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Human factors in firefighting: ergonomic-, cardiopulmonary-, and psychogenic stress-related issues

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Summary

There are many issues in firefighting that involve human factors and cardiopulmonary conditioning. Population-based mortality and disability surveillance studies suggest a relatively small but significant excess of disability but not mortality from nonmalignant cardiovascular disease for fire fighters. More targeted cohort and case-control studies do not support such an excess and instead suggest a strong healthy worker effect. Pulmonary function among fire fighters has been extensively studied, with contradictory findings. Extreme exposures and long-term exposure in combination with cigarette smoking may be risk factors for respiratory disorders and accelerated decline in airflow. It appears likely that individual fire fighters who show early signs of illness are often selectively transferred out of active firefighting positions. Despite exposure to substances such as carbon monoxide that may predispose to cardiovascular mortality and morbidity, excesses are not consistently shown in mortality studies. Clinical studies of individual fire fighters do suggest an elevated risk for myocardial ischemia. The ergonomic demands of firefighting are extreme at peak activity because of high energy costs for activities such as climbing aerial ladders, the positive heat balance from endogenous and absorbed environmental heat, and encumbrance by bulky but necessary protective equipment. The psychological stresses of firefighting include long periods of relative inactivity punctuated by highly stressful alarms and extremely stressful situations such as rescues, as reflected in physiological and biochemical indicators. Fire fighters are at risk for depression and posttraumatic stress disorder, although morale overall is generally much higher than in comparable occupations. Women firefighter candidates as a group perform less well on selection test simulating the demands of active firefighting, but some individual women perform very well.

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References

  1. Anonymous (1974) Fire-fighting: an insidious hazard. Lancet II:91

  2. Anonymous (1975) Firemen's lungs. Lancet I: 439

  3. Arborelius M Jr, Dahlback GO, Data PG (1983) Cardiac output and gas exchange during heavy exercise with a positive pressure respiratory protective apparatus. Scand J Work Environ Health 3:471–477

    Google Scholar 

  4. Barnard RJ (1975) Fire fighters — a fit population with ischemic heart disease. Sports Med Bull 10:7–9

    Google Scholar 

  5. Barnard RJ (1979) Carbon monoxide: a hazard to fire fighters. Arch Environ Health 34:255–257

    Google Scholar 

  6. Barnard RJ, Anthony DF (1980) Effect of health maintenance programs on Los Angeles City fire fighters. J Occup Med 22:667–696

    Google Scholar 

  7. Barnard RJ, Duncan HW (1975) Heart rate and ECG responses of fire fighters. J Occup Med 17:247–250

    Google Scholar 

  8. Barnard RJ, Gardner GW, Diaco NV (1976) “Ischemic” heart disease in fire fighters with normal coronary arteries. J Occup Med 18:818–820

    Google Scholar 

  9. Barnard RJ, Gardner GW, Diaco NV, Kattus AA (1978) Near-maximal ECG stress testing and coronary artery disease risk factor analysis in Los Angeles City fire fighters. J Occup Med 17:693–695

    Google Scholar 

  10. Beaumont J, Chu G, Jones J, Schenker M, Singleton J, Piantanida L, Reiterman M (1991) An epidemiologic study of mortality from cancer and other causes of death in San Francisco fire fighters. Am J Ind Med 19:357–372

    Google Scholar 

  11. Bergstrom CE, Tornling G, Unge G (1988) Acquired progressive asthma in a fire fighter. Eur Resp J 1:469–470

    Google Scholar 

  12. Brandt-Rauf PW, Cosman B, Fallon LF Jr, Tarantini T, Idema C (1988) Health hazards of fire fighters: Acute pulmonary effects after toxic exposures. Br J Ind Med 45:606–612

    Google Scholar 

  13. Byrd R, Collins M (1980) Physiologic characteristics of fire fighters. Am Corr Therap J 34:106–109

    Google Scholar 

  14. Cady LD, Bischoff DP, O'Connell ER, Thomas PC, Allan JH (1979) Strength and fitness and subsequent back injuries in fire fighters. J Occup Med 21:269–272

    Google Scholar 

  15. Cady LD, Thomas PC, Karwasky RJ (1985) Program for increasing health and physical fitness of fire fighters. J Occup Med 27:110–114

    Google Scholar 

  16. Cahalane M, Demling RH (1984) Early respiratory abnormalities from smoke inhalation. JAMA 251:771–773

    Google Scholar 

  17. Davis PO, Biersner RJ, Barnard RJ, Schamadan J (1982) Medical evaluation of fire fighters: how fit are they for duty? Postgrad Med 72:241–245

    Google Scholar 

  18. Decker WJ, Garcia-Cantu A (1986) Toxicology of fires: an emerging clinical concern. Vet Hum Toxicol 28(5):431–433

    Google Scholar 

  19. Dibbs E, Thomas HE Jr, Weiss ST, Sparrow D (1982) Fire fighting and coronary heart disease. Circulation 65:943–946

    Google Scholar 

  20. Douglas DB, Douglas RB, Oakes D, Scott G (1985) Pulmonary functions of London firemen. Br J Ind Med 4:55–58

    Google Scholar 

  21. Duncan HW, Gardner GW, Barnard RJ (1979) Physiological responses of men working in fire fighting equipment in the heat. Ergonomics 22:521–527

    Google Scholar 

  22. Dutton LM, Smolensky MH, Leach CS, Lorimer R, Hsi BP (1978) Stress levels of ambulance paramedics and fire fighters. J Occup Med 20:111–115

    Google Scholar 

  23. Dyer RF, Esch VH (1976) Polyvinyl chloride toxicity in fires: hydrogen chloride toxicity in fire fighters. JAMA 235:393–397

    Google Scholar 

  24. Eliopulos E, Armstrong BK, Spickett JT, Heyworth F (1984) Mortality of fire fighters in Western Australia. Br J Ind Med 41:183–187

    Google Scholar 

  25. Faff J, Tutak T (1989) Physiological responses to working with fire fighting equipment in the heat in relation to subjective fatigue. Ergonomics 32:629–638

    Google Scholar 

  26. Feaner E, Rosenman K (1986) Mortality in police and fire fighters in New Jersey. Am J Ind Med 9:517–527

    Google Scholar 

  27. Felton JS (1973) Conducting cardiopulmonary evaluations of County of Los Angeles safety personnel. Health Serv Res 88:515

    Google Scholar 

  28. Furey B (1987) Command post: critical incident stress management. Fire House 12:82–84

    Google Scholar 

  29. Genovesi MG, Tashkin DP, Chopra S, Morgan M, McElroy C (1977) Transient hypoxemia in firemen following inhalation of smoke. Chest 71:441–444

    Google Scholar 

  30. Gold A, Burgess WA, Clougherty EV (1978) Exposure of fire fighters to toxic air contaminants. Am Ind Hyg Assoc J 39:534–539

    Google Scholar 

  31. Griggs TR (1977) The role of exertion as a determinant of carboxyhemoglobin accumulation in fire fighters. J Occup Med 19:759–761

    Google Scholar 

  32. Guidotti TL (1992) Mortality of fire fighters in Alberta, 1927–1987. Am J Ind Med (in press)

  33. Guidotti TL, Clough V (1992) Occupational health concerns of firefighting. Ann Rev Public Health 13 (in press)

  34. Guidotti TL, Baser M, Goldsmith JR (1987) Comparing risk estimates from occupational disease monitoring data. Public Health Rev 15:1–27

    Google Scholar 

  35. Guralnick L (1963) Mortality by occupation and cause of death. Vital Statistics Special Reports (US Public Health Service) 53(5):139

    Google Scholar 

  36. Heyer N, Weiss NS, Demers P, Rosenstock L (1990) Cohort study of Seattle fire fighters: 1945–1983. Am J Ind Med 17:493–504

    Google Scholar 

  37. Hills M (1986) Fire department sets example for respiratory protection evaluation. Occul Health Saf 63:36–38

    Google Scholar 

  38. Horsfield K, Cooper FM, Buckman MP, Guyuatt AR, Comming G (1988) Respiratory symptoms in West Sussex firemen. Br J Ind Med 45:251–255

    Google Scholar 

  39. Hytten K, Hasle A (1989) Fire fighters: a study of stress and coping. Acta Psychiatr Scand Suppl. 80, 355:50–55

    Google Scholar 

  40. Kalimo R, Lehtonen A, Daleva M, Kuorinka I (1980) Psychological and biochemical strain in firemen's work. Scand J Work Environ Health 6:179–187

    Google Scholar 

  41. Kuorinka I, Korhonen O (1981) Fire fighters' reaction to alarm, an ECG and heart rate study. J Occup Med 23:762–766

    Google Scholar 

  42. Lemon PWR, Hermiston RT (1977) Physiological profile of professional fire fighters. J Occup Med 19:337–340

    Google Scholar 

  43. Lemon PWR, Hermiston RT (1977) The human energy cost of firefighting. J Occup Med 19:558–562

    Google Scholar 

  44. Loke J, Farmer WC, Matthay RA, Virgulto JA, Bouhuys A (1976) Carboxyhemoglobin levels in fire fighters. Lung 154:35–39

    Google Scholar 

  45. Loke J et al (1980) Acute and chronic effects of firefighting on pulmonary function. Chest 77:369–373

    Google Scholar 

  46. Louhevaara V (1986) Respirator wearer's strain: a complex problem. Am J Ind Med 10:3–6

    Google Scholar 

  47. Louhevaara V, Tuomi T, Smolander J, Korhonen O, Tossavainen A, Jaakola J (1985) Cardiorespiratory strain in jobs that require respiratory protection. Int Arch Occup Environ Health 55:195–206

    Google Scholar 

  48. Louhevaara V, Smolander J, Toumi T, Korhonen O, Jaakola J (1985) Effects of an SCBA on breathing pattern, gas exchange, and heart rate during exercise. J Occup Med 27:213–216

    Google Scholar 

  49. Louhevaara V, Smolander J, Korhonen O, Tuomi T (1986) Effects of industrial respirators on breathing pattern at different work levels. Eur J Appl Physiol 55:142–146

    Google Scholar 

  50. Manning JE, Griggs TR (1983) Heart rates in fire fighters using light and heavy breathing equipment: similar near-maximal exertion in response to multiple work load conditions. J Occup Med 25:215–218

    Google Scholar 

  51. Markowitz JS (1989) Self-reported short- and long-term respiratory effects among PVC-exposed fire fighters. Arch Environ Health 44:30–33

    Google Scholar 

  52. Markowitz JS, Guttermanl AM, Link B, Rivera M (1987) Psychological response of fire fighters to a chemical fire. J Hum Stress 13:84–93

    Google Scholar 

  53. Mastromatteo E (1959) Mortality in city firemen: II. A study of mortality in firemen of a city fire department. AMA Arch Ind Health 20:277–283

    Google Scholar 

  54. McFarlane AC (1988) The phenomenology of post-traumatic stress disorders following a natural disaster. J Nerv Ment Dis 176:22–29

    Google Scholar 

  55. McFarlane AC (1988) The longitudinal course of post-traumatic morbidity: the range of outcomes and their predictors. J Nerv Ment Dis 176:30–39

    Google Scholar 

  56. McFarlane AC (1988) The aetiology of post-traumatic stress disorders following a natural disaster. Br J Psychiatr 152:116–121

    Google Scholar 

  57. Minty BD, Royston D, Jones JB, Smith DJ, Searing CSM, Beeley M (1985) Changes in permeability of the alveolar-capillary barrier in fire fighters. Br J Ind Med 42:631–634

    Google Scholar 

  58. Misner JE, Plowman SA, Boileau RA (1987) Performance differences between males and females on simulated firefighting tasks. J Occup Med 29:801–805

    Google Scholar 

  59. Misner JE, Boileau RA, Plowman SA, Elmore BG, Gates MA, Gilbert JA, Horswill C (1988) Leg power characteristics of female fire fighter applicants. J Occup Med 30:433–437

    Google Scholar 

  60. Milham S Jr (1983) Occupational mortality in Washington State, 1950–1979. US Public Health Service, Cincinnati, DHHS (NIOSH) pub no 83-116

    Google Scholar 

  61. Musk AW, Peters JM, Wegman DH (1977) Lung function in fire fighters: I. A three year follow-up of active subjects. Am J Public Health 67:626–629

    Google Scholar 

  62. Musk AW, Monson RR, Peters JM, Peters RD (1978) Mortality among Boston fire fighters, 1915–1975. Br J Ind Med 35:104–108

    Google Scholar 

  63. Musk AW, Smith TJ, Peters JM, McLaughlin E (1979) Pulmonary function in fire fighters: acute changes in ventilatory capacity and their correlates. Br J Ind Med 36:29–34

    Google Scholar 

  64. Musk AW, Peters JM, Bernstein L, Rubin C, Monroe CB (1982) Pulmonary function in fire fighters: a six-year follow-up in the Boston Fire Department. Am J Ind Med 3:3–9

    Google Scholar 

  65. O'Connell ER, Thomas PC, Cady LD, Karwasky RJ (1986) Energy costs of simulated stair climbing as a job-related task in fire fighting. J Occup Med 28:282–284

    Google Scholar 

  66. Peabody HD (1973) San Diego Fire Department health survey. In: Survival in the fire fighting profession: second symposium on occupational health and hazards of the fire service, April 1973, University of Notre Dame, Indiana. John P Redmond Memorial Fund, International Association of Fire Fighters.

    Google Scholar 

  67. Peters JM, Theriault GP, Fine LJ, Wegman DH (1974) Chronic effect of firefighting on pulmonary function. N Engl J Med 291:1320–1322

    Google Scholar 

  68. Petersen GR, Milham S Jr, et al (1983) Occupational mortality in the State of California, 1959–1961. US Public Health Service, Cincinnati, DHHS (NIOSH) pub no 83-116

    Google Scholar 

  69. Phoon WO, Ong CN, Foo SC, Plueksawan W (1983) A cross-sectional study on the health of fire fighters in Singapore. Jpn J Ind Health 25:463–470

    Google Scholar 

  70. Polakoff PL (1976) Attention should be given to limiting firefighting hazards. Occup Health Saf 53:55–56

    Google Scholar 

  71. Raven PB, Davis TO, Shafer CL, Linnebur AC (1977) Maximal stress test performance while wearing a self-contained breathing apparatus. J Occup Med 19:802–806

    Google Scholar 

  72. Reischl UWE, Bair HS, Reischl P (1979) Firefighter noise exposure. Am Ind Hyg Assoc J 40:482–489

    Google Scholar 

  73. Romet TT, Frim J (1987) Physiological responses to fire fighting activities. Eur J App] Physiol 56:633–638

    Google Scholar 

  74. Rosenstock L, Demers P, Heyer NJ, Barnhart S (1990) Respiratory mortality among fire fighters. Br J Ind Med 47:462–465

    Google Scholar 

  75. Sardinas A, Miller JW, Hansen H (1986) Ischemic heart disease mortality of firemen and policemen. Am J Public Health 76:1140–1141

    Google Scholar 

  76. Sheppard D, Distefano S, Morse L, Becker C (1986) Acute effects of routine firefighting on lung function. Am J Industr Med 9:333–340

    Google Scholar 

  77. Sidor R, Peters JM (1973) Differences in ventilatory capacity of Irish and Italian fire fighters. Am Rev Resp Dis 109:669–671

    Google Scholar 

  78. Sidor R, Peters JM (1974) Fire fighting and pulmonary function: an epidemiology study. Am Rev Resp Dis 109:249–254

    Google Scholar 

  79. Sidor R, Peters JM (1974) Prevalence of chronic non-specific respiratory disease in fire fighters. Am Rev Resp Dis 109:255:261

    Google Scholar 

  80. Skoldström B (1987) Physiological responses of fire fighters to workload and thermal stress. Egonomics 30:1589–1597

    Google Scholar 

  81. Smith D (1988) Fire fighters: their lives in their own words. Doubleday, New York

    Google Scholar 

  82. Sparrow D, Bosse R, Rosner B, Weiss ST (1982) The effect of occupational exposure on pulmonary function: a longitudinal evaluation of fire fighters and non fire fighters. Am Rev Resp Dis 125:319–322

    Google Scholar 

  83. Stevenson CJ (1985) Effects of radiant heat in fire fighting instructors. Br J Ind Med 42:67–68

    Google Scholar 

  84. Tashkin DP, Genovesi MG, Chopra S, Coulson A, Simmons M (1977) Respiratory status of Los Angeles firemen: one-month follow-up after inhalation of dense smoke. Chest 71:445–449

    Google Scholar 

  85. UK Registrar General (1961) UK Registrar General's decennial report for England and Wales, 1960. Her Majesty's Stationery Office, London

    Google Scholar 

  86. UK Registrar General (1971) UK Registrar General's decennial report for England and Wales, 1970. Her Majesty's Stationery Office, London

    Google Scholar 

  87. US National Institute for Occupational Safety and Health and US Social Security Administration (1980) Occupational characteristics of disabled workers. US Public Health Service, Cincinnati, DHHS (NIOSH) pub no 80-145

    Google Scholar 

  88. US Social Security Administration and US Public Health Service (1967) Occupational characteristics of disabled workers, by disabling condition. US Government Printing Office, Washington

    Google Scholar 

  89. Vena JE, Fiedler RC (1987) Mortality of a municipal-worker cohort: IV. Fire fighters. Am J Ind Med 11:671–684

    Google Scholar 

  90. von Hallmeyer A, Lingbeil M, Kohn-Heyer G, Meister W, Nehring R, Pfister E, Reum PJ (1981) Physische und psychische Belastungskomponenten in der Tätigkeit des Feuerwehrmannes. Z Gesamte Hyg 27:191–194

    Google Scholar 

  91. White MK, Hodous TK (1987) Reduced work tolerance associated with wearing protective clothing and respirators. Am Ind Hyg Assoc J 48:304–310

    Google Scholar 

  92. Wojtczak-Jaroszowa J, Jaroszz D (1986) Health complaints, sicknesses and accidents of workers employed in high environmental temperatures. Can J Public Health 77 [Suppl 1]

  93. Young I, Jackson J, West S (1980) Chronic respiratory disease and respiratory function in a group of fire fighters. Med J Austr 1:654–658

    Google Scholar 

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Guidotti, T.L. Human factors in firefighting: ergonomic-, cardiopulmonary-, and psychogenic stress-related issues. Int. Arch Occup Environ Heath 64, 1–12 (1992). https://doi.org/10.1007/BF00625945

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