The results showed a strong interrelationship between occupational and health behavioral causes of obesity in firefighters. The relevance of these qualitative findings are discussed along with the implications for future obesity interventions with firefighters.

firefighters had substantially higher CVD risk profiles. Obesity and overweight were less prevalent in female and Asian male firefighters. Conclusions BMI overestimated the prevalence of total overweight and obesity among male firefighters, compared to WC and skinfold-based PBF. Overweight by BMI needs to be more narrowly defined, or the prevalence of BMI-based overweight (27.5-29.9 kg/m 2 ) should be reported additionally for prevention of CVD among male firefighters.Keywords California · Professional firefighters · Obesity · Overweight · Ethnicity · Gender IntroductionObesity is a well-documented risk factor for chronic diseases such as hypertension, coronary heart disease, osteoarthritis, dyslipidemia, type II diabetes, some cancers as well as increased mortality (Flegal et al. 2013 . The prevalence of obesity in the working population of the USA as in the general population has increased, particularly over the last three decades (Caban et al. 2005). Male firefighters are among the top three occupational groups with the highest obesity prevalence in the USA (Caban et al. 2005;Choi et al. 2011;Haddock et al. 2011). As a result, overweight and obesity is an important occupational health issue to be urgently addressed for the 1.1 million US firefighters ) who are at high risk of on-duty cardiovascular disease (CVD) mortality (Geibe et al. 2008;Kales et al. 2007) and musculoskeletal injuries Poplin et al. 2012). AbstractPurpose This study aims to examine whether body mass index (BMI) overestimates the prevalence of overweight or obese firefighters when compared to waist circumference (WC) and skinfold-based percent body fat (PBF) and to investigate differential relationships of the three adiposity measures with other biological cardiovascular disease (CVD) risk factors. Methods The adiposity of 355 (347 males and eight females) California firefighters was assessed using three different measures. Other CVD risk factors (high blood pressure, high lipid profiles, high glucose, and low VO 2 max) of the firefighters were also clinically assessed. Results The prevalence of total overweight and obesity was significantly (p < 0.01) higher by BMI (80.4 %) than by WC (48.7 %) and by PBF (55.6 %) in male firefighters. In particular, the prevalence of overweight firefighters was much higher (p < 0.01) by BMI (57.3 %) than by WC (24.5 %) and PBF (38.3 %). 60-64 % of male firefighters who were assessed as normal weight by WC and PBF were misclassified as overweight by BMI. When overweight by BMI was defined as 27.5-29.9 kg/m 2 (vs. the standard definition of 25.0-29.9 kg/m 2 ), the agreement of the adiposity classification increased between BMI and other two adiposity measures. Obese firefighters had the highest CVD risk profiles across all three adiposity measures. Only when overweight by BMI was defined narrowly, overweight

Many additional 24-hr shifts and prolonged sedentary work substantially increased the risk for obesity in male firefighters. Am. J. Ind. Med. 59:486-500, 2016. © 2016 Wiley Periodicals, Inc.

Shift work and overtime have been implicated as important work-related risk factors for cardiovascular disease (CVD). Many firefighters who contractually work on a 24-hr work schedule, often do overtime (additional 24-hr shifts) which can result in working multiple, consecutive 24-hr shifts. Very little research has been conducted on firefighters at work that examines the impact of performing consecutive 24-hr shifts on cardiovascular physiology. Also, there have been no standard field methods for assessing in firefighters the cardiovascular changes that result from 24-hr shifts, what we call "cardiovascular strain". The objective of this study, as the first step toward elucidating the role of very long (> 48 hrs) shifts in the development of CVD in firefighters, is to develop and describe a theoretical framework for studying cardiovascular strain in firefighters on very long shifts (i.e., > 2 consecutive 24-hr shifts). The developed theoretical framework was built on an extensive literature review, our recently completed studies with firefighters in Southern California, e-mail and discussions with several firefighters on their experiences of consecutive shifts, and our recently conducted feasibility study in a small group of firefighters of several ambulatory cardiovascular strain biomarkers (heart rate, heart rate variability, blood pressure, salivary cortisol, and salivary C-reactive protein). The theoretical framework developed in this study will facilitate future field studies on consecutive 24-hr shifts and cardiovascular health in firefighters. Also it will increase our understanding of the mechanisms by which shift work or long work hours can affect CVD, particularly through CVD biological risk factors, and thereby inform policy about sustainable work and rest schedules for firefighters.

Relatively little is known about the short-term test-retest reliability of the Job Content Questionnaire (JCQ) and Effort-Reward Imbalance Questionnaire (ERIQ). Seventeen JCQ and six ERIQ items were qualitatively reviewed by 19 firefighters in focus groups. The items were then administered twice to 81 firefighters with a time interval of 1-8 weeks. The short-term reliability of the JCQ and ERIQ items and scales with the four-point Likert item responses was at least fair or moderate with several complementary statistical methods. It improved substantially when the four-point responses were simplified into the two ('agree' or 'disagree') responses. The JCQ psychological demands and the ERIQ effort scales were among the least reliable scales and their items were most frequently indicated by the firefighters to be clarified. The responses of professional firefighters to the JCQ and ERIQ items and scales were stable during an 8-week period, particularly when dichotomous item responses were used.