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We Don't Know What We Don't Ask

I joined fire service leaders from the IAFC, the U.S. Fire Administration, the International Association of Firefighters, FEMA’s Grants Directorate, the National Volunteer Fire Council and the National Fallen Firefighters Foundation as we reviewed the current body of knowledge on the subject.

The review topics were divided into three categories that drove the major emphasis of current research:

  • The need for regular and ongoing medical surveillance
  • The need for regular and ongoing emphasis on physical fitness
  • An enhanced behavioral-health focus, including stress, alcohol use, tobacco cessation, depression, PTSD and sleep disturbance

There was excitement as well as consensus that we’re increasingly at a transformational period in the history of the fire service, one in which data and research is increasingly guiding our services and decision making as well as practices: evidence-based, as many referred to it.

In each category, evidence suggests we have more work to accomplish and improvement to achieve. Evidence demonstrates that potentially dangerous physiological changes occur in our bodies when engaging in fireground activities. Evidence also demonstrates that many in the fire service—like the general population—suffer from high rates of obesity, high blood pressures and cholesterol, and pre- and actualized diabetes.

These colliding realities create a coalition of evils that directly results in ongoing line-of-duty deaths and disabilities.

Research has clearly demonstrated there are significant aerobic and strength requirements to engage in the rigors of fireground operations—requirements often similar to those of well-conditioned athletes.

An analogy was advanced that you wouldn’t dream of running a long race or any other endurance and strength event without some degree of regular preparation to succeed and avoid injury or worse. Firefighting presents similar parallels.

Behavioral health was identified as needing more attention to complete this triad of cardiovascular research. Evidence shows that the rigors of the fire service manifest themselves with elevated rates of alcohol abuse, stress, PTSD, sleep disturbances and tobacco use, among other altered coping mechanisms.

In the fire service, we must follow this evidence-based knowledge to continue to provide support to our firefighters in each of these areas.

Lastly, we discussed what further research needs and gaps exist within the fire service and how best to address these.

This gathering of the most dedicated and respected researchers should serve as a call to arms for fire service leaders and firefighters alike! Health, wellness and survival ultimately are rooted in knowledge, allowing appropriate action!

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