FRESH Calendar: RESOURCES (click each tab to open)
Scroll down for calendar page pdfs
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Physical Activity -
Links to research and articles that may be of interest (check out the references for more):
https://pubmed.ncbi.nlm.nih.gov/35416941/
Pearce M, Garcia L, Abbas A, et al. Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2022;79(6):550-559.
It doesn’t take much exercise to reduce your risk of depression.
https://bjsm.bmj.com/content/57/19/1231
Webber BJ, Yun HC, Whitfield GP. Leisure-time physical activity and mortality from influenza and pneumonia: a cohort study of 577 909 US adults. Br J Sports Med. 2023;57:1231-1237.
Being physically active boosts your immune system and reduces the risk of dying from infectious diseases like influenza and pneumonia.
https://pubmed.ncbi.nlm.nih.gov/16534088/
Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. CMAJ. 2006;174(6):801-809. doi:10.1503/cmaj.051351
The evidence supports the numerous health benefits of physical activity and shows the relationship between more physical activity incurring greater health benefits.
A summary and list of research linking physical activity to a reduced risk of cancer.
Additional Resources:
Health & Wellness - Fitness - First Responder Center for Excellence
First Responder Center for Excellence (FRCE): Resources and trainings for becoming and staying fit.
https://www.nvfc.org/wp-content/uploads/2020/07/Top10ExercisesForFirefighters.pdf
Top 10 exercises for firefighters with pictures and sample workout.
https://www.cdc.gov/physical-activity-basics/guidelines/adults.html
How much physical activity should I get?
https://www.cdc.gov/physical-activity-basics/health-benefits/adults.html
Health Benefits of Physical Activity for Adults
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Know Your Numbers -
Links to research and articles that may be of interest (check out the references for more):
Journal of Occupational and Environmental Medicine (lww.com)
Smith DL, Graham E, Stewart D, Mathias KC. Cardiovascular Disease Risk Factor Changes Over 5 Years Among Male and Female US Firefighters. J Occup Environ Med. 2020;62(6):398-402.
Many cardiovascular health indicators studied over a 5-year period worsened, despite growing awareness of the need to address CVD risk factors within the fire service.
Potential impact of metabolic syndrome on cognitive function in US firefighters (nih.gov)
Seo MW, Gann J, Lee JM, Heffernan KS, Kim JY, Jung HC. Potential impact of metabolic syndrome on cognitive function in US firefighters. Front Public Health. 2023;11:1150121
Metabolic syndrome (MetSyn) negatively affected cognitive function in FFs, suggesting prevention of MetSyn could enhance FFs’ safety and job performance.
Tobia M, LeDuc TJ, Jahnke SA, Smith DL. Occupational medical evaluations in the US fire service: State of the art review. Int. Fire Serv. J. Leadersh. Manag. 2020;14:17–26.
Summary on the state of the science, barriers, and types of medical evaluations being delivered in the US fire service.
Better Heart — The Science Alliance (science-alliance.org)
First Responder Health and Safety Laboratory, Skidmore College. BETTER HEART. May 2023.
The latest medical findings and FF research was used to develop recommendations and guidelines for the detection of CVD in FFs.
Additional Resources:
Heart-Healthy-Firefighter-Resource-Guide.pdf (nvfc.org)
Keep It Strong: NVFC Heart-healthy Firefighter Resource Guide includes information on assessing and reducing FF risk for CVD.
Know your numbers health tips | UnitedHealthcare (uhc.com)
Or:
Know Your Numbers | The Texas Heart Institute®
Both provide guidelines for determining if your numbers are in a healthy range.
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SLEEP -
Links to research and articles that may be of interest (check out the references for more):
Harvard Work Hours Health and Safety Group | Sleep Medicine
The Harvard Work Hours Health and Safety Group research includes large-scale surveys of nearly 7,000 firefighters in 66 fire departments investigating the health and safety impact of work hours and sleep.
Sleep deprivation among firefighters is linked to major health risks which necessitates a cultural shift in the fire service to prioritize sleep hygiene.
Additional Resources:
A report, quiz and video that addresses sleep deprivation in the Fire Service.
MasterClass on Sleep and the Human Body
Walker explains how we can learn to boost our immunity and reduce health risks by sleeping better.
Can’t Sleep? Try These Strategies - O2X Human Performance
Strategies for tactical athletes, such as first responders, to employ when you are having trouble falling/staying asleep.
Tips for Shift Workers: How To Get Better Sleep | Sleep Foundation
Tips for staying alert when on shift work.
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Healthy Eating -
Links to research and articles that may be of interest (check out the references for more):
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9653630/
Joe MJ, Hatsu IE, Tefft A, Mok S, Adetona O. Dietary Behavior and Diet Interventions among Structural Firefighters: A Narrative Review. Nutrients. 2022;14(21):4662.
FFs know the importance of a healthy diet, but do not adhere to one. Peers impact food choices. Diets, e.g., the Mediterranean diet, showed positive health improvements.
https://pubmed.ncbi.nlm.nih.gov/37173909/
Sidossis A, Lan FY, Hershey MS, Hadkhale K, Kales SN. Cancer and Potential Prevention with Lifestyle among Career Firefighters: A Narrative Review. Cancers (Basel). 2023;15(9):2442.
Beyond occupational factors, lifestyle choices play a role in cancer prevention for FFs.
Processed meat and cancer: What you need to know | MD Anderson Cancer Center
Underferth D. Processed meat and cancer: What you need to know. The University of Texas MD Anderson Cancer Center. February 2016.
Eating processed meats increases your cancer risk.
Eating Habits among US Firefighters and Association with Cardiometabolic Outcomes (nih.gov)
Christodoulou A, Christophi CA, Sotos-Prieto M, Moffatt S, Kales SN. Eating Habits among US Firefighters and Association with Cardiometabolic Outcomes. Nutrients. 2022;14(13):2762.
The Mediterranean diet is related to better cardiometabolic profiles in FFs.
Additional Resources:
Multiple articles specific to firefighters on a variety of current nutrition topics
Loads of healthy and delicious recipes with the firefighter in mind
https://www.iaff.org/nutrition/
A selection of infographics, strategies, recipes, guides and information tailored to firefighters to support healthy eating.
https://www.hsph.harvard.edu/firefighters-study/feeding-americas-bravest/
Information, videos, and guidance on the Mediterranean Diet tailored to firefighters
Take a free online nutrition course designed for FFs
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Mental Health -
Links to research and articles that may be of interest (check out the references for more):
Shaul Bar Nissim H, Dill J, Douglas R, Johnson O, Folino C. The Ruderman White Paper Update on Mental Health and Suicide of First Responders. Ruderman Family Foundation; May 2022.
This report provides an update on the mental health of first responders.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755986/
Lassale C, Batty GD, Baghdadli A, et al. Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Mol Psychiatry. 2019;24(7):965-986.
This review assesses the role of dietary interventions to prevent depression.
Additional Resources:
First Responder Behavioral Health Access Program (BHAP) Toolkit (established by the Second Alarm Project)
Comprehensive resource to support the behavioral health needs of fire and EMS personnel. Includes evidence-informed strategies, interventions and resources to establish or enhance an existing behavioral health program.
Psychologically Healthy Fire Department
Click on “PHFD Implementation Toolkit”
Designed by NVFC to foster wellbeing while enhancing department performance.
Wellness-Fitness Initiative 4th Edition
Developed by the IAFF and IAFC. Outlines a comprehensive behavioral health program to support the mental and behavioral health needs of recruits, active FFs, and retirees.
24_Mindfulness-Focus-on-the-image-copy.jpg (firstrespondercenter.org)
Mindfulness techniques geared towards tactical athletes such as first responders.
Resource Guides - IAFF (International Association of Fire Fighters)
Links to a variety of resources from coping with grief, to dealing with burnout, to understanding PTSD.
The Resilient First Responder - Firefighter Mental Well-Being - Fire Engineering
Short article on what resilience means for first responders.
Links to a variety of stress management resources including guides, fact sheets, tips, etc.
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Hydration -
Links to research and articles that may be of interest (check out the references for more):
The Science Behind Rhabdomyolysis and the Firefighter - CRACKYL Magazine
Hollerbach BS. The Science Behind Rhabdomyolysis and the Firefighter. Crackyl.
Signs, symptoms, and why FFs are at an increased risk of rhabdo.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111227/
Walker A, Pope R, Orr RM. The impact of fire suppression tasks on firefighter hydration: a critical review with consideration of the utility of reported hydration measures. Ann Occup Environ Med. 2016;28:63.
Drinking ad libitum (as desired) during fire suppression activities helps prevent dehydration, but may not always be sufficient.
https://pubmed.ncbi.nlm.nih.gov/33829868/
Périard JD, Eijsvogels TMH, Daanen HAM. Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies. Physiol Rev. 2021;101(4):1873-1979.
This article reviews how the human body responds to exercise under heat stress and the countermeasures that can be used to improve aerobic performance in hot conditions.
https://pmc.ncbi.nlm.nih.gov/articles/PMC2867093/
Hostler D, Bednez JC, Kerin S, Reis SE, Kong PW, Morley J, Gallagher M, Suyama J. Comparison of rehydration regimens for rehabilitation of firefighters performing heavy exercise in thermal protective clothing: a report from the fireground rehab evaluation (FIRE) trial. Prehosp Emerg Care. 2010 Apr-Jun;14(2):194-201.
Performance was similar across rehydration methods with adequate hydration. No participant completed two consecutive 50-minute exertion periods, suggesting the NFPA "two cylinders before rehab" guideline may not always be suitable.
https://pubmed.ncbi.nlm.nih.gov/22443314/
Horn GP, DeBlois J, Shalmyeva I, Smith DL. Quantifying dehydration in the Fire Service using field methods and novel devices. Prehosp Emerg Care. 2012;16(3), 347-355.
A large proportion of firefighters arrived at training dehydrated. Hydration status through salivary osmolality measurements may offer a feasible field measurement tool.
Additional Resources:
https://health.clevelandclinic.org/what-urine-color-means
Check what the color of your urine means in terms of your hydration level.
Adapting to extreme heat to be #SummerReady (fema.gov)
Dr. Moore-Merrell interviews AZ fire chiefs about adapting to the extreme heat
Practical recommendations for firefighter hydration.
Rhabdomyolysis and Work | Rhabdomyolysis | CDC
Overview of Rhabdo (what it is, signs/symptoms, risk factors, prevention, etc.).
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Alcohol -
Links to research and articles that may be of interest (check out the references for more):
https://pubmed.ncbi.nlm.nih.gov/23064207/
Haddock CK, Jahnke SA, Poston WS, et al. Alcohol use among firefighters in the Central United States. Occup Med (Lond). 2012;62(8):661-664.
Relatively high rates of heavy and binge drinking were found among FFs in the study.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772477/pdf/main.pdf
Haddock CK, Jitnarin N, Caetano R, et al. Norms about Alcohol Use among US Firefighters. Saf Health Work. 2022;13(4):387-393.
Alcohol norms found in this study were in line with a “culture of drinking” in the fire service.
https://www.jscimedcentral.com/public/assets/articles/substanceabuse-2-1012.pdf
Jahnke SA, Poston WS, Haddock CK. Perceptions of alcohol use among US firefighters. J Subst Abuse Alcohol. 2014; 2(2):1012-18.
Explores reasons given by FFs for use of alcohol in the fire service.
Additional Resources:
Treatment for Alcohol Problems: Finding and Getting Help | National Institute on Alcohol Abuse and Alcoholism (NIAAA) (nih.gov)
A guide that provides treatment choices for those seeking help with alcohol problems.
Confidential and anonymous resource to help people find treatment for mental and substance use disorders.
CDC: Get started with drinking less
Tips to help you drink in moderation.
Science Alliance Alcohol Monograph (FYI, this is the same resource as the one noted on the bottom of this month, just in case you already checked out that QR code.)
This monograph aims to support fire departments in addressing alcohol use, raising awareness of its impact on firefighter health and safety, and offering guidance for preventive interventions.
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Cardiorespiratory Fitness -
Links to research and articles that may be of interest (check out the references for more):
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8625752/
Chizewski A, Box A, Kesler R, Petruzzello SJ. Fitness Fights Fires: Exploring the Relationship between Physical Fitness and Firefighter Ability. Int J Environ Res Public Health. 2021;18(22):11733.
A strong association exists between fitness and firefighting performance.
Association between Cardiovascular Disease Risk Factors and Cardiorespiratory Fitness in Firefighters: A Systematic Review and Meta-Analysis (nih.gov)
Ras J, Kengne AP, Smith DL, Soteriades ES, Leach L. Association between Cardiovascular Disease Risk Factors and Cardiorespiratory Fitness in Firefighters: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2023;20(4):2816. Available at:
Cardiovascular disease risk factors and cardiorespiratory fitness were significantly and inversely associated with firefighters.
Additional Resources:
High intensity workouts designed for firefighters.
Cardiovascular Endurance: Five Exercises to Push Yourself (verywellhealth.com)
Benefits of CV endurance and workouts to improve CRF.
2024 NFPA 1582 Amendments: Firefighter Health and Fitness - UDS (udshealth.com)
Overview of changes to NFPA 1582 CRF standards.
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Musculoskeletal Injuries -
Links to research and articles that may be of interest (check out the references for more):
A Profile of Injuries Sustained by Firefighters: A Critical Review - PMC (nih.gov)
Orr R, Simas V, Canetti E, Schram B. A Profile of Injuries Sustained by Firefighters: A Critical Review. Int J Environ Res Public Health. 2019;16(20):3931. Published 2019 Oct 16.
Review of most common injuries sustained by firefighters.
Firefighters – US Spine and Sport Foundation
Links to studies related to FFs and back injury.
https://www.sciencedirect.com/science/article/abs/pii/S0925753511000208
Park K, Rosengren KS, Horn GP, Smith DL, and Hsiao-Wecksler, E.T. Assessing gait changes in firefighters due to fatigue and protective clothing. Safety Science. 2011;49(5), 719-726.
Wearing PPE and heat-stress induced fatigue are associated with reduced gait performance and increased risk for tripping over obstacles.
https://pubmed.ncbi.nlm.nih.gov/26360190/
Kesler RM, Horn GP, Rosengren KS, Hsiao-Wecksler ET. Analysis of foot clearance in firefighters during ascent and descent of stairs. Appl Ergon. 2016;52:18-23.
Reduced clearance during ascent due to fatigue or load carriage may heighten risk of tripping. Increased clearance during descent may indicate a compensation strategy to ensure stair clearance or a greater risk of over-stepping.
https://pubmed.ncbi.nlm.nih.gov/29477318/
Kesler RM, Deetjen GS, Bradley FF, et al. Impact of SCBA size and firefighting work cycle on firefighter functional balance. Appl Ergon. 2018;69:112-119.
Different types of SCBA (particularly larger) and extended duration firefighting can impact dynamic balance ability.
https://www.sciencedirect.com/science/article/pii/S0003687018300309
Angelini MJ, Kesler RM, Petrucci MN, Rosengren KS, Horn GP, Hsiao-Wecksler ET. Effects of simulated firefighting and asymmetric load carriage on firefighter obstacle crossing performance. Appl Ergon. 2018;70:59-67.
Findings in this study indicate that both acute fatigue and carrying additional load can impair firefighter movement, potentially increasing the risk of slips, trips, and falls.
Additional Resources:
Chapter 1: Ergonomics and Wellness (firefighter injuries) (fema.gov)
Data on FF injuries.
Firefighter Longevity & Proper Workout Regimens | Firehouse
Functional training for new recruits through seasoned firefighters to reduce injury and improve efficiency.
Workout Tips To Reduce Firefighter Injuries - Fire Rescue Fitness
Ways for FFs to avoid injury while working out.
https://www.performancehealth.com/articles/top-fitness-exercises-for-firefighters
Functional FF exercises designed to help reduce injuries.
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Hazardous Exposures -
Links to research and articles that may be of interest (check out the references for more):
Horn GP, Kerber S, Fent KW, Smith DL. Management of Firefighters’ Chemical & Cardiovascular Exposure Risks on the Fireground. Int. Fire Serv. J. Leadersh. Manag. 2020;14:17–26.
This review provides fire service updated scientific information so fire service leaders
Additional Resources:
https://training.fsri.org/course/150/contamination-control-strategies-for-the-fire-service
This course synthesizes current research on fire service contamination control.
Additional, related courses can be found at the FSRI Safety Academy (https://training.fsri.org/) by searching for ‘exposure’
Firefighter Resources - Job Hazards | NIOSH | CDC
Links to a variety of publications that include different hazardous exposures for FFs.
National Firefighter Registry | NIOSH | CDC
Go to this site to join the National Firefighter Registry for Cancer to help better understand the connection between firefighting and cancer. The registry is for all FFs, not just those with a cancer diagnosis.
https://www.fsi.illinois.edu/research/cardiochem/#!/
Toolkit developed at IFSI to help translate findings from the Cardiovascular & Chemical Exposure Risks in Today's Fire Service studies for the fire service
https://www.firefightercancersupport.org/resources/library
A variety of resources, reports, guidance and information both at above website and under their “Resources” tab
https://firstrespondercenter.org/resource-hub/cancer/
https://www.iafc.org/topics-and-tools/resources/resource/cancer-prevention-resources
A variety of resources related to cancer can be found at the above websites.
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Stress -
Links to research and articles that may be of interest (check out the references for more):
Health outcomes of psychosocial stress within firefighters: A systematic review of the research landscape - PubMed (nih.gov)
Igboanugo S, Bigelow PL, Mielke JG. Health outcomes of psychosocial stress within firefighters: A systematic review of the research landscape. J Occup Health. 2021;63(1):e12219.
Psychosocial stressors can affect the health and well-being of FFs; interventions should promote self-esteem, enhance self-efficacy, and strengthen social support.
A Behavioral-Analytic Model for Assessing Stress in Firefighters - PubMed (nih.gov)
Schuhmann BB, Henderson SN, Black RA, et al. A Behavioral-Analytic Model for Assessing Stress in Firefighters. Behav Modif. 2022;46(2):267-293.
Development and validation of a tool (Firefighter Assessment of Stress Test) to detect and quantify stress in fire rescue personnel.
Additional Resources:
https://my.clevelandclinic.org/health/diseases/11874-stress
Overview of stress, how it affects the body, and management/treatment.
Managing Stress - FirefighterNation: Fire Rescue - Firefighting News and Community
Stress management techniques for FFs.
https://health.clevelandclinic.org/how-to-meditate-and-top-benefits
Meditation techniques.
Mindfulness exercises - Mayo Clinic
Learn some different mindfulness methods.
Yoga: https://youtu.be/9t3eovyxDjQ?si=ISYojAZjGX7ELuJZ
10 minute beginner yoga routine for first responders.
A variety of mental and emotional wellness resources for first responders, including links to self-assessments, mindfulness practices, and stress management information.
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Culture -
Cultural Change - Everyone Goes Home
The first of NFFF’s 16 Life Safety Initiatives involves cultural change.
How to Develop a ‘Winning’ Culture in Your Firehouse (fireengineering.com)
Insights on culture in first responder agencies.
How to build a successful fire service organizational culture (firerescue1.com)
Ways to improve fire service organizational culture.
Click the images to view and/or download the pdf
