Effects of cardiovascular health, musculoskeletal health and physical fitness on occupational performance of firefighters: protocol for a systematic review and meta-analysis

Abstract

IntroductionFirefighting is a hazardous occupation, where firefighters are involved in life-threatening situations, being placed under tremendous physical strain, while wearing heavy and insulated equipment to protect them from chemicals, fumes and high temperatures. This necessitates that firefighter stay in good physical condition and maintain adequate cardiovascular fitness to cope with these stressors and perform their duties with minimal health risks. The aim of this systematic review and meta-analysis is to determine the effect of cardiovascular health, musculoskeletal health and physical fitness on the occupational performance of firefighters.Methods and analysisAll study types and designs will be included and appraised. The following electronic databases will be searched: PubMed/Medline, Scopus, Web of Science, Embase, EBSCOHost and CINAHL, with no restrictions on publication date. The literature search will be conducted comprehensively to enable the capturing of as many relevant articles as possible but will be limited to English-language papers only. A combination of the appropriate terms (search string) will be used to ensure the inclusion of the relevant components of the participants, exposure, comparison and outcome. A researcher-generated form with the key characteristics of each study will be used to retrieve all relevant details from the selected studies for initial eligibility screening. The Rayyan Intelligent Systematic Review tool will be used to screen and select studies for inclusion, and information from the included studies will be captured on the researcher-generated data extraction form. The The appraisal tool for cross-sectional studies (AXIS) checklist and the Critical Appraisal Skills Programme toolkit will be used to conduct the methodological assessment of each study. Data will be analysed using Review Manager V.5.3. Generated results will be presented using a combination of figures, graphs and tables. The synthesis of quantitative data (using a meta-analysis methodology) will involve the integration of quantitative findings from multiple studies to achieve coherence.Ethics and disseminationThis study obtained ethical clearance from the University of the Western Cape Biomedical Research Ethics Committee (BM21/10/9). We will disseminate the findings of in peer-reviewed journals and at national and international conferences. The protocol will form part of a chapter for a doctoral thesis.PROSPERO registration numberCRD42021258898.

Effects of Cardiovascular Disease Risk Factors, Musculoskeletal Health, and Physical Fitness on Occupational Performance in Firefighters—A Systematic Review and Meta-Analysis

“…Exclusion criteria included: (i) studies focusing on other outcome measures as the main exposures or outcomes; (ii) systematic reviews or other types of reviews; (iii) articles that are non-English. The protocol for this study has been published and more information on the methods involved in the current manuscript may be found at: Ras et al [51].…”

“…Providing more information on the effect that cardiovascular disease risk factors, musculoskeletal health and physical fitness have on occupational performance may provide valuable evidence in informing policy makers and fire departments. For more information on the aim and objectives of this review, please refer to the published protocol: Ras et al [51]. Briefly, the aim of this systematic review and meta-analysis was to determine the effects of CVD risk factors, musculoskeletal health and physical fitness on the occupational performance of firefighters.…”

Association between Physical Fitness and Cardiovascular Health in Firefighters

“…The metabolic demands of firefighting highlight the need for firefighters to maintain an adequate level of physical fitness in order to perform their duties aptly [9,10]. Many firefighting tasks require firefighters to perform multiple forceful repetitions and/or maintain strong isometric contractions, such as during forcible entry, equipment carries, equipment hoist and hose drag [13][14][15]. Moreover, the higher the force produced by firefighters, the more efficiently firefighters can perform their duties [13][14][15].…”

“…Many firefighting tasks require firefighters to perform multiple forceful repetitions and/or maintain strong isometric contractions, such as during forcible entry, equipment carries, equipment hoist and hose drag [13][14][15]. Moreover, the higher the force produced by firefighters, the more efficiently firefighters can perform their duties [13][14][15]. Generally, more fit and stronger firefighters would participate in regular physical activity, which is crucial in maintaining adequate levels of physical fitness, which is particularly important as firefighters age [2,16,17].…”

Association between physical fitness and musculoskeletal health in firefighters

“…However, it is also possible that higher levels of physical fitness may cause firefighters to exert themselves more vigorously during emergency operations, thereby triggering workload-related feeling of MSD and chronic pain, and this may be exacerbated by repetitive movements ( Rintala et al, 2015 ). Higher physical fitness has been shown to be related to improved occupational performance in firefighters, and it is logical to assume that increased levels of physical activity and physical fitness would also provide an additional benefit of better musculoskeletal health (MSH) ( Ras et al, 2022a ; Ras et al, 2022b ).…”