Hearing loss and use of hearing protection among career firefighters in the United States.

OBJECTIVE: To determine the prevalence and characteristics of noise-induced hearing loss (NIHL) and the use of hearing protection devices (HPDs) among career firefighters. METHODS: A Web-based survey and a standard audiometric test were performed with 425 firefighters from three states in the United States. RESULTS: More than 40% showed hearing loss in the noise-sensitive frequencies (4 and 6 kHz). The left ear showed significantly poorer hearing than the right ear. Firefighters having longer years of work in fire services demonstrated significantly worse hearing. Reported use of HPDs was 34% of the time that was needed. Firefighters who used HPDs less were significantly more likely to have hearing loss. CONCLUSIONS: This study demonstrated a considerable NIHL problem and low use of HPDs in firefighters. More comprehensive hearing conservation programs should be implemented to reduce NIHL for firefighters.

Perception and attitudes of firefighters on noise exposure and hearing loss.

Noise exposure of firefighters results in increased risk of hearing loss. Noise-induced hearing loss (NIHL) can be prevented by the consistent use of hearing protection devices (HPDs). However, little is known about firefighters' perceptions and attitudes on NIHL and HPD use. The purposes of the study were (1) to identify common noise sources of fire fighting equipment and activities; and (2) to describe the attitudes and beliefs of firefighters concerning the importance of their hearing, occupational noise exposure, NIHL, and HPD use. A nonexperimental, descriptive focus group design was used to gather qualitative data from firefighters at two fire houses in southeast Michigan. The study identified sources of noise unique to fire fighting, such as driving fire/emergency trucks with sirens on; operating water pumps, saws, and other equipment; and shouting to communicate with civilians and fellow firefighters. Firefighters acknowledged the significance of good hearing in fire fighting service but perceived NIHL was unavoidable on the job and viewed it as a small risk compared with other hazards. HPDs were not used regularly because firefighters believed they interfered with the ability to hear commands during emergency conditions, interfered with other required safety equipment, and were generally forgotten when gearing up. Firefighters recognized the importance of hearing health and the benefit of a hearing conservation program, including annual training, and identified several topics that should be included in a training program. These findings will provide critical information in planning what type of program should be developed and carried out for the fire fighting population.

Hazardous decibels: hearing health of firefighters.

Noise-induced hearing loss ranks among the most significant occupational health problems. In the United States, more than 1 million firefighters are at risk for noise-induced hearing loss due to exposure to hazardous levels of intermittent noise from sirens, air horns, and engines of emergency vehicles and fire trucks. Although irreversible, noise-induced hearing loss is entirely preventable through both engineering controls and personal protective equipment. This article describes occupational noise exposure, hearing loss, and strategies to prevent noise-induced hearing loss among firefighters.

Reimbursement profile of a private toxicology practice.

This article presents two years of billing and collection data for a bedside toxicology consultation service. The collections rate was 34% or dollars 26.19 per hour of consultative time. There was an inverse correlation between collection rates and patient acuity.

Cardiovascular risks in firefighters: implications for occupational health nurse practice.

Limited cardiovascular risk data are available for firefighters. This cross sectional study of data collected during annual physical examinations described the prevalence of cardiovascular risk factors among firefighters (N = 200) and examined relationships between body mass index (BMI) and other cardiovascular risk factors. Evidence based guidelines were used to determine prevalence of cardiovascular risk factors and Framingham risk scoring was used to estimate probability of coronary heart disease (CHD). Firefighters ranged in age from 22 to 64 with a mean of 41. The prevalence of obesity, elevated total cholesterol, and elevated blood pressure in firefighters exceeded Healthy People 2010 targets. In addition, their prevalence of obesity, low high density lipoprotein (HDL), high low density lipoprotein (LDL), and high total cholesterol levels was higher relative to the general population. Elevated body mass index (BMI) values had positive significant (p < or = .01) associations with elevated blood pressures, triglycerides, and glucose levels, and a negative significant (p < .05) association with lower HDL cholesterol levels. Fire department worksite health and fitness policies and programs should proactively target firefighters' cardiovascular risks. Future firefighter related intervention research will benefit from considering not only the individual determinants of cardiovascular disease, but also the ecological framework that includes the influences of workplace and external environmental factors.

Effect of firefighter masks on monocular and binocular peripheral vision.

Peripheral vision can impact essential job functions of firefighters and other workers who use Self-Contained Breathing Apparatus and other full face masks. It is important for physicians to know how these masks alter peripheral vision. Also, one must understand the effect of monocular vision on peripheral vision. Using the Goldman Perimeter Machine we measured peripheral vision in the monocular and binocular state, with and without two different types of masks. The results show that monocularity causes an average loss of 23 degrees in the nasal meridian. The use of the masks did not affect this difference. Also, the masks caused an average loss of 28 degrees of peripheral vision in the inferior meridian. How these losses affect the ability of the users of the masks to perform their essential job functions still needs to be researched.

Cause, type, and workers' compensation costs of injury to fire fighters.

BACKGROUND: Work-related injury rates in the fire service industry exceed those for most other industries, however little is known about the cost of injury to firefighters. METHODS: This is a preliminary investigation of detailed worker's compensation records of firefighter injuries, 1,343 claims in all, collected from 1992-1999. Summary statistics and regression analysis regarding the cause, nature, and cost of injury to firefighters are presented. RESULTS: Overexertion accounted for a significant portion (over 1/3) of injuries to firefighters, typically involved injuries to the back, and was associated with significantly higher costs than other types of injuries. The per-claim average worker's compensation cost of injury to firefighters was $5,168 and the average for injuries caused by overexertion was $9,715. CONCLUSIONS: Overexertion is a costly source of injury to firefighters that can likely be reduced through policy intervention.