title: Health concerns of the U.S. fire service: perspectives from the firehouse.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  This study uses the cross-sectional qualitative data collection techniques of key informant interviews and focus groups.
  
  
  METHODS
  Data collection occurred with a national sample of firefighters from 28 (municipal and federal) career fire departments.
  
  
  METHODS
  Participants were 332 career firefighters (57.2%), company officers (23.4%), fire chiefs (15.4%), and other fire service personnel (3.9%).
  
  
  METHODS
  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.
authors.affiliation: Center for Fire Rescue & EMS Health Research, Institute for Biobehavioral Health Research, National Development & Research Institutes, Leawood, Kansas 66204, USA. sara@hopehri.com
authors.forename: Sara A
authors.initials: SA
authors.lastname: Jahnke
authors.forename: Walker S C
authors.initials: WS
authors.lastname: Poston
authors.forename: Nattinee
authors.initials: N
authors.lastname: Jitnarin
authors.forename: C Keith
authors.initials: CK
authors.lastname: Haddock
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D061388:Firefighters / Q000523:psychology*; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000523:psychology*; D016272:Occupational Health; D036301:Qualitative Research; D014481:United States