Abstract:Fire Service Instructors frequently experience high levels of physiological and perceptual strain during live fire exposures. Instructors are also at risk of cardiovascular illnesses, with cardiac death being the greatest cause of fire fighter death. Current practice for UK instructors is to select undergarment type based on personal preference, between a boiler suit (BOILER) and a wicking base layer (WBL). Research suggests that shorts and t-shirt (SHORTS) may also be a beneficial alternative undergarment cho… Show more
“…In addition, not all variation in IL‐6, IL‐1β, CRP and IgG was explained by monthly exposure numbers. It is reasonable to suggest that there are many other factors that were outside of the scope of the present study that might have influenced these variables, such as the overall thermal load experienced from the wears completed, the types of wears completed (Watkins et al., 2019b), level of smoke/particulate exposure, stress levels of participants, and the use by FSIs of hydration guidance, clothing (Watkins & Richardson, 2017) and pre/post cooling interventions (Watkins, Hayes, Watt, & Richardson, 2018b) for each wear performed. Stress, anxiety and depression have also previously been associated with systemic inflammation (Majd, Saunders, & Engeland, 2019; Renna, O'Toole, Spaeth, Lekander, & Mennin, 2018) but were not measured in the present study.…”
Section: Discussionmentioning
confidence: 98%
“…In addition, not all variation in IL-6, IL-1 , CRP and IgG was explained by monthly exposure numbers. It is reasonable to suggest that there are many other factors that were outside of the scope of the present study that might have influenced these variables, such as the overall thermal load experienced from the wears completed, the types of wears completed (Watkins et al, 2019b), level of smoke/particulate exposure, stress levels of participants, and the use by FSIs of hydration guidance, clothing (Watkins & Richardson, 2017) and pre/post cooling interventions (Watkins, Hayes, Watt, & Richardson, 2018b) Participants who reported themselves as FSIs were classified as such, regardless of the number of wear exposures, to ensure that the data represented the FSI population. This resulted in two FSIs with no wears completed in the previous month being included in the FSI group, despite them having a lower monthly number of wears than the FF group mean.…”
Fire Service Instructors (FSIs) experience ∼10 times more fire exposures than firefighters (FFs), and the increased physiological stress from this potentially puts them at risk of ill health and future cardiac events. The aim of the study was to establish whether FSIs exhibit elevated biomarkers associated with cardiac event risk, identify whether FSIs experience systemic inflammation linked to the frequency of fire exposure and evaluate a proposed exposure limit of nine exposures per month. Blood samples were collected from 110 Fire Service personnel (mean ± SD, age,44 ± 7 years; height, 178.1 ± 7.1 cm; and body mass, 84.3 ± 12.0 kg; FSIs n = 53 and FFs n = 57) for biomarker analysis. Work history details were collected from all participants. Participants with biomarker concentrations above healthy reference ranges were classified as being 'at risk'. The neutrophil-to-lymphocyte ratio, platelet count, cardiac troponin T, interleukin (IL)-6, IL-1 , C-reactive protein and immunoglobulin G were greater in FSIs than in FFs (P < 0.05). Multiple regression analysis revealed that 18.8% of IL-6, 24.9% of IL-1 , 29.2% of C-reactive protein and 10.9% of immunoglobulin G variance could be explained by the number of exposures to heat per month. Odds ratios revealed that those FSIs above the nine per month exposure limit were six to 12 times more likely to be classified as 'at risk' and were 16 times more likely to experience symptoms of ill health. Increased cytokine levels suggest that FSIs experience systemic inflammation, which is related to symptoms of ill health. We propose that an exposure limit could reduce the prevalence of these biomarker risk factors and ill health.
“…In addition, not all variation in IL‐6, IL‐1β, CRP and IgG was explained by monthly exposure numbers. It is reasonable to suggest that there are many other factors that were outside of the scope of the present study that might have influenced these variables, such as the overall thermal load experienced from the wears completed, the types of wears completed (Watkins et al., 2019b), level of smoke/particulate exposure, stress levels of participants, and the use by FSIs of hydration guidance, clothing (Watkins & Richardson, 2017) and pre/post cooling interventions (Watkins, Hayes, Watt, & Richardson, 2018b) for each wear performed. Stress, anxiety and depression have also previously been associated with systemic inflammation (Majd, Saunders, & Engeland, 2019; Renna, O'Toole, Spaeth, Lekander, & Mennin, 2018) but were not measured in the present study.…”
Section: Discussionmentioning
confidence: 98%
“…In addition, not all variation in IL-6, IL-1 , CRP and IgG was explained by monthly exposure numbers. It is reasonable to suggest that there are many other factors that were outside of the scope of the present study that might have influenced these variables, such as the overall thermal load experienced from the wears completed, the types of wears completed (Watkins et al, 2019b), level of smoke/particulate exposure, stress levels of participants, and the use by FSIs of hydration guidance, clothing (Watkins & Richardson, 2017) and pre/post cooling interventions (Watkins, Hayes, Watt, & Richardson, 2018b) Participants who reported themselves as FSIs were classified as such, regardless of the number of wear exposures, to ensure that the data represented the FSI population. This resulted in two FSIs with no wears completed in the previous month being included in the FSI group, despite them having a lower monthly number of wears than the FF group mean.…”
Fire Service Instructors (FSIs) experience ∼10 times more fire exposures than firefighters (FFs), and the increased physiological stress from this potentially puts them at risk of ill health and future cardiac events. The aim of the study was to establish whether FSIs exhibit elevated biomarkers associated with cardiac event risk, identify whether FSIs experience systemic inflammation linked to the frequency of fire exposure and evaluate a proposed exposure limit of nine exposures per month. Blood samples were collected from 110 Fire Service personnel (mean ± SD, age,44 ± 7 years; height, 178.1 ± 7.1 cm; and body mass, 84.3 ± 12.0 kg; FSIs n = 53 and FFs n = 57) for biomarker analysis. Work history details were collected from all participants. Participants with biomarker concentrations above healthy reference ranges were classified as being 'at risk'. The neutrophil-to-lymphocyte ratio, platelet count, cardiac troponin T, interleukin (IL)-6, IL-1 , C-reactive protein and immunoglobulin G were greater in FSIs than in FFs (P < 0.05). Multiple regression analysis revealed that 18.8% of IL-6, 24.9% of IL-1 , 29.2% of C-reactive protein and 10.9% of immunoglobulin G variance could be explained by the number of exposures to heat per month. Odds ratios revealed that those FSIs above the nine per month exposure limit were six to 12 times more likely to be classified as 'at risk' and were 16 times more likely to experience symptoms of ill health. Increased cytokine levels suggest that FSIs experience systemic inflammation, which is related to symptoms of ill health. We propose that an exposure limit could reduce the prevalence of these biomarker risk factors and ill health.
“… Fig. 2 Selected causes of inflammation in firefighters (Wolkow et al 2015 ; Adetona et al 2016 ; Billings and Focht 2016 ; Adetona et al 2017 ; Watkins and Richardson 2017 ; Keaney et al 2018 ; Walsh 2018 ; Watkins et al 2019 ; Dolsen et al 2019 ; Jang et al 2020 ; Barros et al 2021 ; Savall et al 2021 ) (own source, used photos from SciePro/Bigstockphoto and Canva) …”
Section: Airway and Systemic Inflammation In Firefightersmentioning
Health status depends on multiple genetic and non-genetic factors. Nonheritable factors (such as lifestyle and environmental factors) have stronger impact on immune responses than genetic factors. Firefighters work is associated with exposure to air pollution and heat stress, as well as: extreme physical effort, mental stress, or a changed circadian rhythm, among others. All these factors can contribute to both, short-term and long-term impairment of the physical and mental health of firefighters. Increased levels of some inflammatory markers, such as pro-inflammatory cytokines or C-reactive protein (CRP) have been observed in firefighters, which can lead to local, acute inflammation that promotes a systemic inflammatory response. It is worth emphasizing that inflammation is one of the main hallmarks of cancer and also plays a key role in the development of cardiovascular and respiratory diseases. This article presents possible causes of the development of an inflammatory reaction in firefighters, with particular emphasis on airway inflammation caused by smoke exposure.
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