Structural firefighters are responsible for protecting properties and saving lives during emergency operations. Despite efforts to prepare firefighters for these hazardous occupational demands, the unfortunate reality is that the incidence of health morbidities is increasing within the fire service. Specifically, cardiovascular disease, cancer, and mental health disorders are among the most documented morbidities in firefighters. Pubmed and Google Scholar search engines were used to identify peer-reviewed English language manuscripts that evaluated firefighters’ occupational health threats, allostatic factors associated with their occurrence, and evidence-based strategies to mitigate their impact. This narrative review provides fire departments, practitioners, and researchers with evidence-based practices to enhance firefighters’ health.

Langford, EL, Bergstrom, HC, Lanham, S, Eastman, AQ, Best, S, Ma, X, Mason, MR, and Abel, MG. Evaluation of work efficiency in structural firefighters. J Strength Cond Res 37(12): 2457–2466, 2023—To perform occupational tasks safely and effectively, firefighters (FF) must work quickly and consume air provided by the self-contained breathing apparatus (SCBA) efficiently. However, most literature only factors work rate into performance, neglecting the inherent time limitation imposed by the SCBA. The purpose of this article was to (a) evaluate the reliability and variability in a “work efficiency” (WE) performance metric reflective of both work rate and air consumption; (b) explore the relationship between WE and established measures of metabolic strain; and (c) identify fitness, anthropometric, and demographic correlates of WE. About 79 structural FF completed an air consumption drill while breathing through an SCBA. Self-paced work duration and air consumption were entered into the WE equation. A subsample of FF (n = 44) completed another randomized trial while breathing through a portable gas analyzer. Anthropometric and fitness data were collected separately. Correlations were performed between WE vs. fitness, anthropometric, demographic, and metabolic outcomes. Multiple linear regression was used to identify the strongest predictors of WE. WE was reliable (intraclass correlation coefficient = 0.71) and yielded inter-FF variability {0.79 ± 0.25 ([lb·in⁻²·min]⁻¹) × 10⁴; coefficient of variation = 31.6%}. WE was positively correlated to oxygen consumption (V̇O₂) (L·minute⁻¹, mL·kg⁻¹·minute⁻¹) and tidal volume and negatively correlated to V̇E/V̇O₂ and respiratory frequency. Height, upper-body endurance, and aerobic endurance were identified as the strongest predictors of WE (adjusted R ² = 0.59, RMSE = 0.16). WE is a reliable and occupationally relevant method to assess FF performance because it accounts for work rate and air consumption. Firefighters may enhance WE through a training intervention focused on improving metabolic tolerance, upper-body endurance, and aerobic endurance.

The purpose of this study was to query healthcare practitioners (HCPs) who treat firefighter injuries to identify risk factors and mechanisms associated with musculoskeletal injuries during exercise. A phenomenological design was utilized to understand the experiences of HCPs while treating firefighters’ musculoskeletal injuries due to exercise. Semi-structured interviews were conducted with 14 HCPs. Two interviews were pilot-tested with HCPs to ensure reliability and validity. Interviews were transcribed and uploaded to a qualitative analysis software program. Although the study inquired about injuries incurred by any exercise modality (e.g., endurance and resistance training), injuries induced during resistance training were prominent among HCPs as resistance training emerged as a primary exercise injury mechanism. HCPs indicated that the back and shoulder were prevalent anatomical exercise injury locations. Risk factors for exercise injuries included age, immobility, movement proficiency, and factors associated with fatigue. Exercise injury mechanisms included poor resistance training technique and overexertion. These findings could guide exercise program design, use of movement assessments, and the identification of other countermeasures to decrease the risk of resistance training exercise injuries among firefighters.

Objective: This study examines variability in air consumption (AC) between firefighters (FF) working at a standardized pace, evaluates the relationship between air consumption efficiency (ACE) and work economy, identifies parameters associated with ACE, and explores the relationship between ACE and self-paced work rate. Methods: FF completed randomized trials of an air consumption drill at a standardized pace while breathing through a self-contained breathing apparatus and a gas analyzer. A subsample completed another trial at a self-selected pace. Results: The average AC variability (±1 standard deviation) was ~3.1 min of cylinder usage (13.7%). AC was positively associated with work economy and numerous physiological and anthropometric outcomes. No relationship was found between ACE and self-paced air consumption drill time. Conclusions: FF working at higher internal strain demonstrated poorer ACE. Improving metabolic tolerance may extend the self-contained breathing apparatus' functional duration to enhance productivity and safety.

Law enforcement officers (LEOs) must maintain a certain level of physical fitness to perform occupational tasks successfully. Because of the wide variation among operators, there does not appear to be a standard fitness test battery that is appropriate to assess occupational fitness for different groups of law enforcement officers. Therefore, multi-faceted fitness assessments are important to evaluate tactical personnel’s various essential fitness components, which are often unique to each environment. Fitness standards and training protocols must be developed for each law enforcement agency and customised to the specific audience. This article aims to systematically review the relevant literature to identify biomotor abilities associated with occupational physical ability. This study examined the results of 17 international studies to ultimately synthesise information that (i) aids in the selection of the most used biomotor abilities and occupational physical abilities for LEOs and (ii) serves as a starting point for the development of occupational physical abilities assessment protocols. In conclusion, this study underscores the complex and diverse physical demands on LEOs, advocating for tailored fitness programs and policy reforms to enhance their operational readiness and long-term health.

This study evaluated the effects of continuous and intermittent walking on oxygen uptake (V̇O2), Rating of Perceived Exertion (RPE), and enjoyment during exercise, and excess post-exercise oxygen consumption (EPOC) and enjoyment after exercise. Methods: Four women and six men (mean ± SD) aged 24 ± 5 years completed four walking bouts in counterbalanced order matched for volume (90 metabolic equivalent [MET]-min): 1) one, 30-min continuous walking (CW) bout at moderate-intensity (3 METs; ≈4.8 km/h), 2) three, 10-min intermittent walking bouts (IW) at moderate-intensity (3 METs; ≈4.8 km/h) separated by 20 min of rest, 3) three, 8-min interval walking (IIW1) bouts at moderate-intensity (5 METs; ≈6.4 km/h: 3 METs; ≈4.8 km/h) separated by 20 min of rest, and 4) three, 8-min 40-s interval walking (IIW2) bouts at moderate-intensity (5 METs; ≈6.4 km/h: 3 METs; ≈4.8 km/h separated by 20 min of rest. VO2 was measured during exercise and EPOC was measured for 20 minutes post exercise. RPE was assessed during exercise and enjoyment of exercise was assessed during- and post exercise. Results: Average accumulated O2 uptake during exercise and EPOC in IW (39,186 ± 4,290 mL; EPOC: 2,582 ± 339 mL), IIW1 (36,964 ± 3,789 mL; EPOC: 3,365 ± 507 mL), and IIW2 (35,804 ± 3,979 mL; EPOC: 3,083 ± 339 mL) were higher (all p 2 uptake and EPOC, respectively – compared to moderate-intensity continuous walking matched by MET-min with no difference in enjoyment or RPE.