Murray Margaret, Beckman Stella, Heinzerling Amy, Frederick Matthew, Cummings Kristin J, Gandhi Sheiphali, Harrison Robert
Division of Occupational, Environmental, and Climate Medicine, University of California San Francisco, San Francisco, California, USA.
California Department of Public Health, Occupational Health Branch, Richmond, California, USA.
Am J Ind Med. 2025 Feb;68(2):184-193. doi: 10.1002/ajim.23691. Epub 2024 Dec 18.
Firefighters have a higher rate of heat-related illness (HRI) compared to other occupations. Given the changing climate, firefighters' risk of occupational HRI merits attention. Therefore, we aimed to identify demographic, temporal, and geographic risk factors associated with occupational HRI in California firefighters between 2001 and 2020.
Within the California Workers' Compensation Information Systems (WCIS), we identified firefighters from 2001 to 2020 using industry and class codes and assigned occupation titles using the NIOSH Industry and Occupation Computerized Coding system (NIOCCS). HRI claims among firefighters were identified using International Classification of Diseases (ICD) Ninth or Tenth revision codes, WCIS nature and cause of injury codes, and keywords. We calculated HRI incidence rates adjusted by sex, age, year, and county. Estimates of California firefighter employment were obtained from the American Community Survey.
We identified 2185 firefighter HRI claims between 2001 and 2020 (305.5 claims/100,000 firefighters, 90% CI: 278.7-740.7). Firefighters aged 18 to 29 years had a statistically significant higher risk of HRI compared to those aged 40 to 49 years (rate ratio = 3.5, 90% CI: 3.1-3.9). The HRI rate increased over time, and the risk from 2016 to 2020 was 1.8 times higher than it was from 2001 to 2005 (90% CI: 1.7-1.9). Northern California counties, including Shasta (2313.9) and Sacramento (1772.1), had the highest HRI rates.
Firefighters in certain demographic groups and northern California counties were at highest risk of HRI. With rising temperatures and larger wildfires, additional prevention efforts are needed to reduce HRI in California firefighters.
与其他职业相比，消防员患与热相关疾病（HRI）的比例更高。鉴于气候变化，消防员职业性HRI的风险值得关注。因此，我们旨在确定2001年至2020年加利福尼亚州消防员中与职业性HRI相关的人口统计学、时间和地理风险因素。
在加利福尼亚州工人赔偿信息系统（WCIS）中，我们使用行业和类别代码确定了2001年至2020年的消防员，并使用美国国家职业安全与健康研究所（NIOSH）行业和职业计算机编码系统（NIOCCS）指定职业头衔。使用国际疾病分类（ICD）第九版或第十版代码、WCIS伤害性质和原因代码以及关键词来识别消防员中的HRI索赔。我们计算了按性别、年龄、年份和县调整的HRI发病率。加利福尼亚州消防员就业估计数来自美国社区调查。
我们在2001年至2020年期间确定了2185起消防员HRI索赔（305.5起索赔/100,000名消防员，90%置信区间：278.7 - 740.7）。与40至49岁的消防员相比，18至29岁的消防员患HRI的风险在统计学上显著更高（率比 = 3.5，90%置信区间：3.1 - 3.9）。HRI发病率随时间增加，2016年至2020年的风险比2001年至2005年高1.8倍（90%置信区间：1.7 - 1.9）。北加利福尼亚州的县，包括沙斯塔（2313.9）和萨克拉门托（1772.1），HRI发病率最高。
特定人口群体和北加利福尼亚州县的消防员患HRI的风险最高。随着气温上升和野火规模扩大，需要采取更多预防措施以减少加利福尼亚州消防员的HRI。
