Center for Fire, Rescue and EMS Health Research, Institute for Biobehavioral Health Research, NDRI-MA, NDRI: National Development and Research Institutes, Inc, 1920 West 143rd Street Suite 120, Leawood, KS 66224, USA.
BMC Public Health. 2013 Sep 5;13:805. doi: 10.1186/1471-2458-13-805.
Firefighters suffer from high prevalence of obesity, substandard fitness, and cardiovascular-related deaths. There have been a limited number of firefighter health promotion programs that have been developed and empirically-tested for this important occupational group. We evaluated the health of firefighters from departments with well-developed health promotion programs and compared them with those from departments not having such programs using a large national sample of career fire departments that varied in size and mission. We measured a broad array of important individual firefighter health outcomes (e.g., body composition, physical activity, and general and behavioral health) consistent with national fire service goals and addressed significant statistical limitations unaccounted for in previous studies.
Using the approach of purposive sampling of heterogeneous instances, we selected and conducted a national evaluation of 10 departments already implementing wellness and fitness programs (Wellness Approach; WA) with 10 departments that did not (Standard). Participants were 1,002 male firefighters (WA n = 522; Standard n = 480) who underwent assessments including body composition, fitness, and general/behavioral health (e.g., injury, depressive symptoms).
Firefighters in WA departments were healthier than their Standard department counterparts. For example, they were less likely to be obese (adjusted [A]OR = 0.58; 95% CI = 0.41-0.82), more likely to meet endurance capacity standards for firefighting (AOR = 5.19; 95% CI = 2.49-10.83) and have higher estimated VO2max (40.7 ± 0.6 vs. 37.5 ± 1.3 for firefighters in Standard departments; p = 0.001). In addition, WA firefighter were substantially less likely to smoke (AOR = 0.30; 95% CI = 0.17-0.54) or ever have been diagnosed with an anxiety disorder (AOR = 0.27; 95% CI = 0.14-0.52) and they expressed higher job satisfaction across several domains. However, WA firefighters were somewhat more likely to have reported an injury to Workers' Compensation (AOR = 1.74; 95% CI = 1.05-2.90). It was notable that both groups evidenced high prevalence of smokeless tobacco use and binge drinking.
Firefighters in departments selected based on having strong wellness programs (WA) were healthier along a number of dimensions important to firefighter wellness and operational readiness. However, several health areas require greater attention including problematic alcohol consumption and smokeless tobacco use, suggesting that more emphasis on these behavioral health issues is needed in the fire service.
消防员中肥胖症、体能不达标和心血管相关死亡的患病率很高。已经有一些针对这一重要职业群体的消防员健康促进计划被开发和经验测试，但数量有限。我们评估了具有完善健康促进计划的部门的消防员健康状况，并将其与没有此类计划的部门的消防员健康状况进行了比较，使用了一个规模和任务各不相同的大型职业消防部门的全国性样本。我们测量了一系列重要的个体消防员健康结果（例如身体成分、身体活动以及一般和行为健康），这些结果与国家消防服务目标一致，并解决了之前研究中未考虑到的重要统计限制。
我们采用有差异实例的有目的抽样方法，选择并对已经实施健康和健身计划的 10 个部门（健康方法；WA）进行了全国性评估，对 10 个没有此类计划的部门（标准）进行了评估。参与者是 1002 名男性消防员（WA 组 n = 522；标准组 n = 480），他们接受了身体成分、体能和一般/行为健康（例如，受伤、抑郁症状）的评估。
WA 部门的消防员比标准部门的消防员更健康。例如，他们肥胖的可能性较低（调整后的[A]OR = 0.58；95%CI = 0.41-0.82），更有可能达到消防耐力能力标准（AOR = 5.19；95%CI = 2.49-10.83），并且估计的 VO2max 更高（40.7 ± 0.6 与标准部门消防员的 37.5 ± 1.3 相比；p = 0.001）。此外，WA 消防员吸烟的可能性明显较低（AOR = 0.30；95%CI = 0.17-0.54）或曾经被诊断出患有焦虑症（AOR = 0.27；95%CI = 0.14-0.52），并且在几个领域表现出更高的工作满意度。然而，WA 消防员向工人赔偿报告受伤的可能性略高（AOR = 1.74；95%CI = 1.05-2.90）。值得注意的是，两组都有很高的使用无烟烟草和狂饮的流行率。
根据具有强大健康计划（WA）选择的部门中的消防员在一些对消防员健康和操作准备很重要的方面更健康。然而，一些健康领域需要更多关注，包括有问题的酒精消费和使用无烟烟草，这表明消防部门需要更加重视这些行为健康问题。
