Obesity is a significant problem affecting United States (US) firefighters. While body mass index (BMI) is widely used to diagnose obesity, its use for this occupational group has raised concerns about validity. We examined rates and types of misclassification of BMI-based obesity status compared to body fat percentage (BF%) and waist circumference (WC). Male career firefighters (N = 994) from 20 US departments completed all three body composition assessments. Mean BMI, BF%, and WC were 29 kg/m2, 23%, and 97 cm, respectively. Approximately 33% and 15% of BF%- and WC-defined obese participants were misclassified as non-obese (false negatives) using BMI, while 8% and 9% of non-obese participants defined by BF% and WC standards were identified as obese (false positives) using BMI. When stratified by race/ethnicity, Pacific Islanders showed high rates of false positive misclassification. Precision in obesity classification would be improved by using WC along with BMI to determine firefighters' weight status.
Adipose Tissue ; Body Composition ; Body Mass Index ; Classification ; Firefighters* ; Humans ; Male ; Obesity* ; Occupational Groups ; United States ; Waist Circumference

Obesity and fitness have been identified as key health concerns among USA firefighters yet little is known about the current habits related to exercise and diet. In particular, high-intensity training (HIT) has gained increasing popularity among this population but limited quantitative data are available about how often it is used and the relationship between HIT and other outcomes. Using survey methodology, the current study evaluated self-reported HIT and diet practice among 625 male firefighters. Almost one-third (32.3%) of participants reported engaging in HIT. Body composition, as measured by waist circumference and percentage body fat, was significantly related to HIT training, with HIT participants being approximately half as likely to be classified as obese using body fat [odds ratio (OR) = 0.52, 95% confidence interval (CI) = 0.34-0.78] or waist circumference (OR = 0.61, 95% CI = 0.37-0.98). Those who engaged in HIT were more than twice as likely as those who did not (OR = 2.24, 95% CI = 1.42-3.55) to meet fitness recommendations. Findings highlight directions for future prevention and intervention efforts.
Adipose Tissue ; Body Composition ; Surveys and Questionnaires ; Diet ; Firefighters* ; Humans ; Male ; Obesity ; Waist Circumference

Background: Prevalence rates of smokeless tobacco (SLT) use among firefighters are remarkably high and substantially higher than similar occupational groups and the general U.S. population. The purpose of this study was to explore the perspectives of fire service personnel regarding cancer and its associations with tobacco and SLT use. Methods: This descriptive study used a qualitative approach. Key informant interviews were conducted in 39 career firefighters and fire service administration from across the U.S. Discussion were recorded, transcribed verbatim and transferred to NVivo software for narrative analysis. Topics explored included cancer perceptions, attitudes and beliefs, and cultural factors related to SLT use behaviors. Results: Major themes that emerged among fire service personnel included concerns about cancer and its risk factors including firefighting tasks, such as fire overhaul operations, and from their lifestyle behaviors, such as alcohol and tobacco use. Firefighters also suggested a number of reasons for their increased SLT use, such as fire department tobacco-free policy and fire service culture. Conclusion The current study provides a rich foundation for future research, prevention, and intervention efforts for the fire service and research communities regarding tobacco and SLT use and cancer risk. Additional research on firefighters' cancer beliefs deserves future research in order to improve messaging about the risks of cancer due to firefighting.

Background: Problem drinking is a perennial concern in the US fire service. A large literature has documented the importance of addressing alcohol norms in intervention research. The purpose of this study was to explore alcohol norms in a national cohort of firefighters (FFs) to inform intervention development in this occupational group. Methods: Data were from a national online survey of career and volunteer FFs (N = 674). Participants were recruited through national fire service listservs and a database of FFs who had agreed to be contacted for research. Results: When asked about “acceptable” levels of alcohol consumption, FFs on average suggested levels which exceeded public health guidelines. Further, approximately half of career and volunteer FFs believed that, at least under some circumstances, drinking until intoxicated was normative. When asked how long should elapse between a FFs last drink and reporting for duty, the average suggested lag was 11.2 hours (sd = 4.6). However, among male volunteer FFs who reported heavy drinking, the average was 6.68 hours (sd = 4.77). Conclusions Given the high prevalence of heavy and binge drinking in the fire service, it is not surprising that the alcohol norms found in this study were consistent with a culture of drinking. Participants' reports of alcohol use among their peers were consistent with the actual prevalence of problem drinking. Thus, education and prevention efforts in this occupation should focus on changing norms about alcohol use, including linking heavy drinking to other health and safety issues they face.

Background: Firefighting is risky and impacts the mental and physical health of personnel. While most research focuses on men firefighters, recent work has highlighted mental health concerns among women including depression, anxiety, and post-traumatic stress disorder (PTSD). Social support is a known protective factor for mental health; however, women may be excluded from the supportive peer network of the firehouse. Methods: This cross-sectional study compared the prevalence of perceived stress, peer (functional) support, anxiety, depression, PTSD, chronic work discrimination and harassment, resilience, and job satisfaction in recruit (n=184) and incumbent (n=200) career women firefighters. Results: While depression and perceived stress did not differ between recruits and incumbents, recruits were more likely to score in the range of concern for anxiety (26.1% and 15.5%, respectively). Incumbents were more likely to score at risk for PTSD (16.5% and 10.3%, respectively) and more likely to report sex discrimination, sexual harassment, and sexist behaviors in the workplace. Compared to the low stress group, those who reported moderate or high stress were more likely to score in the range of concern for anxiety (OR=3.86, CI=1.76-8.89) and PTSD (OR=1.30, CI=1.15-1.47), and report poor organizational cohesion (OR=1.13, CI=1.02-1.25). Conclusion Addressing mental health in the context of women firefighters requires a comprehensive and multi-faceted approach including collaboration between fire departments, mental health professionals, advocacy groups, and the broader community.

Background: Firefighting is risky and impacts the mental and physical health of personnel. While most research focuses on men firefighters, recent work has highlighted mental health concerns among women including depression, anxiety, and post-traumatic stress disorder (PTSD). Social support is a known protective factor for mental health; however, women may be excluded from the supportive peer network of the firehouse. Methods: This cross-sectional study compared the prevalence of perceived stress, peer (functional) support, anxiety, depression, PTSD, chronic work discrimination and harassment, resilience, and job satisfaction in recruit (n=184) and incumbent (n=200) career women firefighters. Results: While depression and perceived stress did not differ between recruits and incumbents, recruits were more likely to score in the range of concern for anxiety (26.1% and 15.5%, respectively). Incumbents were more likely to score at risk for PTSD (16.5% and 10.3%, respectively) and more likely to report sex discrimination, sexual harassment, and sexist behaviors in the workplace. Compared to the low stress group, those who reported moderate or high stress were more likely to score in the range of concern for anxiety (OR=3.86, CI=1.76-8.89) and PTSD (OR=1.30, CI=1.15-1.47), and report poor organizational cohesion (OR=1.13, CI=1.02-1.25). Conclusion Addressing mental health in the context of women firefighters requires a comprehensive and multi-faceted approach including collaboration between fire departments, mental health professionals, advocacy groups, and the broader community.

Background: Firefighting is risky and impacts the mental and physical health of personnel. While most research focuses on men firefighters, recent work has highlighted mental health concerns among women including depression, anxiety, and post-traumatic stress disorder (PTSD). Social support is a known protective factor for mental health; however, women may be excluded from the supportive peer network of the firehouse. Methods: This cross-sectional study compared the prevalence of perceived stress, peer (functional) support, anxiety, depression, PTSD, chronic work discrimination and harassment, resilience, and job satisfaction in recruit (n=184) and incumbent (n=200) career women firefighters. Results: While depression and perceived stress did not differ between recruits and incumbents, recruits were more likely to score in the range of concern for anxiety (26.1% and 15.5%, respectively). Incumbents were more likely to score at risk for PTSD (16.5% and 10.3%, respectively) and more likely to report sex discrimination, sexual harassment, and sexist behaviors in the workplace. Compared to the low stress group, those who reported moderate or high stress were more likely to score in the range of concern for anxiety (OR=3.86, CI=1.76-8.89) and PTSD (OR=1.30, CI=1.15-1.47), and report poor organizational cohesion (OR=1.13, CI=1.02-1.25). Conclusion Addressing mental health in the context of women firefighters requires a comprehensive and multi-faceted approach including collaboration between fire departments, mental health professionals, advocacy groups, and the broader community.

Background: Firefighting is risky and impacts the mental and physical health of personnel. While most research focuses on men firefighters, recent work has highlighted mental health concerns among women including depression, anxiety, and post-traumatic stress disorder (PTSD). Social support is a known protective factor for mental health; however, women may be excluded from the supportive peer network of the firehouse. Methods: This cross-sectional study compared the prevalence of perceived stress, peer (functional) support, anxiety, depression, PTSD, chronic work discrimination and harassment, resilience, and job satisfaction in recruit (n=184) and incumbent (n=200) career women firefighters. Results: While depression and perceived stress did not differ between recruits and incumbents, recruits were more likely to score in the range of concern for anxiety (26.1% and 15.5%, respectively). Incumbents were more likely to score at risk for PTSD (16.5% and 10.3%, respectively) and more likely to report sex discrimination, sexual harassment, and sexist behaviors in the workplace. Compared to the low stress group, those who reported moderate or high stress were more likely to score in the range of concern for anxiety (OR=3.86, CI=1.76-8.89) and PTSD (OR=1.30, CI=1.15-1.47), and report poor organizational cohesion (OR=1.13, CI=1.02-1.25). Conclusion Addressing mental health in the context of women firefighters requires a comprehensive and multi-faceted approach including collaboration between fire departments, mental health professionals, advocacy groups, and the broader community.