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.

Emergency Medical Services (EMS) providers experience substantial occupational stress, which may contribute to alcohol use as a coping mechanism. Despite growing attention to workforce wellness among first responders, relatively little research has examined how alcohol-related education should be developed and delivered for EMS providers. This qualitative study explored non–fire-based EMS providers’ perspectives on alcohol-related education, training, and support through semi-structured interviews with 31 EMS clinicians representing multiple certification levels and regions of the United States. Participants consistently described existing alcohol-related education as limited, passive, and focused primarily on patient care rather than provider well-being. They recommended educational approaches that incorporate EMS-specific data, information on the physiological effects of alcohol, personal narratives, and interactive instructional strategies. Participants also emphasized the importance of broader support systems, including peer support, family involvement, and improved awareness of available resources. Taken together, these findings suggest that alcohol-related education in EMS should be tailored to the occupational realities of the profession and integrated with broader efforts to support workforce health and well-being.

Firefighters face elevated risks of alcohol misuse due to occupational stress, trauma exposure, and cultural norms within the fire service. This beta test study evaluated the feasibility, acceptability, and preliminary outcomes of From Bottle to Nozzle, a digitally delivered alcohol awareness and prevention intervention tailored for firefighters. Fifty fire service personnel were invited to participate; 46 consented and completed baseline questionnaires, and 22 completed the full program. The intervention consisted of five self-paced online modules incorporating multimedia content, quizzes, and self-assessments that addressed alcohol history, fire service culture, risk-reduction strategies, communication, and health effects. Pre- and post-intervention assessments measured changes in alcohol-related knowledge, alcohol use, motivation to reduce drinking, and usability. Reinforcement messages were delivered via text and email. Alcohol-related knowledge improved significantly post-intervention, particularly in the general and total knowledge domains. Moderate drinkers showed reductions in drinking days and AUDIT scores. Among heavy drinkers, overall consumption declined slightly, though binge-drinking episodes increased. Changes in motivation to reduce drinking were mixed. Usability ratings were high, with an 80% module completion rate and favorable feedback on program brevity and format, though navigation and video length were noted as challenges. From Bottle to Nozzle demonstrated strong feasibility and acceptability. While knowledge gains were robust, behavioral outcomes were mixed, highlighting the need for larger controlled studies with extended follow-up.

Alcohol use among emergency medical service (EMS) providers is an emerging concern given the demanding and stressful nature of the profession, although little research has explored how alcohol fits within EMS culture. This study examined EMS providers’ perceptions of alcohol use and how it intersects with their occupation. Semi-structured interviews were conducted with 31 providers from non-fire-based EMS agencies across the United States. Participants represented a range of licensure levels, agency sizes, geographic regions, and drinking patterns. Interviews explored perceptions of alcohol use, workplace norms, and organizational influences related to drinking. Data were analyzed using an inductive qualitative approach to identify common themes across interviews. Participants described alcohol use as a driving force for social bonding, stress relief, and informal coping with the demands of the job. These findings highlight the importance of considering occupational culture and social norms when developing strategies to address alcohol use and support workforce health in EMS.

Bullying in the fire service has long been overlooked, although efforts to understand the phenomenon have increased over the past few decades. Recent research has highlighted high rates of bullying in the fire service, regardless of gender and race. Despite established issues of bullying, workplace bullying training has yet to be examined in the fire service. Using qualitative data from interviews with a national sample of firefighters and fire service leaders, this foundational research sought to understand current and future needs related to training on bullying prevention and effective messaging for the fire service. Common themes that emerged from the data include current training opportunities, the effectiveness of training, and components of effective training.