NEW YORK
(Reuters Health)
C. E.
Huggins
Reuters
11:50 a.m. CST, November 15, 2013
- For
a physically demanding job like firefighting, fitness is a basic requirement
and may protect against injury, U.S. researchers say.
After
tracking men and women in the Tucson, Arizona, fire department for five years,
the study team found firefighters with the highest aerobic capacity tended to
have the fewest work-related sprains, strains and other injuries.
Even though
the least fit firefighters were in better shape than the general population,
the study shows "those that are ‘less fit’ in an otherwise fairly fit
population of firefighters and medics are still susceptible to an increased
risk of injury as compared to their ‘more fit’ counterparts," according to
lead author Dr. Gerald S. Poplin, of the University of Virginia.
Poplin and
his co-authors used aerobic capacity - the ability of the body to use oxygen -
as a gauge of firefighters overall fitness levels. They got fitness information
from records of the fire fighters' annual physicals and tracked injuries in
fire department reports covering 2005 through 2009.
The Tucson
fire department operates 21 fire stations and serves 520,000 city residents.
Among 799
male and female fire service employees included in the study, 357 had at least
one reported injury during the study period. There were a total of 773 injuries
- not including strokes, heart attack, heat exhaustion and other conditions
that suggest an underlying disease or problem.
Two thirds
of all work-related and exercise-related injuries were sprains and strains.
Thirty percent of injuries led to lost time on the job.
Poplin's
team followed standards from the Wellness Fitness Initiative of the
International Association of Fire Fighters (IAFF) and the International
Association of Fire Chiefs (IAFC) to divide participants according to fitness
level.
They used a
measure of aerobic fitness, VO2 max, that represents maximum oxygen levels
transported through the body during extreme exertion in the form of milliliters
of oxygen per kilogram of body weight per minute.
To put
things in perspective, Poplin told Reuters Health, for non fire-service
workers, gardening may require 14ml/kg/min of aerobic capacity, whereas
professional basketball or cross-country skiing may require more than
50ml/kg/min of aerobic capacity.
In the
general population of nonathletes, the average healthy man will have a maximum
capacity between about 35 and 40 and for the average healthy woman it will be about
27 to 31.
For the
firefighters, an aerobic capacity of less than 43 was considered "less
fit" and those with a capacity greater than 48 were considered "more
fit." Overall fitness levels among the study participants ranged from
about 43.6 to 55.8, the researchers report in the American Journal of
Epidemiology.
In general,
the firefighters' risk of on-the-job injury increased as their fitness levels
decreased. The least physically fit firefighters were more than twice as likely
to experience injury as the fittest.
The least
physically fit individuals also experienced injury sooner, within about two
years, than the most physically fit firefighters, who lasted about four years
without injury.
In their
report, Poplin's team says it's not clear why the fittest firefighters were
less likely to get hurt, but they speculate that those "in the top levels
of a fitness spectrum may not be as susceptible to microtraumas and may recover
better from injury than their less-fit counterparts."
The
researchers conclude, "These findings illustrate the importance of fitness
in reducing the risk of injury in physically demanding occupations, such as the
fire service, and support the need to provide dedicated resources for
structured fitness programming and the promotion of injury prevention
strategies to people in those fields."
Jim
Brinkley, director of Occupational Health and Safety for the International
Association of Fire Fighters agreed and also emphasized the importance of
teaching proper lifting and bending techniques.
"Fitness
without proper movement patterns or proper movement without fitness both leave
you unprepared to meet the physical demands of the job," he told Reuters
Health.
According to
Poplin, the study results indicate that for an individual firefighter,
improving aerobic capacity by 3.5 ml/kg/minute would reduce injury risk by
about 14 percent.
However,
improving physical fitness among firefighters will require financial resources
and specialized trainers, such as the peer fitness trainers used in the
Wellness Fitness Initiative, he said.
A key aspect
of the initiative, which calls for individualized wellness-fitness programs for
active firefighters, is a holistic wellness approach that addresses
"medical, fitness, injury/fitness/medical rehabilitation and behavioral
health," according to the IAFF Website.
Currently
only about 10 states, including Washington, Texas, and New York, have fire
departments participating in the initiative, along with one department in
Alberta, Canada.
"We
have this make-believe image that firefighters and paramedics know how to keep
themselves in shape but they need proper instruction just like everyone
else," Poplin said.
Noting that
"a lot of fire departments rely on other fire departments," Poplin
added that volunteer firefighters would also greatly benefit from such
resources.
Brinkley
cautioned against a "knee-jerk reaction" of setting a physical
fitness standard that all firefighters must adhere to, however.
"Everybody's
always looking for that cut off," such as a specific number of push ups or
sit ups, he said.
"There
are certain levels (of physical fitness) that are benchmarks to improve to meet
the demands of the job," he said, but the specific benchmark varies from
individual to individual.
"To say
that every firefighter must be able to do X" is not right, he said.
"It is our position that the best way to measure (fitness) is on an
individual basis," he said.
SOURCE:
http://bit.ly/1asOfa7 American Journal of Epidemiology, online October 31,
2013.
http://www.chicagotribune.com/health/sns-rt-us-firefighters-injury-20131115,0,2954988.story?page=1
