Tiffany Lipsey

Cardiorespiratory fitness and the metabolic syndrome in firefighters

BACKGROUND The leading cause of mortality in on-duty firefighters is sudden cardiac death. While the reason for this remains unclear, low cardiorespiratory fitness and the metabolic syndrome have been associated with increased risk of cardiovascular disease-related events. AIMS To document the levels of cardiorespiratory fitness and the metabolic syndrome, as well as to determine if there is a relationship between these variables, in firefighters. METHODS Maximal cardiorespiratory fitness was assessed using the Bruce treadmill protocol in 214 male firefighters from Colorado. As part of a comprehensive cardiovascular disease risk evaluation, each firefighter was also screened for the metabolic syndrome using the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) guidelines. RESULTS At the time of their evaluation, 32 firefighters (15%) met the NCEP/ATP III diagnostic criteria for the metabolic syndrome, and 54 firefighters (25%) failed to achieve a generally accepted minimum cardiorespiratory fitness level of 42.0 ml/kg/min. A significant inverse trend of increasing cardiorespiratory fitness with decreasing metabolic abnormalities was found (P < 0.001). CONCLUSIONS Increased levels of cardiorespiratory fitness are associated with an improved metabolic profile in male firefighters. Comprehensive cardiovascular disease risk factor management and cardiorespiratory fitness improvement are essential for firefighter health and safety.

Firefighter Noise Exposure During Training Activities and General Equipment Use

Multiple noise measurements were taken on 6 types of fire station equipment and 15 types of emergency response vehicle-related equipment used by firefighters during routine and emergency operations at 10 fire stations. Five of the six types of fire station equipment, when measured at a distance of one meter and ear level, emitted noise equal to or greater than 85 dBA, including lawn maintenance equipment, snow blowers, compressors, and emergency alarms. Thirteen of 15 types of equipment located on the fire engines emitted noise levels equal to or greater than 85 dBA, including fans, saws, alarms, and extrication equipment. In addition, noise measurements were taken during fire engine operations, including the idling vehicle, vehicle sirens, and water pumps. Results indicated that idling fire-engine noise levels were below 85 dBA; however, during water pump and siren use, noise levels exceeded 85 dBA, in some instances, at different locations around the trucks where firefighters would be stationed during emergency operations. To determine if the duration and use of fire fighting equipment was sufficient to result in overexposures to noise during routine training activities, 93 firefighter personal noise dosimetry samples were taken during 10 firefighter training activities. Two training activities per sampling day were monitored during each sampling event, for a mean exposure time of 70 min per day. The noise dosimetry samples were grouped based on job description to compare noise exposures between the different categories of job tasks commonly associated with fire fighting. The three job categories were interior, exterior, and engineering. Mean personal dosimetry results indicated that the average noise exposure was 78 dBA during the training activities that lasted 70 min on average. There was no significant difference in noise exposure between each of the three job categories. Although firefighters routinely use equipment and emergency response vehicles that can produce hazardous levels of noise, this study showed that the average noise levels experienced by firefighters was below generally accepted guidelines.

A Long-Duration (118-day) Backpacking Trip (2669 km) Normalizes Lipids Without Medication: A Case Study

Abstract Objective.—To evaluate the effects of a long-distance backpacking trip on body composition, weight, blood lipids, and lipoproteins. Methods.—Single-subject (male, aged 49 years) study of an experienced backpacker who hiked 118 days on the Appalachian Trail. Outcome measures that were assessed pre-hike and post-hike included body fat (%) by hydrostatic weighing and skinfold assessment, height and weight, body mass index (BMI), circumference measurements (umbilicus, anterior suprailiac, maximum hip, greater trochanter, minimum waist, umbilicus/anterior suprailiac ratio), and blood pressure (systolic and diastolic at rest and peak). Dietary analyses (total kilocalories, protein, carbohydrate, fat, cholesterol, saturated fat, monounsaturated fat, polyunsaturated fat, dietary fiber) were conducted pre-hike, on days 54 through 56, and on days 98 through 100. Blood lipids and lipoproteins (triglycerides, high-density lipoprotein, low-density lipoprotein) were measured pre-hike, on day 89, and post-hike. Results.—Pre-post differences showed decreases in body weight, from 85.3 kg to 73.9 kg (−11.4 [−13.4%]); percent body fat, hydrostatic weighing, from 25.18 to 14.31 (−10.87 [−43.2%]); percent body fat, skinfolds (7-site), from 23.79 to 11.61 (12.18 [−51.2%]); and BMI, from 29.37 to 25.46 (−3.91 [−13.3%]). Pre-post differences in blood lipid changes over the course of 118 days were as follows: triglycerides (mg·dL−1) fell from 319 to 79 (−240 [−75%]); total cholesterol (mg·dL−1) fell from 276 to 196 (−80 [−29%]); high-density lipoprotein (HDL) (mg·dL−1) rose from 46 to 63 (+17 [+37%]); low-density lipoprotein (LDL) (mg·dL−1) fell from 167 to 118 (−49 [−29%]); LDL/HDL ratio fell from 3.63 to 1.87 (−1.76 [−48%]); and total cholesterol/HDL ratio fell from 6.00 to 3.11 (−2.89 [−48%]). Conclusion.—The physical activity and diet associated with an extended backpacking adventure can considerably reduce and clinically normalize blood lipids and lipoproteins without medication and can very positively affect body composition and weight.

Cardiac health and fitness of Colorado male/female firefighters

Background Cardiovascular disease (CVD) is documented as the leading cause of mortality in on-duty firefighters. Aims To examine the prevalence of metabolic syndrome (MetS) components, cardiorespiratory fitness levels and the association between them in firefighters in Colorado, USA. Methods This study included male and female Colorado firefighters. MetS was identified where three or more metabolic abnormalities were present, using Cholesterol Education Program/Adult Treatment Panel III guidelines. Cardiorespiratory fitness (indicated by VO2 max) was evaluated with the Bruce protocol. Poisson regression was conducted to examine the association between MetS components and VO2 max. Results Among the 947 male and 76 female study subjects, MetS was present in 9% of all firefighters, in 5% of females and 10% of males. The mean age was 37 ± 10 years. MetS prevalence increased with age (from 3% at age <30 to 17% at 50 and older, data not shown). In addition, 35% had one and 19% had two abnormal MetS components and 49% of participants did not meet the minimum recommended VO2 max of 42.0 ml/kg/min. VO2 max was negatively associated with abnormal MetS components (incident rate ratios = 0.95, 95% confidence interval 0.94-0.96, P < 0.001). Conclusions About one in 10 of these Colorado firefighters had MetS and nearly half had insufficient cardiorespiratory fitness. Comprehensive CVD risk management and cardiorespiratory fitness improvement are essential for firefighter health and safety.

Noise Characterization of Oil and Gas Operations

ABSTRACT In cooperation with The Colorado Oil and Gas Conservation Commission, researchers at Colorado State University performed area noise monitoring at 23 oil and gas sites throughout Northern Colorado. The goals of this study were to: (1) measure and compare the noise levels for the different phases of oil and gas development sites; (2) evaluate the effectiveness of noise barriers; and (3) determine if noise levels exceeded the Colorado Oil and Gas Conservation Commission noise limits. The four phases of oil and gas development include drilling, hydraulic fracturing, completion and production. Noise measurements were collected using the A- and C-weighted sound scales. Octave band analysis was also performed to characterize the frequency spectra of the noise measurements.  Noise measurements were collected using noise dosimeters and a hand-held sound-level meter at specified distances from the development sites in each cardinal direction. At 350 ft (107 m), drilling, hydraulic fracturing, and completion sites without noise barriers exceeded the maximum permissible noise levels for residential and commercial zones (55 dBA and 60 dBA, respectively). In addition, drilling and hydraulic fracturing sites with noise barriers exceeded the maximum permissible noise level for residential zones (55 dBA). However, during drilling, hydraulic fracturing, and completion operations, oil producers are allowed an exception to the noise permissible limits in that they only must comply with the industrial noise limit (80 dBA). It is stated in Rule 604.c.(2)A. that: “Operations involving pipeline or gas facility installation or maintenance, the use of a drilling rig, completion rig, workover rig, or stimulation is subject to the maximum permissible noise levels for industrial zones (80dBA).”[8] Production sites were within the Colorado Oil and Gas Conservation Commission permissible noise level criteria for all zones. At 350 ft (107 m) from the noise source, all drilling, hydraulic fracturing, and completion sites exceeded 65 dBC.  Current noise wall mitigation strategies reduced noise levels in both the A- and C-weighted scale measurements. However, this reduction in noise was not sufficient to reduce the noise below the residential permissible noise level (55 dBA).

Occupational Exposures to Noise Resulting from the Workplace Use of Personal Media Players at a Manufacturing Facility

This study examined the contribution of noise exposures from personal media player (PMP) use in the workplace to overall employee noise exposures at a Colorado manufacturing facility. A total of 24 workers’ PMP and background noise exposures were measured. Twelve PMP users worked in high-background-noise exposure (HBNE) areas, and 12 worked in low-background-noise exposure (LBNE) areas. The self-selected PMP listening level of each worker was measured using an ear simulator, and the background noise of each employee workstation was measured using a sound level meter. Workers’ self-reported PMP duration of use, PMP listening exposure levels, and background noise levels were used to estimate the daily occupational noise exposures. Measured background noise levels averaged 81 dBA for HBNE workers and 59 dBA for LBNE workers. Measured, free-field equivalent listening exposure levels were significantly greater for HBNE workers (85 dBA) compared with LBNE workers (75 dBA) (p = 0.0006). Estimated mean daily noise exposures for both groups were below the ACGIH threshold limit value for noise of 85 dBA8-hr time weighted average (TWA), specifically 84 dBA TWA for HBNE workers and 72 dBA TWA for LBNE workers. Three of 12 (25%) HBNE workers had estimated exposures greater than 85 dBA TWA when only background noise was considered, yet when PMP use was also considered, 6 of 12 (50%) had estimated exposures greater than 85 dBA TWA, suggesting that PMP use doubled the number of overexposed workers. None of the LBNE workers had estimated exposures greater than 85 dBA TWA. The contribution of PMP use to overall noise exposures was substantially less among HBNE workers than LBNE workers due to the disproportionate selection of noise-attenuating headsets among HBNE workers compared with LBNE workers. It is recommended that the facility management either restrict workplace PMP use among HBNE workers or require output-limiting technology to prevent occupational noise-induced hearing loss.

Examining usability in the communication design of health wearables

This panel consists of six case studies that investigate how emerging contexts for use created by health wearables present UX designers with challenges related to agency, surveillance, and health outcomes, as wearables assess the body in new, potentially unforeseen ways.

Blue-Collars/Tough Designs: UX Within Fire Service Occupational Safety and Health Programs

We discuss a set of ongoing participatory design projects where participants are working to adapt a physiological monitoring prototype for use within the fire service. These projects include members of the fire service community, the director of a comprehensive firefighter medical and fitness program called the Firefighter Testing Program (FTP) located in the Human Performance Clinical Research Laboratory (HPCRL) at Colorado State University (CSU), a user-experience researcher, and a team of developers. The original AvidCor prototype (AC-1) is an affordable physiological monitor that pairs with a smartphone, allowing a user to independently record data about their electrocardiogram (EKG), pulse oximetry, and body temperature. The purpose of one of these participatory design projects is to identify barriers and envision opportunities where the AC-1 prototype and smart-phone app could be used to increase firefighters’ access to information and care that can be used to manage cardiovascular risk. Similarly, the purpose of the second project is to develop and test a second prototype, the AvidCor Fire-ground (AC-FG), capable of streaming real-time information about firefighters’ physiological performance which can enrich the types of decisions making processes that EMS professionals, firefighters, fire officers, and incident commanders engage in while operating within hazardous work environments.

Correlates of atherosclerotic cardiovascular disease risk in older Colorado firefighters

Background It has been documented that cardiovascular disease is the leading cause of mortality in on-duty firefighters and little is known about the association between cardiorespiratory fitness and 10-year risk of atherosclerotic cardiovascular disease (ASCVD). Aims To estimate the probability of 10-year ASCVD risk and its association with per cent body fat (%BF), metabolic syndrome (MetS) and physical fitness in Colorado firefighters. Methods Ten-year ASCVD risk was calculated using the newly developed pooled cohort equations in firefighters. Logistic regression was conducted to examine the association of 10-year ASCVD risk (<5 versus ≥5%) with estimated maximum volume of oxygen (VO2 max), %BF and MetS. Results Out of 294 firefighters, 9% had a 10-year ASCVD risk >5%. In the unadjusted models, %BF (odds ratio [OR] = 1.13, P < 0.01), VO2 max (OR = 2.87, P < 0.05) and MetS (OR = 2.66, P < 0.05) were significantly associated with 10-year ASCVD risk. In the adjusted model, only %BF (OR = 1.17, P < 0.01) was significantly associated with 10-year ASCVD risk. Conclusions Among Colorado firefighters, %BF, but not cardiorespiratory fitness, was independently associated with 10-year ASCVD.

Case study: noise characterization and exposure at a ski resort.

A ccording to the National Institute for Occupational Safety and Health (NIOSH), work-related hearing loss continues to be a critical workplace safety and health issue, and it is estimated that 5 to 30 million workers are exposed to hazardous levels of noise. NIOSH has stated that occupational-related hearing loss persists as a crucial occupational safety and health issue and has classified occupational hearing loss as one of the 21 priority areas for research in the next century. NIOSH also estimates that 10 million workers have sustained irreversible noise-induced hearing loss (NIHL) as a result of exposure to on-the-job hazardous noise exposure. Although NIHL is permanent and irreversible, it is also 100 percent preventable.(1) NIHL is one of the most common occupational diseases sustained by workers and is the second most self-reported occupational illness or injury according to NIOSH. (1) Although recognized as an occupational hazard and critical issue facing the workforce of today, hazardous levels of noise are still present in many workplaces.