Michael J. Conner

Objective: Examine the effects of transitioning from a 24/48 to a 48/96 shift schedule on health and performance in firefighters assigned to a single, suburban station. Methods: A longitudinal analysis was conducted over 3 time points in 11 male firefighters. Measures included VO _{2 peak} , peak power, blood pressure, resting heart rate, lipid profiles, and psychological assessments. Linear mixed-effects models analyzed changes across time points. Results: Transitioning to the 48/96 schedule was associated with improvements in peak power (+27.1 W, P = 0.042), resting blood pressure (SBP −5.5 mm Hg, P = 0.05, DBP −5.8 mm Hg, P = 0.04), heart rate (−13.2 bpm, P = 0.03), sleep quality (ISI −2.6, P = 0.03), and alcohol use (AUDIT −1.8, P = 0.02); VO _2peak did not reveal a significant time effect ( P > 0.05). Conclusions: Extended intershift recovery in a 48/96 schedule may promote cardiovascular recovery and readiness without negative health effects in similar departments.

Background: Age is considered an independent cardiovascular disease (CVD) risk factor, but limited data exist concerning the impact of age and years in the fire service on firefighter health and physical performance. Objectives: We assessed the impact of age and years in the fire service on structural firefighter health and physical performance. Methods: 142 firefighters completed an annual clinical assessment. General linear model (GLM) multivariate and univariate analyses were performed across age groups, with years of fire service experience as a covariate. Partial Eta squared (η_p²) values for the GLM statics and Cohen’s d for pairwise comparisons were used to assess effect size. Results: GLM analyses revealed statistically significant differences (p < 0.05) for several demographic, body composition, blood biomarker, and physical performance parameters. Pairwise comparisons revealed that younger firefighters displayed more favorable health and fitness profiles than their older counterparts. Interestingly, when accounting for years of fire service experience, differences for only the following variables remained: body mass index, waist circumference, lean mass, visceral adipose tissue, triglycerides, cardiopulmonary exercise test time-to-exhaustion, and VO₂max. Conclusions: These findings suggest differences in CVD risk biomarkers, physical fitness levels, and body composition metrics across age groups. However, years of fire service experience appears to have a greater impact on these variables, suggesting that firefighters’ time in the fire service may accelerate the effects of aging on these outcomes. While age-specific health interventions are recommended to manage and mitigate CVD risk effectively, there also should be consideration for the years of fire service.

Objective: This analysis establishes reference values for health and performance indicators in a large sample of US firefighters. Methods: Data from 3867 firefighters (3651 males and 216 females) were analyzed to establish percentiles for anthropometrics, body composition, graded exercise, hemodynamics, and pulmonary function. Results: The median characteristics of all male firefighters included: age, 38 years; body mass index, 29.2 kg/m²; body fat percentage, 24%; and VO₂max 32 mL/kg/min. The median characteristics of all female firefighters included: age, 33 years; body mass index, 25.7 kg/m²; body fat percentage, 29%; and VO₂max, 31 mL/kg/min. Reference values stratified by decade of age were also established. Conclusions: The presented values can be used to contextualize the performance of individual firefighters and fire departments and to promote evidence-based discussions regarding physical evaluations and standards for occupational readiness.

Background: Alcohol misuse is prevalent among firefighters, and associated adverse cardiometabolic health consequences could negatively impact readiness for duty. Mental health conditions may confer additional risk. Therefore, we aimed to determine whether alcohol misuse increases cardiometabolic risk among firefighters and whether mental health conditions modify these relationships.Methods: Deidentified data from firefighters (N = 2405; 95.8% males, 38 ± 9 years, 29.6 ± 4.6 kg/m²) included demographics, Alcohol Use Disorders Identification Test (AUDIT) and AUDIT‐C scores, mental health screening scores, anthropometrics, metabolic panel, and cardiorespiratory testing results. Differences in cardiometabolic parameters between firefighters with low AUDIT‐C (p < 0.05) higher total cholesterol (TC), high‐density lipoprotein (HDL‐C), and systolic blood pressure (SBP) and diastolic blood pressure (DBP) and lower hemoglobin A1C (HbA1c) than those with low AUDIT‐C. In unadjusted and/or adjusted analyses, those with high AUDIT‐C had increased risk for overweight/obesity, hypercholesterolemia, and prehypertension/hypertension, and decreased risk for low HDL and elevated HbA1c. There were inverse moderation effects by posttraumatic stress disorder (PTSD), depression, and anxiety on relationships between AUDIT‐C score and BP. Insomnia (directly) and anxiety (inversely) moderated relationships between AUDIT‐C score and circulating lipids.Conclusions: Firefighters with high AUDIT‐C have differential cardiometabolic risk, with specific relationships altered by mental health status. Whether higher HDL and lower HbA1c with high AUDIT‐C in firefighters is protective long‐term remains to be explored. Overall, these results underscore the need for alcohol screening and intervention to maintain cardiometabolic health and long‐term occupational readiness among firefighters.

The National Fire Protection Association (NFPA) sets operational standards for fire departments, including criteria for evaluating firefighters’ readiness and fit for duty status. The recently revised NFPA 1580 standard replaces absolute aerobic capacity threshold with the American College of Sports Medicine’s general population, percentile-based classification system. The purpose of this study was to compare classification outcomes between the previous NFPA 1582 and the revised NFPA 1580 to examine whether age, sex, or body mass index (BMI) were associated with differing fit for duty status’ by age classifications. Retrospective data were analyzed from 6009 career firefighters (366 females). Aerobic capacity was directly assessed via a cycling-based protocol. Participants were classified under the previous NFPA 1582 and the revised NFPA 1580 standards. Ordinal logistic regression models estimated the odds of being categorized into a restricted duty classification (RDC), using age, BMI, and sex as predictors. Odds ratios with 95% confidence intervals were calculated. Under the previous NFPA 1582, increased age, higher BMI, and being female were associated with lower odds of being classified as fit for duty. Under the revised NFPA 1580, older age groups, especially those aged 60–69 years, were ∼38× more likely (OR = 37.48) to be classified as fit for duty, despite lower aerobic capacity. RDC likelihood increased among younger, male firefighters. The transition to a percentile-based framework may misalign fit for duty classification with unchanging job demands and compromise occupational safety. Future standards should prioritize task-based validations to ensure occupational readiness reflect the actual physiological demands of firefighting.

The fire service suffers from high rates of cardiovascular disease and poor overall health, and firefighters often suffer fatal and non-fatal injuries while on the job. Most fatal injuries result from sudden cardiac death, while non-fatal injuries are to the musculoskeletal system. Previous works suggest a mechanistic link between several health and performance variables and injury risk. In addition, studies have suggested physical activity and nutrition can improve overall health and occupational performance. This review offers practical applications for exercise via feasible training modalities as well as nutritional recommendations that can positively impact performance on the job. Time-efficient training modalities like high-intensity interval training and feasible modalities such as resistance training offer numerous benefits for firefighters. Also, modifying and supplementing the diet and can be advantageous for health and body composition in the fire service. Firefighters have various schedules, making it difficult for planned exercise and eating while on shift. The practical training and nutritional aspects discussed in this review can be implemented on-shift to improve the overall health and performance in firefighters.

The fire service command structure encompasses recruit, incumbent firefighter, and officer positions. The purpose of this study was to quantify the effect of rank (recruits, incumbent firefighters, and officers) on health and physical ability characteristics within the fire service. Retrospective data from thirty-seven recruits (age = 29 ± 5 yrs, BMI = 26.5 ± 2.3 kg/m²); eighty-two incumbent firefighters (age = 30 ± 7 yrs, BMI = 28.8 ± 4.3 kg/m²); and forty-one officers (age = 41 ± 6 yrs, BMI = 28.6 ± 4.3 kg/m²) from a single department were used. Participants completed body composition tests (i.e., body fat percentage [%BF] and body mass index [BMI]), an air consumption test (ACT), and cardiopulmonary exercise testing. The ACT consisted of 10 standardized tasks. Five separate one-way analyses of co-variance (ANCOVA) were calculated, accounting for age. Partial eta squared statistics were calculated and Bonferroni-corrected post-hoc analyses were employed. The results demonstrated a significant effect of rank on %BF (F = 9.61, p < 0.001, η² = 0.10); BMI (F = 3.45, p = 0.02, η² = 0.05); relative VO_2MAX (F = 12.52, p < 0.001; η² = 0.11); and HR_MAX (F = 18.89, p < 0.001, η² = 0.03), but not on ACT time (F = 0.71, p = 0.55, η² = 0.01). These outcomes suggest there are variations in anthropometric and physiological metrics of health across firefighter ranks. Administrators should be aware how these markers of health may vary across firefighter ranks.