Evaluation of the relationship between occupational-specific task performance and measures of physical fitness, cardiovascular and musculoskeletal health in firefighters.

INTRODUCTION: Firefighters are required to perform physically strenuous tasks such as hose drags, victim rescues, forcible entries and stair climbs to complete their public safety mission. Occupational-specific tasks are often used to evaluate the ability of firefighters to adequately/safely perform their duties. Depending on the regions, occupational-specific tasks include six to eight individual tasks, which emphasize distinct aspects of their physical fitness, while also requiring different levels of cardiovascular (CVH) and musculoskeletal health (MSH). Therefore, the aim of this study was to evaluate the relationship between specific occupational task performance and measures of physical fitness, cardiovascular and musculoskeletal health. METHODS: Using a cross-sectional design, 282 full-time male and female firefighters were recruited. A researcher-generated questionnaire and physical measures were used to collect data on sociodemographic characteristics, CVH, MSH and weekly physical activity habits. Physical measures were used to collect data on physical fitness and occupational-specific task performance. RESULTS: Absolute cardiorespiratory fitness (abV̇O2max), grip strength, leg strength, push-ups, sit-ups and lean body mass (all p < 0.001) had an inverse association with completion times on all occupational-specific tasks. Age was positively related to the performance of all tasks (all p < 0.05). Higher heart rate variability (HRV) was associated with better performance on all tasks (all p < 0.05). Bodyfat percentage (BF%) and diastolic blood pressure were positively associated with the step-up task (p < 0.05). Lower back musculoskeletal injury (LoBMSI), musculoskeletal discomfort (MSD), and lower limb MSD were associated with a decreased odds of passing the step-up. Upper body MSIs (UBMSI), LoBMSIs and Lower back MSD were associated with decreased odds of passing the rescue drag. CONCLUSION: Firefighters that were taller, leaner, stronger and fitter with a more favourable CVH profile, higher HRV and less musculoskeletal discomfort performed best on all occupational-specific tasks.

Physical fitness, cardiovascular and musculoskeletal health, and occupational performance in firefighters.

Introduction: To perform their work efficiently and safely, firefighters should maintain all aspects of physical fitness. Cardiac-related incidents are the leading cause of duty-related deaths in firefighters, and many firefighters have poor musculoskeletal health (MSH) that hinder their occupational performance (OP). Establishing the relationship between physical fitness, cardiovascular health (CVH), MSH and OP may add new insight on the most significant factors influencing OP in firefighters, specifically in the City of Cape Town Fire and Rescue Service (CoCTFS), which had not been studied before. Therefore, the purpose of this study was to investigate whether physical fitness, CVH and MSH were associated with OP in firefighters, in the COCTFRS. Methods: This cross-sectional study included 283 full-time firefighters aged 20-65 years from Cape Town, South Africa. A researcher-generated questionnaire was used to collect data on sociodemographic characteristics, lifestyle factors and MSH. Physical measures were used to collect information on physical fitness, CVH, and OP [using a physical ability test (PAT)]. Linear and binary logistic regressions, adjusted for age, sex, height and weekly metabolic equivalent minutes (WMETM), multivariate analysis of covariance (MANCOVA), adjusted for age, sex, height and body mass index (BMI) and backward stepwise regressions were used to investigate the associations between the various constructs. Results: From multivariable analyses, age, lean body mass, body fat percentage (BF%), estimated absolute oxygen consumption (abV̇O2max), grip strength, leg strength, push-ups, sit-ups, WMETM and heart rate variability were associated with PAT completion times (all p < 0.01). The MANCOVA showed a significant difference between performance categories of the PAT based on physical fitness and CVH (both p < 0.001). WMETM, BF%, abV̇O2max, grip strength, leg strength and sit-ups explained the highest proportion (50.5%) of the variation in PAT completion times. Conclusion: Younger, non-obese, fitter and stronger firefighters, with a better CVH status, performed significantly better and were most likely to pass the PAT in firefighters, in Cape Town, South Africa. Firefighters should maintain high levels of physical fitness and a good level of CVH to ensure a satisfactory level of OP.

Association between physical fitness and musculoskeletal health in firefighters.

Introduction: Firefighters are often placed in situations that require high levels of physical exertion, leading to significant strain on firefighters' musculoskeletal system, predisposing them to musculoskeletal discomfort (MSD) and/or musculoskeletal injury (MSI). Physical fitness programs are often recommended and justified, in part, to prevent injuries. The aim of this study was to determine the association between physical fitness and musculoskeletal health (MSH) in firefighters. Methods: A total of 308 full-time firefighters took part in the study conducted in Cape Town, South Africa. Physical fitness tests encompassed a non-exercise estimation for cardiorespiratory fitness, grip and leg strength for upper and lower body strength, push-ups and sit-ups for muscular endurance, and sit-and-reach for flexibility. The Nordic Musculoskeletal Questionnaire and Cornell Musculoskeletal Discomfort Questionnaire were used to determine MSIs and MSD, respectively. A p-value <0.05 indicated statistical significance. Results: Every one-unit increase in AbVO2max, push-ups, sit-ups, and sit-and-reach decreased the odds of firefighters reporting MSIs by 5% (p = 0.005), 3% (p = 0.017), 3% (p = 0.006), and 3% (p = 0.034), respectively. Every one repetition increase in push-up capacity increased the odds of firefighters reporting neck, elbow and forearm, wrist and hand, and thigh discomfort by 3% (p = 0.039), 4% (p = 0.031), 5% (p = 0.002), and 5%` (p = 0.007), respectively. Every one repetition increase in sit-up capacity increased the odds of firefighters reporting upper back discomfort and thigh discomfort by 5% (p = 0.045) and 7% (p = 0.013), respectively. Conclusion: Maintenance of physical fitness is likely beneficial in reducing MSIs, which, however, may increase the feeling of MSD in firefighters. In addition, it may be noticed that there is an ideal level of physical fitness that is conducive to the reduction of MSIs and should be studied further.

Association between Physical Fitness and Cardiovascular Health in Firefighters.

Firefighters perform strenuous work in dangerous and unpredictable environments requiring optimal physical conditioning. The aim of this study was to investigate the association between physical fitness and cardiovascular health (CVH) in firefighters. This cross-sectional study systematically recruited 309 full-time male and female firefighters between the ages of 20 to 65 years in Cape Town, South Africa. Physical fitness was assessed using absolute (abV̇O2max) and relative oxygen consumption (relVO2max), grip and leg strength, push-ups and sit-ups, sit-and-reach for flexibility and lean body mass (LBM). CVH encompassed age, smoking, blood pressure (BP), blood glucose, lipid profile, body mass index, body fat percentage (BF%), and waist circumference. Linear regressions and logistic regressions were applied. Multivariable analysis indicated that relVO2max was associated with systolic BP (p < 0.001), diastolic BP (p < 0.001), non-fasting blood glucose (p < 0.001), and total cholesterol (p = 0.037). Poor CVH index was negatively associated with relV̇O2max (p < 0.001), leg strength (p = 0.019), and push-ups (p = 0.012). Furthermore, age was inversely associated with V̇O2max (p < 0.001), push-up and sit-up capacity (p < 0.001), and sit-and-reach (p < 0.001). BF% was negatively associated with abV̇O2max (p < 0.001), grip and leg strength (p < 0.001), push-ups (p = 0.008), sit-ups (p < 0.001), and LBM (p < 0.001). Cardiorespiratory fitness, muscular strength, and muscular endurance were significantly associated with a better overall CVH profile.

Association between Cardiovascular and Musculoskeletal Health in Firefighters.

OBJECTIVE: The aim of the study is to determine the association between cardiovascular health (CVH) and musculoskeletal health in firefighters. METHODS: This cross-sectional study involved 309 full-time firefighters aged 20 to 65 years. Cardiovascular health encompassed cardiovascular disease risk factors, risk scores, CVH metrics, and heart rate variability. Musculoskeletal health was assessed using two validated questionnaires. RESULTS: Increasing age ( P = 0.004), body mass index ( P < 0.001), body fat percentage ( P < 0.001), diastolic blood pressure ( P = 0.003), total cholesterol ( P = 0.006), and Framingham risk score ( P = 0.011) increased the risk of reporting musculoskeletal injuries (MSIs). Obesity ( P = 0.018), hypertension ( P = 0.034), and dyslipidemia ( P = 0.005) increased the risk of reporting MSIs. Musculoskeletal discomfort was associated with total cholesterol ( P = 0.0.34) and low-density lipoprotein ( P = 0.014). CONCLUSIONS: Adverse cardiovascular disease risk profile was associated with MSIs and musculoskeletal discomfort in firefighters. Firefighters should maintain an ideal CVH profile, especially as they age.

Association between Cardiovascular Disease Risk Factors and Cardiorespiratory Fitness in Firefighters: A Systematic Review and Meta-Analysis.

Approximately 45% of on-duty related mortalities were due to sudden cardiac death, with many of these fatalities related to cardiovascular disease and overexertion, while performing emergency duties. Therefore, the aim of this systematic review was to determine the association between cardiovascular disease risk factors and cardiorespiratory fitness in firefighters. A literature search of PubMed, SCOPUS, Web of Science, Embase, EBSCOHost, and ScienceDirect was conducted; the Rayyan® intelligent systematic review tool was used to screen and select studies for inclusion. The appraisal tool for cross-sectional studies and the Critical Appraisal Skills Programme toolkit were used for methodological assessment of included studies. Data were analyzed using the Review Manager 5.3 and MedCalc® statistical softwares to determine the effects of obesity (Z = 10.29, p < 0.001) and aging (Z = 4.72, p < 0.001) on cardiorespiratory fitness. Furthermore, there was a significant effect for cardiorespiratory fitness level on systolic blood pressure (Z = 5.94, p < 0.001), diastolic blood pressure (Z = 2.45, p < 0.001), total cholesterol levels (Z = 3.80, p < 0.001), low-density lipoprotein cholesterol (Z = 4.44, p < 0.001), triglycerides (Z = 3.76, p < 0.001) and blood glucose concentration (Z = 4.78, p < 0.001). Cardiovascular disease risk factors and cardiorespiratory fitness were significantly and inversely associated in firefighters. Fire service departments should adopt behavioral intervention strategies to maintain optimum cardiovascular disease risk factor profiles and cardiorespiratory fitness among firefighters to ensure their occupational well-being.

A Pilot Study on the Relationship between Cardiovascular Health, Musculoskeletal Health, Physical Fitness and Occupational Performance in Firefighters.

Firefighters' face life threatening situations and are frequently exposed to numerous physical, chemical, biological, ergonomic and psychosocial hazards. The purpose of this pilot study was to investigate the feasibility of conducting a large-scale study on cardiovascular and musculoskeletal health, physical fitness and occupational performance of firefighters. We conducted a cross-sectional pilot study by recruiting 36 firefighters. A researcher-generated questionnaire and physical measures were used to collect data on sociodemographic characteristics, cardiovascular and musculoskeletal health, physical fitness and occupational performance using a physical ability test (PAT). We documented a high equipment and intra-assessor reliability (r > 0.9). The potential logistic and/or administrative obstacles in the context of a larger study were discerned. Data were successfully retrieved using available equipment and survey instruments. Hypertension (30.6%) dyslipidaemia (33.3%), obesity (36.1%) and physical inactivity (66.7%) were the most prevalent cardiovascular disease risk factors. A significant difference between genders in total PAT completion time was also seen (p < 0.001). Cardiorespiratory fitness, lean body mass, grip strength and leg strength were significantly associated with occupational performance (p < 0.001). The pilot study supports the larger study feasibility and verified equipment and assessors' reliability for research. Cardiovascular health, musculoskeletal health and physical fitness may be related to PAT performance.

Effects of Cardiovascular Disease Risk Factors, Musculoskeletal Health, and Physical Fitness on Occupational Performance in Firefighters-A Systematic Review and Meta-Analysis.

Background: Firefighting is a strenuous occupation, which necessitates that firefighters stay in good physical condition and maintain adequate cardiovascular and musculoskeletal fitness to perform their duties with minimal health and safety risks. The aim of this review is to determine the effects of cardiovascular disease risk factors, musculoskeletal health, and physical fitness on the occupational performance of firefighters. Methods: PubMed/Medline, SCOPUS, Web of Science, EBSCOHost, and ScienceDirect were searched without time-restriction. The appraisal tool for cross-sectional studies and the Critical Appraisal Skills Programme toolkit were used to conduct the methodological assessment. Data were analyzed using Review Manager 5.3, and MedCalc® statistical software. Results: Age had a moderate effect on occupational performance (Z = 5.15, p < 0.001), whereas gender had a large effect size on occupational performance (Z = 4.24, p < 0.001). A significant moderate negative correlation was found between cardiorespiratory fitness and occupational performance (R = -0.584, p < 0.001). Significant low negative correlations were found between upper body endurance (R = -0.344, p < 0.001), abdominal endurance (R = -0.308, p < 0.001), grip strength (R = -0.421, p < 0.001), upper body strength (R = -0.318, p < 0.001), and lower body strength (R = -0.216, p = 0.020) and occupational performance. Conclusions: Aged firefighters with poor body composition and lower levels of physical fitness performed worse on all occupational performance tasks.

Cardiovascular Disease Risk Factors, Musculoskeletal Health, Physical Fitness, and Occupational Performance in Firefighters: A Narrative Review.

Introduction: Firefighting is a strenuous occupation that requires firefighters to be in peak physical condition. However, many firefighters have risk factors for cardiovascular disease, impaired musculoskeletal health, and are not physically fit for duty, which all negatively impact their occupational performance. Therefore, the aim of this review is to determine the relationship between cardiovascular disease risk factors, musculoskeletal health, physical fitness, and occupational performance in firefighters. Methods: The electronic databases PubMed, SCOPUS, and Web of Science were searched online via the library portal of the University of the Western Cape. Publications and grey literature between the years 2000 to present were used. In total, 2607 articles were identified; after the removal of duplicates 1188 articles were then screened, and were excluded for not meeting initial screening criteria. The remaining 209 full-text articles were screened based on the inclusion and exclusion criteria, where 163 articles were excluded. Only studies that were quantitative were included. This left 46 articles that were then finally included in the current narrative review. Results: The current literature indicated that significant relationships existed between cardiovascular risk factors, musculoskeletal health, physical fitness, and occupational performance. The results indicated firefighters who were aged, obese, physically inactive, cigarette smokers, and unfit were at the highest risk for cardiovascular and musculoskeletal health complications, and unsatisfactory occupational performance. Musculoskeletal health complications significantly affected occupational performance and work ability and were related to physical fitness of firefighters. Most cardiovascular risk factors were related to physical fitness, and all physical fitness parameters were related to occupational performance in firefighters. Conclusion: The overwhelming evidence in the current review established that physical fitness is related to occupational performance. However, the relationship between cardiovascular risk factors and musculoskeletal health in relation to occupational performance is less clear and still understudied. Significant gaps remain in the literature.

Firefighters' Health Knowledge, Cardiovascular Disease Risk Factors, and Sociodemographic Characteristics as Predictors of Firefighters Attitudes Toward Health.

OBJECTIVE: The aim of the study is to determine the predictors of firefighters' attitudes toward health based on firefighters' knowledge cardiovascular disease (CVD) risk factors and sociodemographic characteristics. METHODS: The study used a web-based cross-sectional, descriptive, and correlational research design. Convenience sampling was used to recruit 110 firefighters, males, and females, aged 18 to 65 years. RESULTS: Firefighters' health knowledge, age group 30 to 39 years, and having CVD risk factors present were significant predictors of firefighters' attitudes toward regular aerobic exercise ( P < 0.05). Firefighters' health knowledge was a significant predictor of firefighters liking exercise to look physically fit, and health knowledge and the age group 20 to 29 and 30 to 39 years were significant predictors of firefighters liking exercise to be fit for firefighting ( P < 0.05). CONCLUSIONS: Health knowledge, age group, years of experience, and having CVD risk factors present were significant predictors of firefighters' attitudes toward health.

Effects of cardiovascular health, musculoskeletal health and physical fitness on occupational performance of firefighters: protocol for a systematic review and meta-analysis.

INTRODUCTION: Firefighting is a hazardous occupation, where firefighters are involved in life-threatening situations, being placed under tremendous physical strain, while wearing heavy and insulated equipment to protect them from chemicals, fumes and high temperatures. This necessitates that firefighter stay in good physical condition and maintain adequate cardiovascular fitness to cope with these stressors and perform their duties with minimal health risks. The aim of this systematic review and meta-analysis is to determine the effect of cardiovascular health, musculoskeletal health and physical fitness on the occupational performance of firefighters. METHODS AND ANALYSIS: All study types and designs will be included and appraised. The following electronic databases will be searched: PubMed/Medline, Scopus, Web of Science, Embase, EBSCOHost and CINAHL, with no restrictions on publication date. The literature search will be conducted comprehensively to enable the capturing of as many relevant articles as possible but will be limited to English-language papers only. A combination of the appropriate terms (search string) will be used to ensure the inclusion of the relevant components of the participants, exposure, comparison and outcome. A researcher-generated form with the key characteristics of each study will be used to retrieve all relevant details from the selected studies for initial eligibility screening. The Rayyan Intelligent Systematic Review tool will be used to screen and select studies for inclusion, and information from the included studies will be captured on the researcher-generated data extraction form. The The appraisal tool for cross-sectional studies (AXIS) checklist and the Critical Appraisal Skills Programme toolkit will be used to conduct the methodological assessment of each study. Data will be analysed using Review Manager V.5.3. Generated results will be presented using a combination of figures, graphs and tables. The synthesis of quantitative data (using a meta-analysis methodology) will involve the integration of quantitative findings from multiple studies to achieve coherence. ETHICS AND DISSEMINATION: This study obtained ethical clearance from the University of the Western Cape Biomedical Research Ethics Committee (BM21/10/9). We will disseminate the findings of in peer-reviewed journals and at national and international conferences. The protocol will form part of a chapter for a doctoral thesis. PROSPERO REGISTRATION NUMBER: CRD42021258898.

Relationship Between Physical Activity, Coronary Artery Disease Risk Factors and Musculoskeletal Injuries in the City of Cape Town Fire and Rescue Service.

Musculoskeletal injuries in firefighters are a common occurrence, that increase as firefighters age, and may be related to the firefighters' physical activity habits outside of the job. Certain CAD risk factors, such as obesity, cigarette smoking and ageing may be linked to increased injury risk in firefighters. Although firefighters may meet the recommended minimum physical activity minutes, they may remain at risk for sustaining musculoskeletal injuries. Therefore, this study aims to determine the relationship between physical activity and CAD risk factors, between CAD risk factors and musculoskeletal injuries and between physical activity and musculoskeletal injuries. A total of 124 full-time firefighters, males and females, were conveniently recruited from the City of Cape Town Fire and Rescue Service. A researcher-generated questionnaire was used to collect injury, CAD risk factor and physical activity data. The proportion of firefighters who participated in leisure-time physical activity (LTPA) was 63.7%, and those who were physically inactive was 69.4%. The prevalence musculoskeletal injuries among all firefighters was 27.4%. The most prevalent musculoskeletal injury was shoulder injuries in 35.3% of firefighters, followed by multiple injuries in 26.5% and back injuries in 14.7%. Age was a significant predictor of physical inactivity in firefighters [P = .002, OR = 1.08], BMI was a significant predictor of physical inactivity [P = .050, OR = 1.08], cigarette smoking was a significant predictor of firefighters not exercising [P = .007, OR = 2.31] and the total amount of vigorous-intensity exercise was a significant predictor of musculoskeletal injuries [P = .050, OR = 1.00]. In conclusion, older firefighters were more physically inactive and had a higher prevalence of musculoskeletal injuries, and the latter decreased significantly after the age of 50 years. Emphasis should be placed on firefighters exercising in their leisure-time, especially as they aged.

Evaluating physical fitness and the relationship between field and non-field tests in male rugby academy players based on playing position.

BACKGROUND: Rugby is a globally played sport with statistically significant variance in the physical fitness levels of rugby players in different playing positions. The aim of the study was to evaluate the physical fitness levels in rugby academy players and to determine the relationship between non-field and field tests based on the forward and backline playing positions. METHODS: The study made use of cross-sectional, secondary data and employed a quantitative and correlational research design. Forty-five rugby academy players from a rugby academy in the Western Province were conveniently recruited for the study and split into forward and backline playing positions. The non-field tests were stature, body mass, and body fat percentage, bench-press, pull-ups, and vertical jump, while the field tests were the10-m, 30-m, and 40-m sprints, the Broncho Test, and the repeat sprintability test. Data analysis comprised independent samples t-test, Pearson's correlation, and linear and logistic regression analysis. The level of statistical significance was set at P<0.05. RESULTS: Forwards were significantly heavier, stronger and more powerful than backline players (P<0.05). Backline players had a lower body fat percentage, were faster, and had a higher anaerobic endurance capacity, and higher muscular endurance (P<0.05). Body mass, body fat percentage, aerobic capacity, absolute muscular power, and relative muscular strength were all significant predictors of speed (P<0.01), and body mass was a significant predictor of anaerobic capacity (P<0.05). CONCLUSIONS: Forwards had higher absolute muscular strength and peak power output, whereas backs were significantly lighter, faster, relatively stronger, and possessed higher muscular endurance and were significantly influenced, in particular, by body composition and aerobic capacity.

Knowledge of and attitudes toward health and cardiovascular disease risk factors among firefighters in Cape Town, South Africa.

BACKGROUND: Firefighting is a hazardous occupation, and the firefighters' fitness for duty is affected by their knowledge of and attitudes toward their health and their relationship in the development of cardiovascular disease (CVD). The aim of this study was to assess knowledge and attitude toward health and CVD risk factors among firefighters in South Africa. DESIGN AND METHODS: The study used a cross-sectional research design. A sample of 110 firefighters, males and females, aged 18 to 65 years were conveniently sampled from the City of Cape Town Fire and Rescue Service. A researcher-generated self-administered questionnaire was completed online to obtain data from firefighters. A p-value of less than 0.05 indicated statistical significance. RESULTS: The results showed that 52.8% of firefighters had a poor knowledge of health, and 47.2% had a good knowledge of health, while 10% reported a negative attitude towards health and 90.0% had a positive attitude towards health. There was a significant difference between firefighters' knowledge of health and their attitudes toward health (p<0.05), particularly related to marital status, age, years of experience and in those with CVD risk factors (p<0.05). Significant correlations were found between knowledge of CVD and knowledge of health-risk behaviors (p<0.05). CONCLUSION: Significant differences in health knowledge and attitudes toward health were present in married, aged and hypertensive firefighters. Overall health knowledge and health-risk behaviours were significant predictors of attitudes toward health.

Relationship Between Various Coronary Artery Disease Risk Factors in Firefighters.

OBJECTIVE: To determine the correlation between the various coronary artery disease risk factors in firefighters. METHODS: The study used a quantitative, cross-sectional, and correlational study design. A total of 124 full-time firefighters were conveniently recruited to participate. Research procedures were based on the ACSM guidelines. RESULTS: Significances were found between age and body mass index (BMI) (r = 0.42, P < 0.001), age and waist circumference (WC) (r = 0.52, P < 0.001), BMI and WC (r = 0.88, P < 0.001), BMI and diastolic blood pressure (DBP) (r = 0.48, P < 0.001), between WC and DBP (r = 0.48, P < 0.001) and between gender and cigarette smoking (χ2[1] = 5.66, P = 0.017). CONCLUSION: There were significant strong relationships between BMI, SBP, DBP, dyslipidemia, and increasing age, especially in male firefighters. Reducing key risk factors should be emphasized.

Prevalence of coronary artery disease risk factors in firefighters in the city of Cape Town fire and rescue service - A descriptive study.

Background: Over 45% of firefighter deaths are attributable to sudden cardiac death related to coronary artery disease (CAD), with many of these deaths attributed to comorbidities. The purpose of the study is to determine the prevalence of coronary artery disease (CAD) risk factors in firefighters in the City of Cape Town (CoCT). Design and Methods: The study used a quantitative, cross-sectional and descriptive design. A total of 124 full-time firefighters were conveniently recruited between September and November 2019 from the City of Cape Town Fire and Rescue Service. Results: The most prevalent CAD risk factors among firefighters were hypertension (33.1%), obesity (37.1%), cigarette smoking (39.5%) and dyslipidaemia (40.3%). A total of 41.9% of firefighters were categorized as low-risk, 54.8% as moderate-risk, and 3.2% as high-risk for CAD. Conclusion: The majority of firefighters had at least one CAD risk factor, with older males having the highest prevalence of multiple CAD risk factors. Compared to other regions of the world, the (CoCT) firefighters have higher prevalence of dyslipidaemia and cigarette smoking. Preventative behavioural strategies and education on CAD should be promoted to mitigate the development of CAD.