Health, Safety, and Readiness of Tactical Populations

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 28194

Special Issue Editors


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Guest Editor
Sports Medicine Research Institute, University of Kentucky, Lexington, KY, USA
Interests: military performance and injury prevention; rehabilitation and return to duty; neuromuscular control and biomechanics

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Guest Editor
Department of Exercise and Nutrition Montevallo, University of Montevallo, Montevallo, AL, USA
Interests: first responder readiness; health and safety of first responders; validation of occupational assessments
First Responder Research Laboratory, University of Kentucky, Lexington, KY 40506-0219, USA
Interests: firefighter; first responder; health; injury; law enforcement; military; operator; safety; tactical
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Special Issue Information

Dear Colleagues,

Tactical populations include first responders (firefighters, law enforcement officers, EMS personnel, etc.) and military personnel that have committed to protect life and property. Many of these occupations require the performance of arduous physical tasks in austere environments. As such, musculoskeletal injuries, psychological (e.g., PTSD) and physical morbidities (e.g., cancer, cardiovascular disease, obesity), and decreased physical fitness occur across the career span. We are pleased to invite you to provide researchers, administrators, and practitioners with empirical research to elucidate these occupational threats, identify risk factors and mechanisms associated with their occurrence, and provide evidence-based practices to address them in tactical populations. 

In this Special Issue, original research articles and reviews are welcome. Research aims and study designs on tactical populations may include (but not limited to) the following:

  • Elucidate and evaluate critical (mental and physical) health, injury, and performance issues confronting tactical populations;
  • Quantitative and qualitative investigations to identify risk factors and mechanisms of injuries;
  • Longitudinal assessments of interventions to enhance health, injury, fitness and occupational performance outcomes to develop evidence-based practices;
  • Cross-sectional designs to evaluate the role of physical fitness and occupational readiness in health and injury outcomes;
  • Validation research to develop relevant assessments of occupational physical ability and technologies to support operator readiness in recruit and incumbent populations and to guide return to duty post-injury;
  • Evaluate the impact of allostatic load (physical and psychological stressors) on occupational readiness, health, and injury outcomes.

We look forward to receiving your contributions.

Dr. Nicholas R. Heebner
Dr. Emily Lynn Langford
Prof. Dr. Mark Abel
Guest Editors

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Keywords

  • first responder
  • firefighter
  • law enforcement
  • military
  • tactical
  • health
  • safety
  • injury

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Published Papers (13 papers)

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Research

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11 pages, 252 KiB  
Article
Etiology of Exercise Injuries in Firefighters: A Healthcare Practitioners’ Perspective
by Alyssa Q. Eastman, Beth Rous, Emily L. Langford, Anne Louise Tatro, Nicholas R. Heebner, Phillip A. Gribble, Rosie Lanphere and Mark G. Abel
Healthcare 2023, 11(22), 2989; https://doi.org/10.3390/healthcare11222989 - 19 Nov 2023
Viewed by 1360
Abstract
The purpose of this study was to query healthcare practitioners (HCPs) who treat firefighter injuries to identify risk factors and mechanisms associated with musculoskeletal injuries during exercise. A phenomenological design was utilized to understand the experiences of HCPs while treating firefighters’ musculoskeletal injuries [...] Read more.
The purpose of this study was to query healthcare practitioners (HCPs) who treat firefighter injuries to identify risk factors and mechanisms associated with musculoskeletal injuries during exercise. A phenomenological design was utilized to understand the experiences of HCPs while treating firefighters’ musculoskeletal injuries due to exercise. Semi-structured interviews were conducted with 14 HCPs. Two interviews were pilot-tested with HCPs to ensure reliability and validity. Interviews were transcribed and uploaded to a qualitative analysis software program. Although the study inquired about injuries incurred by any exercise modality (e.g., endurance and resistance training), injuries induced during resistance training were prominent among HCPs as resistance training emerged as a primary exercise injury mechanism. HCPs indicated that the back and shoulder were prevalent anatomical exercise injury locations. Risk factors for exercise injuries included age, immobility, movement proficiency, and factors associated with fatigue. Exercise injury mechanisms included poor resistance training technique and overexertion. These findings could guide exercise program design, use of movement assessments, and the identification of other countermeasures to decrease the risk of resistance training exercise injuries among firefighters. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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19 pages, 2807 KiB  
Article
Four-Year Training Course for Police Officers (CFOP) and Fitness Outcomes of Police Academy Cadets: A Cohort Study from 2004 to 2020
by Luís Miguel Massuça, Luís Monteiro, Gabriel Coutinho and Vanessa Santos
Healthcare 2023, 11(21), 2901; https://doi.org/10.3390/healthcare11212901 - 3 Nov 2023
Cited by 3 | Viewed by 1877
Abstract
This study examines the effect of gender, age, and a 4-year training course for police officers (CFOP) on the physical fitness attributes of Portuguese police academy cadets. This longitudinal cohort study considered 686 police cadets (female, n = 131; male, n = 555 [...] Read more.
This study examines the effect of gender, age, and a 4-year training course for police officers (CFOP) on the physical fitness attributes of Portuguese police academy cadets. This longitudinal cohort study considered 686 police cadets (female, n = 131; male, n = 555 male), corresponding to 2578 fitness assessments (female, n = 509; male, n = 2069). The database of police cadets’ physical fitness evaluations (from 2004/2005 to 2019/2020) comprises body size, speed, agility, strength, flexibility, and aerobic capacity first assessment (T0) and evaluations at the end of the first four years of the CFOP (T1, T2, T3, T4). Results showed that (i) female cadets are younger (p < 0.05), shorter, lighter, less fast, less agile, less strong, and perform worse in aerobic capacity assessments than male cadets (all, p < 0.001) but perform better in the flexibility assessment (p < 0.001); (ii) female cadets > 29 years are significantly heavier, slower, jump less, perform fewer sit-ups, and perform less on the Cooper test (but they have more handgrip strength), and male cadets > 29 years are significantly heavier, slower, jump less, perform fewer sit-ups, and have less flexibility and aerobic capacity (still, they have superior back and lumbar strength and handgrip strength); and (iii) from T0 to T4 (Δ), female cadets are significantly faster (60 m, −0.32 s; slalom, −0.78 s), jump further (+4 cm), have more abdominal strength endurance (+2.6 repetitions) and more back and lumbar strength (+89.8 kg), and male cadets are significantly heavier (+3.27 kg), faster (60 m, −0.23 s; 30 m, −0.15 s; slalom, −0.91 s), jump further (+8 cm), complete more repetitions in the sit-ups (+4.9 repetitions) and in pull-ups (+2.5 repetitions) and have more back and lumbar strength (+92.1 kg) and handgrip strength (+8.6 kg) but a lower aerobic capacity (Cooper test, −74.8 m; VO2max, −1.3 mL/kg/min) when compared to T0. The study’s findings lead to widely accepted conclusions within the discipline. Nevertheless, this work provides valuable insights into the impact of various factors on the physical fitness of Portuguese police academy cadets, i.e.: (i) it is an essential study with practical implications for recruitment, training, and the ongoing development of Portuguese police academy cadets and police officers; and (ii) these results can also assist in tailoring training programs to different age groups and genders, which is crucial in police training. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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15 pages, 2265 KiB  
Article
Effects of 12-Month Training Intervention on Physical Fitness, Body Composition, and Health Markers in Finnish Navy Soldiers
by Mikko Myllylä, Kai I. Parkkola, Tommi Ojanen, Olli J. Heinonen, Juha-Petri Ruohola, Tero Vahlberg and Heikki Kyröläinen
Healthcare 2023, 11(19), 2698; https://doi.org/10.3390/healthcare11192698 - 9 Oct 2023
Viewed by 1289
Abstract
Background: Most Western adults do not meet the recommendations for sufficient activity, and obesity is a global problem. Similar trends are also seen among Western military personnel. Many successful physical training interventions have been carried out in military environments, but the interventions have [...] Read more.
Background: Most Western adults do not meet the recommendations for sufficient activity, and obesity is a global problem. Similar trends are also seen among Western military personnel. Many successful physical training interventions have been carried out in military environments, but the interventions have been quite short term, and the training has been supervised. Therefore, the aim of this study was to investigate the effects of a 12-month voluntary motivational training intervention among the Finnish Defence Forces’ (FDF) Navy soldiers. Methods: In total, 77 FDF Navy soldiers, serving in missile patrol boats, took part in the study. The intervention group (IG) contained 45 participants and the control group (CG) contained 32 participants. The IG was divided into four teams that carried out the intervention, while the CG took part in only the measurements. Results: Most of the participants (65%) in the IG reported that they had increased their exercise volume during the intervention, but no major beneficial impacts on the physical fitness, body composition, or health markers were observed. Nevertheless, there was a clear diversity visible between the subgroups in the IG. The team that reported the most exercise had the best motivation and the most motivated team coach and also had the most improved physical fitness and body composition results. Conclusions: The present study points out that in military environments, long-term voluntary training interventions may not be as successful as short-term supervised interventions. The results also suggest that in voluntary training interventions among military personnel, the participants’ motivation to exercise is a key factor when improving physical fitness. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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12 pages, 522 KiB  
Article
Heart Rate Variability Assessment of Land Navigation and Load Carriage Activities in Specialist Police Selection
by Colin D. Tomes, Elisa F. D. Canetti, Ben Schram and Robin Orr
Healthcare 2023, 11(19), 2677; https://doi.org/10.3390/healthcare11192677 - 3 Oct 2023
Viewed by 1254
Abstract
Police tactical group (PTG) personnel are exposed to physical, mental, and emotional stressors. Consequently, PTG selection courses (SCs) impart similar challenges, often resulting in candidate attrition. Holistic assessment may provide additional support to stakeholders given these risks. Heart Rate Variability (HRV) is an [...] Read more.
Police tactical group (PTG) personnel are exposed to physical, mental, and emotional stressors. Consequently, PTG selection courses (SCs) impart similar challenges, often resulting in candidate attrition. Holistic assessment may provide additional support to stakeholders given these risks. Heart Rate Variability (HRV) is an objective holistic stress measure that may be applicable in PTG SCs but has not been thoroughly researched. Therefore, this study aimed to report HRV data in an end-user accessible format and determine the relationship between HRV and attrition. A total of 18 qualified Australian State law enforcement officers completed a 1-day physical readiness assessment. Of those, six males progressed to an additional two-day course, on which this study is focused. This two-day selection consisted of additional physical challenges and occupational assessments. HRV was obtained from 2-lead ECGs and defined as the percentage of R-R intervals that varied by ≥50 ms (pRR50). Data were summarized in a heat map of consecutive short-term analyses. Three candidates withdrew. A logistic regression based on heat map data found high HRV was significant for predicting attrition, χ2 (6) = 8.318, p = 0.004. HRV may provide insight for PTG stakeholders monitoring attrition. While the sample size was limited and replication is needed, this study tentatively establishes value for HRV monitoring in PTG SCs. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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12 pages, 688 KiB  
Article
Prevalence of Reproductive Health Issues among US Female Law Enforcement Officers
by Ainslie Kehler, Sara Jahnke, Filip Kukić, Aspen E. Streetman and Katie M. Heinrich
Healthcare 2023, 11(19), 2647; https://doi.org/10.3390/healthcare11192647 - 28 Sep 2023
Viewed by 1192
Abstract
Reproductive health is a considerable concern among US female law enforcement officers (LEOs). Miscarriage and preterm birth rates are significantly higher in women firefighters than published US averages. Since law enforcement and firefighting share occupational conditions and practices, adverse birth outcomes were hypothesized [...] Read more.
Reproductive health is a considerable concern among US female law enforcement officers (LEOs). Miscarriage and preterm birth rates are significantly higher in women firefighters than published US averages. Since law enforcement and firefighting share occupational conditions and practices, adverse birth outcomes were hypothesized to be greater in female law enforcement officers (LEOs) than the US averages. Occupational hazards may place pregnant LEOs at a higher risk for complicated pregnancies and adverse birth outcomes. This study quantified pregnancy outcomes in female LEOs using a cross-sectional survey and compared them to US averages and large prospective studies. The participants (N = 162, 72.2% aged 31–49, 85.2% Caucasian) averaged 2.5 ± 1.4 pregnancies. Stress (59.1%) and shiftwork (59.8%) were the most common reported exposures. Miscarriage and preterm birth rates were 19.1% and 16.4%, respectively. Miscarriages were significantly greater among participants compared to prospective studies [χ2 (1, N = 911,971) = 20.51, p < 0.001]. Female LEOs of childbearing age should receive education about potential reproductive health hazards and take precautions against them. Moreover, policymakers, human resources, and healthcare providers should understand how law enforcement work might affect maternal health. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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12 pages, 1749 KiB  
Article
Slow Breathing Reduces Biomarkers of Stress in Response to a Virtual Reality Active Shooter Training Drill
by Courtney C. Dillard, Hunter Martaindale, Stacy D. Hunter and Matthew J. McAllister
Healthcare 2023, 11(16), 2351; https://doi.org/10.3390/healthcare11162351 - 21 Aug 2023
Cited by 2 | Viewed by 1413
Abstract
Tactical occupations regularly encounter life-threatening situations while on duty. Although these occupations are often trained to utilize slow breathing (SB) during intense stress, there is no evidence supporting the effects on markers of stress in response to a virtual reality active shooter training [...] Read more.
Tactical occupations regularly encounter life-threatening situations while on duty. Although these occupations are often trained to utilize slow breathing (SB) during intense stress, there is no evidence supporting the effects on markers of stress in response to a virtual reality active shooter training drill (VR-ASD). The purpose of the study was to determine the impact of acute SB on biomarkers of stress in response to a VR-ASD. Seventy-nine (n = 79) subjects performed either slow breathing method 1 (SB1), slow breathing method 2 (SB2), or normal breathing (control) for five minutes, both pre- and post-VR-ASD. Saliva samples were analyzed for stress markers, including α-amylase (sAA) and secretory immunoglobulin-A (SIgA). Both methods of SB resulted in significantly lower sAA concentrations at 5 (p < 0.001) and 30 min post-VR-ASD (SB1: p = 0.008; SB2: p < 0.001) compared to the control. In the control condition, the sAA concentrations were significantly elevated 5 min post-VR-ASD (p < 0.001) but did not change across time in SB1 or SB2 (p > 0.05). Thus, both SB1 and SB2 reduced the sAA response and resulted in lower concentrations post-VR-ASD. This study was pre-registered as a clinical trial (“Impact of Breathing Interventions on Stress Markers”; NCT05825846). Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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13 pages, 1307 KiB  
Article
Musculoskeletal Injury Risk Stratification: A Traffic Light System for Military Service Members
by Megan H. Roach, Matthew B. Bird, Matthew S. Helton and Timothy C. Mauntel
Healthcare 2023, 11(12), 1675; https://doi.org/10.3390/healthcare11121675 - 7 Jun 2023
Cited by 2 | Viewed by 1509
Abstract
Risk factor identification is a critical first step in informing musculoskeletal injury (MSKI) risk mitigation strategies. This investigation aimed to determine if a self-reported MSKI risk assessment can accurately identify military service members at greater MSKI risk and determine whether a traffic light [...] Read more.
Risk factor identification is a critical first step in informing musculoskeletal injury (MSKI) risk mitigation strategies. This investigation aimed to determine if a self-reported MSKI risk assessment can accurately identify military service members at greater MSKI risk and determine whether a traffic light model can differentiate service members’ MSKI risks. A retrospective cohort study was conducted using existing self-reported MSKI risk assessment data and MSKI data from the Military Health System. A total of 2520 military service members (2219 males: age 23.49 ± 5.17 y, BMI 25.11 ± 2.94 kg/m2; and 301 females: age 24.23 ± 5.85 y, BMI 25.59 ± 3.20 kg/m2, respectively) completed the MSKI risk assessment during in-processing. The risk assessment consisted of 16 self-report items regarding demographics, general health, physical fitness, and pain experienced during movement screens. These 16 data points were converted to 11 variables of interest. For each variable, service members were dichotomized as at risk or not at risk. Nine of the 11 variables were associated with a greater MSKI risk and were thus considered as risk factors for the traffic light model. Each traffic light model included three color codes (i.e., green, amber, and red) to designate risk (i.e., low, moderate, and high). Four traffic light models were generated to examine the risk and overall precision of different cut-off values for the amber and red categories. In all four models, service members categorized as amber [hazard ratio (HR) = 1.38–1.70] or red (HR = 2.67–5.82) were at a greater MSKI risk. The traffic light model may help prioritize service members who require individualized orthopedic care and MSKI risk mitigation plans. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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22 pages, 2132 KiB  
Article
The Relationship between Psychological Hardiness and Military Performance by Reservists: A Moderation Effect of Perceived Stress and Resilience
by Svajone Bekesiene, Rasa Smaliukienė and Rosita Kanapeckaitė
Healthcare 2023, 11(9), 1224; https://doi.org/10.3390/healthcare11091224 - 25 Apr 2023
Cited by 6 | Viewed by 2903
Abstract
The purpose of this study is to evaluate the effect of hardiness on the perceived military performance of reservists, i.e., young people who have full-time jobs in a civilian sector and perform military training as a part of their civic duty. We proposed [...] Read more.
The purpose of this study is to evaluate the effect of hardiness on the perceived military performance of reservists, i.e., young people who have full-time jobs in a civilian sector and perform military training as a part of their civic duty. We proposed the conceptual model with conditional indirect effects of the hardiness on personal military performance, where mediated moderation effects are observed from personality traits and variables important for military service: team cohesion, perceived stress, and psychological resilience. The final dataset was comprised of 384 self-reported paper–pencil questionnaires filled out by reserve soldiers, and PROCESS Macro 3.5 Model 7 and Model 14 were used for the analysis. The results revealed that perceived stress (Model 1) and psychological resilience (Model 2) have a statistically significant moderate mediating effect on the interlink between hardiness and performance when personality traits and team cohesion are taken into consideration. The change in R2 is statistically significant and explains how perceived stress and psychological resilience affect individuals. When psychological hardiness is low, the level of perceived stress has a statistically significant moderating effect, i.e., it reduces the effect of hardiness on performance. When comparing the effects of perceived stress and psychological resilience, the latter has a stronger moderating effect on performance. Specifically, the moderating effect of resilience was more evident in Model 2 (66.9% variance, r = 0.818) for the military performance of the reservists than the perceived stress in Model 1 (52.5% variance, r = 0.724). This means that resilience increases the accountability of Model 2 compared to Model 1 by 14.4%. We conclude that resilience training could statistically significantly increase the military performance of reserve soldiers as a tactical population. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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11 pages, 517 KiB  
Article
Evolution of Physical Training in Police Academies: Comparing Fitness Variables
by Bridget Melton, Gregory Ryan, Victor Zuege, Haresh Rochani, Derick Anglin and Joseph Dulla
Healthcare 2023, 11(2), 261; https://doi.org/10.3390/healthcare11020261 - 14 Jan 2023
Cited by 4 | Viewed by 2678
Abstract
The purpose of this study was to evaluate the effectiveness of three different physical training approaches to improving cadets’ fitness variables. Retrospective data for male and female land management law enforcement officers attending a 15-week training program at three separate time points were [...] Read more.
The purpose of this study was to evaluate the effectiveness of three different physical training approaches to improving cadets’ fitness variables. Retrospective data for male and female land management law enforcement officers attending a 15-week training program at three separate time points were provided for analysis. The time points reflected the three different training approaches, including calisthenic training (CT) = 83, functional fitness training (FT) = 90, and strength training (ST) = 110. Inferential data analysis was used to find which mode of exercise had the greatest impact on body composition, cardiovascular endurance, muscular strength, agility, and flexibility. All groups displayed decreases in body fat percentage, with weight loss being more significant within the CT and FT groups, while the ST group increased in body weight. The CT group had the greatest flexibility increases compared to the FT and ST groups. ST training elicited significantly smaller changes in cardiovascular endurance than the FT and CT groups. ST training showed greater improvements in lean mass, while CT and FT showed greater increases in flexibility and endurance. These results suggest that training protocols can increase performance and optimize the abilities to perform job tasks in tactical athletes. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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11 pages, 520 KiB  
Article
Inter-Rater and Intra-Rater Reliability of Return-to-Work Screening Tests for UK Firefighters Following Injury
by Liam Noll, Jason Moran and Adrian Mallows
Healthcare 2022, 10(12), 2381; https://doi.org/10.3390/healthcare10122381 - 27 Nov 2022
Viewed by 2021
Abstract
The aim of this study was to assess the inter-rater and intra-rater reliability of a return-to-work (RTW) screening test to be used on UK firefighters following injury. The inter rater and intra-rater reliability of eight tasks involved in a screening test was used [...] Read more.
The aim of this study was to assess the inter-rater and intra-rater reliability of a return-to-work (RTW) screening test to be used on UK firefighters following injury. The inter rater and intra-rater reliability of eight tasks involved in a screening test was used to assess readiness to RTW for UK firefighters following injury. These tasks included the following: (1) putting on and removing a breathing apparatus set (BA), (2) a ladder lift simulation, (3) a ladder carry simulation, (4) a light portable pump (LPP) lift and carry simulation, (5) a hose run, (6) a ladder climb with leg lock, (7) a casualty evacuation and (8) a confined space crawl simulation. The inter-rater reliability between each individual screening task was interpreted as Excellent (ICC = 0.94–1.00) for eleven (68.75%) of the screening task videos and as Good (ICC = 0.75–0.88) for five (31.25%) of the screening task videos. Intra-rater reliability was interpreted as Excellent (ICC = 1) for twenty-six participants (74.3%), Good (ICC = 0.76–0.88) for eight participants (22.9%) and Moderate for one participant (2.8%). Due to the reliability of this screening test, it allows conclusions to be made from the results which can inform a RTW decision for a firefighter. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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Review

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20 pages, 1268 KiB  
Review
Firefighter Health: A Narrative Review of Occupational Threats and Countermeasures
by Drew E. Gonzalez, Sarah N. Lanham, Steven E. Martin, Richard E. Cleveland, Thad E. Wilson, Emily L. Langford and Mark G. Abel
Healthcare 2024, 12(4), 440; https://doi.org/10.3390/healthcare12040440 - 8 Feb 2024
Cited by 1 | Viewed by 4527
Abstract
Structural firefighters are responsible for protecting properties and saving lives during emergency operations. Despite efforts to prepare firefighters for these hazardous occupational demands, the unfortunate reality is that the incidence of health morbidities is increasing within the fire service. Specifically, cardiovascular disease, cancer, [...] Read more.
Structural firefighters are responsible for protecting properties and saving lives during emergency operations. Despite efforts to prepare firefighters for these hazardous occupational demands, the unfortunate reality is that the incidence of health morbidities is increasing within the fire service. Specifically, cardiovascular disease, cancer, and mental health disorders are among the most documented morbidities in firefighters. Pubmed and Google Scholar search engines were used to identify peer-reviewed English language manuscripts that evaluated firefighters’ occupational health threats, allostatic factors associated with their occurrence, and evidence-based strategies to mitigate their impact. This narrative review provides fire departments, practitioners, and researchers with evidence-based practices to enhance firefighters’ health. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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41 pages, 1071 KiB  
Review
An Examination of Subjective and Objective Measures of Stress in Tactical Populations: A Scoping Review
by Whitney Tramel, Ben Schram, Elisa Canetti and Robin Orr
Healthcare 2023, 11(18), 2515; https://doi.org/10.3390/healthcare11182515 - 11 Sep 2023
Cited by 2 | Viewed by 2219
Abstract
Persons working in tactical occupations are often exposed to high-stress situations. If this stress is to be measured, an understanding of the stress outcomes used in these occupations is needed. The aim of this review was to capture and critically appraise research investigating [...] Read more.
Persons working in tactical occupations are often exposed to high-stress situations. If this stress is to be measured, an understanding of the stress outcomes used in these occupations is needed. The aim of this review was to capture and critically appraise research investigating subjective and objective outcome measures of physiological stress in tactical occupations. Several literature databases (PubMed, EMBASE, EBsco) were searched using key search words and terms. Studies meeting inclusion criteria were critically evaluated and scored by two authors using the Joanne Briggs Institute (JBI) critical appraisal tool. Of 17,171 articles, 42 studies were retained. The Cohen’s Kappa agreement between authors was 0.829 with a mean JBI Score of included studies of 8.1/9 ± 0.37 points. Multiple subjective and objective measures were assessed during a variety of high-stress tasks and environments across different occupations, including police officers, emergency service personnel, firefighters, and soldiers in the military. Common objective outcomes measures were heart rate, cortisol, and body temperature, and subjective measures were ratings of perceived exertion, and the Self Trait Anxiety Inventory. Often used in combination (i.e., subjective and objective), these outcome measures can be used to monitor stressors faced by tactical personnel undergoing on-the-job training. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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Other

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9 pages, 671 KiB  
Brief Report
Body Composition Is Related to Maximal Effort Treadmill Test Time in Firefighters
by Benjamin J. Mendelson, Rudi A. Marciniak, Carly A. Wahl and Kyle T. Ebersole
Healthcare 2023, 11(11), 1607; https://doi.org/10.3390/healthcare11111607 - 31 May 2023
Cited by 3 | Viewed by 1729
Abstract
Firefighting tasks may require near maximal levels of cardiorespiratory fitness. Previous research has indicated that body fat percentage (BF%) and aerobic capacity (VO2peak) are related to the performance of firefighting tasks. Since a standard submaximal treadmill test for firefighters is terminated [...] Read more.
Firefighting tasks may require near maximal levels of cardiorespiratory fitness. Previous research has indicated that body fat percentage (BF%) and aerobic capacity (VO2peak) are related to the performance of firefighting tasks. Since a standard submaximal treadmill test for firefighters is terminated at 85% of maximal heart rate (MHR), key performance information relating to maximal cardiorespiratory effort may not be measured in a submaximal test. The purpose of this study was to examine the relationships between body composition and time spent running at intensities greater that 85% MHR. Height, weight, body mass index (BMI; kg/m2), BF%, MHR (bpm), VO2peak (mL/kg/min), predicted VO2peak (P-VO2peak; mL/kg/min), submaximal treadmill test time (WFIsub Test Time; min), and maximal treadmill test time (WFImax Test Time; min) were collected in fifteen active-duty firefighters. The results indicated that significant relationships (p < 0.05) existed between BF% and VO2peak, BF% and WFImax Test Time, BF% and Tdiff, and VO2peak and WFImax Test Time. P-VO2peak was not significantly different than VO2peak, and the WFImax Test Time was significantly longer than the WFIsub Test Time. These results indicate that a submaximal treadmill test may reasonably predict VO2peak, but key information about physiological work at intensities greater than 85% MHR may be missed when using submaximal effort tests. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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