Sara A. Jahnke

The prevalence of overweight, obesity, and substandard fitness in a population-based firefighter cohort.

Objective: To examine the prevalence of overweight and obesity in firefighters. Methods: Body mass index (BMI), waist circumference, and body fat percentage (BF%) were assessed in 478 career and 199 volunteer male firefighters from randomly selected departments. Results: High prevalence rates of overweight + obesity (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) were found in career (79.5%; 33.5%) and volunteer firefighters (78.4%; 43.2%). False-positive obesity misclassification based on BMI, compared to waist circumference and BF%, was low (9.8% and 2.9%, respectively). False negatives were much higher: 32.9% and 13.0%. Obese firefighters demonstrated unfavorable cardiovascular disease (CVD) profiles. Conclusions: The prevalence of overweight and obesity exceeded that of the US general population. Contrary to common wisdom, obesity was even more prevalent when assessed by BF% than by BMI, and misclassifying muscular firefighters as obese by using BMI occurred infrequently.

Obesity and incident injury among career firefighters in the central United States.

Firefighting is a dangerous profession with high injury rates, particularly musculoskeletal (MS), but limited longitudinal data is available to examine predictors of MS injuries in this population.

An examination of the benefits of health promotion programs for the national fire service

BackgroundFirefighters 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.MethodsUsing the approach of purposive sampling of heterogeneous instances, we selected and conducted a national evaluation of 10 departments already implementing wellness and fitness programs (Wellness Approach; WA) with 10 departments that did not (Standard). Participants were 1,002 male firefighters (WA n = 522; Standard n = 480) who underwent assessments including body composition, fitness, and general/behavioral health (e.g., injury, depressive symptoms).ResultsFirefighters in WA departments were healthier than their Standard department counterparts. For example, they were less likely to be obese (adjusted [A]OR = 0.58; 95% CI = 0.41-0.82), more likely to meet endurance capacity standards for firefighting (AOR = 5.19; 95% CI = 2.49-10.83) and have higher estimated VO2max (40.7 ± 0.6 vs. 37.5 ± 1.3 for firefighters in Standard departments; p = 0.001). In addition, WA firefighter were substantially less likely to smoke (AOR = 0.30; 95% CI = 0.17-0.54) or ever have been diagnosed with an anxiety disorder (AOR = 0.27; 95% CI = 0.14-0.52) and they expressed higher job satisfaction across several domains. However, WA firefighters were somewhat more likely to have reported an injury to Workers’ Compensation (AOR = 1.74; 95% CI = 1.05-2.90). It was notable that both groups evidenced high prevalence of smokeless tobacco use and binge drinking.ConclusionsFirefighters in departments selected based on having strong wellness programs (WA) were healthier along a number of dimensions important to firefighter wellness and operational readiness. However, several health areas require greater attention including problematic alcohol consumption and smokeless tobacco use, suggesting that more emphasis on these behavioral health issues is needed in the fire service.

Obesity and Injury-Related Absenteeism in a Population-Based Firefighter Cohort

A consistent relationship has been demonstrated between obesity and absenteeism in the workplace. However, most studies have focused on primarily sedentary occupational groups. Firefighting is a physically demanding profession that involves significant potential for exposure to dangerous situations and strenuous work. No studies to date have evaluated the impact of obesity on risk for absenteeism among firefighters. We examined the cross‐sectional association between BMI and obesity and injury‐related absenteeism. BMI, body fat percentage (BF%), waist circumference (WC), injury, and injury‐related absenteeism were assessed in 478 career male firefighters. One hundred and fifteen firefighters reported an injury in the previous year and the number of days absent from work due to their injury. BMI was an independent predictor of absenteeism due to injury even after adjustment for confounding variables. Firefighters meeting the definition of class II and III obesity had nearly five times (odds ratio (OR) = 4.89; 95% confidence interval (CI) = 3.63–6.58) the number missed work days due to injury when compared to their normal weight counterparts and their elevated risk was greater than firefighters with class I obesity (OR = 2.71; 95% CI = 2.01–3.65) or those who were overweight (OR = 2.55; 95% CI = 1.90–3.41). The attributable per capita costs of class II and III obesity‐related absenteeism over the last year were

Alcohol use among firefighters in the Central United States.

1,682.90 per firefighter,

Injury among a population based sample of career firefighters in the central USA

254.00 per firefighter for class I obesity, and

A qualitative analysis of the tobacco control climate in the U.S. military

74.41 per firefighter for overweight. Our findings suggest that class II and III obesity were associated with substantial attributable costs to employers and our cost estimates probably underestimate the actual financial burden.

The health of women in the US fire service

BACKGROUND Although the US National Fire Service is concerned about alcohol use among firefighters, little research has been conducted on the topic. AIMS To survey alcohol use patterns among career and volunteer firefighters. METHODS Data were from a population-based cohort study of male firefighters conducted in randomly selected career and volunteer departments. Data were collected from 2008 to 2010. RESULTS There were 656 participants from 11 career and volunteer 13 departments included in the study with a response rate of 97%. Career firefighters drank approximately 10 days per month (just about half of their off duty days) and drank relatively heavily on those days. Fifty-eight per cent of career and 40% of volunteer firefighters averaged three or more drinks and similar percentages reported binge drinking on the days they consumed alcohol. In general, firefighters who drank but did not binge drink tended to have the best health outcomes, while those who binge drank typically were at highest risk of negative health outcomes. Nine per cent of career and 10% of volunteer firefighters who drank self-reported driving while intoxicated in the previous 30 days. CONCLUSIONS Given the high rates of heavy and binge drinking, local and nationally coordinated efforts to increase the surveillance of drinking behaviour among firefighters and the development of targeted prevention interventions are critically needed.

Weight- perception in male career firefighters and its association with cardiovascular risk factors

Background Rates of occupational injuries among firefighters are high because of the physically demanding and variable tasks required by their job. While descriptive data about injuries exist, few studies have explored individual risk factors and their relationship to occupational injury. Methods The current study presents data from a population-based sample of 462 career firefighters from 11 randomly-selected fire departments in the Missouri Valley region of the USA (Kansas, Missouri, Iowa, North Dakota, South Dakota, Colorado, Wyoming, Nebraska) who participated in a study evaluating risks for negative cardiovascular outcomes and injury. Relationships were examined between injury and demographic characteristics, body composition, fitness, and health behaviours. Results Participants were most likely to be injured during physical exercise and those who reported regular on-duty exercise had a fourfold increase in risk for exercise-related injury compared with those who did not exercise on duty (OR=4.06, 95% CI 1.73 to 12.24). However, those who exercised were half as likely to sustain non-exercise injuries (OR=0.53, 95% CI 0.32 to 0.85). Conclusions Findings highlight the benefit of physical training for firefighters despite the risk of injury during exercise.

Tobacco use among firefighters in the central United States.

INTRODUCTION Rates of tobacco use in the U.S. military have traditionally been higher than in the general U.S. population. While the military has experienced decreases in tobacco use over the past two decades, recent surveys suggest a trend of increased use. Given the negative impact of tobacco on both the readiness and the long-term health of military members, it is important to understand what factors may be related to the increased use rates. It has been suggested that there is a culture that supports tobacco use in the military. METHODS We examined perceptions about the climate of tobacco control among military installation Tobacco Control Managers and Service Policy Leaders from all four branches of the military (n = 52) using semistructured interviews. RESULTS The primary strength of the militarys tobacco control program, according to the participants, was mandating the provision of treatment services on every military installation. Any military member can receive both counseling and pharmacotherapy for tobacco. Opinions vary on the most promising new strategies for tobacco control. Many have pushed for a completely tobacco-free Department of Defense, including requiring troops to be tobacco-free and banning tobacco sales on military installations. However, a number of tobacco control experts within the military worry about unintended consequences of a complete ban. DISCUSSION While several benefits of the current tobacco control program were identified, opportunities for improvement were identified at both the installation and service level.