by Kimberly Quiros, National Volunteer Fire Council

Most firefighters and EMTs pride themselves on being ready for the call. They go through countless hours of training, gain experience in emergencies of all kinds, and conduct initiatives to prepare their department and communities for disasters. But are they truly ready? How many have taken stock of their own health lately to make sure they are physically up to the challenges that lie ahead?

Think about the members of your fire department. Would you classify any as overweight or obese? Are there those that rarely exercise? What are their eating habits like? Have any of your responders suffered from heart disease or related conditions? Have any had a heart attack?

Chances are you answered yes to at least some of these questions. Now think about your own health – are you doing everything you can to be physically ready for the strenuous job of a first responder? If the answer is no, you are not alone. Yet being heart healthy is as important for a firefighter and EMT as being properly trained and practicing the utmost safety on the fireground.

Heart disease is the number one threat to firefighters, but it can be prevented. This article highlights why it is important to focus on health in the fire service and steps you can take to help you and your department members get heart strong and avoid preventable tragedies.

Look at the Facts

For those who are not convinced that heart attack and obesity are a problem in the fire service that needs to be addressed, consider the following evidence.

Heart attack is consistently the leading cause of on-duty deaths for firefighters each year. The U.S. Fire Administration reports heart attack caused 47.2% of on-duty deaths in 2012. Between 2003 and 2012, 504 firefighters suffered a line-of-duty death from heart attacks. More than half of these (312) were volunteers.

A 2007 study published in the New England Journal of Medicine found that firefighters are at a greater risk of dying from a heart attack while responding to emergencies. It concluded that emergency firefighting duties were associated with a risk of death from coronary heart disease that was markedly higher than the risk associated with nonemergency duties. Fire suppression was associated with the highest risk.

A study on firefighter obesity released in 2011 by the National Volunteer Fire Council (NVFC) reported that the rates of overweight and obese individuals in the fire service are higher than those found in the general public. Between 73 to 88 percent of firefighters are overweight or obese.

A 2013 study in the Obesity Journal found that weight was a significant predictor of incident musculoskeletal injury, with obese firefighters 5.2 times more likely to experience this type of injury than firefighters who fell into a normal weight range. The study concluded that focusing on firefighters’ body composition, nutrition, and fitness can decrease risk for injury.

Another study on obesity in the fire service released in July by the Centers of Disease Control and Prevention also reported that the percentage of overweight or obese firefighters exceeds the national average. The findings indicated that healthcare providers do not consistently provide overweight and obese firefighters with weight advice, marking a missed opportunity to positively impact firefighter weight and reduce negative health outcomes caused by obesity.

Challenges for Volunteers

These studies illustrate the increased risk for heart disease, heart attack, and obesity in the U.S. fire service. Additional concerns include high blood pressure, high cholesterol, diabetes, sleep deprivation, and other conditions and risk factors that can negatively impact the health of firefighters. When it comes to addressing firefighter health and implementing programs to create a healthier fire service and reduce the risk of these negative outcomes, volunteer and combination departments face unique challenges.

Balancing a full-time job, family commitments, and the fire service often leads to eating on the go and little free time to head to the gym. Funding also becomes an issue, as many volunteer departments are struggling to purchase and maintain needed gear and equipment, with nothing left over to invest in a health and wellness program.

Many departments struggle with having sufficient staffing to provide needed services to their communities. The department leaders may be concerned that implementing wellness initiatives and enforcing strict health standards would result in firefighters leaving the department or being benched from responding, thus creating an even greater staffing shortage.

Challenges may exist to establishing a healthy precedent in a department, but it is worth taking the time to figure out how to overcome the challenges so that preventable health-related tragedies can be eliminated. The fire service community needs to redefine how it looks at health and where its priorities are placed. When it comes to protecting our nation’s firefighters, reducing line-of-duty death and injury should be the top priority. Every chief, officer, firefighter, and EMT should be focused on doing whatever it takes to ensure that everyone goes home. This means placing health and wellness at the top of the list and not at the bottom or as an after thought.

What You Can Do

The first step is to make health a priority in your department. Leadership needs to lead by example and encourage healthy behaviors. Ideally, identify a member of the department who is health-minded and willing to be the department’s advocate for health and wellness. This person can serve as the motivator for the rest of the personnel, as well as the point of contact for establishing and implementing health and wellness initiatives, with guidance and approval from leadership.

Firefighters also need to overcome the notion that they don’t have time for good nutrition and fitness. Making healthier food choices doesn’t have to be difficult or expensive. If eating on the go, choose a healthier restaurant or menu option. Trade snacks that are high in sugar, fat, and sodium for smarter options like nuts, fruit, yogurt, whole grain cereals, or popcorn. Select lean meats and bake, broil, or grill it instead of frying. Limit your intake of added sugars, especially sugar-sweetened beverages such as soda, sports drinks, and some fruit drinks. Add more whole grains and vegetables to your diet. Find more guidance for making healthy eating choices here.

Fit in exercise when you can. It is not enough to assume you are getting exercise simply because you are a firefighter. You need to make the effort to ensure your body is ready for the call. There are many exercises that can be done while at the station and using only items that can readily be found in a firehouse. Some examples are available here. Fitness should also be incorporated into a department’s regular training activities. For instance, the East Whiteland Fire Department in Malvern, PA, incorporates fitness training into their real-world fire and EMS training sessions. Make it a group effort and challenge the entire department to focus on getting and staying healthy. This way the firefighters can be there to support and encourage each other in their efforts.

Getting healthy isn’t just beneficial for firefighters. Get the family involved by utilizing family time to participate in fun, healthy activities, such as taking walks, playing sports, and cooking creative healthy meals together.

Encourage youth in junior firefighter programs to establish healthy habits from their start in the fire service. Emphasize it is part of a firefighter’s job to be ready to respond, and they need to make sure they are physically prepared. The National Junior Firefighter Program offers resources to help local programs focus on health and wellness, including the Training the Next Generation course and supplemental fitness video series.

Departments should also do their best to meet the recommended National Fire Protection Association (NFPA) standards for health and wellness. The NVFC partnered with the NFPA to create a series of guides to help volunteer and combination departments meet critical safety standards in their departments. This includes NFPA 1500, Standard on Fire Department and Occupational Safety and Health Programs. Access the guide here.

Resources from the Heart-Healthy Firefighter Program

The NVFC established the Heart-Healthy Firefighter Program in 2003 to address heart health in the fire service, reduce deaths and injuries from heart attacks and related illnesses, and provide resources and tools to help firefighters and EMTs get and stay healthy. Available resources include the following:

Resources for starting and implementing a health and wellness program in your fire/EMS department
Health and Wellness Advocate Workshop to train personnel to start a department health and wellness program and motivate their fellow responders to focus on health and fitness
Fired Up for Fitness Challenge, an interactive tool to motivate first responders to get active
Information on heart health, fitness, nutrition, and lifestyle choices
International Fire/EMS Safety and Health Week, held each June in partnership with the IAFC to encourage departments and personnel to focus on safety and health topics especially critical to the fire and emergency services
Health and wellness monthly challenges to help motivate your department
Online training courses to educate first responders about important health and wellness topics
Securing Sponsors for Department Health and Wellness Programs, a toolkit for finding funding to support a wellness program in your department
Heart Healthy Firefighter Cookbook featuring tasty yet healthy recipes submitted by firefighters from across the country
Smoking cessation resources
Success stories from first responders from across the country who have succeeded in getting heart healthy
Fitness and nutrition demonstration videos

Focus on Health in the Long Term

Heart attacks and related tragedies can be prevented. Make heart health a priority in your life and in your department. By creating a culture that embraces good health, nutrition, and fitness, you will strengthen your department and ensure your firefighters are truly ready to respond.