Health concerns of the U.S. fire service: perspectives from the firehouse.

PURPOSE: Firefighters are expected to respond to any domestic emergency at a moment's notice, and therefore their health and readiness are key to the public safety net. Although emerging research is focusing on understanding firefighters' increased risk for disease and injury, the perspectives of fire service personnel is lacking.
DESIGN: This study uses the cross-sectional qualitative data collection techniques of key informant interviews and focus groups.
SETTING: Data collection occurred with a national sample of firefighters from 28 (municipal and federal) career fire departments. PARTICIPANTS: Participants were 332 career firefighters (57.2%), company officers (23.4%), fire chiefs (15.4%), and other fire service personnel (3.9%).
METHOD: Focus groups and informant interviews were conducted with firefighters, fire chiefs, health promotion personnel, and medical directors to assess attitudes, opinions, and perceptions about firefighter health.
RESULTS: Major themes that developed among fire service personnel included concerns about cancer, risk of cardiovascular disease, the importance of and barriers to physical fitness, the food culture of the firehouse, psychological stress resulting from repeated exposure to trauma, sleep disruptions, injuries, and risk for infectious disease. Health concerns identified by firefighters are juxtaposed with current efforts and trends within the national fire service.
CONCLUSIONS: The health concerns of firefighters parallel both available epidemiological research and the health priorities of national fire service organizations. Unfortunately, these concerns often are in contrast with efforts by local governments to limit their financial liability for illnesses presumed to be caused by occupational exposures and long-held traditions in the fire service. This study highlights the need for epidemiological surveillance of firefighters and innovative health and organizational policy in the fire service. Future directions for the fire service, the public health community, and researchers are discussed.