Stress among on-duty firefighters: an ambulatory assessment study

Abstract

BackgroundStress at work has been broadly acknowledged as a worldwide problem and has been the focus of concern for many researchers. Firefighting, in particular, is frequently reported as a highly stressful occupation. In order to investigate firefighters’ occupational health in terms of stress events, perceptions, symptoms, and physiological reactions under real-world conditions, an ambulatory assessment protocol was developed.MethodsSeventeen firefighters’ cardiac signal was continuously monitored during an average of three shifts within a working week with medical clinically certified equipment (VitalJacket®), which allows for continuous electrocardiogram (ECG) and actigraphy measurement. Psychological data were collected with a software application running on smartphones, collecting potential stressful events, stress symptoms, and stress appraisal.ResultsA total of 450.56 h of medical-quality ECG were collected, and heart rate variability (HRV) analysis was performed. Findings suggest that although ‘fire’ situations are more common, ‘accidents’ are more stressful. Additionally, firefighters showed high levels of physiological stress (based on AVNN and LF/HF HRV metrics) when compared to normative healthy population values that may not be diagnosed using merely self-reports.DiscussionThe proposed ambulatory study seems to be useful for the monitoring of stress levels and its potential impact on health of first responders. Additionally, it could also be an important tool for the design and implementation of efficient interventions and informed management resolutions in real time. Potential applications of this research include the development of quantified occupational health (qOHealth) devices for real life monitoring of emergency personnel stress reactions.

Relationships Between Heart Rate Variability, Occupational Performance, and Fitness for Tactical Personnel: A Systematic Review

“…One found significant relationships between greater basal RMSSD and two computerized cognitive stress tests, as well as during recovery from those tasks (38). The last study found a significant decrease in AVNN at the start of a two-choice critical reaction time task and a significant change in LF/HF ratio following the task (43).…”

“…Selected publications included males only in 11 studies, both males and females in seven studies and the gender distribution was not reported in three studies. Seven tactical subpopulations were represented; general law enforcement officers ( 32 , 33 ), Army ( 27 , 29 , 31 , 34 – 36 , 46 ), Defense Force trainees ( 37 ), Naval cadets ( 38 ), Army Ranger trainees ( 39 ) firefighters/rescue personnel ( 28 , 30 , 40 , 41 , 43 , 45 ), and Air Force fighter pilots ( 42 ). Specifically, the Army personnel were members of either the US, Brazilian or Spanish militaries.…”

“…For the Fire/Rescue personnel, members were serving in French, Brazilian, Finnish, Portuguese, or South Korean communities. A total of nine countries were represented: USA ( 27 , 32 , 33 ), Spain ( 29 , 31 , 34 , 35 ), Brazil ( 30 , 36 , 42 , 46 ), South Africa ( 37 ), Norway ( 38 ), France ( 28 , 39 ), Finland ( 40 , 41 ), Portugal ( 43 , 44 ), and South Korea ( 45 ).…”

“…The root-mean square of successive differences (RMSSD) was the most popular time-domain analysis, with 11 studies documenting this HRV characteristic. Other time-domain analyses included pNN20 ( 54 ), pNN50 ( 30 , 35 , 37 , 54 ), mean interbeat interval, or AVNN ( 36 , 37 , 39 , 43 , 46 , 54 ), or SDNN/SDRR ( 28 , 37 , 39 , 41 , 42 , 45 , 54 ).…”

“…Three studies included a measurement of cognitive performance ( 34 , 38 , 43 ). Of these three, one found significant correlations between sound recall and the LF domain following a combat simulation (see section above) ( 34 ).…”