BY BOBBY HALTON
Firefighters are three times more likely to die on the job than individuals of any other occupation, according to the U.S Department of Labor. The National Fire Protection Association (NFPA) has long established that half of all of these deaths are attributable to stress from overexertion. Will Rogers said, “It is not what you don’t know that is going to kill you but what you know that ain’t so.” I had always thought that firefighters needed to be in good shape. I thought that most heart attacks happened to firefighters because of preexisting cardiovascular disease, some others were because of poor physical conditioning, and others were simply a matter of age. It appears that I was partially right about some points and dead wrong about others.
Dr. Stephen Kales, in 2007, reported that nearly all firefighters who had died from heart attacks in a sample study had underlying cardiovascular disease. Age and poor physical conditioning place a firefighter at extremely high risk. This risk is further compounded by the presence of any preexisting cardiovascular disease. A sad footnote from this study was that many of the firefighters who died from heart attacks were in their forties. We have always thought that good physical conditioning would make all the difference; if we passed our annual NFPA 1582-compliant physical, we would be fine.
However, two recent studies led by Dr. Jim Brown provide us with some important findings that all firefighters need to be made aware of. In the first study, with the Maryland Fire & Rescue Institute (MFRI) on fitness hydration and training, it was revealed that firefighters of average and lower levels of overall physical conditioning responded physiologically just about the same. In that same study, firefighters with high levels of physical conditioning had much less physical stress in the same training activities. The study also supplied us with critical information on the need to have proper hydration whenever participating in any firefighting activity. On the surface, it appeared that those with average and low-level conditioning were at a greater risk than those of above-average conditioning. This seems to make sense: Good physical conditioning equals a good outcome, but maybe not.
In the second study by Dr. Brown, with the Indiana Firefighter Health and Safety Research Division, “Physiological Stress Associated with Structural Firefighting Observed in Professional Firefighters,” are some startling and far-reaching conclusions. It’s important to note that the study was done on real firefighters going to real fires and emergencies. They wanted to see the real physical effects of firefighting work on firefighters’ cardiac and respiratory systems. The researchers followed Indianapolis firefighters while on duty and used modern technology to measure the physiological stress on these firefighters during different aspects of firefighting. They measured the responses during the initial attack, responding, overhaul, and the recovery period.
The Indiana study determined that a firefighter’s age, time on the job, and physical conditioning, combined with the size of the building and the amount of fire involved in the building, can determine a fire scene’s potential for inducing firefighter cardiovascular and respiratory stress. Now there’s nothing we can do about how long we have been on the job, our age, the size of the building, or the amount of fire we might be facing, but we can affect our physical conditioningin particular, our weight and our aerobic conditioning.
The study noted that the stress begins when the alarm is received and that heart rates typically rise to 80 percent of their maximum and begin to decline once the firefighter has donned personal protective equipment and gotten on the rig. The next thing the study noticed is that the amount of time on the jobexperiencematters, so older and more experienced firefighters had fewer increases in heart rate on receipt of an alarm.
The study identified that the physiological stress a firefighter will experience is directly proportional to the structure and the amount of fire in the building. This means that the structure sets the level of intensity. Another very critical piece of the study identified that multiple fires in one shift can have much greater effects physiologically on firefighters than was ever before considered.
The study recommends that these firefighters who routinely respond to a higher call volume need to be held to a much higher standard of physical preparedness to recover quickly enough to function at the next event and not suffer potentially fatal consequences. It is recommended they be in elite athletic condition, much like a professional swimmer or professional triathlete.
The evidence is clear: Most heart attacks on the job are caused by preexisting heart disease. Going to fires is a substantial trigger for cardiac events. Therefore, firefighters with preexisting cardiovascular disease are at extreme risk for heart attacks, strokes, and other cardiovascular system problems at fires.
It is time we honestly recognize that firefighting can cause heart attacks and strokes and that the best defense is physical training. If we are going be taken seriously as promoting safety, we must require it of ourselves and each other. We can no longer allow our unhealthy and unfit members to put themselves, their families, and their fellow firefighters in danger. We must all adopt NFPA 1583 and develop those physical fitness components it lists as critical to our survival to our absolute best.
Unfortunately, if we go back to Will Rogers, we must note that the study did not cover anything about sleep deprivation, heart rate variability, parasympathetic balance, or the effect that using self-contained breathing apparatus (SCBA) has on our respiratory systems. We know these all have an effect on our bodies. We don’t know what that means to our survivability.
