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How firefighting is killing you

Aside from the well-known fire fighting dangers lurks other forces that will reduce your health and possibly your lifespan


It is no secret that firefighting is a dangerous job or that fighting fires can have a negative impact on health. It is well known that firefighting is related to higher rates of several types of cancer, which is clearly linked to exposures on the fireground to the byproducts of combustion.

These byproducts, combined with the physical exertion of firefighting, also are clear triggers linked to the risk of cardiovascular events. 

However, dangers of the job extend beyond the carcinogens and physical exertion required to respond to fire and rescue calls. Several factors related to being in the fire service actually lead to increased risk.

For instance, research has found higher rates of being overweight and obese among firefighters than the general population. While it seems this risk is the simple result of personal choices related to eating and fitness, the job itself makes weight gain more likely. 

Although there is debate and speculation about the best or worst shift schedule for health, it is clear that the interrupted sleep required by the fire service has a negative impact on health in general.

Shift work that requires an interrupted circadian rhythm (the 24 hour cycle of physiology a body goes through) has been related to several health concerns including increased risk for cardiovascular disease, diabetes, cancer and obesity.

Sleep and mental health
Interrupted sleep also can lead to developing or worsened sleep disorders such as sleep apnea. Sleep apnea, in turn, increases risk for obesity as the body doesn't have an opportunity to fully rest and enter the appropriate sleep cycle.

Shift work and interrupted sleep also lead to decreased levels of serotonin, which, in turn, contributes to an increased risk of behavioral health concerns. This physiologic risk combined with the repeated exposure to trauma fire and EMS personnel face responding to calls leads to higher risk of anxiety, depression and post-traumatic stress symptoms. 

Negative behavioral health outcomes are often related to increased alcohol and substance use and abuse. Research has found rates of binge and heavy drinking among firefighters to be high, which, it has been suggested, can be a response to repeated exposure to trauma.

Binge drinking also carries with it a large number of empty calories that contributes to obesity.

Eating in the firehouse can also be a challenge. Food and eating habits are highly engrained in the firehouse culture with bonding taking place around the kitchen table individual food choices more difficult for a firefighter who wants to make changes on their own. 

Busy house food, fitness
Firehouses that are busy also have the challenge of unpredictable eating schedules. While I have never seen any specific research on the issue, it seems that the better the meal is, the more likely it is to be interrupted with a call.

In addition, firefighters have to be ready and fueled to fight a fire on any given night. Often these factors lead to personnel eating large meals fast — more than they would actually be hungry for at a leisurely meal.

Busy houses or trucks often depend on fast food with little nutritional value as staples in their meal rotations. 

Fitness, while engrained in some departments, is difficult in others where calls often interrupt scheduled work out time. The crew's focus, and specifically the priorities of the company officer, typically determine the goals and practices of the crew.

Some risk factors — such as interrupted sleep or shift work, the exposures on the fireground, and the physiologic impact of emergency response — are inherent to the job and cannot be changed.

These occupational risks that impede the health of firefighters make prevention and intervention even more important.

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