Physiological Status Monitoring for Firefighters

Over the past decade, the number of firefighter on-duty deaths has remained persistently high (about 100) despite significant improvements in personal protective equipment (PPE). Providing better gear, although critically important, has had the unintended...


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Over the past decade, the number of firefighter on-duty deaths has remained persistently high (about 100) despite significant improvements in personal protective equipment (PPE). Providing better gear, although critically important, has had the unintended consequence of letting firefighters go in deeper and for longer periods, which exposes them to even more risk.

To reduce firefighter fatalities, we have to look at the causes of on-duty deaths. The single largest cause resulting in nearly half (45%) of all deaths, according to the U.S. Fire Administration (USFA)1, is stress and overexertion. Physiological Status Monitoring (PSM) holds out the promise of identifying when a firefighter is in high- risk physiological stress before he becomes a fatality.

Firefighters face a unique set of risk factors that are all associated with stress and overexertion. Among these, as cited by a study conducted by the Orange County, CA, Fire Authority2, are:

  • Sudden nervous system surges caused by unexpected alarms
  • Rapid shifts from low to high levels of exertion
  • Carrying, lifting and wearing heavy protective gear and equipment
  • Prolonged exposure to high temperatures
  • Excessive fluid loss

And in firefighting, all of these risk factors are often present together.

When you break down the risk to a firefighter of a fatal cardiovascular event by activity, according to the New England Journal of Medicine3, you can readily see a pattern:

  • 32% during fire suppression
  • 17% returning from an alarm
  • 13% responding to an alarm
  • 9% non-fire emergencies
  • 13% physical training
  • 15% non-emergency duties

Although responding, engaging and returning from an emergency takes a relatively small portion of the total time a firefighter is on duty, it makes up over two-thirds of all on-duty fatalities.

When you factor in the time spent in each activity, the odds of a fatal on-duty cardiac event is 10 to 100 times greater during fire suppression than non-emergency duty, two times greater than for police officers and three times greater overall than all workers4. It's no wonder that the International Association of Fire Fighters (IAFF), International Association of Fire Chiefs (IAFC) and National Volunteer Fire Council (NVFC) are all strong advocates for health, wellness and fitness programs for firefighters.

In addition, The National Fire Service Research Agenda Symposium5 identified several aspects of firefighter health, wellness and fitness issues that need the highest priority for further research and action, including candidate selection and assessment, health maintenance, identifying risk factors for cardiovascular disease, physiological effects of heat stress and incident response, and functional capacity evaluation. Physiological Status Monitoring is a tool that can be utilized in all of these areas. Clearly, the fire service has recognized the problem and is aggressively looking for solutions.

Innovative Technology

Most active people today are aware of heart-rate monitors that are used by runners and for fitness workouts. The object is to monitor your heart rate, allowing you to spend as much time as possible in a heart rate "zone" that is typically a percentage of your maximum predicted heart rate based on age. These normally strap-based systems communicate through short-range signals to a watch-like device to monitor your workout. These systems are a rudimentary version of Physiological Status Monitoring, but they aren't sufficient to meet the needs of the fire service.

A new and more technically advanced PSM system is now being developed by a team led by Globe and Foster-Miller for use by the military and the fire service. It embeds a built-in sensor system into a moisture-wicking and fire-resistant T-shirt that would replace the cotton T-shirts worn today by almost every firefighter. These sensors measure heart rate, respiration rate, skin temperature, activity level and posture. This data is collected and transmitted in real-time as packets of information out to a tiny receiver plugged into a laptop computer. If the system detects a potentially dangerous condition, it can alert the individual and the incident commander to pay attention before it's too late. And it can record this data for post-activity analysis if the need arises.

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