In the aftermath of the bombing of the World Trade Center, the world developed a new admiration and respect of the dangerous – and sometimes deadly – occupation of fighting fires. It has been a popular myth that all firefighters answer to a stringent health-and-fitness standard. Though definitely called to do so, the truth is that for the most part we are average people doing an extraordinary, physically demanding task.
Totally by coincidence, on Sept. 12, 2001, Juan Plaza, an exercise physiologist, made an appointment to talk with me about a project he was proposing for his master’s degree in exercise physiology. His proposal was that he be allowed to do a six-month study of 11 of my paid staff members at Benton Fire District No. 4. The program, he told me, would be designed to enhance overall fitness, health and physical ability. It would include baseline data on each participant, including body composition, flexibility, muscle strength and endurance, along with aerobic capacity. In addition, participants would be tested for their vulnerability to stress. Four job-specific tasks would be used to measure ability and establish performance levels for the group as a whole.
On any given day, I would have been intrigued by his proposal. On this particular day, after watching 24 hours of heroism far beyond human endurance by my brother firefighters in New York City, I was totally sold, as was my entire department. We went forward with the program immediately.
Body composition was measured with underwater weighing and basic girth measurements. Flexibility was measured by the sit and reach method along with a test for body rotation. Muscle strength was measured by a maximum bench press along with a maximum leg press. Muscle endurance was measured by a maximum number of push-ups and a maximum number of sit-ups in one minute. Aerobic capacity was measured with a stress test and VO2 measurement.
The job-specific test included advancing a charged 1¾-inch hoseline at 150 psi in full turnouts and self-contained breathing apparatus (SCBA) for 90 feet, climbing a ladder at a 50-degree angle in full turnouts and SCBA, climbing a ladder at a 50-degree angle with 50 pounds of weight and climbing two flights of stairs in a training tower with 50 pounds of weight.
We became so enthusiastic about the program that the department enlisted the aid of registered dietitian Jean Andrews Doss. She taught the firefighters and their spouses the basics of good nutrition and how to enhance their physical performance through healthy eating. Each individual in the program was given chapters to read on basic nutrition and sports nutrition. Along with this, numerous pamphlets and handouts were provided. Topics discussed were the Diabetic Exchange List, food groups, fats, proteins, carbohydrates, supplements, chemicals, cholesterol, triglycerides, behavior modification and lifestyle change. The Food Guide Pyramid was explained, as were the principles of variety, proportionality and moderation in their individual diets.
Part of the nutrition program included throughout the six-month program was a three-day food recall. The food recalls were periodically evaluated and returned to the participants with suggestions from the dietitian. In the beginning, the group’s diet as a whole consisted of fried breads, fried meats and sweet drinks. Many of the diets were more than 50% fat calories rather than the 30% that is recommended. Few members of the group ate fruits or green vegetables, drank milk or consumed any calcium-rich foods. For those participants who were interested, Doss provided individual diet counseling. As the program progressed consistent changes were slow to occur.
An individual exercise program was designed for each firefighter. Their programs were divided into six four-week workout periods. The programs covered strength and endurance, along with cardiovascular exercise. Everyone hit their stride early, and their programs were running smooth as glass.
But then, seemingly out of nowhere, tragedy struck and our department became a statistic. A sickening statistic. One of our firefighters suffered cardiac arrest while fighting a structure fire. While his resuscitation was a success, it reinforced that cardiovascular disease is an occupational health hazard. This alone is a good reason for a proactive, aggressive health-and-fitness standard that needs developing for our industry. Doss used this incident to illustrate the importance of a heart-healthy diet, which ultimately produced better results. Those results were documented in the food diaries.
As our study ended it was visually apparent that the group had achieved impressive results – in other words, we not only felt better, we looked better. Another assessment was repeated and the results were remarkable. All of the participants, ranging from 20 to 48 years of age, had made significant improvement. Resting heart rate improved by 10%; body composition by 9%; muscle strength by 20%; muscle endurance by 31%; flexibility by 8%; and aerobic capacity by 14%. Additionally, the results of our vulnerability to stress showed a 20% improvement, meaning that our group was less likely to have adverse effects of critical incident stress.
While all our data showed healthier, fit employees, the most remarkable accomplishment was a 47% improvement in the job-specific test. Though we expected some results, these were far beyond our wildest dreams, and we have devised a maintenance program that will keep us up to speed. As a check and balance, annual testing will be administered on strength, body composition and flexibility.
Instead of relying on how fast someone can run a mile and a half once in a career, we will use VO2 measurements to annually monitor how effectively all employees can use oxygen while fighting a fire. Our standard will be a minimum VO2 of 40 for all male employees. Also, physical ability will be measured with all four job-specific testing requiring a satisfactory score of 60 seconds for all tasks as a term of employment.
The data we compiled has given us the necessary information to institute a mandatory health-and-fitness standard both for new hires and current employees. This increases the safety of the public we serve, along with their confidence in our abilities. Most important, however, is that the program has increased our confidence in our abilities – as individuals and as a team.
Our department’s goal is to continually strive to improve our fitness standards through healthy eating and exercise. We feel we have set the right course toward improving the level of lifesaving ability necessary for every firefighter to perform their duties. If we can offer any other information on our fitness initiative, please feel free to contact me at 318-965-9454 or [email protected].
Chief Concerns is a forum addressing issues of interest to chief fire officers. Opinions expressed are those of the writer. We invite all volunteer and career chief fire officers to share their concerns, experiences and views in this column. Please submit articles to Chief Concerns, Firehouse Magazine, 445 Broad Hollow Road, Melville, NY 11747. Heart Attack Leading Cause Of Death For FirefightersThe U.S. Fire Administration (USFA) has released a comprehensive study which examines the causes of deaths for “on-duty” firefighters. The USFA Firefighter Fatality Retrospective Study: 1990-2000 is an in-depth analysis as to the causes for more than 1,000 on-duty deaths which occurred in the United States during the last decade of the 20th century. The goal of the study is to identify trends in firefighter mortality and use the information to help reduce firefighter deaths by 25% in five years.
The key findings of the study include:
- The leading cause of death for firefighters is heart attack (44%). Death from trauma, including internal and head injuries, is the second-leading cause of death (27%). Asphyxia and burns account for 20% of firefighter fatalities.
- Each year in the United States, approximately 100 firefighters are killed while on duty and tens of thousands are injured. Although the number of firefighter fatalities has steadily decreased over the past 20 years, the incidence of firefighter fatalities per 100,000 incidents has actually risen over the past five years, with 1999 having the highest rate of firefighter fatalities per 100,000 incidents since 1978.
- Firefighters under the age of 35 are more likely to be killed by traumatic injuries than they are to die from medical causes (e.g., heart attack or stroke). After age 35, the proportion of deaths due to traumatic injuries decreases, and the proportion of deaths due to medical causes rises steadily.
- Since 1984, motor vehicle collisions (MVCs) have accounted for between 20% and 25% of all firefighter fatalities, annually. One quarter of the firefighters who died in MVCs were killed in personally owned vehicles (POVs). Following POVs, the apparatus most often involved in fatal collisions were water tankers, engines/pumpers and airplanes. More firefighters are killed in tanker accidents than in engines and ladders combined.
- About 27% of fatalities in MVCs involved firefighters being ejected from the vehicle at the time of the collision. Only 21% of firefighters were reportedly wearing their seatbelts prior to the collision.
- Approximately 60% of all firefighter fatalities were individuals over the age of 40, and one-third were over 50. Nationwide, firefighters over 40 make up 46% of the fire service, with those over 50 accounting for only 16% of firefighters. About 40% of volunteer firefighters are over the age of 50, compared to 25% of career firefighters.
- The majority of firefighter fatalities (57%) involved members of local or municipal volunteer fire agencies, including combination departments. Full-time career firefighters account for 33% of firefighter fatalities. Numerically more volunteer firefighters are killed than career personnel, yet career personnel lose their lives at a rate disproportionate to their representation in the fire service.
- In many fire departments, EMS calls account for between 50% and 80% of their emergency call volume. These EMS incidents result in only 3% of firefighter fatalities. Trauma (internal/head) accounts for the deaths of 50% of firefighters who were involved in EMS operations at the time of their fatal injury. Another 38% involved in EMS operations died from heart attack.
For the past 25 years, the USFA has tracked the number of firefighter fatalities and conducted an annual analysis. Through the collection of this information on the causes of firefighter deaths, the USFA is able to focus on specific problems and direct national efforts to finding solutions for the reduction of firefighter fatalities in the future. The information in this study is also used to measure the effectiveness of current programs directed toward firefighter health and safety. One of the USFA main program goals is a 25% reduction in firefighter fatalities in five years and a 50% reduction within 10 years.
The complete report may be viewed and downloaded from the USFA website. The USFA is a part of the Federal Emergency Management Agency (FEMA).
J.T. Wallace is chief of Benton Fire District No. 4 in Benton, LA. Previously, he served 26 years with the Bossier City, LA, Fire Department, the last eight as chief. Wallace is the vice chairman of the Louisiana Highway Safety Commission and serves on numerous statewide boards for fire and emergency medical services. He has lectured statewide and regionally on emergency service issues.
