Conner Reagan, Porter Cynthia, Lutrick Karen, Beitel Shawn C, Hollister James, Healy Olivia, Kern Krystal J, Wardenaar Floris, Gulotta John J, Jack Kepra, Huentelman Matthew, Burgess Jefferey L, Furlong Melissa
Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States.
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States.
JMIR Res Protoc. 2025 Apr 16;14:e67120. doi: 10.2196/67120.
Occupational cancer and acute cardiac events are the leading causes of death among firefighters. Increased exposure to toxicants on the fire ground, such as polycyclic aromatic hydrocarbons, benzene, and per- and poly-fluoroalkyl substances (PFAS), has been linked to certain cancers, cardiovascular disease, accelerated epigenetic aging, and other adverse health effects. PFAS are a major concern because they are persistent, can bioaccumulate, and are present in several firefighting tools. Compared to the general population, firefighters have elevated serum levels of some types of PFAS. A randomized clinical trial in Australian firefighters found that routine blood and plasma donation for 1 year led to decreased serum PFAS levels, although health outcomes were not directly measured in that study.
In collaboration with fire service leadership in Arizona, the Firefighter Collaborative Research Project (FCRP) was established to evaluate the effectiveness of 3 interventions in a randomized controlled trial design to reduce serum PFAS levels, reduce cancer and cardiovascular risk, and improve overall health and wellness in US firefighters.
This study aimed to recruit and enroll up to 1500 active firefighters between August 2023 and October 2024. Between August 2023 and October 2024, active firefighters were recruited and randomized into a study arm based on their eligibility, including serum PFOS levels, for the specific arms. The trial arms include (1) blood and plasma donation, (2) zone 2 physical activity, and (3) intermittent fasting. FCRP outcomes include serum PFAS reduction (arm 1), epigenetic age acceleration (all arms), cardiovascular conditioning (arm 2) and cognitive outcomes (all arms), mental health (all arms), and overall disease risk (all arms). Each study arm includes an intervention and a control group. At enrollment and end of the study, participants provide blood and urine samples and complete a comprehensive questionnaire on their occupational and health history, exposures, and lifestyle behaviors. At the end of the study, participants also participated in a cognitive evaluation. Depending on the study arm, participants may additionally complete a cardiopulmonary exercise test at baseline and follow-up, a mid-study survey, and a mid-study blood and urine collection.
Participant activities and data collection will conclude by December 2025.
The FCRP is a randomized controlled trial that aims to test the effectiveness of fire service-selected interventions in reducing serum PFAS levels. Study results will contribute to potential interventions that could be used to reduce serum PFAS levels in firefighters.
ClinicalTrials.gov NCT05869747; https://clinicaltrials.gov/study/NCT05869747.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/67120.
职业性癌症和急性心脏事件是消防员死亡的主要原因。在火灾现场接触多环芳烃、苯和全氟及多氟烷基物质（PFAS）等有毒物质的增加，与某些癌症、心血管疾病、表观遗传加速衰老以及其他不良健康影响有关。PFAS是一个主要问题，因为它们具有持久性、可生物累积性，并且存在于多种消防工具中。与普通人群相比，消防员血清中某些类型PFAS的水平有所升高。澳大利亚消防员的一项随机临床试验发现，连续1年定期献血和血浆可降低血清PFAS水平，尽管该研究未直接测量健康结果。
与亚利桑那州的消防部门领导合作，设立了消防员合作研究项目（FCRP），以在随机对照试验设计中评估3种干预措施对降低美国消防员血清PFAS水平、降低癌症和心血管疾病风险以及改善整体健康状况的有效性。
本研究旨在在2023年8月至2024年10月期间招募多达1500名在职消防员。在2023年8月至2024年10月期间，根据他们的资格，包括血清全氟辛烷磺酸（PFOS）水平，招募在职消防员并随机分配到特定研究组。试验组包括：（1）献血和血浆；（2）2区体育活动；（3）间歇性禁食。FCRP的结果包括血清PFAS降低（第1组）、表观遗传年龄加速（所有组）、心血管调节（第2组）和认知结果（所有组）、心理健康（所有组）以及总体疾病风险（所有组）。每个研究组都包括一个干预组和一个对照组。在入组时和研究结束时，参与者提供血液和尿液样本，并完成一份关于其职业和健康史、接触情况以及生活方式行为的综合问卷。在研究结束时，参与者还参加了认知评估。根据研究组的不同，参与者可能还需要在基线和随访时完成心肺运动试验、中期研究调查以及中期血液和尿液采集。
参与者的活动和数据收集将于2025年12月结束。
FCRP是一项随机对照试验，旨在测试消防部门选定的干预措施在降低血清PFAS水平方面的有效性。研究结果将有助于确定可用于降低消防员血清PFAS水平的潜在干预措施。
ClinicalTrials.gov NCT05869747；https://clinicaltrials.gov/study/NCT05869747。
国际注册报告识别码（IRRID）：DERR1-10.2196/67120。
