Objective To examine the prevalence of overweight and obesity in firefighters. Methods Body mass index (BMI), waist circumference, and body fat percentage (BF%) were assessed in 478 career and 199 volunteer male firefighters from randomly selected departments. Results High prevalence rates of overweight + obesity (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) were found in career (79.5%; 33.5%) and volunteer firefighters (78.4%; 43.2%). False-positive obesity misclassification based on BMI, compared to waist circumference and BF%, was low (9.8% and 2.9%, respectively). False negatives were much higher: 32.9% and 13.0%. Obese firefighters demonstrated unfavorable cardiovascular disease (CVD) profiles. Conclusions The prevalence of overweight and obesity exceeded that of the US general population. Contrary to common wisdom, obesity was even more prevalent when assessed by BF% than by BMI, and misclassifying muscular firefighters as obese by using BMI occurred infrequently.

Objective: Firefighting is a dangerous profession with high injury rates, particularly musculoskeletal (MS), but limited longitudinal data is available to examine predictors of MS injuries in this population. Design and Methods: The relationship between personal individual, nonoccupational factors (e.g., demographic characteristics, body composition, fitness, and health behaviors) and incident injury and incident MS injury in a prospective cohort of 347 firefighters from the central United States was examined. Results: Baseline weight status was a significant predictor of incident MS injury, with obese (BMI ! 30 kg m À2 ) firefighters 5.2 times more likely (95% CI ¼ 1.1-23.4) to experience a MS injury than their normal weight (BMI ¼ 18.5-24.9 kg m À2 ) colleagues over the course of the study. Similarly, firefighters who were obese based on WC (>102.0 cm) were almost three times as likely (OR ¼ 2.8, 95% CI ¼ 1.2-6.4) to have a MS injury at follow-up. Conclusions: Findings highlight the importance of focusing on firefighters' body composition, nutrition and fitness as a means of decreasing risk for injury.

Given the high rates of heavy and binge drinking, local and nationally coordinated efforts to increase the surveillance of drinking behaviour among firefighters and the development of targeted prevention interventions are critically needed.