By Shane Wells
of the Leatherhead Instructors
Firefighters are at increased risk of musculoskeletal injuries and cardiorespiratory illnesses compared to other occupations. Each year tens of thousands of firefighters are injured while fighting fires, rescuing people, responding to emergencies, and training incidences. Occupational injuries are the leading cause of disability and early retirement. Cardiovascular disease is the most common cause of work related death. All of these injuries contribute to a significant human and financial toll. In addition departments suffer lost work hours, higher insurance premiums, increased overtime, disability and early retirement payments.
Despite measures to prevent injuries such as improving our protective clothing and changing health and safety regulations very little about individual factors influencing firefighter injuries are known. Certain literature has predicted things such as; equipment failure, protective equipment not being worn, lack of training, fitness, team work, and human error, in addition to fatigue, weather, poor decision making and communication systems. However, very little information about how individual lifestyle variables and obesity contribute to the risk of injuries among firefighters.
Obesity in adults has doubled in the past 15 years, and the rate of severe obesity has quadrupled. Today roughly 2/3 of adults are overweight and 1/3 is obese. It is also known that as BMI increases certain diseases increase as well, including cardiovascular disease, hypertension, diabetes and certain types of cancer. Studies have shown ties between obesity and increased risk of occupational injuries. Research is scarce about the association between obesity and risk of occupational injuries among firefighters.
Posten and colleagues conducted a study of 433 firefighters that participated in the Promoting Healthy Lifestyles Alternative Models Effects (PHLAME) worksite wellness program. This program was implemented in fire departments in Oregon and Washington five years after that program was first introduced. These were the findings; of the 433 firefighters there were 184 injuries overall and 160 injured firefighters had at least one injury. Of the 184 injuries, 68 were injuries for which a worker’s compensation claim was filled (37%). About 35% of injuries involved the back which was twice as many as the next largest category which was knee and lower leg at 17%. Twenty five percent of firefighters were in the normal weight category. Fifty-six percent were in the overweight category. Nineteen percent were in the obese category. Firefighters that were in the overweight or obese categories had a higher percentage of injury prevalence for all types of physician’s visits. The body part injured the most was the back. There were also a higher percentage of firefighters in the obese category that required a visit to a specialist as compared to the 12.5 % of firefighters in the normal weight category.
Other studies also show a mismatch between fitness and health requirements of firefighting and the current profile of the fire service. Current standards recommend that firemen participate in a fitness program, but it is the responsibility of each individual department to decide whether or not to institute a program. The NFPA 1583 Standard recommends a program that is positive, non-punitive, and does not set fitness standards. Cardiovascular events are by far the leading cause of line of duty deaths among firefighters. Appropriate fitness programs can enhance overall health, improve performance, and lessen the risk of firefighter injury and fatality. Firefighters and the public they serve will benefit from more fitness programs in the Fire Service. Some different types of physical training include; aerobic training, Sprint Interval Training (SIT), and functional training. Aerobic training provides several health benefits, including improved body composition, serum lipids, glucose metabolism, and maximal aerobics capacity. SIT is a type of high-intensity interval training that is designed to improve endurance, increase anaerobic threshold, and improve maximal performance. Functional training targets movements that are necessary for everyday living. Functional training utilizes full-body, dynamic movements to increase muscular strength and endurance as well as aerobic capacity using equipment such as medicine balls, physioballs, and exercise bands to provide resistance. This type of exercise mimics the high-intensity demands of firefighting. CrossFit workouts have been gaining popularity in progressive departments across the country.
There must be a cultural change within the U.S Fire Service in order to improve fitness and decrease injuries and cardiac events. Fit firefighters have increased mobility, energy, and endurance, allowing them to better perform job duties efficiently and safely. Fit firefighters also are less likely to jeopardize the safety of their fellow firefighters or the public they serve.
Kuehl, K. S., Kisbu-Sakarya, Y., Elliot, D. L., Moe, E. L., DeFrancesco, C. A., MacKinnon, D. P. & Kuehl, H. E. (2012). Body mass index is a predictor of fire fighter injury and worker compensation claims. Journal of Occupational and Environmental Medicine, 54(5), 579.
Smith, D. L. (2011). Firefighter fitness: improving performance and preventing injuries and fatalities. Current sports medicine reports, 10(3), 167-172.