PMC11010940 DOI: 10.3390/cancers16071305] [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: 01/26/2024] [Revised: 03/09/2024] [Accepted: 03/18/2024] [Indexed: 04/14/2024] Open
Abstract
Introduction: Survival outcomes for prostate cancer among specific occupational groups prone to regular medical check-ups vis-à-vis the general population have been understudied. For firefighters, a demographic subject to rigorous medical evaluations, possessing above-average medical expertise, and exposed to specific carcinogens of interest, prostate cancer survival in the US has never been studied. Methods: We conducted a retrospective study, utilizing data from the Florida Cancer Data System spanning 2004 to 2014, coupled with firefighter certification records from the Florida State Fire Marshal's Office. Our study cohort consisted of 1058 prostate cancer cases among firefighters as well as prostate cases for the Florida general population (n = 150,623). We compared cause-specific survival between the two using Cox regression models adjusted for demographics and clinical characteristics, including PSA levels, Gleason scores, and treatment modalities. Results: Firefighters demonstrated a higher five-year cause-specific survival rate (96.1%, 95% CI: 94.7-97.1%) than the general population (94.2%, 95%CI: 94.1-94.3%). Overall, firefighters' diagnoses were established at younger ages (median age 63 vs. 67 in the general population), exhibited a higher proportion of localized stage cancers (84.7% vs. 81.1%), and had a greater utilization of surgery (46.4% vs. 37.6%), a treatment modality with a high success rate but potential side effects. In multivariable analysis, firefighters displayed a survival advantage for localized stage (adjusted hazard ratio [aHR] = 0.53; 95%CI: 0.34-0.82). However, for regional or distant stages, firefighters aged 65 and above exhibited a higher risk of death (aHR = 1.84; 95% CI: 1.18-2.86) than the general population. Conclusion: Firefighters experience enhanced prostate cancer survival, primarily in cases diagnosed at localized stages, likely due to increased PSA testing. Nonetheless, for regional or distant stage, survival among older firefighters' lags behind that of the general population. Further investigations are warranted to unravel factors influencing the development of aggressive disease beyond PSA and Gleason scores in this population, as well as to assess the impact of a higher rate of surgical treatment on firefighters' quality of life.
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Affiliation(s)
- Paulo S. Pinheiro
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (T.K.-S.); (E.N.K.); (A.J.C.-M.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (W.Z.); (D.R.H.)
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (T.K.-S.); (E.N.K.); (A.J.C.-M.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (W.Z.); (D.R.H.)
| | - Wei Zhao
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (W.Z.); (D.R.H.)
| | - Diana R. Hernandez
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (W.Z.); (D.R.H.)
| | - Monique N. Hernandez
- Florida Cancer Data System, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
| | - Erin N. Kobetz
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (T.K.-S.); (E.N.K.); (A.J.C.-M.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (W.Z.); (D.R.H.)
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (T.K.-S.); (E.N.K.); (A.J.C.-M.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (W.Z.); (D.R.H.)
| | - David J. Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (T.K.-S.); (E.N.K.); (A.J.C.-M.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (W.Z.); (D.R.H.)
- Florida Cancer Data System, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
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Thompson C, Ferrie L, Pearson SJ, Highlands B, Matthews MJ. In the heat of the moment: the effects of extreme temperatures on the cognitive functioning of firefighters. Ergonomics 2024:1-15. [PMID: 38477628 DOI: 10.1080/00140139.2024.2326584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
Exposure to high temperatures can have detrimental effects on cognitive processing and this is concerning for firefighters who routinely work in extreme temperatures. Whilst past research has studied the effects of heat on firefighter cognition, findings are mixed, and no work has measured the time course of cognitive recovery. This study compared working memory, vigilance, and cognitive flexibility of 37 firefighters before and after they engaged in a live-fire training exercise with temperatures exceeding 115 °C. To assess recovery, cognition was measured on exiting the fire, then 20- and 40-minutes post-fire. Results showed impaired vigilance and cognitive flexibility (increased errors, slower responses) immediately after the fire, but recovery at 20-minutes. These findings indicate that a live indoor fire negatively impacts cognitive processing, but this effect is relatively short-lived and return to baseline functioning is seen 20-minutes after exiting the fire. The findings could be used to inform re-entry and cooling decisions.
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Affiliation(s)
| | - Lucy Ferrie
- School of Health and Society, University of Salford, Salford, UK
| | | | - Brian Highlands
- School of Health and Society, University of Salford, Salford, UK
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5
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Park S, Kim HS, Oh HJ, Chung I, Ahn YS, Jeong KS. Assessment of phthalate exposure at a fire site in Korean firefighters. Int J Environ Health Res 2024; 34:1800-1809. [PMID: 37584337 DOI: 10.1080/09603123.2023.2246388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 08/06/2023] [Indexed: 08/17/2023]
Abstract
To determine phthalate exposure in 32 firefighters, the concentrations of urinary phthalate metabolites, immediately (exposure day) and three weeks (control day) after fire suppression, were compared. Mono-(2-ethyl-5-carboxypentyl) phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate, mono-(2-ethyl-5-oxohexyl) phthalate, mono-n-butyl phthalate (MBP), mono-n-benzyl phthalate (MBzP), and total phthalates (∑phthalates) levels, and creatinine-adjusted levels of MBP, MBzP, and ∑phthalates were significantly higher on exposure day than on control day. Phthalate concentration was significantly higher in firefighters who performed the fire extinguishing tasks (geometric mean [GM], 149.9 μg/L) than in those who performed other tasks (GM 70.8 μg/L) (p = .012). The GM concentration of firefighters who were active ≤ 50 m from the fire was 119.0 μg/L, and 37.6 μg/L for those who were > 50 m away (p = .012). The GM concentration was significantly different (p = .039) in firefighters with subjective symptoms after fire suppression (151.9 μg/L) compared to those without symptoms (81.6 μg/L). This study showed that firefighters were exposed to phthalate.
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Affiliation(s)
- Soyoung Park
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Total Healthcare Centre, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyun-Soo Kim
- Industrial Health and Work Environment Research Institute, Korean Industrial Health Association, Seoul, Republic of Korea
| | - Hyun-Jeong Oh
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Insung Chung
- Department of Occupational and Environmental Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Yeon-Soon Ahn
- Department of Preventive Medicine, Wonju College of medicine, Yonsei University, Wonju, Republic of Korea
| | - Kyoung Sook Jeong
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
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6
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Kimbrel NA, Aho NA, Neal LC, Bernes SA, Beaver TA, Hertzberg JA, Lutrey A, Leto F, Ostiguy W, Cammarata C, Meyer EC, Wilson SM, Dennis MF, Calhoun PS, Beckham JC, Stanley B, Gulliver SB. Development and Implementation of Web-Based Safety Planning Intervention Training for Firefighter Peer Support Specialists. Crisis 2024; 45:108-117. [PMID: 37727969 DOI: 10.1027/0227-5910/a000924] [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: 09/21/2023]
Abstract
Background: Recent findings indicate that firefighters may be at increased risk for death by suicide; however, there has been only limited suicide prevention work in fire service to date. Aim: The objective of this program evaluation project was to develop and evaluate a web-based Safety Planning Intervention (SPI) training course for firefighter peer support specialists. Method: Peer support specialists who completed the web-based SPI training were administered evaluation questionnaires before the training and then again at a 3-month follow-up assessment. Results: A total of 213 peer support specialists completed the SPI training. Most participants took 2-3 h to complete the training. Participants generally reported high levels of satisfaction with the course, with the vast majority (94.4%) indicating they would recommend it to their peers. Course completers also demonstrated significant gains in SPI knowledge and self-efficacy from baseline to 3-month follow-up (all p's < .001). Moreover, the percentage of participants who reported completing a safety plan with someone they suspected at being of risk for suicide increased approximately 7-fold from baseline (3.5%) to 3-month follow-up (25.2%; p < .001). Participants further reported that 97.6% of the safety plans that they completed resulted in a positive outcome. Limitations: This was a program evaluation project that did not include a control group. Thus, causality cannot be inferred. Conclusions: The present findings suggest that web-based SPI training is a feasible and scalable approach for training peer support specialists to deliver the SPI to at-risk individuals.
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Affiliation(s)
- Nathan A Kimbrel
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Natalie A Aho
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
| | - Lydia C Neal
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
| | - Sarah A Bernes
- International Association of Fire Fighters, Washington, DC, USA
| | - Tiffany A Beaver
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
| | - Jeffrey A Hertzberg
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
| | - Alice Lutrey
- International Association of Fire Fighters, Washington, DC, USA
| | - Frank Leto
- International Association of Fire Fighters, Washington, DC, USA
- Fire Department of the City of New York, NY, USA
| | - Willy Ostiguy
- International Association of Fire Fighters, Washington, DC, USA
- Boston Fire Department, Boston, MA, USA
| | - Claire Cammarata
- New York City Office of Labor Relations Employee Assistance Program, New York, NY, USA
| | - Eric C Meyer
- Department of Counseling and Behavioral Health, University of Pittsburgh, PA, USA
| | - Sarah M Wilson
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Michelle F Dennis
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Patrick S Calhoun
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Jean C Beckham
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Barbara Stanley
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Suzy B Gulliver
- International Association of Fire Fighters, Washington, DC, USA
- Warriors Research Institute, Waco, TX, USA
- Department of Psychiatry and Human Behavior, Texas A&M Health Science Center, Bryan, TX, USA
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Rapisarda F, Guay S, Ouellet-Morin I, Bond S, Geoffrion S. Longitudinal assessment of psychological distress and its determinants in a sample of firefighters based in Montreal, Canada. Front Psychol 2024; 15:1303063. [PMID: 38425559 PMCID: PMC10902061 DOI: 10.3389/fpsyg.2024.1303063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Firefighters face elevated risks of common mental health issues, with distress rates estimated at around 30%, surpassing those of many other occupational groups. While exposure to potentially traumatic events (PTEs) is a well-recognized risk factor, existing research acknowledges the need for a broader perspective encompassing multidimensional factors within the realm of occupational stress. Furthermore, this body of evidence heavily relies on cross-sectional studies. This study adopts an intensive longitudinal approach to assess psychological distress and its determinants among firefighters. Methods Participants were recruited from 67 fire stations in Montreal, Canada, meeting specific criteria: full-time employment, smartphone ownership, and recent exposure to at least one PTE, or first responder status. Subjects underwent a telephone interview and were directed to use an app to report depressive, post-traumatic, and generalized anxiety symptoms every 2 weeks, along with work-related stressors, social support, and coping styles. Analyses involved 274 participants, distinguishing between those exceeding clinical thresholds in at least one distress measure (the "distressed" subgroup) and those deemed "resilient." The duration and onset of distress were computed for the distressed group, and linear mixed models were employed to evaluate determinants for each psychological distress variable. Results Clinical psychological distress was observed in 20.7% of participants, marked by depressive, post-traumatic, and anxiety symptoms, often within the first 4-week reference period. Contextual factors (operational climate, social support, solitude) and individual factors (coping style, solitude and lifetime traumatic events in private life) exhibited more significant impacts on psychological distress than professional pressures within the firefighters' work environment. Discussion This study reports lower rates of psychological distress than previous research, possibly attributable to sample differences. It highlights that reported symptoms often represent a combined and transient layer of distress rather than diagnosable mental disorders. Additionally, determinants analysis underscores the importance of interpersonal relationships and coping mechanisms for mental health prevention interventions within this worker group. The findings carry implications for the development of prevention and support programs for firefighters and similar emergency workers.
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Affiliation(s)
- Filippo Rapisarda
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
| | - Stéphane Guay
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
- Département de Psychiatrie et d’Addictologie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- École de Criminologie, Faculté des Arts et des Sciences, Université de Montréal, Montreal, ON, Canada
| | - Isabelle Ouellet-Morin
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
- École de Criminologie, Faculté des Arts et des Sciences, Université de Montréal, Montreal, ON, Canada
| | - Suzie Bond
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
- Département de Sciences Humaines, Lettres et Communications, Université TÉLUQ, Quebec City, QC, Canada
| | - Steve Geoffrion
- Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
- École de Psychoéducation, Faculté des Arts et des Sciences, Université de Montréal, Montreal, QC, Canada
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Peters S. Chronic respiratory symptoms observed in US veterans following deployment may not be unique to that population. Occup Environ Med 2024; 81:57-58. [PMID: 38228389 DOI: 10.1136/oemed-2023-109320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 01/18/2024]
Affiliation(s)
- Susan Peters
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
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Geuzinge R, Visse M, Vermetten E, Duyndam J. Differentiating social environments of high-risk professionals and specialised nurses: a qualitative empirical study on social embeddedness. Eur J Psychotraumatol 2024; 15:2306792. [PMID: 38289061 PMCID: PMC10829832 DOI: 10.1080/20008066.2024.2306792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/08/2024] [Indexed: 02/01/2024] Open
Abstract
Objective: High-risk professionals and specialised nurses in hospitals are frequently exposed to potentially traumatic events. Psychotrauma researchers have extensively studied personal risk factors of traumatisation among high-risk professionals, but it is hard to understand psychological functioning when professionals are decontextualised from their social environment. Generally, it has been well documented that to reduce the risk of posttraumatic stress disorder (PTSD) or other mental health problems related to traumatisation, it is essential to be embedded in a supportive social environment. However, study results among and within these occupational groups show great variety and even inconsistencies as to what is a supportive social environment.Method: This ethnographical research, including participant observation, in-depth interviews, and document analysis, explored the social environment of firefighters, police officers, ambulance paramedics, specialised nurses, and military personnel and aims to explore their social connections and embeddedness. We performed a thematic content analysis of data to identify themes related to social or emotional support, social relationships, and stress or traumatisation.Results: An analysis of the observational field notes, which covered 332 h of participant observation and 71 evenly distributed formal in-depth interviews, identified four themes related to social connections and embeddedness: Family, Hierarchical relations versus autonomy, Group versus individual, and Conditional family 'love'. Results revealed that the military, police, and professional firefighters have family-like hierarchical connections and highly value group unity. Paramedics and most specialised nurses, however, tend to value individuality and autonomy in their work relationships.Conclusion: This research shows noticeable differences in the social environments and social connections of these professionals, which implicates that prevention and mental health treatment might also have to be differentiated among occupational groups.
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Affiliation(s)
- Renate Geuzinge
- Humanism and Social Resilience, University of Humanistic Studies, Utrecht, the Netherlands
| | - Merel Visse
- Care Ethics, University of Humanistic Studies, Utrecht, the Netherlands
| | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Joachim Duyndam
- Humanism and Social Resilience, University of Humanistic Studies, Utrecht, the Netherlands
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Thompson C, Ferrie L, Pearson SJ, Highlands B, Matthews MJ. Do extreme temperatures affect cognition? A short review of the impact of acute heat stress on cognitive performance of firefighters. Front Psychol 2024; 14:1270898. [PMID: 38274689 PMCID: PMC10808688 DOI: 10.3389/fpsyg.2023.1270898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/29/2023] [Indexed: 01/27/2024] Open
Abstract
Research shows that exposure to high environmental temperatures can affect task performance. Theoretical explanations outline that heat is a source of stress that competes for limited-capacity resources, therefore if a task is resource-intensive, and/or if heat stress is extreme, performance will suffer. One occupation in which individuals complete demanding tasks and make difficult decisions, often in temperatures exceeding 200°C, is firefighting. Yet very little is currently known about the impact of heat stress on the cognitive functioning of firefighters. This short review summarizes the limited research in this area, focusing on studies that measured cognition of firefighters following a realistic training exercise. The findings are mixed with evidence that heat stress improves, impairs, and has no impact on cognitive functioning. While there are differences in the firefighting activities utilized, and the temperatures that participants were exposed to, it is argued that the varied findings can be attributed to the tasks used to assess cognitive processing, and the cognitive functions being measured. In accordance with the wider field of research, it is concluded that complex functioning, such as sustained attention, vigilance, and working memory is negatively impacted by acute exposure to extreme heat. Greater understanding of factors affecting cognition would inform safety practices and more research is needed to understand how and when heat stress may influence cognition in firefighting scenarios.
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Affiliation(s)
- Catherine Thompson
- Department of Psychology, Liverpool Hope University, Liverpool, United Kingdom
| | - Lucy Ferrie
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Stephen J. Pearson
- School of Health Sciences, University of Salford, Salford, United Kingdom
| | - Brian Highlands
- School of Health Sciences, University of Salford, Salford, United Kingdom
| | - Martyn J. Matthews
- School of Health Sciences, University of Salford, Salford, United Kingdom
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11
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Cannon MF, Goldfarb DG, Zeig-Owens RA, Hall CB, Choi J, Cohen HW, Prezant DJ, Weiden MD. Normal Lung Function and Mortality in World Trade Center Responders and NHANES III Participants. Am J Respir Crit Care Med 2024. [PMID: 38163381 DOI: 10.1164/rccm.202309-1654oc] [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: 09/20/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024] Open
Abstract
RATIONALE Low forced expiratory volume at one second (FEV1) is a biomarker of increased mortality. The association of normal lung function and mortality is not well described. OBJECTIVE To evaluate the FEV1-mortality association among participants with normal lung function. METHODS 10,999 Fire Department of the City of New York (FDNY) responders and 10,901 NHANES III participants, ages 18-65 with FEV1 ≥80% predicted, were analyzed, with FEV1 percent predicted calculated using Global Lung Function Initiative Global race-neutral reference equations. Mortality data were obtained from linkages to the National Death Index. Cox proportional hazards models estimated the association between FEV1 and all-cause mortality, controlling for age, sex, race/ethnicity, smoking history, and, for FDNY, work assignment. Cohorts were followed for a maximum of 20.3 years. MEASUREMENTS AND MAIN RESULTS We observed 504/10,999 deaths (4.6%) for FDNY and 1,237/10,901 deaths (9.4% [weighted]) for NHANES III. Relative to FEV1 ≥120% predicted, mortality was significantly higher for FEV1 100-109%, 90-99%, and 80-89% predicted in the FDNY cohort. In the NHANES III cohort, mortality was significantly higher for FEV1 90-99% and 80-89% predicted. Each 10% higher predicted FEV1 was associated with 15% (HR=0.85, 95% CI 0.80-0.91) and 23% (HR=0.77, 95% CI 0.71-0.84) lower mortality for FDNY and NHANES III, respectively. CONCLUSIONS In both cohorts, higher FEV1 is associated with lower mortality, suggesting higher FEV1 is a biomarker of better health. These findings demonstrate that a single cross-sectional measurement of FEV1 is predictive of mortality over two decades, even when FEV1 is in the normal range.
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Affiliation(s)
- Madeline F Cannon
- Montefiore Medical Center, 2013, Department of Medicine, Bronx, New York, United States
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, United States
| | - David G Goldfarb
- Montefiore Medical Center, 2013, Department of Medicine, Bronx, New York, United States
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, United States
- Albert Einstein College of Medicine, 2006, Department of Epidemiology and Population Health, Bronx, New York, United States
| | - Rachel A Zeig-Owens
- Montefiore Medical Center, 2013, Department of Medicine, Bronx, New York, United States
- Fire Department of the City of New York, 101588, Bureau of Health Services, Brooklyn, New York, United States
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, New York, United States
| | - Charles B Hall
- Albert Einstein College of Medicine, 2006, Department of Epidemiology and Population Health, Bronx, New York, United States
| | - Jaeun Choi
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, New York, United States
| | - Hillel W Cohen
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, New York, United States
| | - David J Prezant
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, United States
- Montefiore Medical Center, Department of Medicine, Bronx, New York, United States
- Albert Einstein College of Medicine, 2006, Department of Epidemiology and Population Health, Bronx, New York, United States
| | - Michael D Weiden
- Fire Department of the City of New York, 101588, Bureau of Health Services, Brooklyn, New York, United States
- New York University Grossman School of Medicine, 12296, Division of Pulmonary, Critical Care, and Sleep Medicine, New York, New York, United States;
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12
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Sire T, Roy K, Marcel-Millet P, Poirier S, Gendron P. Cardiovascular disease risk factors in career firefighters: A 6-year follow-up study. Arch Environ Occup Health 2023; 78:443-446. [PMID: 37906526 DOI: 10.1080/19338244.2023.2275155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/21/2023] [Indexed: 11/02/2023]
Abstract
This study sought to investigate the evolution of cardiovascular disease (CVD) risk factors in career firefighters. A questionnaire was sent to a cohort of 233 Québec career firefighters in 2015 and 2021 to collect demographic and occupational information and the presence of CVD risk factors. Ninety-six (96) firefighters (1 female) responded to the questionnaire in 2015 and 2021. Body weight (2015: 88.3 ± 10.9, 2021: 89.6 ± 10.7 kg, p = 0.01), body mass index (2015: 27.6 ± 3.2, 2021: 28.0 ± 3.0 kg/m2, p = 0.01), number of CVD risk factors (2015: 1.1 ± 1.0, 2021: 1.3 ± 0.9 CVD risk factors, p = 0.05), and proportion of firefighters with at least 1 CVD risk factor (2015: 71, 2021: 82%, p = 0.02) increased. Overall, our results highlight an aggravation of several CVD risk factors in Québec career firefighters over the years.
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Affiliation(s)
- Thomas Sire
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Kamille Roy
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Philémon Marcel-Millet
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
- Laboratoire Culture Sport Santé Société, Université de Franche-Comté, Besançon, France
- Unité de physiologie de l'exercice et des activités en conditions extrêmes, Département Environnements Opérationnels, Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France
| | - Sébastien Poirier
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
- Département d'anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
- Unité d'enseignement et de recherche en science de la santé, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec, Canada
| | - Philippe Gendron
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
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13
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Wang L, Chen F, Zhang Y, Ye M. Association Between Social Support, and Depressive Symptoms Among Firefighters: The Mediating Role of Negative Coping. Saf Health Work 2023; 14:431-437. [PMID: 38187206 PMCID: PMC10770279 DOI: 10.1016/j.shaw.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 09/12/2023] [Accepted: 10/03/2023] [Indexed: 01/09/2024] Open
Abstract
Background Depressive symptoms (DS) can erode physical and mental health; social support (SS) is considered a buffer for DS and a promoter for improving coping and recovery abilities. However, there is almost no research on the mediating role of negative coping (NC) in SS and DS, especially among firefighters. Methods A cross-sectional survey was conducted among firefighters in Chongqing, China, and the valid data of 407 firefighters were collected through questionnaires distributed on the WeChat platform in 2020. Statistical Product and Service Solutions (SPSS) 26.0 is used for descriptive statistics and correlation analysis. Structural equation modeling was adopted to analyze the association among SS, NC, and DS. The mediation effect is also evaluated. Results Firefighters' detection rate of DS is 23.3%, and when they receive more SS were less likely to develop DS. NC was positively correlated with DS (β = 0.54, p < 0.001) after controlling for SS. Besides, the results of structural equation modeling showed that NC partially mediates the relationship between SS and DS (standard error = 0.039, indirect effects = 0.109, 95% confidence interval: 0.047-0.200 p < 0.001). Conclusion NC has a partial indirect effect between SS and DS among firefighters. SS could not only affect DS directly but also indirect work on it by affecting NC. This discovery will be a novel and meaningful part of the research on the firefighter population.
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Affiliation(s)
- Liang Wang
- College of Public Health, Chongqing Medical University, China
| | - Fengqiong Chen
- Chongqing Center for Disease Control and Prevention, China
| | - Yulu Zhang
- College of Public Health, Chongqing Medical University, China
| | - Mengliang Ye
- College of Public Health, Chongqing Medical University, China
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14
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Aljaroudi AM, Bhattacharya A, Strauch A, Quinn TD, Williams WJ. Effect of cooling on static postural balance while wearing firefighter's protective clothing in a hot environment. Int J Occup Saf Ergon 2023; 29:1460-1466. [PMID: 36259654 PMCID: PMC10182180 DOI: 10.1080/10803548.2022.2138142] [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: 10/24/2022]
Abstract
Objectives. Postural imbalance can result from hyperthermia-mediated muscular fatigue and is a major factor contributing to injuries from falling. The objective of this study was to investigate the effect of exercise-induced hyperthermia and the impact of cooling on postural balance while wearing firefighters' protective clothing (FPC) in a hot environment. Methods. A portable force platform measured postural balance characterized by postural sway patterns using center of pressure metrics. Twelve healthy, physically fit males were recruited to stand on the force platform once with eyes open and once with eyes closed before and after treadmill exercise (40% V ˙ O 2 max ) inside an environmental chamber under hot and humid conditions (30 °C and 70% relative humidity) while wearing FPC. Subjects participated in two randomly assigned experimental phases: control and cooling intervention. Results. A significant increase in physiological responses and postural balance metrics was observed after exercising in the heat chamber while wearing FPC. Cooling resulted in a significant effect only on postural sway speed after exercise-induced hyperthermia. Conclusions. Hyperthermia can negatively alter postural balance metrics, which may lead to an increased likelihood of falling. The utilization of body cooling reduced the thermal strain but had limited impact on postural balance stability.
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Affiliation(s)
- Ali M. Aljaroudi
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), USA
- Department of Engineering Technology, Sam Houston State University, USA
- Current address: College of Aviation, Embry-Riddle Aeronautical University, USA
| | - Amit Bhattacharya
- Department of Environmental & Public Health Sciences, University of Cincinnati, USA
| | - Amanda Strauch
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), USA
- Environmental Science Center, Environmental Protection Agency (EPA), USA
| | - Tyler D. Quinn
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), USA
| | - W. Jon Williams
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), USA
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15
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Kyung M, Chin DL, Phelps S, Hong O. Testing the reliability and validity of the modified Amsterdam Inventory for Auditory Disability and Handicap in career firefighters in the United States. Am J Ind Med 2023; 66:1101-1108. [PMID: 37717215 DOI: 10.1002/ajim.23536] [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: 04/06/2023] [Revised: 09/02/2023] [Accepted: 09/06/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Firefighters are routinely exposed to loud noise that put them at risk for hearing loss. A reliable and valid measure to assess firefighters' hearing function is important. This study aims to test the reliability and validity of the modified Amsterdam Inventory for Auditory Disability and Handicap ((m)AIADH) in firefighters. METHOD A cross-sectional study was conducted using a convenience sample of 239 career firefighters from six partnered fire departments in Central Texas and Northern California. The internal consistency, convergent and criterion validity, and the ability to discriminate groups by measured hearing, perceived hearing, and a combination of measured and perceived hearing, were examined using the total score and score for each of the five subscales of the (m)AIADH. RESULTS The study participants were primarily men (93%). Satisfactory internal consistency was revealed for the (m)AIADH with Cronbach's alpha above 0.80 for all five subscales. Criterion analysis presented a moderate correlation between the (m)AIADH and the average of hearing threshold at high frequencies (4, 6, and 8 kHz). For convergent validity, the (m)AIADH was moderately to highly related with perceived hearing. There were statistically significant differences in the total (m)AIADH score and the five subscales for measured hearing thresholds except for "intelligibility in quiet." The (m)AIADH also showed a discriminative ability to distinguish between the group with good perceived hearing and the group with bad perceived hearing. CONCLUSION The (m)AIADH is a reliable and valid measure to assess various dimensions of hearing function among firefighters.
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Affiliation(s)
- Minjung Kyung
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Dal Lae Chin
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Stephanie Phelps
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - OiSaeng Hong
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
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16
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Rynne PJ, Derella CC, McMorrow C, Dickinson RL, Donahue S, Almeida AA, Carty M, Feairheller DL. Blood pressure responses are dependent on call type and related to hypertension status in firefighters. Blood Press 2023; 32:2161997. [PMID: 36597210 DOI: 10.1080/08037051.2022.2161997] [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: 01/05/2023]
Abstract
BACKGROUND Impaired cardiovascular health is a concern for firefighters, with over 50% of line-of-duty deaths having cardiac causes. Many firefighters have hypertension and <25% have their blood pressure (BP) controlled. The alarm response could be an unidentified cardiac risk, but interestingly, the BP response to different calls and on-the-job activity is unknown. PURPOSE We aimed to measure the physiological stress resulting from different call types (fire, medical) and job activity (riding apparatus, pre-alert alarms) through ambulatory BP (ABP) monitoring in a population of firefighters. MATERIALS AND METHODS During 111 12-h work shifts firefighters wore an ABP monitor. BP was measured at 30-min intervals and manual measurements were prompted when the pager went off or whenever they felt stress. RESULTS Firefighters were hypertensive (124.3 ± 9.9/78.1 ± 6.7 mmHg), overweight (30.2 ± 4.6 kg/m2), middle-aged (40.5 ± 12.6 years) and experienced (17.3 ± 11.7 years). We calculated an average 11% increase in systolic and 10.5% increase in diastolic BP with alarm. Systolic BP (141.9 ± 13.2 mmHg) and diastolic BP (84.9 ± 11.1 mmHg) and the BP surges were higher while firefighters were responding to medical calls compared to fire calls. Between BP groups we found that medical call systolic BP (p = .001, d = 1.2), diastolic BP (p = .017, d = 0.87), and fire call systolic BP (p = .03, d = 0.51) levels were higher in the hypertensive firefighters. CONCLUSION This is the first report of BP surge responses to alarms and to occupational activities in firefighters, and medical calls elicited the largest overall responses.PLAIN LANGUAGE SUMMARYCardiovascular disease and impaired cardiovascular health are substantially more prevalent in firefighters, with over 50% of line-of-duty deaths being cardiac related.Many firefighters are diagnosed with high blood pressure (hypertension), which is known to increase the risk of heart attacks, strokes, heart disease, and other serious health complications.Upon stress, our body enacts the 'fight or flight' response where sympathetic nervous system activity triggers an immediate increase in heart rate and blood pressure. This response can be dangerous when surges reach extreme levels due to underlying impaired cardiovascular function. It is known that alarm sounds trigger a stress response.Firefighters respond to different alarms while on the job, each indicating different call types, such as a house fire or a medical emergency. Due to the prevalence of impaired cardiovascular health in firefighters, the physical stress resulting from these alerts is cause for concern.The blood pressure surge response to different call types and job activities in healthy and hypertensive firefighters had not been measured before this study.Through the ambulatory blood pressure monitoring of 111 on-duty firefighters, this study discovered that medical calls caused the greatest blood pressure and heart rate surge.Also, firefighters with hypertension experienced a greater blood pressure surge in response to alarms than their non-hypertensive co-workers.
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Affiliation(s)
- Paige J Rynne
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | | | - Carly McMorrow
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | | | - Stephanie Donahue
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA.,Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Andrew A Almeida
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | - Megan Carty
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - Deborah L Feairheller
- Department of Kinesiology, California State University San Marcos, San Marcos, CA, USA
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17
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Kajaks T, Ziebart C, Galea V, Vrkljan B, MacDermid JC. Posture Evaluation of Firefighters During Simulated Fire Suppression Tasks. Workplace Health Saf 2023; 71:606-616. [PMID: 37997916 PMCID: PMC10676042 DOI: 10.1177/21650799231214275] [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: 11/25/2023]
Abstract
BACKGROUND Posture mechanics during fire suppression tasks are associated with musculoskeletal injuries in firefighters. METHODS This study uses the Ovako Working Posture Analyzing System (OWAS) ergonomics tool to describe and evaluate the postures of 48 firefighters during 3 simulated tasks: (a) hose drag, (b) hose pull, and (c) high-rise pack lift. Ergonomics intervention prioritizations based on the OWAS action classification (AC) scores were identified using Wilcoxon signed-rank tests. Chi-square analyses identified associations between firefighter characteristics and OWAS AC scores. FINDINGS The initial hose pick-up phase of each task was identified as a high priority for ergonomics intervention (OWAS AC = 4) in 45.8%, 54.2%, and 45.8% of cases for Tasks 1, 2, and 3, respectively. Lower BMI was associated with higher AC scores for the initial hose pick-up during Task 3 (likelihood ratio = 9.20, p value = .01). CONCLUSION The results inform ergonomics priorities for firefighter training based on the tasks analyzed. Application to Practice: This study evaluates the posture mechanics of three commonly performed firefighting tasks. The results help inform an ergonomics training intervention focused on posture mechanics during occupational activities for firefighters.
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Affiliation(s)
- Tara Kajaks
- Department of Kinesiology, McMaster University
| | | | - Vickie Galea
- School of Rehabilitation Science, McMaster University
| | | | - Joy C. MacDermid
- School of Physical Therapy, Western University
- School of Rehabilitation Science, McMaster University
- McFarlane Hand and Upper Limb Centre, St. Joseph’s Health Care London
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18
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Tyagi O, Hopko S, Kang J, Shi Y, Du J, Mehta RK. Modeling Brain Dynamics During Virtual Reality-Based Emergency Response Learning Under Stress. Hum Factors 2023; 65:1804-1820. [PMID: 34865562 DOI: 10.1177/00187208211054894] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Stress affects learning during training, and virtual reality (VR) based training systems that manipulate stress can improve retention and retrieval performance for firefighters. Brain imaging using functional Near Infrared Spectroscopy (fNIRS) can facilitate development of VR-based adaptive training systems that can continuously assess the trainee's states of learning and cognition. OBJECTIVE The aim of this study was to model the neural dynamics associated with learning and retrieval under stress in a VR-based emergency response training exercise. METHODS Forty firefighters underwent an emergency shutdown training in VR and were randomly assigned to either a control or a stress group. The stress group experienced stressors including smoke, fire, and explosions during the familiarization and training phase. Both groups underwent a stress memory retrieval and no-stress memory retrieval condition. Participant's performance scores, fNIRS-based neural activity, and functional connectivity between the prefrontal cortex (PFC) and motor regions were obtained for the training and retrieval phases. RESULTS The performance scores indicate that the rate of learning was slower in the stress group compared to the control group, but both groups performed similarly during each retrieval condition. Compared to the control group, the stress group exhibited suppressed PFC activation. However, they showed stronger connectivity within the PFC regions during the training and between PFC and motor regions during the retrieval phases. DISCUSSION While stress impaired performance during training, adoption of stress-adaptive neural strategies (i.e., stronger brain connectivity) were associated with comparable performance between the stress and the control groups during the retrieval phase.
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Affiliation(s)
- Oshin Tyagi
- Wm. Michael Barnes '64 Industrial and Systems Engineering, Texas A&M University, College Station, TX, USA
| | - Sarah Hopko
- Wm. Michael Barnes '64 Industrial and Systems Engineering, Texas A&M University, College Station, TX, USA
| | - John Kang
- Wm. Michael Barnes '64 Industrial and Systems Engineering, Texas A&M University, College Station, TX, USA
| | - Yangming Shi
- Department of Civil & Coastal Engineering, University of Florida, Gainesville, FL, USA
| | - Jing Du
- Department of Civil & Coastal Engineering, University of Florida, Gainesville, FL, USA
| | - Ranjana K Mehta
- Wm. Michael Barnes '64 Industrial and Systems Engineering, Texas A&M University, College Station, TX USA
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19
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D'Isabel S, Berny LM, Frost A, Thongphok C, Jack K, Chaudhry S, Arena R, Smith DL. The effect of mild to moderate COVID-19 infection on the cardiorespiratory fitness of firefighters. Front Public Health 2023; 11:1308605. [PMID: 38106889 PMCID: PMC10724018 DOI: 10.3389/fpubh.2023.1308605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/13/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction An adequate level of cardiorespiratory fitness (CRF) is critical for firefighters to perform the strenuous and physiologically demanding work of firefighting safely and effectively. The coronavirus disease 2019 (COVID-19) has been shown to negatively impact CRF in both the acute phase and longer-term following infection. This study aimed to determine changes to the CRF of firefighters pre- to post-mild to moderate COVID-19 infection and to investigate the impact of days past COVID-19 infection on change in CRF. Methods CRF measures from cardiopulmonary exercise testing (CPET) at annual occupational health exams that occurred pre-COVID-19 infection in 2019 were obtained for firefighters from seven Arizona fire departments. Measures were compared to CPET evaluations from annual health exams the following year in a cohort of firefighters who self-reported mild to moderate illness following COVID-19 infection between exams. Results Among a cohort of 103 firefighters, mean age 40 ± 9 years, CRF [as measured by peak oxygen consumption (VO2)] declined by an average of 2.55 ml·kg-1·min-1 or 7.3% (d = -0.38, p < 0.001) following COVID-19 infection (mean time from COVID-19 infection to CPET was 110 ± 78 days). The number of days past COVID-19 infection showed a small, yet significant, relationship to peak VO2 (r = 0.250, p = 0.011). Estimated marginal effects indicated that when biological sex, age, and BMI are controlled for, predicted peak VO2 returned to pre-COVID-19 values ~300 days after COVID-19 infection. Conclusion Peak VO2 (ml·kg-1·min-1) declined 7.3% among firefighters an average of 110 days past reporting mild to moderate COVID-19 infection. This decrease has implications for the operational readiness and safety of firefighters.
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Affiliation(s)
- Susanne D'Isabel
- First Responder Health and Safety Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Lauren M. Berny
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
| | - Alex Frost
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Chanhtel Thongphok
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Kepra Jack
- HeartFit for Duty, Mesa, AZ, United States
| | | | - Ross Arena
- MET-Test, Atlanta, GA, United States
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, United States
| | - Denise L. Smith
- First Responder Health and Safety Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
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20
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Anderson N, Marcum J, Bonauto D, Siegel M, LaSee C. The Relative Burden of Occupational Injuries and Illnesses in Firefighters: An Analysis of Washington Workers' Compensation Claims, 2006-2020. Int J Environ Res Public Health 2023; 20:7077. [PMID: 37998308 PMCID: PMC10671377 DOI: 10.3390/ijerph20227077] [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: 08/24/2023] [Revised: 10/10/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023]
Abstract
Firefighters face many hazards on the job and have a high rate of work-related injuries and illnesses (WRII). We analyzed Washington workers' compensation claims from 2006-2020 to characterize WRII in firefighters compared to law enforcement officers and "all other" workers. There were 9187 compensable claims for firefighters, 7801 for law enforcement officers, and 586,939 for "all other" workers. Nearly 40% of claims for firefighters were work-related musculoskeletal disorders (WMSDs). The claim rate per 10,000 full-time equivalent (FTE) firefighters was 716.4, which is significantly higher than that of law enforcement officers (510.0) and "all other" workers (163.2). The rate per 10,000 FTE of WMSD claims was also higher in firefighters (277.0) than in law enforcement officers (76.2) and "all other" workers (57.6). Additional WRII among firefighters commonly included being struck or caught in objects, slipping or tripping, and exposure to caustic or noxious substances; and amongst law enforcement, transportation accidents and violence. Medical costs and time-loss days per claim were lower for firefighters and law enforcement than for "all other" workers. Common tasks associated with WMSDs in firefighters included lifting and transporting patients, using specific tools and equipment, and physical training. WMSDs stand out as an area for prevention and intervention activities.
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Affiliation(s)
- Naomi Anderson
- SHARP Program, Washington State Department of Labor and Industries, Olympia, WA 98504-4000, USA; (J.M.); (D.B.); (C.L.)
| | - Jennifer Marcum
- SHARP Program, Washington State Department of Labor and Industries, Olympia, WA 98504-4000, USA; (J.M.); (D.B.); (C.L.)
| | - David Bonauto
- SHARP Program, Washington State Department of Labor and Industries, Olympia, WA 98504-4000, USA; (J.M.); (D.B.); (C.L.)
| | - Miriam Siegel
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH 45226, USA;
| | - Claire LaSee
- SHARP Program, Washington State Department of Labor and Industries, Olympia, WA 98504-4000, USA; (J.M.); (D.B.); (C.L.)
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21
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Marvin G, Schram B, Orr R, Canetti EFD. Occupation-Induced Fatigue and Impacts on Emergency First Responders: A Systematic Review. Int J Environ Res Public Health 2023; 20:7055. [PMID: 37998287 PMCID: PMC10671419 DOI: 10.3390/ijerph20227055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
Fatigue in emergency first responders (EFRs) is known to affect performance abilities and safety outcomes for both patients and EFRs. The primary aim of this review was to determine the main contributors to occupation-induced fatigue in EFRs and its subsequent impacts. Following the PRIMSA checklist, academic databases (Medline, Embase, CINAHL, and SPORTDiscus) were searched using key terms with results subjected to inclusion and exclusion criteria. Populations of interest were firefighters, paramedics, or emergency call centre personnel. Of the 5633 records identified, 43 studies, which reported on 186 unique measures from a total population of 6373 participants, informed the review. Synthesis revealed fatigue was caused by lack of sleep during the shift and consistent poor sleep quality which negatively impacted cognitive function, alertness, and physical and mental health while increasing safety-compromising behaviours and injuries. Both subjective and objective assessments of fatigue are necessary for effective risk management in EFRs. EFRs that are consistently fatigued are at a greater risk of poor physical and mental health, reduced cognitive function, and increased injuries. No studies reported on fatigue in emergency call centre personnel, highlighting a literature gap. Funding was provided by the Australian Capital Territory Emergency Services Agency. Preregistration was filed in OSF: osf.io/26f3s.
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Affiliation(s)
- Graham Marvin
- Tactical Research Unit, Faculty of Health Sciences & Medicine, Bond University, Robina, QLD 4226, Australia
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22
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Heinrich KM, Kukić F, Hollerbach BS. Editorial: Physical activity behavior, obesity, and stress as crucial sources of health issues in stressful occupations. Front Endocrinol (Lausanne) 2023; 14:1323360. [PMID: 38027099 PMCID: PMC10676219 DOI: 10.3389/fendo.2023.1323360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Katie M. Heinrich
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., New York, NY, United States
- Department of Kinesiology, Kansas State University, Manhattan, KS, United States
| | - Filip Kukić
- Faculty of Physical Education and Sports, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Brittany S. Hollerbach
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., New York, NY, United States
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23
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Jung AM, Furlong MA, Goodrich JM, Cardenas A, Beitel SC, Littau SR, Caban-Martinez AJ, Gulotta JJ, Wallentine DD, Urwin D, Gabriel J, Hughes J, Graber JM, Grant C, Burgess JL. Associations Between Epigenetic Age Acceleration and microRNA Expression Among U.S. Firefighters. Epigenet Insights 2023; 16:25168657231206301. [PMID: 37953967 PMCID: PMC10634256 DOI: 10.1177/25168657231206301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 09/20/2023] [Indexed: 11/14/2023] Open
Abstract
Epigenetic changes may be biomarkers of health. Epigenetic age acceleration (EAA), the discrepancy between epigenetic age measured via epigenetic clocks and chronological age, is associated with morbidity and mortality. However, the intersection of epigenetic clocks with microRNAs (miRNAs) and corresponding miRNA-based health implications have not been evaluated. We analyzed DNA methylation and miRNA profiles from blood sampled among 332 individuals enrolled across 2 U.S.-based firefighter occupational studies (2015-2018 and 2018-2020). We considered 7 measures of EAA in leukocytes (PhenoAge, GrimAge, Horvath, skin-blood, and Hannum epigenetic clocks, and extrinsic and intrinsic epigenetic age acceleration). We identified miRNAs associated with EAA using individual linear regression models, adjusted for sex, race/ethnicity, chronological age, and cell type estimates, and investigated downstream effects of associated miRNAs with miRNA enrichment analyses and genomic annotations. On average, participants were 38 years old, 88% male, and 75% non-Hispanic white. We identified 183 of 798 miRNAs associated with EAA (FDR q < 0.05); 126 with PhenoAge, 59 with GrimAge, 1 with Horvath, and 1 with the skin-blood clock. Among miRNAs associated with Horvath and GrimAge, there were 61 significantly enriched disease annotations including age-related metabolic and cardiovascular conditions and several cancers. Enriched pathways included those related to proteins and protein modification. We identified miRNAs associated with EAA of multiple epigenetic clocks. PhenoAge had more associations with individual miRNAs, but GrimAge and Horvath had greater implications for miRNA-associated pathways. Understanding the relationship between these epigenetic markers could contribute to our understanding of the molecular underpinnings of aging and aging-related diseases.
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Affiliation(s)
- Alesia M Jung
- Department of Community, Environment & Policy, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
- Department of Pharmacology & Toxicology, R. Ken Coit College of Pharmacy, College of Public Health, Tucson, AZ, USA
| | - Melissa A Furlong
- Department of Community, Environment & Policy, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Jaclyn M Goodrich
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Andres Cardenas
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
| | - Shawn C Beitel
- Department of Community, Environment & Policy, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Sally R Littau
- Department of Community, Environment & Policy, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Alberto J Caban-Martinez
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | | | | | - Derek Urwin
- Los Angeles County Fire Department, Los Angeles, CA, USA
- Department of Chemistry & Biochemistry, University of California Los Angeles, Los Angeles, CA, USA
- Division of Health Safety and Medicine, International Association of Fire Fighters, Washington, DC, USA
| | - Jamie Gabriel
- Los Angeles County Fire Department, Los Angeles, CA, USA
| | | | - Judith M Graber
- Department of Biostatistics & Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Casey Grant
- Fire Protection Research Foundation, Quincy, MA, USA
| | - Jefferey L Burgess
- Department of Community, Environment & Policy, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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Pennington ML, Dupree J, Hoffman K, Beattie EH, Coe E, Ostiguy W, Kimbrel NA, Meyer EC, Gulliver SB. First Responder Attitudes Regarding Working Near a Supervised Injection Facility: Relationship to Burnout, Secondary Traumatic Stress, and Compassion Satisfaction. Workplace Health Saf 2023; 71:543-550. [PMID: 37530030 DOI: 10.1177/21650799231188364] [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: 08/03/2023]
Abstract
BACKGROUND Emergency responders are the most frequent overdose responders, however, little is known about the impact of supervised injection facility (SIF) location on first responders. The purpose of this study was to determine whether firefighter/paramedic attitudes about being stationed near an SIF were related to burnout, secondary traumatic stress, and compassion satisfaction. METHODS Firefighter/paramedics from Vancouver Fire and Rescue Services (n = 54) completed an online survey. General linear models were used to assess differences in burnout, secondary traumatic stress, and compassion satisfaction based on attitudes regarding being stationed near an SIF while controlling for occupational stress. FINDINGS Firefighters with negative attitudes regarding station placement near an SIF experienced more burnout compared with those with neutral/mixed attitudes and less compassion satisfaction compared with those with positive attitudes. There were no differences between those with positive and neutral/mixed attitudes. CONCLUSIONS These findings have implications for education and training of emergency responders stationed near SIFs. They also highlight the need for more research into the effects of and possible clinical opportunities needed to support first responders' work near an SIF. APPLICATION TO PRACTICE While these findings represent early exploratory evidence, increased burnout and reduced compassion satisfaction may be common reactions among first responders who experience negative attitudes toward SIFs. Prevention efforts could incorporate programs to enhance health and well-being of first responders and education regarding substance use and harm reduction, while workforce surveillance for signs of distress or burnout could be implemented to trigger additional mental health services and interventions. while policymakers should remain aware of SIF-related impacts on all stakeholders, including first responders.
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Affiliation(s)
| | | | - Kristy Hoffman
- Baylor Scott & White Research Institute
- Baylor University
| | | | | | | | - Nathan A Kimbrel
- Durham Veterans Affairs (VA) Health Care System
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center
- Duke University School of Medicine
| | | | - Suzy B Gulliver
- Baylor Scott & White Research Institute
- Texas A&M University Health Science Center
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25
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Barry B, Ricciardelli R, Cramm H. "We are unique": organizational stressors, peer support and attitudes toward mental health treatment among airport firefighters. Health Promot Chronic Dis Prev Can 2023; 43:450-459. [PMID: 37991888 PMCID: PMC10753901 DOI: 10.24095/hpcdp.43.10/11.03] [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: 11/24/2023]
Abstract
INTRODUCTION Airport firefighters are responsible for providing emergency responses to aviation incidents on a runway or in the vicinity of an airport, including airplane crashes, mass casualty events, emergency landings and many other concerns on airport grounds. While data exist on the occupational stressors of firefighters and public safety personnel in general, there is a gap in knowledge regarding the experiences of airport firefighters, particularly in relation to their organizational stressors, peer supports and attitudes toward mental health treatment. METHODS We conducted two focus groups with 10 career firefighters working at an airport in Atlantic Canada in 2019. Focus groups were recorded; the recordings were transcribed and later coded using thematic analysis, which took an inductive, iterative, narrative approach. RESULTS Airport firefighters face unique challenges, and operational stressors are overshadowed by organizational stressors. Additionally, peer support is an integral aspect of coping with both organizational stressors and critical incidents. Firefighters were found to have positive attitudes toward mental health treatment in general, but several barriers still remain, such as stigma, fear of being placed on leave and fear of confidentiality breach. CONCLUSIONS Specialized treatment options for public safety personnel and airport firefighters who engage in serious incidents outside of their regular duties are needed.
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Affiliation(s)
- Bridget Barry
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Rosemary Ricciardelli
- School of Maritime Studies, Fisheries and Marine Institute, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
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26
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Oliveira J, Aires Dias J, Duarte IC, Caldeira S, Marques AR, Rodrigues V, Redondo J, Castelo-Branco M. Mental health and post-traumatic stress disorder in firefighters: an integrated analysis from an action research study. Front Psychol 2023; 14:1259388. [PMID: 37965662 PMCID: PMC10642162 DOI: 10.3389/fpsyg.2023.1259388] [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: 07/15/2023] [Accepted: 09/26/2023] [Indexed: 11/16/2023] Open
Abstract
Introduction The presence of post-traumatic stress disorder (PTSD) symptomatology in firefighters is an ever-pressing issue that requires close attention for adequate interventions. The present study investigated PTSD and global psychopathology prevalence in a sample of highly risk-exposed Portuguese firefighters, collected after the widespread deadly wildfires in 2017 that ravaged the country. Following an action research approach, the aim of this study was to depict this sample and examine the impact of cumulative adverse experiences on their mental health, which is a phenomenon worth attention. Method From an initial sample of 283 firefighters who manifested interest in participating, a total of 139 firefighters from the Coimbra District, of whom 130 unequivocally experienced a potentially traumatic/adverse event as a firefighter, completed BSI (to obtain indicators on psychopathology), QEPAT (an inventory of adverse events possibly experienced as a firefighter), and PCL-5 (a measure of PTSD symptomatology) through an online survey during the year 2018 by the Regional Medical Organization, as proposed and supervised by the local Centre for Prevention and Treatment of Psychological Trauma (CPTTP). Results We found a global prevalence of 8.6% of possible PTSD and 14.4% of possible psychopathology (n = 139). When considering only firefighters who unequivocally reported a potentially traumatic/adverse event as a firefighter (n = 130), 9.2% present possible PTSD, and 13.8% present possible global psychopathology. This sample experienced a mean of 28 adverse events during firefighting work. Linear regressions (n = 118) demonstrated that the perceived severity of the most traumatic event reported and the experience of more adverse events were both related to an increase in PTSD symptomatology. Global psychopathology was associated with PCL-5 scores, with an emphasis on paranoid ideation, hostility, depression, anxiety, and phobic anxiety. Discussion The severe wildfires of 2017 did not impact PTSD scores in this sample (collected the year after), suggesting that cumulative adverse events are more important than particular episodes. However, the number of reported events was related to PTSD scores. These results can be used to develop interventions that target all firefighters by addressing risk and protective factors. This action research study motivated specialized aid for firefighters involved in this study.
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Affiliation(s)
- Joana Oliveira
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine (FMUC), University of Coimbra, Coimbra, Portugal
| | - Joana Aires Dias
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Isabel Catarina Duarte
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Salomé Caldeira
- Centre for Prevention and Treatment of Psychological Trauma (CPTTP), Department of Psychiatry, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal
| | - António Reis Marques
- Centre for Prevention and Treatment of Psychological Trauma (CPTTP), Department of Psychiatry, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal
| | - Vítor Rodrigues
- Faculty of Medicine (FMUC), University of Coimbra, Coimbra, Portugal
| | - João Redondo
- Centre for Prevention and Treatment of Psychological Trauma (CPTTP), Department of Psychiatry, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine (FMUC), University of Coimbra, Coimbra, Portugal
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Serrano-Ibáñez ER, Corrás T, Del Prado M, Diz J, Varela C. Psychological Variables Associated With Post-Traumatic Stress Disorder in Firefighters: A Systematic Review. Trauma Violence Abuse 2023; 24:2049-2066. [PMID: 35521996 PMCID: PMC10486174 DOI: 10.1177/15248380221082944] [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] [Indexed: 06/14/2023]
Abstract
Firefighters are repeatedly exposed to work-related potential traumatic events and have an increased risk of developing post-traumatic stress disorder (PTSD). However, the mechanisms implicated in this relationship are not clear. The aim of this study was to analyse the risk and protective factors related to the development of PTSD in firefighters. According to PRISMA, a systematic review of scientific literature was conducted in Web of Science, PsycINFO, Scopus, PubMed and the Cochrane Central Register of Controlled Trials. Quality in Prognosis Studies (QUIPS) was used as the methodological quality indicator of the selected articles (PROSPERO reference CRD42020213009). Prognostic studies involving active firefighters with presence of post-traumatic symptomatology, presenting original findings, and written in Spanish or English were included. A total of 1768 potentially eligible articles were identified. According to the inclusion criteria, 87 articles were selected to evaluate the full text. Finally, 19 articles were included, comprising 12,298 active firefighters. There is high heterogeneity in the variables evaluated in the different studies. Taking the data for which this review has found more evidence (moderate support), operational stress, job duration, burnout, expressive suppression and rumination could be risk factors of PTSD, and belongingness and dispositional mindfulness could be protective factors. Other variables with weak support (e.g. resilience) were analysed. This review analyses the available literature, highlighting its scarcity for future research on the subject. Due to repeated trauma exposure, it is important to continue investigations and bear these variables in mind for the prevention of PTSD in firefighters.
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Affiliation(s)
| | - Tania Corrás
- Área de Psicología, Universidad Isabel I, Burgos, España
| | | | - Javier Diz
- Área de Psicología, Universidad Isabel I, Burgos, España
| | - Carmen Varela
- Área de Psicología, Universidad Isabel I, Burgos, España
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Abstract
OBJECTIVE Heightened rates of posttraumatic stress disorder (PTSD) symptoms and alcohol use have been documented among firefighters. Emotion regulation difficulties (ERD) are clinically relevant to both PTSD and alcohol use. Few studies have examined the role of ERD in the association of PTSD symptoms with alcohol use severity and alcohol use motives among firefighters. Thus, the present investigation examined the indirect effect of PTSD symptom severity on alcohol use severity and alcohol use motives through ERD. METHODS The sample was comprised of 685 firefighters (Mage = 38.65, SD = 8.57, 93.6% male) recruited from an urban fire department in the southern U.S. to complete an online survey. Indirect effects were calculated using 10,000 bootstrapped samples. Effects were examined after accounting for years of fire service, occupational stress, trauma load (i.e., number of traumatic event types experienced); in models evaluating alcohol use motives as outcomes, other alcohol use motives (i.e., alternate motives subscales) were included as additional covariates. RESULTS First, ERD explained the association of PTSD symptom severity with alcohol use coping motives (β = .01, SE = .003, 95% CI [.004-.01]). Furthermore, ERD did not significantly account for the association of PTSD symptom severity with alcohol use severity (β = .02, SE = .01, 95% CI [-.004-.04]), alcohol use enhancement motives (β = -.003, SE = .002, 95%CI [-.007-.000]), alcohol use social motives (β = .004, SE = .002, 95% CI [-.000-.01]), or alcohol use conformity motives (β = -.002, SE = .002, 95% CI [-.006-.02]). CONCLUSIONS Results demonstrated that, among firefighters, PTSD symptom severity is positively related to alcohol use coping motives through heightened ERD. Clinical implications and future directions are discussed.
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Affiliation(s)
| | - Shelby J McGrew
- University of Houston, Houston, Texas, USA
- Trauma and Stress Studies Center, Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
| | | | - Anka A Vujanovic
- University of Houston, Houston, Texas, USA
- Trauma and Stress Studies Center, Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA
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29
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Shah NN, Steinberg MB, Caban-Martinez AJ, Austin E, Burgess JL, Hollerbach BS, Edwards DL, Black TM, Black K, Hinton KM, Kubiel BS, Graber JM. Prevalence and predictors of skin cancer screening among a sample of US volunteer firefighters. Am J Ind Med 2023; 66:897-903. [PMID: 37573478 PMCID: PMC10528674 DOI: 10.1002/ajim.23524] [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: 05/18/2023] [Revised: 07/09/2023] [Accepted: 07/27/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND Firefighters have a higher risk of melanoma incidence and mortality compared to the general population. In the United States (US), the National Fire Protection Association recommends all firefighters receive annual skin cancer screening through visual skin examination by a clinician. However, there is limited information on skin cancer screening practices among volunteer firefighters who comprise two-thirds of the US fire service. METHODS This cross-sectional study of 552 US volunteer firefighters estimated the prevalence of skin cancer screening and evaluated associations with their fire service experience, demographics, sun protection practices, and cancer risk perception. RESULTS The prevalence of receiving skin cancer screening among volunteer firefighters was 26.1% (95% confidence interval [CI]: 22.4, 29.8). The odds of being screened for skin cancer, compared to not being screened, were twice as high for firefighters who used sunscreen (odds ratio [OR]: 2.35, 95% CI: 1.48, 3.73) and who perceived their skin likely to burn with prolonged sun exposure (OR: 1.81, 95% CI: 1.10, 3.00). Older age, some college education, and family history of skin cancer were also positively associated with skin cancer screening. A positive exposure-response relationship was observed between more monthly firefighting calls and receiving screening. Cancer risk perception was not associated with screening. CONCLUSION To our knowledge, this is the first large study to assess skin cancer screening among US volunteer firefighters. Our findings suggest gaps in skin cancer prevention efforts in the volunteer fire service. Additional assessment of skin cancer prevention practices within volunteer fire departments could help address these gaps.
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Affiliation(s)
- Nimit N. Shah
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Michael B. Steinberg
- Division of General Internal Medicine; Robert Wood Johnson Medical School; Rutgers, The State University of New Jersey; New Brunswick, New Jersey, USA
- Rutgers, The State University of New Jersey, Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Elena Austin
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Washington, USA
| | - Jefferey L. Burgess
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | | | | | - Taylor M. Black
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Kathleen Black
- Rutgers Environmental and Occupational Health Sciences Institute, Rutgers the State University of New Jersey, Piscataway, New Jersey, USA
| | - Kaleigh M. Hinton
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Brian S. Kubiel
- Toms River Board of Fire Commissioners, District #1, Toms River, New Jersey, USA
| | - Judith M. Graber
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
- Rutgers, The State University of New Jersey, Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
- Rutgers Environmental and Occupational Health Sciences Institute, Rutgers the State University of New Jersey, Piscataway, New Jersey, USA
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30
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Beckett A, Scott JR, Chater AM, Ferrandino L, Aldous JWF. The Prevalence of Metabolic Syndrome and Its Components in Firefighters: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2023; 20:6814. [PMID: 37835084 PMCID: PMC10572458 DOI: 10.3390/ijerph20196814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023]
Abstract
Previous studies consistently report a high prevalence of cardiovascular disease (CVD) risk factors among firefighters. However, the clustering of CVD risk factors, defined as metabolic syndrome (MetSyn), has received little attention by comparison. Therefore, the aim of this study was to estimate the pooled prevalence of MetSyn among firefighters. Using combinations of free text for 'firefighter' and 'metabolic syndrome', databases were searched for eligible studies. Meta-analyses calculated weighted pooled prevalence estimates with 95% confidence intervals (CI) for MetSyn, its components and overweight/obesity. Univariate meta-regression was performed to explore sources of heterogeneity. Of 1440 articles screened, 25 studies were included in the final analysis. The pooled prevalence of MetSyn in 31,309 firefighters was 22.3% (95% CI: 17.7-27.0%). The prevalences of MetSyn components were hypertension: 39.1%; abdominal obesity: 37.9%; hypertriglyceridemia: 30.2%; dyslipidemia: 30.1%; and hyperglycemia: 21.1%. Overweight and obesity prevalence rates in firefighters were 44.1% and 35.6%, respectively. Meta-regression revealed that decreased risk of bias (RoB) score and increased body mass index (BMI) were positively associated with an increase in MetSyn prevalence. Since one in five firefighters may meet the criteria for MetSyn, novel interventions should be explored to both prevent MetSyn and reduce the onset of CVD risk factors.
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Affiliation(s)
- Ashley Beckett
- Institute for Sport and Physical Activity Research (ISPAR), University of Bedfordshire, Bedford MK41 9EA, UK; (J.R.S.); (A.M.C.); (L.F.); (J.W.F.A.)
| | - Jake Riley Scott
- Institute for Sport and Physical Activity Research (ISPAR), University of Bedfordshire, Bedford MK41 9EA, UK; (J.R.S.); (A.M.C.); (L.F.); (J.W.F.A.)
| | - Angel Marie Chater
- Institute for Sport and Physical Activity Research (ISPAR), University of Bedfordshire, Bedford MK41 9EA, UK; (J.R.S.); (A.M.C.); (L.F.); (J.W.F.A.)
- Centre for Behaviour Change (CBC), University College London, London WC1E 6BT, UK
| | - Louise Ferrandino
- Institute for Sport and Physical Activity Research (ISPAR), University of Bedfordshire, Bedford MK41 9EA, UK; (J.R.S.); (A.M.C.); (L.F.); (J.W.F.A.)
| | - Jeffrey William Frederick Aldous
- Institute for Sport and Physical Activity Research (ISPAR), University of Bedfordshire, Bedford MK41 9EA, UK; (J.R.S.); (A.M.C.); (L.F.); (J.W.F.A.)
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Gong C, Gao W, Zhang B, Tang H, Xie Y. Investigation and analysis of training injury and its psychological effects on firefighters in Beijing A cross-sectional study. Medicine (Baltimore) 2023; 102:e35179. [PMID: 37747013 PMCID: PMC10519485 DOI: 10.1097/md.0000000000035179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Firefighters' high-intensity training often leads to injuries in the musculoskeletal system. Studies have found that these injuries in the musculoskeletal system may contribute to poor psychological issues. At the same time, low psychological well-being increases the risk of injuries, illness, and mortality. According to research reports, firefighters generally have a good psychological state. So this study aims to survey and analyze the training-related injuries and psychological states of firefighting and rescue personnel in Beijing. This cross-sectional study employed a questionnaire survey to gather data from a total of 214 firefighters in a certain city. The participants were required to complete a questionnaire about musculoskeletal injuries and psychological status, and then these data were statistically analyzed. The incidence of training-related injuries is relatively high among firefighting and rescue teams, with the highest proportions observed in the lower back, knees, and ankles. Overweight and obese firefighters are more prone to ankle injuries. In the group with injuries, the subjective well-being index is lower compared to the group without injuries. Firefighters experiencing moderate to severe pain due to injuries exhibit lower subjective well-being indices compared to those with mild pain. Psychological resilience and the impact of pain on training and sleep can predict the subjective well-being index of firefighters. It is recommended that firefighting and rescue teams enhance preventive measures for musculoskeletal injuries during training to elevate the subjective well-being of firefighters.
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Affiliation(s)
- Cheng Gong
- Department of Rehabilitation Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wentao Gao
- Combat Training Service, Beijing Dongcheng District Fire and Rescue Detachment, Beijing, China
| | - Bo Zhang
- Department of Rehabilitation Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Haifeng Tang
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Ying Xie
- Department of Rehabilitation Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Yoo JY, McSkimming D, Rajan K, Sarkar A, Labbé N, Groer M, Menon U. A Preliminary Study Exploring the Relationship between Occupational Health Hazards and Gut Microbiota among Firefighters. Life (Basel) 2023; 13:1928. [PMID: 37763331 PMCID: PMC10533145 DOI: 10.3390/life13091928] [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: 08/17/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Firefighters are exposed to occupational hazards and have a higher prevalence of health issues. The gut microbiota plays a crucial role in the immune, endocrine, and neural systems, and disruptions in its composition can impact health outcomes. This pilot study aimed to investigate the potential association between occupational factors, changes in gut microbiota, and the development of adverse health outcomes in firefighters. To test this hypothesis, we recruited 15 firefighters and age/sex-matched controls to investigate the relationship between occupational environment and gut microbiota. Firefighters exhibit lower intestinal bacterial alpha diversity and a higher presence of pathogenic bacteria than the control. Moreover, unique gut bacterial taxa were observed in firefighters with high post-traumatic stress disorder (PTSD) scores, which could contribute to immune dysregulation and higher susceptibility to pathogen colonization. These preliminary findings suggest that occupational factors, including exposure to traumatic stressors and chemicals, may influence firefighters' health by modulating their gut microbiota. The observed changes in gut microbiota composition and the potential link to occupational hazards highlight the need for further research in larger sample-size studies. Understanding the role of gut microbiota in firefighter health may have implications for preventive measures and interventions to mitigate occupational health risks and improve overall well-being.
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Affiliation(s)
- Ji Youn Yoo
- College of Nursing, University of Tennessee Knoxville, Knoxville, TN 37996, USA; (A.S.); (M.G.)
| | - Daniel McSkimming
- Interdisciplinary Unit in Data Science & Analytics, Buffalo State University, Buffalo, NY 14222, USA;
| | - Kalavathy Rajan
- Department of Plant and Soil Science, Fiber and Biopolymer Research Institute, Texas Tech University, Lubbock, TX 79403, USA;
| | - Anujit Sarkar
- College of Nursing, University of Tennessee Knoxville, Knoxville, TN 37996, USA; (A.S.); (M.G.)
| | - Nicole Labbé
- Center for Renewable Carbon, The University of Tennessee Institute of Agriculture, Knoxville, TN 37996, USA;
| | - Maureen Groer
- College of Nursing, University of Tennessee Knoxville, Knoxville, TN 37996, USA; (A.S.); (M.G.)
| | - Usha Menon
- College of Nursing, University of South Florida, Tampa, FL 33612, USA;
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Dobrowolska-Zrałka K, Kujawa K, Regulska-Ilow B. Association of the Length of Service of 24/48 Firefighters with the Quality of Their Diet and Selected Anthropometric Parameters. Nutrients 2023; 15:4029. [PMID: 37764812 PMCID: PMC10536748 DOI: 10.3390/nu15184029] [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: 08/22/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of the study was to examine the association of lengths of service (LS) ≤ 10 years and >10 years in 24/48 shifts with the quality of the observed diet based on the Nutrient Rich Food Index (NRF9.3) and selected anthropometric parameters of 130 firefighters of the State Fire Service (SFS) in Wroclaw, Poland. The study also analysed the individual components of the men's diets required to calculate the NRF9.3 index in both seniority groups. Men with LS > 10 years had statistically significant higher body weight (89.00 kg vs. 81.59 kg), body-fat level (22.80 kg vs. 17.95 kg), waist circumference (96.50 cm vs. 89.00 cm), body-fat percentage (21.94 ± 4.06% vs. 25.00 ± 5.45%), body mass index (BMI) (28.10 kg/m2 vs. 25.40 kg/m2) and waist-hip ratio (WHR) (0.84 0.92 vs. 0.84), compared to the LF ≤ 10 years group. In contrast, the quality of the men's dietary adherence, based on the calculated NRF9.3 index, did not differ between the study groups, and was 662.50 ± 103.1 and 664.78 for the LS ≤ 10 years and LS > 10 years groups, respectively. Based on a statistical analysis using the NRF9.3 diet quality index by tertile (NRF9.3-C), a leading and statistically significant association of LS > 10 years vs. ≤10 years was observed as to most of the anthropometric parameters studied. In contrast, the association of participants' diet quality, as assessed by the NRF9.3 index value, was insignificant for all anthropometric parameters studied.
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Affiliation(s)
- Karolina Dobrowolska-Zrałka
- Department of Dietetics and Bromatology, Wroclaw Medical University, ul. Borowska 211, 50-556 Wroclaw, Poland;
| | - Krzysztof Kujawa
- Statistical Analysis Centre, Wroclaw Medical University, ul. K. Marcinkowskiego 2-6, 50-368 Wroclaw, Poland;
| | - Bożena Regulska-Ilow
- Department of Dietetics and Bromatology, Wroclaw Medical University, ul. Borowska 211, 50-556 Wroclaw, Poland;
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Igboanugo S, Mielke J. The allostatic load model: a framework to understand the cumulative multi-system impact of work-related psychosocial stress exposure among firefighters. Health Psychol Behav Med 2023; 11:2255026. [PMID: 37711429 PMCID: PMC10498803 DOI: 10.1080/21642850.2023.2255026] [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: 12/14/2022] [Accepted: 08/28/2023] [Indexed: 09/16/2023] Open
Abstract
Firefighting is recognised as a profession where health and well-being can be affected by a variety of occupational factors, such as physical, thermal, and chemical stressors. Along with the risks intuitively associated with the fire service, however, psychosocial stress has begun to attract attention as another variable deserving of consideration. Indeed, long-term exposure to work-related psychosocial stress has been linked with poor health outcomes in many workers; however, despite this association, very little has been done to examine how such stressors become biologically embedded in firefighters. To help facilitate research into how psychosocial stress can affect health-related outcomes in the fire service, we propose a framework centered on the notion of allostatic load. First, we reviewed the occupational characteristics that may generate psychosocial stress within firefighters before introducing allostatic load (that is, dysregulation across various physiological systems caused by the need to manage ongoing stressors). Next, we provided a summary of how allostatic load can be measured and touched on the framework's utility for studying the cumulative effects of work-related stress on firefighter health. After this, factors that may influence the steps leading from stress exposure to health outcomes were discussed; in particular, we commented upon how research in this area should consider specific non-modifiable (age, sex, and ethnicity) and modifiable (psychosocial resources and behavioural habits) factors. Finally, we presented methodological barriers and opportunities that may arise when using the allostatic load framework with this professional group. By introducing the framework, we hope to provide a tool that may be used by those interested in stress-health research in firefighters to build the evidence needed to inform primary prevention measures.
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Affiliation(s)
- Somkene Igboanugo
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
- Patient Education and Engagement, University Health Network, Toronto, Canada
| | - John Mielke
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Zegel M, Kabel KE, Lebeaut A, Vujanovic AA. Distress overtolerance among firefighters: Associations with posttraumatic stress. Psychol Trauma 2023; 15:S315-S318. [PMID: 36301294 PMCID: PMC10204075 DOI: 10.1037/tra0001393] [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] [Indexed: 05/25/2023]
Abstract
OBJECTIVE Firefighters experience heightened rates of posttraumatic stress disorder (PTSD) symptoms compared to the general population. Nascent literature has identified distress overtolerance (DO; i.e., the tendency to persist through extremely high levels of distress despite harmful consequences) as a construct of potential relevance to PTSD symptomatology, though empirical research is lacking. The present study examined incremental associations between DO subscales (Capacity for Harm: persevering through distress despite its effect on 1's wellbeing; Fear of Negative Evaluation: persisting through distress due to a fear of being negatively evaluated by others should they quit) and PTSD symptom severity and symptom cluster severity (i.e., intrusion, avoidance, negative alterations in cognitions and mood [NACM], arousal and reactivity) among firefighters. METHOD Participants included 282 trauma-exposed firefighters (91.8% male, Mage = 40.4, SD = 9.6). Covariates included years in the fire service, trauma load (i.e., number of trauma exposure types), and negative affect. RESULTS Results indicated that Capacity for Harm was a significant incremental correlate of total PTSD symptom severity (ΔR² = .045, p = .004), NACM symptoms (ΔR² = .061, p < .001), and arousal/reactivity symptoms (ΔR² = .047, p = .005). Fear of Negative Evaluation was not significantly related to any criterion variables. CONCLUSION Further work examining DO-PTSD relations is necessary to inform intervention and policy for the fire service. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Maya Zegel
- Department of Psychology, University of Houston, Houston, TX
| | | | - Antoine Lebeaut
- Department of Psychology, University of Houston, Houston, TX
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Ledda C, Bracci M, Spadafora A, Motta G, Smecca G, Catelan D, Rapisarda V. Unmasking the Hidden Danger: A Decade-Long Systematic Review of Case-Control Studies on Single Occupational Risks and Prostate Cancer. Life (Basel) 2023; 13:1820. [PMID: 37763224 PMCID: PMC10532927 DOI: 10.3390/life13091820] [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: 07/31/2023] [Revised: 08/21/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
The present systematic review addresses the influence of occupational exposures on prostate cancer risk. Eleven studies were analyzed for a range of occupational exposures, including but not limited to firefighting, physical activity, night shift work, chemical exposure, and solar ultraviolet radiation. The results of the review reveal that firefighters exposed to harmful substances, individuals engaged in physically strenuous work, and workers with chronic night shift routines showed an increased likelihood of developing prostate cancer. Moreover, the review identified an increased risk associated with exposure to certain chemicals, including alkylphenolic compounds and benzene-related substances. The evidence underscores the importance of considering the cumulative effect of multiple risk factors in a comprehensive risk assessment. However, the conclusions indicate the necessity for further research to deepen these relationships and develop more effective strategies for the prevention of prostate cancer.
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Affiliation(s)
- Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy;
| | - Massimo Bracci
- Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60121 Ancona, Italy;
| | - Alba Spadafora
- Occupational Health and Safety Unit, Provincial Health Agency of Siracusa, 96100 Siracusa, Italy;
| | - Giuseppe Motta
- Occupational Medicine Unit, “Garibaldi” Hospital of Catania, 95123 Catania, Italy;
| | - Giuseppe Smecca
- Prevention and Protection Unit, Provincial Health Agency of Ragusa, 97100 Ragusa, Italy;
| | - Dolores Catelan
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy;
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy;
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Ras J, Smith DL, Kengne AP, Soteriades ES, Leach L. Physical fitness, cardiovascular and musculoskeletal health, and occupational performance in firefighters. Front Public Health 2023; 11:1241250. [PMID: 37693709 PMCID: PMC10485367 DOI: 10.3389/fpubh.2023.1241250] [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: 06/16/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction To perform their work efficiently and safely, firefighters should maintain all aspects of physical fitness. Cardiac-related incidents are the leading cause of duty-related deaths in firefighters, and many firefighters have poor musculoskeletal health (MSH) that hinder their occupational performance (OP). Establishing the relationship between physical fitness, cardiovascular health (CVH), MSH and OP may add new insight on the most significant factors influencing OP in firefighters, specifically in the City of Cape Town Fire and Rescue Service (CoCTFS), which had not been studied before. Therefore, the purpose of this study was to investigate whether physical fitness, CVH and MSH were associated with OP in firefighters, in the COCTFRS. Methods This cross-sectional study included 283 full-time firefighters aged 20-65 years from Cape Town, South Africa. A researcher-generated questionnaire was used to collect data on sociodemographic characteristics, lifestyle factors and MSH. Physical measures were used to collect information on physical fitness, CVH, and OP [using a physical ability test (PAT)]. Linear and binary logistic regressions, adjusted for age, sex, height and weekly metabolic equivalent minutes (WMETM), multivariate analysis of covariance (MANCOVA), adjusted for age, sex, height and body mass index (BMI) and backward stepwise regressions were used to investigate the associations between the various constructs. Results From multivariable analyses, age, lean body mass, body fat percentage (BF%), estimated absolute oxygen consumption (abV̇O2max), grip strength, leg strength, push-ups, sit-ups, WMETM and heart rate variability were associated with PAT completion times (all p < 0.01). The MANCOVA showed a significant difference between performance categories of the PAT based on physical fitness and CVH (both p < 0.001). WMETM, BF%, abV̇O2max, grip strength, leg strength and sit-ups explained the highest proportion (50.5%) of the variation in PAT completion times. Conclusion Younger, non-obese, fitter and stronger firefighters, with a better CVH status, performed significantly better and were most likely to pass the PAT in firefighters, in Cape Town, South Africa. Firefighters should maintain high levels of physical fitness and a good level of CVH to ensure a satisfactory level of OP.
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Affiliation(s)
- Jaron Ras
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Denise L. Smith
- Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Andre P. Kengne
- Non-communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Elpidoforos S. Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
- Environmental and Occupational Medicine and Epidemiology (EOME), Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
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Koru-Sengul T, Pinheiro PS, Zhao W, Hernandez MN, Hernandez DR, Maggioni A, Kobetz EN, Caban-Martinez AJ, Lee DJ. Lung cancer survival among Florida male firefighters. Front Oncol 2023; 13:1155650. [PMID: 37664012 PMCID: PMC10473410 DOI: 10.3389/fonc.2023.1155650] [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: 01/31/2023] [Accepted: 04/27/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Lung cancer is a leading cause of cancer incidence and death in the United States. Although most firefighters are fit and do not smoke, they are exposed to many known carcinogens during and in the aftermath of firefighting activities. Comprehensive epidemiologic investigations on lung cancer survival for both career and volunteer firefighters have not been undertaken. Methods Data from the Florida Cancer Data System (1981-2014) were linked with firefighter certification records from the Florida State Fire Marshal's Office to identify all patients of this occupational group; lung cancer cause-specific survival data were compared with other occupational groups using Cox regression models with occupation as the main effect. Adjusted hazard ratios (aHR) and 95% confidence intervals (95% CI) were calculated. Results Out of 210,541 male lung cancer cases diagnosed in Florida (1981-2014), 761 were firefighters (604 career, 157 volunteer). Lung cancer death was similar between volunteer (75.2%) and career firefighters (74.0%) but lower than non-firefighters (80.0%). Survival at 5 years was higher among firefighters (29.7%; career: 30.3%; volunteer: 27.4%) than non-firefighters (23.8%). In a multivariable model, compared with non-firefighters, firefighters have significantly higher cause-specific survival (aHR = 0.84; 95% CI: 0.77-0.91; p < 0.001). However, there were no significant survival differences between career and volunteer firefighters (1.14; 0.93-1.39; p = 0.213). In a separate multivariable model with firefighters as the comparator, other broad occupational groups had significantly lower cause-specific survival [white collar: 1.11 (1.02-1.21); blue collar: 1.15 (1.05-1.25); service: 1.13 (1.03-1.25); others/unknown: 1.21 (1.12-1.32); all p-values < 0.02]. Conclusion Lung cancer survival is significantly higher among firefighters compared with non-firefighters, but there is no significant difference between career and volunteer firefighters. Improved survival for firefighters might be due to a healthy worker effect, lower smoking prevalence relative to other worker groups, and possibly superior treatment adherence and compliance. Many firefighters are cross-trained as EMTs/paramedics and possess a level of medical knowledge that may favorably impact treatment engagement and better navigation of complex cancer care.
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Affiliation(s)
- Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Paulo S. Pinheiro
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Wei Zhao
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Monique N. Hernandez
- Florida Cancer Data System, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Diana R. Hernandez
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Alessandra Maggioni
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Erin N. Kobetz
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Department of Medicine, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Department of Physical Medicine and Rehabilitation, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - David J. Lee
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Florida Cancer Data System, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
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Kling HE, Koru-Sengul T, Solle NS, Louzado-Feliciano P, Lee DJ, Kobetz EN, Caban-Martinez AJ. Weight Status and Binge Drinking Among Male and Female Florida Firefighters. J Occup Environ Med 2023; 65:e565-e570. [PMID: 37253243 PMCID: PMC10524551 DOI: 10.1097/jom.0000000000002894] [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: 06/01/2023]
Abstract
OBJECTIVE The aim of the study is to examine the association between weight status and binge drinking among Florida firefighters. METHODS Health survey data collected between 2015 and 2019 among Florida firefighters participating in the Annual Cancer Survey were analyzed for weight class (healthy, overweight, obese) and binge-drinking behaviors. Binary logistic regression models were fit and stratified by sex while controlling for sociodemographic and health characteristics. RESULTS Among 4002 firefighter participants, 45.1% binge drink, 50.9% are overweight, and 31.3% are obese. Among male firefighters, being overweight (adjusted odds ratio = 1.34; 95% confidence interval = 1.10-1.64) or obese (1.29; 1.04-1.61) was significantly associated with binge drinking compared with healthy weight counterparts. In female firefighters, being obese (2.25; 1.21-4.22) was significantly associated with binge drinking but being overweight was not. CONCLUSIONS Being overweight or obese is selectively associated with binge drinking among male and female firefighters.
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Affiliation(s)
- Hannah E. Kling
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Natasha Schaefer Solle
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Medicine and University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Paola Louzado-Feliciano
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - David J. Lee
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Erin N. Kobetz
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Medicine and University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
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Abstract
OBJECTIVE The aim of the study is to determine the association between cardiovascular health (CVH) and musculoskeletal health in firefighters. METHODS This cross-sectional study involved 309 full-time firefighters aged 20 to 65 years. Cardiovascular health encompassed cardiovascular disease risk factors, risk scores, CVH metrics, and heart rate variability. Musculoskeletal health was assessed using two validated questionnaires. RESULTS Increasing age ( P = 0.004), body mass index ( P < 0.001), body fat percentage ( P < 0.001), diastolic blood pressure ( P = 0.003), total cholesterol ( P = 0.006), and Framingham risk score ( P = 0.011) increased the risk of reporting musculoskeletal injuries (MSIs). Obesity ( P = 0.018), hypertension ( P = 0.034), and dyslipidemia ( P = 0.005) increased the risk of reporting MSIs. Musculoskeletal discomfort was associated with total cholesterol ( P = 0.0.34) and low-density lipoprotein ( P = 0.014). CONCLUSIONS Adverse cardiovascular disease risk profile was associated with MSIs and musculoskeletal discomfort in firefighters. Firefighters should maintain an ideal CVH profile, especially as they age.
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Everaert S, Schoeters G, Claes K, Raquez JM, Buffel B, Vanhaecke T, Moens J, Laitinen J, Van Larebeke N, Godderis L. Balancing Acute and Chronic Occupational Risks: The Use of Nitrile Butadiene Rubber Undergloves by Firefighters to Reduce Exposure to Toxic Contaminants. Toxics 2023; 11:534. [PMID: 37368634 DOI: 10.3390/toxics11060534] [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] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/01/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
Firefighters are exposed via multi-route exposure to a multitude of chemicals (PAHs, VOCs, flame retardants, dioxins, etc.) that may cause acute and long-term health effects. The dermal absorption of contaminants is a major contributor to the overall exposure and can be reduced by wearing appropriate personal protective equipment. As leather firefighters' gloves cannot be decontaminated regularly by wet cleaning, many Belgian firefighters wear supplementary undergloves made of nitrile butadiene rubber (NBR) to protect against the accumulation of toxicants. However, the safety of this practice has been questioned. In this commentary, the current practice and risks are outlined for the first time, assessed by an interdisciplinary working group of the Belgian Superior Health Council. As NBR sticks to the skin more at high temperatures, the contact time on removal will be prolonged, posing an additional risk for deeper burns. However, based on the physicochemical properties of NBR and the existing experience of firefighters and burn centers, it is estimated that such incidents occur relatively rarely in practice. On the other hand, the risk of repeated exposure to contaminated gloves if no undergloves are worn is unacceptable. Despite the slightly increased risk for deeper burns, it is concluded that wearing disposable NBR gloves under regular firefighters' gloves is an appropriate and effective preventive measure against toxic contamination. The nitrile butadiene rubber must always be fully covered to avoid any contact with the heat.
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Affiliation(s)
- Stijn Everaert
- Chemical Environmental Factors Group, Superior Health Council, 1060 Brussels, Belgium
| | - Greet Schoeters
- Department of Biomedical Sciences, University of Antwerp, 2650 Antwerp, Belgium
| | - Karel Claes
- Burn Center & Department of Plastic Surgery, Ghent University Hospital, 9000 Ghent, Belgium
| | - Jean-Marie Raquez
- Polymer and Composite Materials Department, University of Mons, 7000 Mons, Belgium
| | - Bart Buffel
- Department of Materials Engineering, KU Leuven, 8200 Bruges, Belgium
| | - Tamara Vanhaecke
- Department of In Vitro Toxicology and Dermato-Cosmetology, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Jonas Moens
- Belgian Poison Centre, 1120 Brussels, Belgium
| | - Juha Laitinen
- Pelastusopisto, Emergency Services Academy Finland, 70821 Kuopio, Finland
| | - Nicolas Van Larebeke
- Department of Radiotherapy and Experimental Cancerology, Ghent University, 9000 Ghent, Belgium
- Department of Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Lode Godderis
- Center for Environment and Health, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
- IDEWE, External Service for Prevention and Protection at Work, 3001 Heverlee, Belgium
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Mayer AC, Fent KW, Wilkinson AF, Chen IC, Siegel MR, Toennis C, Sammons D, Meadows J, Kesler RM, Kerber S, Smith DL, Masoud F, Bhandari D, Wang Y, Blount BC, Calafat AM, Horn GP. Evaluating Exposure to VOCs and Naphthalene for Firefighters Wearing Different PPE Configurations through Measures in Air, Exhaled Breath, and Urine. Int J Environ Res Public Health 2023; 20:6057. [PMID: 37372644 DOI: 10.3390/ijerph20126057] [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: 05/08/2023] [Revised: 05/23/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023]
Abstract
Firefighters are at an increased risk of cancer due to their occupational exposure to combustion byproducts, especially when those compounds penetrate the firefighter personal protective equipment (PPE) ensemble. This has led to questions about the impact of base layers (i.e., shorts vs. pants) under PPE ensembles. This study asked 23 firefighters to perform firefighting activities while wearing one of three different PPE ensembles with varying degrees of protection. Additionally, half of the firefighters unzipped their jackets after the scenario while the other half kept their jackets zipped for five additional minutes. Several volatile organic compound (VOC) and naphthalene air concentrations outside and inside of hoods, turnout jackets, and turnout pants were evaluated; biological (urinary and exhaled breath) samples were also collected. VOCs and naphthalene penetrated the three sampling areas (hoods, jackets, pants). Significant (p-value < 0.05) increases from pre- to post-fire for some metabolites of VOCs (e.g., benzene, toluene) and naphthalene were found. Firefighters wearing shorts and short sleeves absorbed higher amounts of certain compounds (p-value < 0.05), and the PPE designed with enhanced interface control features appeared to provide more protection from some compounds. These results suggest that firefighters can dermally absorb VOCs and naphthalene that penetrate the PPE ensemble.
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Affiliation(s)
- Alexander C Mayer
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH 45226, USA
| | - Kenneth W Fent
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH 45226, USA
| | - Andrea F Wilkinson
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH 45226, USA
| | - I-Chen Chen
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH 45226, USA
| | - Miriam R Siegel
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH 45226, USA
| | - Christine Toennis
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH 45226, USA
| | - Deborah Sammons
- Division of Science Integration, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH 45226, USA
| | - Juliana Meadows
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH 45226, USA
| | - Richard M Kesler
- Fire Safety Research Institute, UL Research Institutes, Columbia, MD 21045, USA
| | - Steve Kerber
- Fire Safety Research Institute, UL Research Institutes, Columbia, MD 21045, USA
| | - Denise L Smith
- Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY 12866, USA
- Illinois Fire Service Institute, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Farzaneh Masoud
- Illinois Fire Service Institute, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Deepak Bhandari
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30341, USA
| | - Yuesong Wang
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30341, USA
| | - Benjamin C Blount
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30341, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30341, USA
| | - Gavin P Horn
- Fire Safety Research Institute, UL Research Institutes, Columbia, MD 21045, USA
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Singh A, Zeig-Owens R, Cannon M, Webber MP, Goldfarb DG, Daniels RD, Prezant DJ, Boffetta P, Hall CB. All-cause and cause-specific mortality in a cohort of WTC-exposed and non-WTC-exposed firefighters. Occup Environ Med 2023; 80:297-303. [PMID: 36972975 PMCID: PMC10523283 DOI: 10.1136/oemed-2022-108703] [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: 10/17/2022] [Accepted: 03/10/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE To compare mortality rates in World Trade Center (WTC)-exposed Fire Department of the City of New York (FDNY) firefighters with rates in similarly healthy, non-WTC-exposed/non-FDNY firefighters, and compare mortality in each firefighter cohort with the general population. METHODS 10 786 male WTC-exposed FDNY firefighters and 8813 male non-WTC-exposed firefighters from other urban fire departments who were employed on 11 September 2001 were included in the analyses. Only WTC-exposed firefighters received health monitoring via the WTC Health Programme (WTCHP). Follow-up began 11 September 2001 and ended at the earlier of death date or 31 December 2016. Death data were obtained from the National Death Index and demographics from the fire departments. We estimated standardised mortality ratios (SMRs) in each firefighter cohort versus US males using demographic-specific US mortality rates. Poisson regression models estimated relative rates (RRs) of all-cause and cause-specific mortality in WTC-exposed versus non-WTC-exposed firefighters, controlling for age and race. RESULTS Between 11 September 2001 and 31 December 2016, there were 261 deaths among WTC-exposed firefighters and 605 among non-WTC-exposed. Both cohorts had reduced all-cause mortality compared with US males (SMR (95% CI)=0.30 (0.26 to 0.34) and 0.60 (0.55 to 0.65) in WTC-exposed and non-WTC-exposed, respectively). WTC-exposed firefighters also had lower rates of all-cause mortality (RR=0.54, 95% CI=0.49 to 0.59) and cancer-specific, cardiovascular-specific and respiratory disease-specific mortality compared with non-WTC-exposed firefighters. CONCLUSION Both firefighter cohorts had lower than expected all-cause mortality. Fifteen years post 11 September 2001, mortality was lower in WTC-exposed versus non-WTC-exposed firefighters. Lower mortality in the WTC-exposed suggests not just a healthy worker effect, but additional factors such as greater access to free health monitoring and treatment that they receive via the WTCHP.
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Affiliation(s)
- Ankura Singh
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Rachel Zeig-Owens
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Madeline Cannon
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Mayris P Webber
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - David G Goldfarb
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Robert D Daniels
- Division of Science integration, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - David J Prezant
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
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Girase A, Shinde A, Ormond RB. Qualitative Assessment of Off-Gassing of Compounds from Field-Contaminated Firefighter Jackets with Varied Air Exposure Time Intervals Using Headspace GC-MS. Textiles (Basel) 2023; 3:246-256. [PMID: 37786878 PMCID: PMC10544876 DOI: 10.3390/textiles3020016] [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] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Firefighters are exposed to a complex mix of volatile and semi-volatile compounds from burning construction materials, consumer products, and other elements during fire suppression and rescue. These compounds can be absorbed onto the gear worn by firefighters and, depending on their volatility, can be released from the gear under different conditions. Few studies have focused on the off-gassing of toxic compounds from firefighters' gear, particularly in terms of qualitative analysis methods. This study introduces a novel qualitative analysis method using headspace gas chromatography-mass spectrometry (HS-GC-MS) to assess off-gassing from field-contaminated jackets at regular intervals. Our findings show that certain compounds, such as acetic acid and di-ethyl-hexyl-phthalate (DEHP), remained present even after the gear were allowed to air out for 48 h. The persistent off-gassing of chemicals, even under ambient conditions, raises concerns about potential hazards that could pose risks for personnel in the vicinity of contaminated gear, including inside fire stations. The implications of these findings extend beyond fire stations and may have significant public health implications for firefighters who are repeatedly exposed to these compounds over time.
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Affiliation(s)
- Arjunsing Girase
- Textile Protection and Comfort Center, Wilson College of Textiles, North Carolina State University, Raleigh, NC 27606, USA
| | - Adhiraj Shinde
- Textile Protection and Comfort Center, Wilson College of Textiles, North Carolina State University, Raleigh, NC 27606, USA
| | - Robert Bryan Ormond
- Textile Protection and Comfort Center, Wilson College of Textiles, North Carolina State University, Raleigh, NC 27606, USA
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Ras J, Smith DL, Soteriades ES, Kengne AP, Leach L. Association between Physical Fitness and Cardiovascular Health in Firefighters. Int J Environ Res Public Health 2023; 20:5930. [PMID: 37297534 PMCID: PMC10252711 DOI: 10.3390/ijerph20115930] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 06/12/2023]
Abstract
Firefighters perform strenuous work in dangerous and unpredictable environments requiring optimal physical conditioning. The aim of this study was to investigate the association between physical fitness and cardiovascular health (CVH) in firefighters. This cross-sectional study systematically recruited 309 full-time male and female firefighters between the ages of 20 to 65 years in Cape Town, South Africa. Physical fitness was assessed using absolute (abV̇O2max) and relative oxygen consumption (relVO2max), grip and leg strength, push-ups and sit-ups, sit-and-reach for flexibility and lean body mass (LBM). CVH encompassed age, smoking, blood pressure (BP), blood glucose, lipid profile, body mass index, body fat percentage (BF%), and waist circumference. Linear regressions and logistic regressions were applied. Multivariable analysis indicated that relVO2max was associated with systolic BP (p < 0.001), diastolic BP (p < 0.001), non-fasting blood glucose (p < 0.001), and total cholesterol (p = 0.037). Poor CVH index was negatively associated with relV̇O2max (p < 0.001), leg strength (p = 0.019), and push-ups (p = 0.012). Furthermore, age was inversely associated with V̇O2max (p < 0.001), push-up and sit-up capacity (p < 0.001), and sit-and-reach (p < 0.001). BF% was negatively associated with abV̇O2max (p < 0.001), grip and leg strength (p < 0.001), push-ups (p = 0.008), sit-ups (p < 0.001), and LBM (p < 0.001). Cardiorespiratory fitness, muscular strength, and muscular endurance were significantly associated with a better overall CVH profile.
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Affiliation(s)
- Jaron Ras
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town 7535, South Africa;
| | - Denise L. Smith
- Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY 12866, USA;
| | - Elpidoforos S. Soteriades
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia 2220, Cyprus;
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Boston, MA 02115, USA
| | - Andre P. Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa;
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town 7535, South Africa;
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46
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Senger AR, McGrew SJ, Gallagher MW, Vujanovic A. Associations of resilience and hope with mental and physical health among firefighters. J Clin Psychol 2023. [PMID: 37212250 DOI: 10.1002/jclp.23534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/28/2023] [Accepted: 05/03/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Firefighters represent an understudied population with high rates of chronic exposure to stress and potentially traumatic events. Thus, there is a need to identify modifiable resilience factors to address posttraumatic stress disorder (PTSD) symptoms (PTSD) and chronic pain in firefighters to inform prevention and intervention efforts. METHODS The current sample included 155 firefighters (93.5% male; Mage = 42.2, SD = 9.8) recruited online from career, volunteer, and combination (i.e., volunteer and career) departments in a large metropolitan area in the southern United States. RESULTS Structural equation modeling (SEM) was used to investigate the associations between/among resilience and hope on PTSD symptoms, chronic pain, well-being, and posttraumatic growth (PTG). Resilience had a stronger, negative relationship with PTSD and chronic pain compared to hope, while hope had a stronger, positive relationship with PTG and well-being compared to resilience. Hope and resilience combined predicted 10%-33% of the variance in the outcomes. CONCLUSION The current findings may provide evidence to promote interventions that increase resilience and hope in firefighters.
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Affiliation(s)
- Amy R Senger
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Shelby J McGrew
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Matthew W Gallagher
- Department of Psychology, University of Houston, Houston, Texas, USA
- Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, Texas, USA
| | - Anka Vujanovic
- Department of Psychology, University of Houston, Houston, Texas, USA
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47
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Lee DJ, Ahn S, McClure LA, Caban-Martinez AJ, Kobetz EN, Ukani H, Boga DJ, Hernandez D, Pinheiro PS. Cancer risk and mortality among firefighters: a meta-analytic review. Front Oncol 2023; 13:1130754. [PMID: 37251928 PMCID: PMC10213433 DOI: 10.3389/fonc.2023.1130754] [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: 01/10/2023] [Accepted: 04/26/2023] [Indexed: 05/31/2023] Open
Abstract
Background Firefighting is a hazardous occupation that is associated with an increased risk of select cancers. The number of studies has grown in recent years allowing for a synthesis of findings. Methods Following PRISMA guidelines, multiple electronic databases were searched to identify studies on firefighter cancer risk and mortality. We computed pooled standardized incidence risk (SIRE) and standardized mortality estimates (SMRE), tested for publication bias, and conducted moderator analyses. Results Thirty-eight studies published between 1978 and March 2022 were included for final meta-analysis. Overall, cancer incidence and mortality were significantly lower for firefighters (SIRE = 0.93; 95% CI: 0.91-0.95; SMRE = 0.93; 95% CI: 0.92 - 0.95) compared to the general population. Incident cancer risks were significantly higher for skin melanoma (SIRE = 1.14; 95% CI:1.08 - 1.21), other skin cancers (SIRE = 1.24; 95% CI:1.16-1.32), and prostate cancer (SIRE = 1.09; 95% CI: 1.04-1.14). Firefighters showed higher mortality for rectum (SMRE = 1.18; 95% CI: 1.02-1.36), testis (SMRE = 1.64; 95% CI: 1.00-2.67), and non-Hodgkin lymphoma (SMRE = 1.20; 95% CI: 1.02-1.40). There was evidence of publication bias for SIRE and SMRE estimates. Some moderators explained variations in study effects, including study quality scores. Conclusion Firefighters are at higher risk for several cancers; to the extent that some (e.g., melanoma and prostate) are screening amenable, more study into firefighter-specific recommendations for cancer surveillance is needed. Moreover, longitudinal studies with more detailed data on the specific length and types of exposures are necessary, as well as on unstudied subtypes of cancers (e.g., subtypes of brain cancer and leukemias) are needed.
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Affiliation(s)
- David J. Lee
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Soyeon Ahn
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami, Miami, FL, United States
| | - Laura A. McClure
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Alberto J. Caban-Martinez
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
- Department of Physical Medicine and Rehabilitation, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Erin N. Kobetz
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
- Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Henna Ukani
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Devina J. Boga
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Diana Hernandez
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Paulo S. Pinheiro
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
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48
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Sidossis A, Lan FY, Hershey MS, Hadkhale K, Kales SN. Cancer and Potential Prevention with Lifestyle among Career Firefighters: A Narrative Review. Cancers (Basel) 2023; 15:cancers15092442. [PMID: 37173909 PMCID: PMC10177420 DOI: 10.3390/cancers15092442] [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: 03/09/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
Career firefighters are at considerable risk for chronic diseases, including an increased risk of various cancers, compared to the general population. Over the last two decades, several systematic reviews and large cohort studies have demonstrated that firefighters have statistically significant increases in overall and site-specific cancer incidence and site-specific cancer mortality compared to the general population. Exposure assessment and other studies have documented exposures to a variety of carcinogens in fire smoke and within the fire station. Other occupational factors such as shift work, sedentary behavior, and the fire service food culture may also contribute to this working population's increased cancer risk. Furthermore, obesity and other lifestyle behaviors such as tobacco use, excessive alcohol consumption, poor diet, inadequate physical activity, and short sleep duration have also been associated with an increased risk of certain firefighting-associated cancers. Putative prevention strategies are proposed based on suspected occupational and lifestyle risk factors.
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Affiliation(s)
- Amalia Sidossis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
| | - Fan-Yun Lan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
- Division of Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA 02139, USA
- Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Occupational Medicine, Department of Family Medicine, National Yang Ming Chiao Tung University Hospital, Yilan 260, Taiwan
| | - Maria S Hershey
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
| | - Kishor Hadkhale
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
- Division of Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA 02139, USA
- Faculty of Social Sciences Health Sciences (Epidemiology), Tampere University, 33100 Tampere, Finland
| | - Stefanos N Kales
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
- Division of Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA 02139, USA
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Ocampos MS, Leite LCS, de Pádua Melo ES, de Cássia Avellaneda Guimarães R, Oliveira RJ, de Cássia Freitas K, Hiane PA, Karuppusamy A, do Nascimento VA. Indirect Methods to Determine the Risk of Damage to the Health of Firefighters and Children Due to Exposure to Smoke Emission from Burning Wood/Coal in a Controlled Environment. Int J Environ Res Public Health 2023; 20:ijerph20085607. [PMID: 37107889 PMCID: PMC10139234 DOI: 10.3390/ijerph20085607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 05/10/2023]
Abstract
People are constantly exposed to particulate matter and chemicals released during fires. However, there are still few studies on gas and particulate emissions related to exposure to burning firewood and charcoal during forest fires, making it difficult to understand the effects on the health of the population. The objective of this study was to quantify the metal(loid)s present in the smoke from wood and charcoal fires through the deposition of metals in beef topside and pork loin, considering the routes of skin exposure, inhalation, and ingestion, contributing to the understanding of metals in the increase of the risks of cancer and mortality associated with firefighting and children. The concentrations of metals [aluminum (Al), chromium (Cr), copper (Cu), iron (Fe), magnesium (Mg), manganese (Mn), molybdenum (Mo), vanadium (V), zinc (Zn)] and metalloids arsenic (As) were determined by inductively coupled plasma-mass spectrometry (ICP OES) after microwave digestion. Moreover, we assessed the associated risk regarding the elemental intake of these elements through the smoke, using the hazard quotient (HQ), hazard index (HI), Total Hazard Index (HIt), and carcinogenic risk (CR). All samples had results for HQ and HIt < 1, indicating a non-potential health risk. However, the carcinogenic risks posed by As and Cr via the three exposure pathways (except for inhalation exposure to children and adults, and by Cr via ingestion and inhalation for children and adults) exceeded the standard threshold. In conclusion, continuous exposure of firefighters or children to smoke from fires containing high concentrations of heavy metals such as As and Cr can be harmful to health. The study used animal tissues; thus, new methods must be developed to quantify the concentration of heavy metals deposited in human tissue when humans are exposed to smoke from fires.
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Affiliation(s)
- Marcelo Sampaio Ocampos
- Group of Spectroscopy and Bioinformatics Applied to Biodiversity and Health (GEBABS), Graduate Program in Health and Development in the Central-West Region of Brazil, School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79079-900, Brazil
| | - Luana Carolina Santos Leite
- Group of Spectroscopy and Bioinformatics Applied to Biodiversity and Health (GEBABS), Graduate Program in Health and Development in the Central-West Region of Brazil, School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79079-900, Brazil
| | - Elaine Silva de Pádua Melo
- Group of Spectroscopy and Bioinformatics Applied to Biodiversity and Health (GEBABS), Graduate Program in Health and Development in the Central-West Region of Brazil, School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79079-900, Brazil
| | - Rita de Cássia Avellaneda Guimarães
- Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79079-900, Brazil
| | - Rodrigo Juliano Oliveira
- Center for Studies in Stem Cells, Cell Therapy and Genetic Toxicology (CeTroGen), School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79079-900, Brazil
| | - Karine de Cássia Freitas
- Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79079-900, Brazil
| | - Priscila Aiko Hiane
- Graduate Program in Health and Development in the Central-West Region of Brazil, Federal University of Mato Grosso do Sul, Campo Grande 79079-900, Brazil
| | - Arunachalam Karuppusamy
- Center for Studies in Stem Cells, Cell Therapy and Genetic Toxicology (CeTroGen), School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79079-900, Brazil
| | - Valter Aragão do Nascimento
- Group of Spectroscopy and Bioinformatics Applied to Biodiversity and Health (GEBABS), Graduate Program in Health and Development in the Central-West Region of Brazil, School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79079-900, Brazil
- Correspondence: or
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Barros B, Oliveira M, Morais S. Biomonitoring of firefighting forces: a review on biomarkers of exposure to health-relevant pollutants released from fires. J Toxicol Environ Health B Crit Rev 2023; 26:127-171. [PMID: 36748115 DOI: 10.1080/10937404.2023.2172119] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Occupational exposure as a firefighter has recently been classified as a carcinogen to humans by International Agency for Research on Cancer (IARC). Biomonitoring has been increasingly used to characterize exposure of firefighting forces to contaminants. However, available data are dispersed and information on the most relevant and promising biomarkers in this context of firefighting is missing. This review presents a comprehensive summary and critical appraisal of existing biomarkers of exposure including volatile organic compounds such as polycyclic aromatic hydrocarbons, several other persistent other organic pollutants as well as heavy metals and metalloids detected in biological fluids of firefighters attending different fire scenarios. Urine was the most characterized matrix, followed by blood. Firefighters exhaled breath and saliva were poorly evaluated. Overall, biological levels of compounds were predominantly increased in firefighters after participation in firefighting activities. Biomonitoring studies combining different biomarkers of exposure and of effect are currently limited but exploratory findings are of high interest. However, biomonitoring still has some unresolved major limitations since reference or recommended values are not yet established for most biomarkers. In addition, half-lives values for most of the biomarkers have thus far not been defined, which significantly hampers the design of studies. These limitations need to be tackled urgently to improve risk assessment and support implementation of better more effective preventive strategies.
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Affiliation(s)
- Bela Barros
- REQUIMTE-LAQV,Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
| | - Marta Oliveira
- REQUIMTE-LAQV,Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
| | - Simone Morais
- REQUIMTE-LAQV,Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
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