Firefighters suffer from high prevalence of obesity, substandard fitness, and cardiovascular-related deaths. There have been a limited number of firefighter health promotion programs that have been developed and empirically-tested for this important occupational group. We evaluated the health of firefighters from departments with well-developed health promotion programs and compared them with those from departments not having such programs using a large national sample of career fire departments that varied in size and mission. We measured a broad array of important individual firefighter health outcomes (e.g., body composition, physical activity, and general and behavioral health) consistent with national fire service goals and addressed significant statistical limitations unaccounted for in previous studies.

Purpose.: Firefighters are expected to respond to any domestic emergency at a moment's notice, and therefore their health and readiness are key to the public safety net. Although emerging research is focusing on understanding firefighters' increased risk for disease and injury, the perspectives of fire service personnel is lacking. Design.: This study uses the cross-sectional qualitative data collection techniques of key informant interviews and focus groups. Setting.: Data collection occurred with a national sample of firefighters from 28 (municipal and federal) career fire departments. Participants.: Participants were 332 career firefighters (57.2%), company officers (23.4%), fire chiefs (15.4%), and other fire service personnel (3.9%). Method.: Focus groups and informant interviews were conducted with firefighters, fire chiefs, health promotion personnel, and medical directors to assess attitudes, opinions, and perceptions about firefighter health. Results.: Major themes that developed among fire service personnel included concerns about cancer, risk of cardiovascular disease, the importance of and barriers to physical fitness, the food culture of the firehouse, psychological stress resulting from repeated exposure to trauma, sleep disruptions, injuries, and risk for infectious disease. Health concerns identified by firefighters are juxtaposed with current efforts and trends within the national fire service. Conclusions.: The health concerns of firefighters parallel both available epidemiological research and the health priorities of national fire service organizations. Unfortunately, these concerns often are in contrast with efforts by local governments to limit their financial liability for illnesses presumed to be caused by occupational exposures and long-held traditions in the fire service. This study highlights the need for epidemiological surveillance of firefighters and innovative health and organizational policy in the fire service. Future directions for the fire service, the public health community, and researchers are discussed.

Despite statements from national fire service organizations, including the International Association of Fire Fighters (IAFF) and the International Association of Fire Chiefs (IAFC), promoting a diverse work force related to gender within the fire service, rates of women firefighters remain very low. Thus, research into why this extensive gender disparity continues is a high priority. Recent years have seen a number of large scale studies on firefighter health and health risk behaviors however, none have focused on the health of women firefighters and nearly all have eliminated women from the sample due to small sample size. Data from the present report is drawn from all females in a large, randomly selected cohort of firefighters in an epidemiological study designed to assess health outcomes and health risk behaviors identified as most important to the fire service.

Background: The prevalence of obesity has reached epidemic proportions worldwide, and is also increasing among public safety professionals like firefighters who are expected to be fit and more active. The present study evaluates the associations among Body Mass Index (BMI), weight perception and cardiovascular risk factors in 768 male career firefighters from two Midwestern states in the United States. Methods: A physical examination was performed and fasting blood samples were taken. Cardio-respiratory fitness (CRF) was determined from symptom- limited maximal treadmill exercise testing with electrocardiogram (ECG) monitoring and estimation of oxygen consumption (metabolic equivalents, METS) using the Bruce protocol. A health and lifestyle questionnaire was administered with standardized written instructions for completion. Self-reports of weight perception were extracted from responses to the completed multiple choice questionnaire. Baseline characteristics were described using the mean (standard deviation) for continuous variables and frequency for categorical variables. Group comparisons were calculated using analysis of variance (ANOVA). Linear models and logistic regression models were used to adjust for possible confounders. Logistic regression analyses were used to calculate the odds ratios of underestimating one’s weight category. Results: A high proportion of overweight and obese male career firefighters underestimate their weight categories (68%). The risk of underestimating one’s weight category increased by 24% with each additional unit of increasing BMI after adjustment for age and CRF. When divided into six groups based on combinations of measured BMI category and weight perception, there were significant differences among the groups for most cardiovascular risk factors. After adjustment for age and BMI, these differences remained statistically significant for CRF, amount of weekly exercise, prevalence of Metabolic Syndrome (MetSyn), body fat percentage and cholesterol measurements. Conclusion: A high proportion of overweight and obese male career firefighters underestimate their measured BMI categories. As a result, they are unlikely to fully appreciate the negative health consequences of their excess weight. The results of this study emphasize the importance of objectively measuring BMI and then informing patients of their actual weight status and the associated disease risks.

Objectives Firefighter health has received a great deal of increased attention over the past decade, but most work has been specific to men in the fire service due to small numbers of women, likely due to challenges with recruitment and retention of women in the fire service. While findings suggest men in the fire service struggle with high rates of overweight and obesity due to a number of occupational challenges, limited data are available on large samples of women firefighters. Methods Using snowball sampling techniques, we conducted an online survey of both career (N=2,398) and volunteer (N=781) women firefighters. Results Rates of obesity for both career (15.4%) and volunteer (31.6%) women firefighters were not only lower than men in the fire service (33.5% career and 43.2% volunteer), but also lower than the general population (41.1%). Women career and volunteer firefighters who engaged in heavy physical activity were less likely to be obese. Being a racial or ethnic minority firefighter was associated with being obese, as was serving more than 20 years in the fire service. Conclusion Findings highlight that women firefighters have been successful in overcoming the occupational risks, such as a challenging nutrition environment, inconsistent schedules, limited time for fitness, and the metabolic impact of shift work, that put firefighters at increased risk for obesity.