Firefighter/EMT Safety, Health & Survival: Igniting Change to Reduce Injuries and Promote Wellness

Fire departments in the Pacific Northwest are advancing science while they improve the health of their firefighters. IGNITE is a study funded by the National Institutes of Health to look at what factors influence a department’s use of the PHLAME program, which focuses on firefighter health risks using an easily implemented, peer-led scripted curriculum designed for shifts at fire stations.

The IGNITE study, headquartered at Oregon Health & Science University in collaboration with Northwest Fire Fighter Fitness Foundation, recruited 12 fire departments in Oregon and Washington and carefully examined the process of using the PHLAME program and its outcomes. PHLAME materials were provided by grant dollars, but it was up to the departments to implement PHLAME.

As expected, there were differences in how well the program was used. In some departments, it never caught fire, while in others it burned brightly. Kim Favorite, a leader in fire service health and wellness, explained that the study’s objectives were to understand the keys to successful implementation and to inform departments what components are needed to make PHLAME work.

When PHLAME was used successfully, health habits improved and money was saved. Chief Dave Carlberg was pleased to have Aberdeen Fire Department use PHLAME: “We had a great experience with the PHLAME program. It gave us a wealth of information and brought awareness to the forefront.”

He explained, “One of the reasons our department was so successful with PHLAME was because our officers supported the program. In an organization, you need to hear from the top down, ‘This is important, we value your health.’”

According to Aberdeen Battalion Chief Tom Hubbard, “PHLAME put a spotlight on positive changes and that has had a positive effect on our department. The whole concept of PHLAME is a team approach and positive peer pressure … I have seen a change in diet. No longer are there donuts; now there are vegetable and fruit trays—that's huge.”

Firefighter Jeff Bingaman of Maple Valley Fire and Life Safety credited PHLAME with another big change. “After 30 years of chewing tobacco, I quit. I had tried to quit multiple times before, but PHLAME was the tipping point. PHLAME brought a heightened awareness.”

Battalion Chief Hubbard added, “Firefighters are routinely operating at 100% of the maximum cardiac output. If you are not completely fit, something is going to break. And it is not just fighting fires; responding to emergencies in the middle of the night, poor sleep, alarms sounding and stress all add up and can take its toll.”

Carlberg emphasized, “Nationwide 56% of the 2010 firefighter on-duty fatalities were cardiac related. It goes to show we need to be paying more attention to those issues that involve nutrition, exercise and maintaining body weight. The physical demands placed on a fire fighter can be extremely high … Not only do we owe that to our coworkers; we owe it to the public. They expect firefighters to perform in stressful, hazardous situations."

When PHLAME worked well, individuals, the department and the community benefited. Linda Hein, Aberdeen’s director of human resources, recently told Carlberg, “We have seen noticeable reductions in reportable workplace injuries. There has been a marked decrease in the last year.”

Carlberg attributed that reduction to PHLAME: “I think it is an indirect result of the PHLAME program.” Aberdeen, like many cities, has been hit hard by the recession and Carlberg knows that many departments are stretched thin. “Everyone is in a budget crunch; every budget is under fire. If we can minimize the number of injuries, that will help.”

Carlberg concluded, “I do believe that we should have a preventative maintenance program for people like we do for equipment. We need to recognize that, embrace that and have that be part of the budgeting process. The awareness that PHLAME brought to the department was huge. I hope that message gets conveyed to the American fire service as a whole. They need to pay attention.”

Researchers still are analyzing findings from IGNITE and in the next few months should have results to develop a guide for how to effectively implement PHLAME in departments. With skyrocketing health-care costs, employee wellness is an issue for all types of worksites, and the lessons from IGNITE can be applied to other businesses and their wellness activities.

Carol DeFrancesco is a senior researcher and registered dietitian in the Division of Health Promotion and Sports Medicine at Oregon Health & Science University. She coordinated the National Institutes of Health PHLAME and IGNITE studies. Kim Favorite is the occupational health & fitness coordinator for the Seattle Fire Department and president of NW Fire Fighter Fitness Foundation. She’s a member of the IAFC’s Safety, Health and Survival Section and has been a technical advisor for the Fire Service Joint Labor-Management Wellness-Fitness Initiative since 1996.

The PHLAME Program—Promoting Healthy Living: Assessing More Effects—was specifically designed for the fire and emergency service. It’s an evidenced-based wellness/injury reduction program; it improves nutrition, enhances fitness, prevents weight gain and—important in these challenging economic times—saves up to $1,000 per firefighter in reduced injuries and illness costs.

PHLAME has been proven effective and is recognized on the National Cancer Institute’s Cancer Research-tested Intervention Programs webpage.

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