By Dr. Rachel Topazian
Wearable devices and new data systems have the potential to protect firefighter health and safety. Specifically, according to NIST, wearables could collect biometric data on calls, informing decision-making in real time, and new data systems or department-level data collection could identify injury and exposure trends. However, the use of such devices prompts concerns about firefighter data privacy.
There is little evidence on firefighter perspectives on how data should be collected, used, accessed or shared, and no studies have examined whether firefighter and fire service leadership views align. To fill this gap, our team at the Johns Hopkins Bloomberg School of Public Health conducted a study to examine firefighter and fire service leader perspectives on health and safety data collected in fire departments.
We wanted to learn how firefighters and fire service leaders viewed two key questions:
- What kinds of data are fire departments collecting right now, and how do they use or share that data?
- How should wearable device data be collected, used, accessed and shared?
We conducted interviews and focus groups with firefighters and department leaders in Maryland and Virginia, and with national-level fire service leaders. Overall, we spoke with 65 people, including 31 career firefighters, 21 department-level leaders, 11 national-level leaders and two union leaders. We audio recorded each interview and focus group, transcribed the recordings and analyzed each transcript to identify themes. Here’s what we found.
Views on current data practices
Fire service leaders and firefighters alike described limited sharing of firefighter health and safety data within departments, and nearly all believed this data was adequately protected by departments. However, several firefighters expressed a general preference that their data be deidentified and only shared in aggregated formats. Firefighters were more reluctant to disclose sensitive information, with mental health viewed as more personal than injury information.
Leaders and firefighters viewed data as valuable for establishing fitness for duty status. Firefighters emphasized the value of exposure and injury information in helping file for workers’ compensation or presumptive benefits. Department leaders were enthusiastic about using injury, fitness and health data for prevention, although there were mixed views within and across departments about whether these efforts were effective. A small number of leaders described using data to support diversity, equity and inclusion priorities, like research studies on the health of women or racial minorities.
On an individual level, firefighters and leaders noted that completing injury and exposure paperwork places burdens on firefighters.
On a departmental level, nearly all leaders described barriers to collecting or analyzing data due to time, personnel or funding limitations. These challenges prevented departments from being able to understand injury trends and design prevention interventions.
Several leaders also believe there is a general apathy toward data in the fire service.
Both firefighters and leaders called for more data collection on exposures and mental health.
Leaders also called for additional health, fitness, biometric and DEI-related data, emphasizing the need for improved data linkages and software platforms. Firefighters and leaders emphasized the need for better data interpretation and communication.
Views on wearable data
Firefighters and leadership held divergent views about whether the benefits of wearables were valuable enough to justify the tradeoffs associated with wearable data. They did agree that exposure data from a wearable could be a tool for facilitating workers’ compensation. Leaders also viewed wearables as a powerful tool for advancing administrative priorities, prevention and, most importantly, ensuring safety on calls. Leaders strongly supported collecting biometric information in real time on a fireground to prevent cardiac events or maydays in an IDLH environment. However, most firefighters believed that wearables placed undue emphasis on the risks of their jobs, undermining their decision to join the profession. Several firefighters viewed wearables as a threat to their autonomy to make decisions on calls and believed wearable data could uncover underlying health risks that might result in punitive action or job loss.
Despite this disagreement, both firefighters and leaders identified some shared guidelines for how wearable data could be used in an ethical and acceptable way. These included preventing or limiting the collection of and access to identifiable data, using wearables in limited settings (e.g. training and research), making wearables voluntary or a pilot program, and providing firefighters with their own data. Firefighters and leaders also emphasized the need for strong communication about the purpose of a wearable program.
Implications
Based on the results, we developed six recommendations for how fire departments can respect firefighters’ data privacy preferences in their day-to-day activities or if they implement wearables.
1. Focus on collecting specific kinds of data
Firefighters and leadership strongly supported efforts to document exposures, especially fire-related exposures, to facilitate workers’ compensation claims. As such, departments should consider strategies for automating fire exposure documentation through their computer aided dispatch (CAD) systems or through software systems like NFORS/NERIS.
Several firefighters and leaders called for regular mental health evaluations, which could be used to assess fitness for duty and, if needed, help firefighters obtain services. However, our finding that mental health data is viewed as highly sensitive suggests that any efforts to collect mental health data should be undertaken with caution.
Department leaders also called for more and higher quality data on non-fatal injuries and fitness.
A small share of leaders discussed the need for data on the experiences of women and racial minorities in the fire service. For instance, departments could examine recruitment and retention trends to assess whether women or racial minorities have differential experiences in the recruitment pipeline. Departments could also examine health and safety outcomes such as whether female firefighters experience differential rates of certain kinds of injuries.
2. Restrict how health and safety information can be used
Firefighters and leaders emphasized that wearable data should only be used for health and safety purposes and should not be used in discriminatory or punitive ways. As such, departments should clearly communicate the use cases for health and safety data and prohibit using health and safety data in punitive ways.
3. Limit the sharing of and access to identifiable data within and outside of departments
Firefighters preferred limiting access to identifiable data, both for existing data collection efforts and future data collection. In some cases, leaders wanted access to identifiable information (e.g. using a biometric device on a fireground), but most favored deidentifying information for research or reporting purposes. Assuring firefighters that their information will only be shared with relevant personnel may help bolster confidence and trust in new data collection efforts. Departments should also ensure that deidentification is thorough, as firefighters pointed out that in small departments, information about fire station or years of experience could easily be used to identify someone.
4. Clearly communicate about and interpret data for firefighters
Firefighters were frustrated that they are often asked to provide data for annual physicals or research studies but may not understand the purpose of data collection, are not given their results or struggle to interpret the results they are given. Departments and researchers should commit to high-quality communication about the purpose of any data collection. If firefighters are asked to provide personal information (e.g., annual physical, providing specimens for a study, completing a department survey), they should receive a copy of their individual results along with explanation of the overall results.
5. Consider deploying new tech like wearables in limited fashion
If departments implement a wearable, they should consider making it optional, engaging with the union or other firefighter representatives, and communicating clearly about the purpose of the device. They should also honor the general privacy preferences described above, such as restricting use of wearable data only for health and safety purposes, limiting access to identifiable data and providing firefighters with their own data. These kinds of protections were supported by both firefighters and leadership in our study. While we found less consensus on using wearables in real time on calls, departments could start by using devices in limited settings such as training environments.
6. Take steps to improve data infrastructure
Nearly all departments described significant resource challenges that limit current data efforts. Departments could consider incorporating data collection or analysis into grant applications to the Assistance to Firefighters Grant Program, which funds priorities including the implementation of wellness and fitness priorities. On the local level, policymakers could allocate funds to strengthen their jurisdictions’ data capabilities. Although this will require additional funding, evidence suggests that prevention results in financial savings long term, and these investments might ultimately pay dividends.
References
- Grant, Casey, Hamins, Anthony, Bryner NP, Jones AW, Koepke GH. Research Roadmap for Smart Fire Fighting. National Institute of Standards and Technology; 2015:NIST SP 1191. doi:10.6028/NIST.SP.1191
- Amidon TR, Williams EA, Lipsey T, Callahan R, Nuckols G, Rice S. Sensors and gizmos and data, oh my: informating firefighters’ personal protective equipment. Commun Des Q. 2018;5(4):15-30.
- About the National Emergency Response Information System (NERIS). U.S. Fire Administration. May 9, 2023.
- Campbell R, Jay T. Petrillo. Fatal Firefighter Injuries in the US in 2022. NFPA. Published online June 2023.
- Campbell, Richard, Hall, Shelby. United States Firefighter Injuries in 2022. NFPA. 2025.
- Transforming Public Safety Operations Through Data. International Public Safety Data Institute.
- Assistance to Firefighters Grants. FEMA.gov. September 20, 2023.
- Butry DT, Webb D, Gilbert S, Taylor J. The Economics of Firefighter Injuries in the United States. Fire Protection Research Foundation; 2019.
- Bushnell PT, Pana-Cryan R, Howard J, Quay B, Ray TK. Measuring the benefits of occupational safety and health research with economic metrics: Insights from the National Institute for Occupational Safety and Health. Am J Ind Med. Published online March 15, 2022.
- Rachel J. Topazian, Aleksandra Wec, Joseph Ali, et al. The value of occupational health and safety data: Perceptions of current data practices in the fire service. Journal of Safety Research 94 (September 2025): 120-127.
ABOUT THE AUTHOR
Dr. Rachel Topazian is an assistant professor in the Division of General Internal Medicine in the University of Colorado School of Medicine and a core faculty member at the Center for Bioethics and Humanities. Her research focuses on the ethical and structural factors that facilitate or hinder occupational health, safety, and wellbeing, as well as the implications for practice and policy. Topazian received a PhD in Health and Public Policy from the Johns Hopkins Bloomberg School of Public Health. Her dissertation research, which was conducted with the Center for Firefighter Injury Research and Safety Trends (FIRST), examined views toward occupational health and safety data in the fire and rescue service, including preferences on the ethical implementation of wearables in the fire service.