Association of Physical and Emotional Parameters with Performance of Firefighters: A Systematic Review.

Firefighting requires a high level of physical fitness and causes substantial psychological stress, engendering musculoskeletal, mental, and cardiac issues. Consequently, it is necessary to measure the preparation of the firefighters daily through the Firefighting Physical Ability Tests (FPATs). According to the literature, some variables are more important for performance in the FPAT. Therefore, we aimed to summarize evidence that relates physical and mental aspects to the FPAT performance. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) method, screening 1055 records from databases and selecting 15 that met inclusion criteria. No emotional and psychological variables were correlated with the FPAT. Most research shows significant correlations between the FPAT performance and the following: aerobic fitness, upper body endurance and strength, anaerobic capacity, body fat, and age. Lower body endurance and strength, as well as anaerobic power, had a low number of investigations and need to be further explored. Abdominal endurance showed weak correlations, while flexibility did not show any correlations in most studies, although these should be considered for injury prevention. We recommend that fitness programs and evaluations include a global analysis considering the evidence presented for methodological improvements.

Efficacy of a program in increasing coping strategies in firefighters: randomized clinical trial.

OBJECTIVE: to evaluate the effectiveness of a program in increasing coping strategies focused on military firefighters' problems and emotions. METHOD: randomized, parallel, single-masked clinical trial. The sample consisted of 51 participants in the intervention group and 49 in the control group. The intervention group received the intervention program including coping strategies based on the Nursing Interventions Classification, lasting six consecutive weeks, one day a week. The control group followed the Service Unit routine. Descriptive statistics, Student's T test with Welch's correction and the Mann-Whitney test were used for the analyses. The magnitude of the intervention effect was calculated using Cohen's d index. A p-value of ≤0.05% was considered. RESULTS: in the analysis of the mean difference between the scores in the groups, the means of the intervention group increased significantly for the coping strategies: social support (p = 0.009), acceptance of responsibility (p = 0.03), problem solving (p = 0.05) and positive reappraisal (p = 0.05). The impact of the intervention was moderate in magnitude for social support (d = 0.54). CONCLUSION: the intervention program enabled the increase of coping strategies focused on military firefighters' problems and emotions. ReBEC: RBR-8dmbzc. (1) The intervention program increases coping strategies. (2) The study included military firefighters. (3) Social support was the main strategy of the study. (4) Intervention group presented better results than the control group. (5) The use of the Nursing Intervention Classification was effective.

Repercussões laborais no autocuidado em saúde de bombeiros militares brasileiros / Labor effects on the self-care of brazilian firefighters

Introdução: O autocuidado é uma importante estratégia para o bombeiro militar manter sua saúde em meio a uma atividade laboral que convive diariamente com situações de insegurança e estresse. Objetivo: identificar as percepções de bombeiros militares sobre as repercussões do seu trabalho no autocuidado em saúde. Metodologia: Trata-se de uma pesquisa qualitativa, realizada nos moldes da Pesquisa Convergente Assistencial desenvolvida por meio de observação participante, grupos focais, oficinas e entrevistas coletivas junto a 34 bombeiros militares pertencentes a um Batalhão localizado no Sul do Brasil. Os dados obtidos foram submetidos a análise temática. Resultado: Obtiveram-se três temas finais, sendo eles, ''Estratégias de autocuidado e de promoção da saúde dos profissionais bombeiros''; e ''Repercussões do labor sob o autocuidado''. Enquanto, a análise dos dados das entrevistas coletivas propiciou a produção do tema ''Pontos de convergências: a pesquisa como promotora de autocuidado''. Conclusão: Embora os participantes estejam conscientes de estratégias que contribuam para o autocuidado, eles também destacam a repercussão negativa que o trabalho tem sobre sua saúde.

Introducción: El autocuidado es una estrategia importante para que el bombero militar mantenga su seguridad en su actividad laboral, donde convive diariamente con situaciones de inseguridad y estrés. Objetivo: Identificar las percepciones de los bomberos militares sobre las repercusiones de su trabajo en el autocuidado de su salud. Metodología: Se trata de una investigación cualitativa, siguiendo el modelo de la investigación convergente asistencial. Fue desarrollada por medio de la observación participante, grupos focales, talleres de trabajo y entrevistas colectivas con 34 bomberos militares pertenecientes a un batallón localizado en el Sur de Brasil. Los datos obtenidos fueron sometidos a análisis temático. Resultados: Se obtuvieron tres temas finales: ''Estrategias de autocuidado y promoción de la salud para bomberos profesionales''y ''Repercusiones del trabajo en el autocuidado''. Además, el análisis de los datos de las entrevistas colectivas condujo a la producción del tema ''Puntos de convergencia: la investigación como promotora del autocuidado''. Conclusión: Aunque los participantes son conscientes de las estrategias que contribuyen al autocuidado, también destacan las repercusiones negativas que el trabajo tiene en su salud.

Introduction: Self-care is an important strategy for military firefighters to preserve their health in a work activity involving daily insecurity and stress. Objective: To identify military firefighters' perceptions about their work's health repercussions. Methodology: This is qualitative research, conducted in the framework of the Convergent Care Research developed through participant observation, focus groups, workshops, and collective interviews with 34 military firefighters from a battalion located in Southern Brazil. The data obtained were subjected to thematic analysis. Results: There were three final themes: ''Strategies for self-care and health promotion for professional firefighters''and ''Repercussions of work on self-care''. The analysis of the data from the collective interviews included the theme ''Points of convergence: research as a promoter of self-care''. Conclusion: Although participants are aware of the strategies that contribute to their self-care, they also emphasize the negative repercussions that work has had on their health.

O fardo da segurança: uma análise institucional com bombeiros militares / The security burden: an institutional analysis with military firefighters / La carga de la seguridad: um análisis institucional com bombeiros militares

A Análise Institucional tem como intuito principal provocar os indivíduos nas instituições a estabelecer um processo de autoanálise e autogestão. Assim, este trabalho consiste no relato de uma análise institucional realizada no Corpo de Bombeiros Militar de um município do Rio Grande do Sul, como tarefa obrigatória para a conclusão de Estágio Básico do Curso de Psicologia. Foram realizadas visitas ao Corpo de Bombeiros, nas quais pode-se observar o funcionamento da instituição. Posteriormente, foram propostas rodas de conversas, nas quais foi lançada como pergunta disparadora de diálogo: "o que significa ser bombeiro para você?". Isso posto, emergiu enquanto demanda a busca de identidade própria dos bombeiros e a necessidade de uma atenção mais sensível às questões institucionais. Destaca-se o anseio dos trabalhadores sobre a necessidade de um profissional da psicologia inserido no cotidiano do quartel militar, disponível para intervenções individuais e coletivos nas unidades de trabalho. (AU)

El Análisis Institucional tiene como objetivo principal provocar individuos de instituciones a establecer un proceso de autoanálisis y autogestión. Así, este trabajo consta del informe de un análisis institucional realizado en el Cuerpo de Bomberos Militares de un municipio de Rio Grande do Sul, como tarea obligatoria para la Formación Básicadel Curso de Psicología. Se realizaron visitas al Cuerpo de Bomberos y se observóel funcionamiento de la institución. Posteriormente, se propusieron rondas de conversaciones y se lanzó la pregunta "¿qué significa ser bomberopara ti?" desencadenante de diálogo. Dicho esto, surgió como una demanda por la búsqueda de una identidad de los bomberos militares, marcando una diferencia en relación a los policías militares, así como la necesidad de una atención más sensible a las cuestiones institucionales.Se destaca la ansiedad de los trabajadores por la necesidad de un psicólogo insertado en la vida cotidiana del cuartel militar, disponible para intervencionesindividualesycolectivasen todas las unidadesde trabajo. (AU)

Institutional Analysis has the main purpose of provoking individuals in institutions to establish a process of self-analysis and self-management. Thus, this study is the report of an institutional analysis accomplished in the Military Fire Department of a municipality in Rio Grande do Sul, as a mandatory task to complete Basic Internshipof the Psychology Course. Visits were made to the Fire Department, in whichwas possible to observe the institution's functioning. Subsequently, rounds of conversations were proposed, in which the question "what does it mean to be a fireman for you?" was launched as a triggering fordialogue. That said, it emerged as a demand for the search for an identity of military firefighters, marking a difference in relation to military police officers, as well as the need for more sensitive attention to institutional issues.Stands out the workers' anxiety about the need for a psychologist inserted in the daily life of the military barracks, available for individual and collective care in allwork units. (AU)

Comparative analysis of the health status of military police officers and firefighters: a cross-sectional study in the State of Paraná, Brazil.

OBJECTIVES: To evaluate the health-condition of military police officers and firefighters. To identify risk factors for not being medically ready for duty. DESIGN: Cross-sectional study. SETTING: Data were extracted from medical records during annual periodic health assessments of police officers and firefighters serving with the military police in Paraná, Brazil. PARTICIPANTS: 6621 police officers (5927 men and 694 women) and 1347 firefighters (1257 men and 90 women) who underwent health assessments between July 2018 and June 2019 were analysed. Pregnant women were excluded. OUTCOME MEASURES: Data included variables such as sex, age, anthropometric measurements, lifestyle, comorbidities and laboratory tests. Multiple logistic regression was used to estimate the probability of not being medically ready for active duty. RESULTS: Overall, police officers had worse health status than firefighters and greater prevalence of overweight and obesity, regardless of sex. Musculoskeletal diseases were the most commonly reported disease by police officers and firefighters of both sexes. Among men, hypertension was the second most prevalent disease, followed by psychiatric diseases and dyslipidaemia. Among women, psychiatric diseases were the second most prevalent. Male police officers ≥40 years old presented the highest probability of not being considered ready for duty (40.1%). The probability of male police officers between the ages of 31 and 40 not being ready was similar to that for male firefighters >40 years old. There was a higher chance of not being medically ready professionals with diseases such as diabetes mellitus (OR 2.95, 95% CI 1.97 to 5.03), dyslipidaemia (OR 2.65, 95% CI 1.96 to 3.58), hypertension (OR 2.29, 95% CI 1.85 to 4.70), high total cholesterol (OR 2.16, 95% CI 1.93 to 2.42), and heart disease (OR 2.13, 95% CI 1.32 to 3.45). CONCLUSIONS: There was a high prevalence of chronic diseases and modifiable cardiovascular risk factors among police officers and firefighters. Healthy protective measures should be offered frequently, particularly to police officers at an earlier age.

Impactos do estresse na exposição ocupacional de bombeiros: revisão integrativa / Impacts of stress on occupational exposure of firefighters: an integrative review / Impactos del estrés en la exposición ocupacional de los bomberos: una revisión integradora

Objetivo: identificar os impactos na saúde mental de bombeiros relacionados ao estresse da exposição ocupacional. Método: trata-se de uma revisão integrativa da literatura nas bases de dados CINAHL (EBSCO), PsycINFO, MEDLINE®, LILACS, Web of Science, Scopus e SCIELO. Para a estratégia de busca utilizou-se os descritores: "Occupational Stress", "Firefighters", "Occupational Exposure". Como critérios de inclusão estabeleceu-se: artigos originais; entre os anos de 2009 e 2019; disponíveis completos; estudos transversais; nos idiomas português, inglês e/ou espanhol; e cuja população de estudo incluíssem bombeiros. Resultados: nessa revisão foram analisados 11 artigos. Evidenciou-se que a exposição de bombeiros impactou o desencadeamento de sintomas de depressão e transtorno de estresse pós-traumático. Conclusão: as evidências deste estudo demonstraram que a exposição ocupacional de bombeiros interfere no seu padrão de saúde mental causando estresse por meio do sofrimento psíquico. Este estudo alerta para a necessidade de intervenção e promoção à saúde do bombeiro.

Objective: to identify mental health impacts of occupational exposure-related stress among firefighters. Method: this integrative literature review searched the CINAHL (EBSCO), PsycINFO, MEDLINE®, LILACS, Web of Science, Scopus and SCIELO databases, suing the descriptors: "Occupational Stress", "Firefighters", "Occupational Exposure". The inclusion criteria were: original articles; between the years 2009 and 2019; full text available; cross-sectional studies; in Portuguese, English and/or Spanish; and whose study population included firefighters. Results: 11 articles were analyzed. Firefighters' exposure was found to impact the triggering of depressive symptoms and post-traumatic stress disorder. Conclusion: the evidence in this study demonstrated that firefighters' occupational exposure interferes with their mental health patterns, causing stress through psychological suffering. This study warns of the need for intervention and promotion of firefighters' health.

Objetivo: identificar los impactos en la salud mental del estrés relacionado con la exposición ocupacional entre los bomberos. Método: esta revisión integradora de la literatura buscó en las bases de datos CINAHL (EBSCO), PsycINFO, MEDLINE®, LILACS, Web of Science, Scopus y SCIELO, demandando los descriptores: "Estrés ocupacional", "Bomberos", "Exposición ocupacional". Los criterios de inclusión fueron: artículos originales; entre los años 2009 y 2019; Texto completo disponible; estudios transversales; en portugués, inglés y / o español; y cuya población de estudio incluyó bomberos. Resultados: se analizaron 11 artículos. Se descubrió que la exposición de los bomberos afecta la activación de síntomas depresivos y el trastorno de estrés postraumático. Conclusión: la evidencia de este estudio demostró que la exposición ocupacional de los bomberos interfiere con sus patrones de salud mental, provocando estrés a través del sufrimiento psicológico. Este estudio advierte de la necesidad de intervención y promoción de la salud de los bomberos.

Crescimento pós-traumático em profissionais de emergências: uma revisão sistemática de estudos observacionais / Posttraumatic growth among emergency workers: a systematic review of observational studies / Crecimiento post-traumático en profesionales de servicios de urgencia: una revisión sistemática de estudios observacionales

A exposição a eventos traumáticos pode gerar Crescimento Pós-Traumático (CPT). O objetivo do presente estudo foi realizar uma revisão sistemática das publicações sobre prevalência de CPT e sua associação com estressores ocupacionais entre profissionais de emergências. A revisão foi baseada no método PRISMA e previamente registrada no PROSPERO. A busca foi realizada nas bases de dados Medical Literature Analysis and Retrieval System Online (Medline), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Scientific Electronic Library Online (ScIELO). Dentre os resultados, não foi possível identificar a prevalência de CPT. Estressores operacionais foram associados ao CPT. Estressores organizacionais foram raramente investigados. Concluiu-se que o CPT é um dos focos em estudos sobre reações pós-traumáticas entre profissionais de emergências e está associado a estressores ocupacionais. Por isso, trata-se de um construto importante para compreender a saúde mental desses profissionais, dada a organização e a natureza de suas tarefas no trabalho. (AU)

Exposure to traumatic events can lead to Posttraumatic Growth (PTG). The present study aimed to was to conduct a systematic review of publications on the prevalence of PTG and its association with occupational stressors among emergency professionals. The review was based on the PRISMA method and previously registered in PROSPERO. The search was conducted in following eletronic databases: Medical Literature Analysis and Retrieval System Online (Mediline), Latin American and Caribbean Literature in Health Sciences (Lilacs), and Scientific Electronic Library Online (Scielo). It was not possible to identify the prevalence of The prevalence of PTG was not identified among emergency professionals. Operational stressors were associated with to PTG. Organizational stressors were rarely investigated. We concluded that PTG is one of the focuses in studies on post-traumatic reactions among emergency professionals and it is associated with occupational stressors. Therefore, it is an important construct to understand the mental health of these professionals given the organization and the nature of their occupational tasks. (AU)

La exposición a eventos traumáticos puede generar Crecimiento Post-Traumático (CPT). El objetivo del presente estudio fue realizar una revisión sistemática de las publicaciones sobre predominio del CPT y su asociación con estresores ocupacionales entre profesionales de servicios de urgencia. La revisión fue basada en el método PRISMA y previamente registrada en el PROSPERO. La búsqueda se llevó a cabo en las bases de datos de Medical Literature Analysis and Retrieval System Online (Medline), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Scientific Electronic Library Online (Scielo). Entre los resultados, no fue posible identificar el predominio del CPT. Estresores operativos se asociaron con el CPT y estresores organizacionales fueron raramente investigados. Se concluyó que el CPT es el foco principal en los estudios sobre reacciones postraumáticas entre los profesionales de servicios de urgencia y está asociado a estresores ocupacionales. Por eso, se trata de un constructo importante para comprender la salud mental de esos profesionales dada la organización y la naturaleza de sus tareas en el trabajo. (AU)

A face humana do herói: análise do processo saúde-doença de bombeiros a partir de comunidades virtuais / The hero's human face: analyzing firemen's health-disease process based on virtual communities / El rostro humano del héroe: análisis del proceso salud-enfermedad de bomberos a partir de comunidades virtuales

Resumo Poucos estudos na literatura nacional abordam a relação trabalho e saúde dos bombeiros militares; entre tais estudos, muitos focam apenas os indicadores patológicos e/ou consequências físicas, sem colocar em debate suas necessidades de saúde e vida no trabalho. Visando analisar essa relação em uma perspectiva ampliada e humanizada do herói, foi realizado um estudo exploratório e metodologicamente inovador em dois blogs da categoria. Desvelaram-se realidades até então invisíveis ou pouco conhecidas socialmente no tocante ao processo de trabalho do grupo investigado, como precarização das condições laborais, adoecimentos, desvios de função, humilhações e insatisfações, evidenciando a necessidade de reconhecer os bombeiros militares como trabalhadores e que carecem de condições dignas de trabalho e atenção integral à saúde, sobretudo no que diz respeito à saúde mental.(AU)

Abstract Few studies deal with military firemen's work/health relationship in national literature, among which many focus only on pathological indicators and/or physical consequences, not discussing their health and life needs at work. Aiming at analyzing this relationship under a wider, humanized perspective of heroes, an exploratory and methodologically innovative study was conducted in two industry blogs. Invisible or socially little known realities concerning the investigated group's work process were unveiled, such as precarious labor conditions, illnesses, role deviation, humiliation, and dissatisfaction. These realities show the need for acknowledging military firemen as workers who lack decent working conditions and comprehensive healthcare, particularly regarding their mental health.(AU)

Resumen Son pocos los estudios en la literatura nacional que abordan la relación trabajo y salud de los bomberos militares, entre ellos, muchos se enfocan solamente en los indicadores patológicos y/o consecuencias físicas, sin poner en debate sus necesidades de salud y vida en el trabajo. Con el objetivo de analizar esa relación desde una perspectiva ampliada y humanizada del héroe, se realizó un estudio exploratorio y metodológicamente innovador en dos blogs de la categoría. Se revelaron realidades hasta entonces invisibles o poco conocidas socialmente en lo que se refiere al proceso de trabajo del grupo investigado, tales como la precarización de las condiciones laborales, enfermedades, desviaciones de función, humillaciones e insatisfacciones, poniendo en evidencia la necesidad de reconocer a los bomberos militares como trabajadores y que carecen de condiciones dignas de trabajo y de atención integral de la salud, principalmente en lo que se refiere a la salud mental.(AU)

Anxiety and contradictory class position in the hierarchy of Brazilian firefighters.

BACKGROUND: Workers holding intermediate hierarchical positions in an institution may have a higher risk of occupational stress-related, ill health. This study examined the prevalence rates and odds ratios (ORs) of anxiety disorders among a hierarchical group of firefighters. METHODS: This cross-sectional study samples firefighters from Minas Gerais, Brazil, who answered a structured questionnaire in 2011 (survey completion rate = 89.5%). The outcome of interest was a medical diagnosis of anxiety disorder. Bivariate and multivariate analyses were conducted among five hierarchical occupational positions: privates (lowest position), corporals, sergeants (intermediate position), sub lieutenants, and officers (highest position). RESULTS: Overall, 8.4% of the sample reported an anxiety disorder, with the highest rate observed among intermediate workers (sergeants = 14.2%), followed by corporals (10%), privates (5.6%), sub lieutenants (5%), and officers (2.1%). Compared with privates, the unadjusted OR for sergeants was 2.49 (95% confidence interval, 1.35, 4.58). This finding remained statistically significant after adjustment for several control variables but was eliminated by age. CONCLUSION: The mental health of firefighters is affected by social class position. Mental health promotion efforts should focus on longitudinal research and work toward interventions aimed at modifying the hierarchical structure of workplaces.

Factors associated with the use of anxiolytic drugs among military firefighters. / Fatores associados ao uso de medicamentos ansiolíticos entre bombeiros militares.

INTRODUCTION: Use of anxiolytic drugs is an option for treating psychological symptoms. However, even if their use is controlled, there are risks of dependence, intoxication and cognitive alterations. Uncontrolled use among workers worsens these problems. OBJECTIVES: Identify the prevalence of anxiolytic use and to know the factors associated with consumption in military firefighters. METHOD: Cross-sectional survey of 711 firefighters from Belo Horizonte, Minas Gerais, Brazil, was conducted through self-reporting. Multinomial logistic regression was used to investigate associations between sociodemographic characteristics, living, working and health conditions and anxiolytic consumption in a controlled or uncontrolled manner. RESULTS: Prevalence of anxiolytic use was 9.9%. For 7.5% of firefighters the consumption occurred without indication and/or specialized therapeutic control. Controlled use was only associated with symptoms compatible with Common Mental Disorder (OR = 23.6; 95%CI 6.54 - 85.11). Uncontrolled use was associated with length of service (OR = 2.57; 95%CI 1.03 - 6.40), smoking (OR = 3.22; 95%CI 1.50 - 6.91) and symptomatology compatible with Common Mental Disorder (OR = 4.02; 95%CI 2.17 - 7.45). CONCLUSION: The high prevalence of consumption indicates alert to occupational health programs.

INTRODUÇÃO: O uso de ansiolíticos é uma opção no tratamento de sintomas psíquicos. Contudo, ainda que o uso seja controlado há riscos de dependência, intoxicação e alterações cognitivas. O uso não controlado entre trabalhadores agrava tais problemas. OBJETIVOS: Identificar a prevalência do uso de ansiolíticos e conhecer os fatores associados ao consumo em bombeiros militares. MÉTODO: Pesquisa transversal de base censitária investigou 711 bombeiros de Belo Horizonte, Minas Gerais, por meio de autorrelato. Regressão logística multinomial foi utilizada para verificar associação entre características sociodemográficas, condições de vida, trabalho e saúde e consumo de ansiolíticos de modo controlado ou não. RESULTADOS: A prevalência do uso de ansiolíticos foi 9,9%. Para 7,5% dos bombeiros o consumo ocorreu sem indicação e/ou controle terapêutico especializado. O uso controlado foi associado ao relato compatível com Transtorno Mental Comum (OR = 23,6; IC95% 6,54 - 85,11). O uso não controlado foi associado ao tempo de serviço (OR = 2,57; IC95% 1,03 - 6,40), ao tabagismo (OR = 3,22; IC95% 1,50 - 6,91) e ao Transtorno Mental Comum (OR = 4,02; IC95% 2,17 - 7,45). CONCLUSÃO: A alta prevalência de consumo indica alerta para as ações dos programas de saúde ocupacional.

Levels of physical activity and associated factors between military policemen and firemen.

BACKGROUND: Military Policemen and Firemen are professionals often involved in life-risking activities as well as duties demanding endurance and muscular strength. Nevertheless, their working conditions are rarely satisfactory. OBJECTIVE: To compare levels of physical activity and social, demographic and occupational factors between military policemen and firemen; factors that may impact their ability to efficiently and effectively accomplish their jobs. METHODS: This cross-sectional study was performed in Brazil with 127 local military personnel (67 policemen and 60 firemen). A sociodemographic questionnaire was applied together with the International Physical Activity Questionnaire (IPAQ), short version. RESULTS: It was observed that the firemen participating in this study are 4 times more likely to be inactive than the policemen. However, policemen showed higher sociodemographic risk factors (less schooling and the higher number of children and workplaces) to work performance when compared to military firemen. CONCLUSION: It could be inferred that in relation to the firemen, policemen suffer from less favorable sociodemographic conditions and face major risk situations more frequently once they are directly involved with the public security of the States; on the other hand, both populations should be incentivized and offered systematized physical activity programs in their workplaces.

Trauma and work factors as predictors of firefighters' psychiatric distress.

BACKGROUND: Studies into the mental health of firefighters have primarily focussed on individual factors (e.g. biological and psychological factors). Little is known about how exposure to traumatic events and psychosocial and organizational work factors influence firefighters' mental health despite the evidence that these are important for employee health. AIMS: To study job demands, job control, social support and operational trauma as predictors of firefighters' psychiatric morbidity, and whether job control and social support moderate these relationships. METHODS: Participants were drawn from a longitudinal cohort study of firefighters in Brazil. Portuguese-language variants of the Self-Report Questionnaire (SRQ-20) and Traumatic Events List for Emergency Professionals measured psychiatric morbidity and exposure to traumatic events. Job demands, job control and social support were measured by the Job Stress Scale. Hierarchical regressions were run controlling for socio-demographics and previous psychiatric morbidity. Subsequent regression steps first included the proposed predictors followed by their interactions. RESULTS: Thirteen per cent of the sample (n = 40/312) met the caseness criteria indicating psychiatric morbidity. Operational trauma, job demands, job control and social support predicted psychiatric morbidity. Both job control and social support functioned as moderators and where these moderators were high, the job demands and psychiatric morbidity relationships were weaker. CONCLUSIONS: These findings show that psychosocial factors and operational trauma predict firefighters' psychiatric morbidity. Crucially, the results that improving social support and job control could mitigate the detrimental influence of job demands highlight the need for more research and practice towards organizational-level interventions.

Atendimento a saúde por bombeiros: dificuldades encontradas que implicam na assistência a população / Health care from firefighters: the faced difficulties that impact in the population's assistance / Cuidado de la salud para los bomberos: las dificultades que entrañan asistencia en la población

Objetivo: Identificar quais as percepções dos bombeiros quanto ao atendimento pré-hospitalar, suas principais dificuldades e riscos encontrados na prestação do atendimento em saúde. Métodos: Trata-se de uma pesquisa do tipo descritiva com abordagem qualitativa, em que se utilizou de uma entrevista semiestruturada guiada por roteiro. Resultados: Os depoimentos dos bombeiros foram sintetizados em três unidades temáticas, assim denominadas: A percepção de bombeiros sobre o atendimento préhospitalar (APH); A necessidade do enfermeiro no APH realizado pela equipe do corpo de bombeiros e a Insegurança versus riscos inerentes do atendimento pré-hospitalar. Conclusão: Através de todo o exposto espera-se, contribuir para a construção do conhecimento e reflexão quanto a percepção e atuação do corpo de bombeiros no APH e a importância de integrar profissionais de saúde na equipe de resgate, assim como investir na capacitação destes e em materiais de qualidade que possibilitem segurança aos profissionais e pacientes

Objetivo: Identificar las percepciones de fuego como la atención prehospitalaria, sus principales dificultades y riesgos encontrados en la prestación de asistencia sanitaria. Métodos: Este es un estudio de enfoque cualitativo descriptivo, que utilizó una entrevista visita guiada semiestructurada. Resultados: El testimonio de los bomberos fueron sintetizados en tres unidades temáticas, los llamados: La percepción de fuego en la atención pre-hospitalaria; La necesidad de enfermeras en APH realizadas por el equipo del cuerpo de bomberos y la inseguridad frente a los riesgos de la atención pre-hospitalaria. Conclusión: Se espera que a través de todo lo anterior, para contribuir a la construcción del conocimiento y la reflexión como las operaciones de percepción y del cuerpo de bomberos de la APH y la importancia de la integración de los profesionales sanitarios en el equipo de rescate, así como invertir en la formación de estos y materiales de calidad que permiten a los profesionales de seguridad y los pacientes

Objective: The research's purpose has been to identify the firefighters' perceptions with regards to the prehospital care, as well as their own main difficulties and risks when performing health care. Methods: This is a descriptive research with a qualitative approach, which used scripted semi-structured interviews for data collection. Results: The firefighters' statements were synthesized in three thematic units, as follows: "The firefighters' perceptions about prehospital care; "The requirement of nurses in the prehospital care performed by firefighters"; and "Insecurity versus prehospital care inherent risks". Conclusion: It is expected that this study may contribute to further increase the knowledge of this field, and the careful thinking about the firefighters' perception and performance towards prehospital care. Furthermore, this study aims to emphasize the importance of integrating health professionals into the rescue team, as well as investing in their training and in quality materials that provide security to both professionals and patients

Fatores associados ao uso de medicamentos ansiolíticos entre bombeiros militares / Factors associated with the use of anxiolytic drugs among military firefighters

RESUMO: Introdução: O uso de ansiolíticos é uma opção no tratamento de sintomas psíquicos. Contudo, ainda que o uso seja controlado há riscos de dependência, intoxicação e alterações cognitivas. O uso não controlado entre trabalhadores agrava tais problemas. Objetivos: Identificar a prevalência do uso de ansiolíticos e conhecer os fatores associados ao consumo em bombeiros militares. Método: Pesquisa transversal de base censitária investigou 711 bombeiros de Belo Horizonte, Minas Gerais, por meio de autorrelato. Regressão logística multinomial foi utilizada para verificar associação entre características sociodemográficas, condições de vida, trabalho e saúde e consumo de ansiolíticos de modo controlado ou não. Resultados: A prevalência do uso de ansiolíticos foi 9,9%. Para 7,5% dos bombeiros o consumo ocorreu sem indicação e/ou controle terapêutico especializado. O uso controlado foi associado ao relato compatível com Transtorno Mental Comum (OR = 23,6; IC95% 6,54 - 85,11). O uso não controlado foi associado ao tempo de serviço (OR = 2,57; IC95% 1,03 - 6,40), ao tabagismo (OR = 3,22; IC95% 1,50 - 6,91) e ao Transtorno Mental Comum (OR = 4,02; IC95% 2,17 - 7,45). Conclusão: A alta prevalência de consumo indica alerta para as ações dos programas de saúde ocupacional.

ABSTRACT: Introduction: Use of anxiolytic drugs is an option for treating psychological symptoms. However, even if their use is controlled, there are risks of dependence, intoxication and cognitive alterations. Uncontrolled use among workers worsens these problems. Objectives: Identify the prevalence of anxiolytic use and to know the factors associated with consumption in military firefighters. Method: Cross-sectional survey of 711 firefighters from Belo Horizonte, Minas Gerais, Brazil, was conducted through self-reporting. Multinomial logistic regression was used to investigate associations between sociodemographic characteristics, living, working and health conditions and anxiolytic consumption in a controlled or uncontrolled manner. Results: Prevalence of anxiolytic use was 9.9%. For 7.5% of firefighters the consumption occurred without indication and/or specialized therapeutic control. Controlled use was only associated with symptoms compatible with Common Mental Disorder (OR = 23.6; 95%CI 6.54 - 85.11). Uncontrolled use was associated with length of service (OR = 2.57; 95%CI 1.03 - 6.40), smoking (OR = 3.22; 95%CI 1.50 - 6.91) and symptomatology compatible with Common Mental Disorder (OR = 4.02; 95%CI 2.17 - 7.45). Conclusion: The high prevalence of consumption indicates alert to occupational health programs.

Reflections on work as done (WAD) and work as imagined (WAI) in an emergency response organization: A study on firefighters training exercises.

Emergency response organizations need to be resilient to cope with escalating events resulting from dynamic, unexpected, or complex situations. In Brazil, the Firefighter Corps are military hierarchal organizations with a culture based on fixed structures, well defined norms and procedures. These push against innovations which are necessary to be resilient. This research describes how firefighter captains in the 30-35-year age range managed an emergency response escalation in light of standard operating procedures (SOPs) during a training exercise. The study used ethnographic methods to find and discuss gaps between the instructions and the activities carried out during the exercise, highlighting the differences between work as done (WAD) and work as imagined (WAI), as it was instantiated in the SOP prescriptions. The aim was to produce reflections on WAI and WAD as a way to raise awareness of the need for a cultural change toward resilience in firefighter organizations. This was achieved through firefighter engagement with a comprehensive visualization of the analysis results which afforded easy interaction between the experts, the data, and the researchers.

Violence at Work and Mental Distress among Firefighters in Guatemala.

BACKGROUND: Firefighting is a highly physically and mentally demanding occupation. In many countries, firefighters are frequently exposed to critical events, violent threats and assault in their job, however, knowledge about its prevalence is limited. In addition, little is known about the impact of workplace violence against firefighters in the development of mental distress. OBJECTIVE: We aimed to determine the prevalence of mental distress in firefighters exposed to workplace violence. METHODS: In this cross-sectional study, 141 male full-time firefighters of Guatemala City and Metropolitan Area (response 80.4%) were invited to answer an interview-based questionnaire including items on sociodemographics, working conditions and mental health (general health questionnaire GHQ-12). Mental distress was defined as a GHQ-12 score above 4. The item '12-months prevalence of violence on the job' included physical violence or sexual abuse from colleagues or the public. Statistical analysis with Epiinfo 7 included descriptive, bivariate and logistic regression analyses. FINDINGS: Exposure to violence at the workplace was common (37%). Prevalence of mental distress was higher in violence-exposed firefighters (54%) than among unexposed firemen (39%; p = 0.08). After adjustment, the odds for distress was not statistically significantly increased for those exposed to violence at the workplace in comparison to the unexposed group (1.87; 0.90-3.87). Especially affected by distress were middle-aged firefighters (40-49 years; adjusted Odds Ratio 2.90; 95% Confidence interval 1.20-7.05) compared to younger firemen (<40 years). CONCLUSIONS: Exposure to violence at the workplace is common in Guatemalan firefighters. Although limited by small numbers, the association between violence and poor mental health is plausible. Therefore, training programs strengthening resilience among firefighters in areas with high crime prevalence are warranted.

Programa de prevenção para manejo de estresse e Síndrome de Burnout para bombeiros: Relato de experiência de uma intervenção / Stress management and Burnout Syndrome prevention program for firefighters: Report of an intervention experience / Programa de prevención para el manejo de estrés e Síndrome de Burnout para bomberos: Informe de una experiencia de intervención

Este artigo relata a experiência de uma intervenção cujo objetivo foi apresentar uma proposta de programa de prevenção para manejo de estresse e Síndrome de Burnout a profissionais bombeiros. O programa, com três meses de duração, periodicidade quinzenal foi estruturado em cinco sessões. São apresentados os objetivos de trabalho de cada sessão, bem como os procedimentos e técnicas utilizados. O programa possibilitou aos participantes lidarem melhor com os estressores laborais. Estudos dessa modalidade de intervenção permitem aos profissionais desenvolverem novas habilidades e que estas sejam conectadas com o seu trabalho.

This article describes the experience of an intervention that aimed to present a stress and Burnout management prevention program for firefighters. The program, with three months' duration on a fortnightly basis, was divided into five sessions. This report presents the work objectives of each session, as well as the procedures and techniques used. The program allowed participants to cope better with work stressors. Intervention studies allow professionals develop new skills and connect them with their work.

Este artículo reporta la experiencia de una intervención que tuvo como objetivo presentar una propuesta de programa de prevención para el manejo del estrés y del síndrome de Burnout entre profesionales bomberos. El programa con tres meses de duración y periodicidad quincenal fue estructurado en cinco sesiones. Este informe presenta los objetivos de trabajo de cada sesión así como los procedimientos y técnicas utilizados. El programa posibilitó a los participantes que pudieran lidiar mejor con los estresores laborales. Estudios de intervención posibilitan a los profesionales que desarrollen nuevas habilidades y que esas sean conectadas a su trabajo.

Resilience as a mediator in emotional social support's relationship with occupational psychology health in firefighters.

This study's objective is to examine the relationship between emotional demands and emotional social support at work, and the impact of resilience on health. A cross-sectional study of 156 firefighters was conducted. Descriptive analyses of the study's variables were performed, along with structural equation analysis and hierarchical regression analysis. The results suggest statistically significant relationships among the study's variables. Social support from one's boss and intense emotional demands were found to have an interaction effect on firefighters' resilience. The findings confirm the mediating role of resilience and the relationship with emotional social support from the boss on firefighters' occupational health.

Pain, health perception and sleep: impact on the quality of life of firefighters/rescue professionals.

OBJECTIVE: To evaluate the quality of life of firefighters and rescue professionals, and characterize their socio-demographic, health, work and lifestyle profile. METHODS: Cross-sectional study that used a socio-demographic, lifestyle, health, work data questionnaire and the WHOQOL-BREF quality of life aspects, in Fire Department bases, Civil Air Patrol Group of the Military Police and Rescue Group of Emergency Services. RESULTS: Ninety professionals participated in this study - 71 firefighters, 9 nurses, 7 doctors and 3 flight crew members. The average age of the group was 36.4 ± 7.8 years; they worked about 63.7 hours per week; 20.2% reported pain in the last week and 72.7% had body mass index above 25 kg/m2. The average of the WHOQOL-BREF domains was: physical (74.6), psychological (75.2), social (76.5) and environmental (58.7). Significant association was found (Mann-Whitney test and Spearman correlation) between the WHOQOL-BREF domains and pain in the past six months, in the last week, health perception, job satisfaction, hours of sleep, domestic tasks and study. CONCLUSION: The main factors related to quality of life were presence of pain, health perception, sleep and domestic activity.

Pain, health perception and sleep: impact on the quality of life of firefighters/rescue professionals / Dor, percepção de saúde e sono: impacto na qualidade de vida de bombeiros/profissionais do resgate / Dolor, percepción de la salud y del sueño: impacto en la calidad de vida de bomberos y profesionales del rescate

Objective: to evaluate the quality of life of firefighters and rescue professionals, and characterize their socio-demographic, health, work and lifestyle profile. Methods: cross-sectional study that used a socio-demographic, lifestyle, health, work data questionnaire and the WHOQOL-BREF quality of life aspects, in Fire Department bases, Civil Air Patrol Group of the Military Police and Rescue Group of Emergency Services. Results: ninety professionals participated in this study - 71 firefighters, 9 nurses, 7 doctors and 3 flight crew members. The average age of the group was 36.4 ± 7.8 years; they worked about 63.7 hours per week; 20.2% reported pain in the last week and 72.7% had body mass index above 25 kg/m2. The average of the WHOQOL-BREF domains was: physical (74.6), psychological (75.2), social (76.5) and environmental (58.7). Significant association was found (Mann-Whitney test and Spearman correlation) between the WHOQOL-BREF domains and pain in the past six months, in the last week, health perception, job satisfaction, hours of sleep, domestic tasks and study. Conclusion: the main factors related to quality of life were presence of pain, health perception, sleep and domestic activity.

Objetivo: avaliar a qualidade de vida de bombeiros e profissionais do resgate e caracterizar o perfil sociodemográfico, de saúde, trabalho e estilo de vida. Método: estudo transversal que utilizou o questionário de dados sociodemográficos, estilo de vida e aspectos da saúde e do trabalho e o de qualidade de vida WHOQOL-BREF, nas bases do Corpo de Bombeiros, no Grupamento de Rádio e Patrulha Aérea da Polícia Militar e no Grupo de Resgate de Atendimento as Urgências. Resultados: 90 profissionais participaram do estudo - 71 bombeiros, nove enfermeiros, sete médicos e três tripulantes de voo. A idade média foi de 36,4±7,8 anos; trabalhavam em média 63,7 horas por semana; 20,2% relataram dor na última semana e 72,7% apresentavam índice de massa corpórea acima de 25kg/m2. A média dos domínios do WHOQOL-BREF foi: físico (74,6), psicológico (75,2), relações sociais (76,5) e ambiental (58,7). Houve associação significante (teste de Mann-Whitney e correlação de Spearman) entre domínios do WHOQOL-BREF e dor nos últimos seis meses, na última semana, percepção de saúde, satisfação com o trabalho, horas de sono e realizar trabalho doméstico e estudar. Conclusão: os principais fatores relacionados à qualidade de vida foram presença de dor, percepção de saúde, sono e trabalho doméstico.

Objetivo: evaluar la calidad de vida de bomberos y profesionales del rescate y caracterizar el perfil sociodemográfico, de salud, trabajo y estilo de vida. Métodos: estudio transversal utilizando la encuesta de datos sociodemográficos, de estilo de vida y aspectos de la salud y del trabajo, además del cuestionario de calidad de vida WHOQOL-BREF, en las bases del Cuerpo de Bomberos, en el Agrupamiento de Radio y Patrulla del Aire de la Policía Militar y en el Grupo de Rescate de Atención de Urgencias. Resultados: en este estudio participaron 90 profesionales-71 bomberos, 9 enfermeras, 7 médicos y 3 miembros de la tripulación de vuelo. La media de edad fue de 36,4 ± 7,8 años y la del trabajo 63,7 horas por semana; el 20,2% de ellos informaron dolor en la última semana y el 72,7% tenían índice de masa corporal por encima de 25 kg/m2. La media de los dominios WHOQOL-BREF fue: físico (74,6), psicológico (75,2), relaciones sociales (76,5) y ambientales (58,7). Hubo asociación significativa (test de Mann-Whitney y correlación de Spearman) entre dominios del WHOQOL-BREF y el dolor en los últimos seis meses, en la última semana, la percepción de la salud, la satisfacción con el trabajo, el hecho de dormir y realizar los estudios y el trabajo doméstico. Conclusión: los principales factores relacionados con la calidad de vida fueron la presencia de dolor, percepción de la salud, sueño y trabajo doméstico.