OVERVIEW OF FIREFIGHTING RISKS
Over 1 million firefighters work in the United States and over 45% of these service personnel are older than the age of 40 (9). The top causes of death in the United States are attributed to cardiovascular disease (4), and the top cause of on-duty death in firefighters is heart attack (8). Recent mortality statistics specific to firefighters document about 100 on-duty fatalities per year. In 2007, 38 of 102 on-duty deaths were attributed to stress- or exertion-related cardiac events (6).
Health and fitness programs tailored to firefighters have demonstrated benefits including increases in strength, power, and endurance in a few studies (10). Research examining the outcomes associated with firefighter-specific programs is not prevalent in the literature, although it is argued that these programs should include firefighter-specific exercise training and education (11). The purpose of this article is to examine the physical demands of firefighters and describe specific programming skills necessary to develop interventions for this population.
Specific tasks associated with the job of a firefighter vary but generally include activities associated with fire suppression, extrication from automobiles or buildings, emergency response management, and general community service. The proportions of these tasks are significantly different now compared with the past (12). Fire retardant building practices, fire prevention technology, and increased use of alarms and sprinkler systems have significantly reduced the number of fires that take place nationally and within communities, reducing the percentage of service calls for fires to as low as 3% (3). The remaining proportions of tasks and service calls include 50% associated with emergency medical service first response, 23% general service, 15% alarm malfunction, and 4.6% rescue calls (9). This change has led to a shift in the tasks and physical demands placed on firefighters as they spend the majority of their time responding to general emergencies in the community, including automobile accidents, medical emergencies, and community emergencies such as natural disasters (12).
Physiological and metabolic demands placed on firefighters depend on the specific activity and external environmental variables such as fire and excessive heat. Firefighters use supplemental air tanks when fighting a fire and wear fire retardant boots, jackets, gloves, and helmets. The added weight of this equipment can be as much as 70 pounds. Managing a hose or axe can increase this load by 30 pounds (8). If the firefighter is required to climb stairs as well, the physiological and metabolic load on the firefighter quickly approaches near maximum levels (2). Exposure to heat stress and psychological stress also add to the strain on the cardiovascular and musculoskeletal systems (3).
Auto extrication represents a high proportion of the job tasks associated with firefighters because many function as first responder in auto accidents (12). Auto extrication devices, known as “the jaws of life” come in several shapes and sizes but most weigh between 50 and 100 pounds and must be held steady for long periods during victim extrication. Other tasks requiring high physical demands include carrying victims, managing hoses, ladders, and other equipments (3). Firefighter-specific tasks require up to 12 times the oxygen uptake compared with rest (2). In addition, firefighters with a low workload tolerance can exceed their metabolic abilities leading to injury or death (5). A recent examination of metabolic demands associated with the firefighter candidate physical ability test found that the metabolic cost associated with the activities was 36.6 mL/kg for women and 38.5 mL/kg for men (13).
A UNIVERSITY-BASED HEALTH AND FITNESS PROGRAM
This section discusses details of a health and fitness program developed by the Sacred Heart University Exercise Science faculty for the Fairfield Fire Department, in Connecticut. The program consisted of the following:
- Stress management
- Peer fitness training
- Supervised group training
Variables examined during the program included the following (Figure 1):
- Resting heart rate and blood pressure
- Body composition
- Cardiopulmonary endurance
- Perceived stress
A series of education classes considered most relevant to firefighters were conducted by university faculty and included the following:
- Fundamentals of exercise training
- Nutrition guidelines for health and fitness
- Cooking demonstrations
- Acute and chronic stress management
The exercise component consisted of several offerings of group personal training, on-site exercise programs, and the provision of training for select firefighters to serve as peer trainers. All programs were designed with the goal of general strength and conditioning. American College of Sports Medicine guidelines for exercise (1) were essentially merged with recommendations from the International Association of Firefighters (IAFF) Peer Fitness Training Program (9). Firefighters serving as peer trainers received special training from the Sacred Heart faculty including supervision and spotting techniques, motivation methods, and specific activities designed to prevent injuries of the low back and shoulder girdle. Firefighters were provided with group personal training sessions at the university's health and fitness center, at their local firehouses, and at the local Young Men's Christian Association.
Research should be conducted to determine the effectiveness of firefighter-specific health and fitness programs. IAFF also recommends that certified peer fitness trainers and strength and conditioning professionals collaborate further to create and administer firefighter-specific health and fitness programs (9).
Health and fitness in firefighters is also correlated with overall job performance (10). Rhea et al. (10) observed higher job performance measures with increased aerobic fitness, upper-body strength, upper-body endurance, squat endurance, and decreased 400-m sprint time. Task-specific training programs can increase the effectiveness of job-specific tasks in addition to providing the firefighter with general health benefits associated with regular exercise.
General goals of a health and fitness program tailored to firefighters should include thorough baseline testing and assessment and exercise programming with general strength and conditioning in mind. A selection of exercises that address increased risk activities and injury prevention should augment a general fitness program. Combining an applied and didactic approach through supervised training and education classes optimizes the potential for the firefighters to apply strength and conditioning activities to the demands of their job.
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