And, like space travelers, emergency services personnel require specific medical screenings and preventative care.
Students attending courses at the National Fire Academy and National Emergency Training Center in Emmitsburg heard that message Monday morning from Dr. Don Stewart, former medical director of NASA's shuttle program.
The USFA sponsored the 8 a.m. lecture to kick off the annual Firefighter/EMS Safety, Health and Survival Week. Attendees were provided with fact sheets containing information about measures the USFA has undertaken to promote the issues.
Stewart, who switched from astronauts to public safety providers 14 years ago, said he enjoys the culture and cohesiveness.
He founded and is president of Medocracy Inc., a corporation that provides physicals and medical care for public safety officials in Fairfax County, Va., and Montgomery County, Md.
Acting U.S. Fire Administrator Glenn Gaines told crowd of students and staff that as fire chief in Fairfax County, Va., he hated having to present flags to the families of fallen firefighters.
"I think I handed out 18 flags to widows and families of firefighters who were dying way too early. Some had died of cancer, heart issues, infectious diseases. I thought enough was enough. We had to do something."
Gaines said it took a lot of work by many including the local IAFF union to sell the idea to county officials. But, after an independent review by a number of business groups, they agreed that a private health and wellness facility would be best for public safety workers -- police, sheriff's deputies, firefighters and EMS personnel.
The local health department employees had been doing physicals, and were known to misdiagnose. Cancers were missed, and it was clear they were overwhelmed by the additional duties. Lab work also was questionable.
Stewart said it was a field they weren't familiar with.
One thing that jumped out at him from the onset was the lack of patient confidentiality. Medical records were literally shared with anyone such as the firefighter's supervisor.
That was one of the first things he addressed. "Confidentiality is so important," he said, adding that it helped gain trust.
Stewart told the crowd that like astronauts, those in the public safety profession have to be totally fit for duty. The job requires everyone to be at the top of their game at all times -- both emotionally as well as physically.
"This is a demanding profession," he said adding that firefighting is typically listed as one of the most dangerous in the country.
Stewart pointed out that regular screenings have resulted in a number of findings. "In a 60 day period, we diagnosed six cases of prostrate cancer."
He said prostrate cancer along with multiple myeloma and non-Hogkins lymphnoma are the most common in responders.
In addition, his staff has found 243 patients with high blood pressure, 43 with diabetes, 59 with high cholesterol and 20 with cancer.
Other issues uncovered include hepatitis C, thyroid problems, multiple sclerosis and PTSD.
Stewart said it took time, but he's pleased with the tremendous rapport developed. "This is a highly networked culture. I feel honored to be part of the team. I have high praise for what they do."
The mindset of public safety workers makes them great patients as well. His staff is not there to keep people from going back to answering alarms or the next call for help. The staff includes physical therapists and psychological counselors.
People with stints, hip replacements and other maladies have returned to duty.
"But, we are not their primary care provider. We work closely with them, however."
Stewart said he is proud of the relationships that have evolved. "I really admire their work, and we are honored to do our share to make sure they are medically and emotionally ready."