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1.
Scand J Trauma Resusc Emerg Med ; 32(1): 22, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38504344

RESUMO

BACKGROUND: Rescue operations are in Norway defined as situations where patients are difficult to access or that more resources are needed than the health services alone possess and can put in operation (Bull A, Redningshåndboken er endelig her! [Internet]. Hovedredningssentralen. 2018 [cited 2023 May 15]. Available from: https://www.hovedredningssentralen.no/redningshandboken-er-endelig-her/ ). Rescue operations after large incidents may include civil protection, military forces, non-governmental organizations and other resources, but the initial rescue effort must be performed by the emergency services as time often is of essence. The central area of an accident where special training and personal protection equipment is necessary or mandatory is called the Hot Zone. This study examines Urban Search And Rescue (USAR) firefighters and police officers reported experiences from ambulance personnel's contribution in the Hot Zone. METHODS: We conducted five focus group interviews with USAR-trained firefighters and police officers. The interviewees were those on duty on the agreed dates. The interviews were taped, transcribed, and analysed using thematic analysis as described by Braun & Clarke. RESULTS: Three themes were identified; Feeling safe during missions, Building USAR capacity, and Trust-building within USAR-teams. The firefighters and police officers reported their and the patients' safety are best managed by EMS-personnel, whose presence strongly contributes to their own feeling of safety in a dangerous area. When EMS handles victims and injured emergency workers, firefighters and police officers can focus on their own primary tasks. Indeed, interviewees reported that building a USAR capacity depends on having USAR-trained EMS-personnel in the Hot Zone. The interviewees have clear and consistent opinions on how to establish an interagency USAR capacity effectively. Trust is paramount to the interviewees, and they express a high degree of trust within USAR Oslo. CONCLUSIONS: Firefighters and police officers regard USAR-trained EMS-personnel as a natural and integrated part in urban search and rescue teams. EMS-personnel in the dangerous area deliver safety and medical professional assistance to both rescue workers and patients. Informants in this study had clear opinions on how to establish and maintain such a service.


Assuntos
Bombeiros , Polícia , Humanos , Feminino , Masculino , Animais , Bovinos , Cães , Polícia/educação , Bombeiros/educação , Paramédico , Grupos Focais , Trabalho de Resgate
2.
Int J Hyg Environ Health ; 248: 114107, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36577282

RESUMO

BACKGROUND: Firefighters are frequently exposed to high temperatures, environmental toxicants, and strenuous physical demands. The health impacts of these occupational exposures on processes including inflammation and kidney function as well as on the gut microbiota are poorly understood. A firefighter training course may provide a controlled environment to assess these health risks. METHODS: Basic health measures, stool, and blood samples were obtained from 24 firefighters participating in a one-week, heat-intensive training course. Indicators of inflammation, gut permeability, kidney health, and stool microbiota composition were measured before and after the training course in 18 participants. Urine specific gravity was measured before and after a heat-intensive training day to evaluate dehydration. RESULTS: The majority of firefighters in this cohort were categorized as hypertensive and experienced multiple heat-related illness symptoms during the training week and dehydration after the heat-intensive training day. While plasma IL-1ß, CXCL8, and NGAL decreased over the training week, other indicators of inflammation and acute kidney injury increased, and estimated kidney function declined. Microbiota composition shifted over the course of the training week, with changes in Peptostreptococcus anaerobius and Streptococcus. CONCLUSIONS: This pilot study conducted in a controlled field setting suggests that the occupational environment of firefighters may increase their risk for systemic inflammation and kidney disease.


Assuntos
Bombeiros , Microbioma Gastrointestinal , Humanos , Bombeiros/educação , Desidratação , Projetos Piloto , Inflamação , Rim
3.
Arq. ciências saúde UNIPAR ; 26(3): 657-670, set-dez. 2022.
Artigo em Português | LILACS | ID: biblio-1399317

RESUMO

Objetivo: Este estudo teve como objetivo desenvolver e validar um instrumento de avaliação das medidas de Biossegurança adotadas pelos bombeiros militares, para a contenção dos agentes biológicos frente a um evento de bioterrorismo. Métodos: Tratou-se de um estudo descritivo de abordagem quantitativa, de desenvolvimento metodológico e do tipo de validação de conteúdo de um instrumento de avaliação. O estudo foi dividido nas fases de desenvolvimento e validação do instrumento. Para o desenvolvimento do instrumento foram feitas revisões da literatura e para a validação do instrumento foi utilizado o método Delphi. Para o estudo foram incluídos 6 juízes que avaliaram o instrumento através da escala numérica tipo Likert. Resultados: Os juízes avaliaram que o instrumento proposto está bem estruturado, possuindo boa clareza e coesão de escrita, com aplicabilidade no campo de estudo e de grande relevância, principalmente em vista a ausência desse tipo de instrumento para a população de bombeiros militares. Para avaliar a concordância entre os juízes foi utilizado o índice de Validade de Conteúdo, que alcançou 98% de concordância e o Índice de Fidedignidade Interavaliadores, que alcançou os conceitos bom e muito bom, mostrando baixa variância das respostas dos juízes, sendo estatisticamente válido. Conclusão: O estudo descreveu o processo de construção e validação do instrumento, provando ser apropriado e confiável para ser utilizado.


Objective: This study aimed to develop and validate an instrument to assess the Biosafety measures adopted by firefighters, for the containment of biological agents in the face of a bioterrorism event. Methods: This is a descriptive study with a quantitative approach, methodological development, and the type of content validation of an assessment instrument. The study was divided into instrument development and validation phases. For the development of the instrument, literature reviews were conducted and for the instrument validation, the Delphi method was used. For the study, 6 judges were included who evaluated the instrument using the Likert-type numerical scale. Results: The judges evaluated that the proposed instrument is well structured, with good clarity and cohesion of writing, with applicability in the field of study and of great relevance, especially considering the absence of this type of instrument for the military firefighter population. To evaluate the agreement between the judges, we used the Content Validity Index which reached 98% of agreement and the Interrate agreement, which reached the concepts good and very good, showing low variance of the judges' answers, being statistically valid. Conclusion: The study described the process of construction and validation of the instrument, proving to be appropriate and reliable to be used.


Objetivo: Este estudio tenía como objetivo desarrollar y validar un instrumento para evaluar las medidas de bioseguridad adoptadas por los bomberos militares para contener los agentes biológicos durante un evento de bioterrorismo. Métodos: Se trata de un estudio descriptivo de abordaje cuantitativo, de desarrollo metodológico y del tipo de validación de contenido de un instrumento de evaluación. El estudio se dividió en las fases de desarrollo y validación del instrumento. Para la elaboración del instrumento se realizaron revisiones bibliográficas y para la validación del mismo se utilizó el método Delphi. Para el estudio se incluyeron 6 jueces que evaluaron el instrumento mediante una escala numérica tipo Likert. Resultados: Los jueces evaluaron que el instrumento propuesto está bien estructurado, poseyendo buena claridad y cohesión de redacción, con aplicabilidad en el campo de estudio y de gran relevancia, especialmente en vista de la ausencia de este tipo de instrumento para la población de bomberos militares. Se utilizó el Índice de Validez de Contenido para evaluar la concordancia entre los jueces, alcanzando un 98% de acuerdo y el Índice de Fiabilidad Inter-registrador, que alcanzó conceptos buenos y muy buenos, mostrando una baja varianza en las respuestas de los jueces, siendo estadísticamente válido. Conclusión: El estudio describió el proceso de construcción y validación del instrumento, demostrando ser apropiado y confiable para ser utilizado.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Contenção de Riscos Biológicos/métodos , Bombeiros/educação , Bioterrorismo/prevenção & controle , Estudos de Avaliação como Assunto , Estudos de Validação como Assunto , Fatores Biológicos , Técnica Delfos , Militares/educação
4.
Int J Hyg Environ Health ; 242: 113969, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35421664

RESUMO

INTRODUCTION: Firefighters are exposed to volatile organic compounds (VOCs) during structural fire responses and training fires, several of which (e.g., benzene, acrolein, styrene) are known or probable carcinogens. Exposure studies have found that firefighters can absorb chemicals like benzene even when self-contained breathing apparatus (SCBA) are worn, suggesting that dermal absorption contributes to potentially harmful exposures. However, few studies have characterized VOC metabolites in urine from firefighters. OBJECTIVES: We quantified VOC metabolites in firefighters' urine following live firefighting activity across two field studies. METHODS: In two separate controlled field studies, spot urine was collected before and 3 h after firefighters and firefighter students responded to simulated residential and training fires. Urine was also collected from instructors from the training fire study before the first and 3 h after the last training scenario for each day (instructors led three training scenarios per day). Samples were analyzed for metabolites of VOCs to which firefighters may be exposed. RESULTS: In the residential fire study, urinary metabolites of xylenes (2MHA), toluene (BzMA), and styrene (MADA) increased significantly (at 0.05 level) from pre- to post-fire. In the training fire study, MADA concentrations increased significantly from pre- to post-fire for both firefighter students and instructors. Urinary concentrations of benzene metabolites (MUCA and PhMA) increased significantly from pre- to post-fire for instructors, while metabolites of xylenes (3MHA+4MHA) and acrolein (3HPMA) increased significantly for firefighter students. The two highest MUCA concentrations measured post-shift from instructors exceeded the BEI of 500 µg/g creatinine. CONCLUSIONS: Some of the metabolites that were significantly elevated post-fire are known or probable human carcinogens (benzene, styrene, acrolein); thus, exposure to these compounds should be eliminated or reduced as much as possible through the hierarchy of controls. Given stringent use of SCBA, it appears that dermal exposure contributes in part to the levels measured here.


Assuntos
Poluentes Ocupacionais do Ar , Bombeiros , Incêndios , Exposição Ocupacional , Hidrocarbonetos Policíclicos Aromáticos , Compostos Orgânicos Voláteis , Acroleína , Poluentes Ocupacionais do Ar/análise , Benzeno/análise , Carcinógenos , Bombeiros/educação , Humanos , Exposição Ocupacional/análise , Hidrocarbonetos Policíclicos Aromáticos/urina , Estirenos , Compostos Orgânicos Voláteis/análise , Xilenos
5.
J Voice ; 36(5): 737.e11-737.e16, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32917461

RESUMO

INTRODUCTION: High exposure to heat and combustion byproducts is associated with health problems and an increased risk of cancer. OBJECTIVE: To study the effects of heat and smoke derived from burning on the upper airway of firefighters. METHODS: Thirteen firefighters underwent a 4-week training program in Compartment Fire Behavior Training simulators while working with live fire, heat, and smoke from pallets and oriented-strand board sheet burns. The firefighters were evaluated before exposure and at the end of the first and fourth weeks of training. The larynx was assessed by the Voice Handicap Index GRBASI scale, laryngoscopy, and peak expiratory flow. RESULTS: There was no change in Voice Handicap Index and GRBASI (only one in three speech therapists judged tension as worse by one point). Laryngoscopy showed alterations in one-third of the firefighters, with the most frequent being increased viscous mucus. Peak expiratory flow decreased significantly from 685 to 552 and 550 L/min in the first and fourth weeks, respectively. CONCLUSIONS: Although participants were protected from gases and smoke during the exercises, which proved to be very effective, the airway was slightly impacted by heat and combustion-derived byproducts.


Assuntos
Bombeiros , Laringe , Exposição Ocupacional , Bombeiros/educação , Gases/análise , Temperatura Alta , Humanos , Exposição Ocupacional/efeitos adversos , Fumaça/efeitos adversos
6.
Nutrients ; 13(8)2021 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-34444948

RESUMO

The present study was conducted to estimate total energy expenditure (TEE) of fire-fighters using tri axial-accelerometers in conjunction with an activity log survey on a large number of subjects undergoing training mimicking a large-scale disaster. Subjects were 240 fire-fighters participating in a two-day fire-fighting training dedicated to large-scale natural disasters. Data was analyzed by job type of activity group and the job rank, and by comparing the average. The average TEE of the total survey training period is about 3619 (±499) kcal, which is the same value of expenditure for professional athletes during the soccer game season. From the activity group, the rescue and other teams consumed significantly more energy than the fire and Emergency Medical Team (EMS) teams. From the job rank, Fire Captain (conducting position) consumed significantly lower energy than the Fire Lieutenant and Fire Sergeant. Furthermore, it was found that a middle position rank consumed the most energy. This research supports a need to reconsider the current rescue food (and protocols) to supplement the energy expenditure of fire-fighters. In addition, since there was a significant difference between the job type and the job rank, it is necessary to examine the energy amount and shape suitable for each.


Assuntos
Acelerometria/métodos , Metabolismo Energético , Bombeiros/estatística & dados numéricos , Trabalho de Resgate , Trabalho/fisiologia , Acelerometria/instrumentação , Adulto , Desastres , Bombeiros/educação , Humanos , Masculino , Necessidades Nutricionais , Treinamento por Simulação , Inquéritos e Questionários
7.
Vasc Med ; 26(3): 240-246, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33606968

RESUMO

Firefighting is associated with an increased risk for a cardiovascular (CV) event, likely due to increased CV strain. The increase in CV strain during firefighting can be attributed to the interaction of several factors such as the strenuous physical demand, sympathetic nervous system activation, increased thermal burden, and the environmental exposure to smoke pollutants. Characterizing the impact of varying thermal burden and pollutant exposure on hemodynamics may help understand the CV burden experienced during firefighting. The purpose of this study was to examine the hemodynamic response of firefighters to training environments created by pallets and straw; oriented strand board (OSB); or simulated fire/smoke (fog). Twenty-three firefighters had brachial blood pressure measured and central blood pressure and hemodynamics estimated from the pressure waveform at baseline, and immediately and 30 minutes after each scenario. The training environment did not influence the hemodynamic response over time (interaction, p > 0.05); however, OSB scenarios resulted in higher pulse wave velocity and blood pressure (environment, p < 0.05). In conclusion, conducting OSB training scenarios appears to create the largest arterial burden in firefighters compared to other scenarios in this study. Environmental thermal burden in combination with the strenuous exercise, and psychological and environmental stress placed on firefighters should be considered when designing fire training scenarios and evaluating CV risk.


Assuntos
Bombeiros , Incêndios , Exercício Físico , Bombeiros/educação , Hemodinâmica , Humanos , Análise de Onda de Pulso
8.
Med Sci Sports Exerc ; 53(4): 740-748, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33044439

RESUMO

PURPOSE: This study aimed to investigate changes in firefighter recruits' select health and fitness measurements, from academy training to the early probationary firefighter period. METHODS: Firefighter recruits from two New England fire academies were followed up prospectively from enrollment at the academy to graduation after 15- to 16-wk training programs, and then for an average of 8 months as probationary firefighters. The participants' demographic, lifestyle, and mental health information was collected using a questionnaire. Body mass index, percent body fat, blood pressure, and push-ups were also measured at each time point. Furthermore, the academies tested the recruits on selected fitness measures (push-ups, pull-ups, and 1.5-mile running time) at academy entry, midtraining, and at graduation. RESULTS: Ninety-two recruits consented and were included in the analyses. The recruits' percent body fat significantly decreased (median, 21.0%-18.2%) from baseline to graduation, and push-up capacity significantly improved (median, 34-53 per minute) in the same period, along with pull-ups and 1.5-mile running time. However, the recruits' blood pressure, both systolic and diastolic, increased significantly by an average of 3 mm Hg during the training. Those completing probationary follow-up (45/92 recruits) showed that most health/fitness improvements declined after graduation. From academy graduation to probationary follow-up, recruits' physical activity decreased and TV screen time increased significantly, leading to a lower healthy lifestyle score (median, 4-3). After multivariate adjustments, the recruits' diastolic blood pressure increased by 2 mm Hg per measuring time throughout the study period. CONCLUSIONS: Fire academy training improved recruits' select health and fitness measurements, but the benefits dissipated as probationary firefighters, and blood pressures increased throughout the study period. Further interventions regarding blood pressure and to maintain training benefits after joining fire departments are warranted.


Assuntos
Bombeiros/educação , Nível de Saúde , Aptidão Física/fisiologia , Adiposidade , Adulto , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Teste de Esforço/métodos , Feminino , Seguimentos , Humanos , Hipertensão/etiologia , Estilo de Vida , Masculino , New England , Condicionamento Físico Humano/métodos , Condicionamento Físico Humano/psicologia , Corrida/fisiologia
9.
J Radiat Res ; 61(6): 871-875, 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-32766804

RESUMO

Willingness to participate in activities during a nuclear disaster situation among firefighters is low. Thus, we aimed to identify the factors affecting the intention to participate in nuclear disaster activities. A questionnaire survey was conducted among firefighter training students (n = 186) and firefighters (n = 410), and a multivariate logistic regression analysis was performed to identify factors affecting the intention to participate in nuclear disaster activities. The percentage of students and firefighters who were willing to participate in nuclear disaster activities was 70.4% (n = 131) and 56.3% (n = 231) (P < 0.01), respectively. The factors affecting the students' intention to participant were "wish to learn more information about radiation" and "firefighters should actively work in a nuclear disaster." Meanwhile, the factors affecting the firefighters' intention to work were "have self-confidence during nuclear disaster activities," "participate if there is an incentive," "unable to get a family member to understand the need to participate in a nuclear disaster activity," and marital status. A student's decision might be strongly connected to social norms about participating in nuclear disaster activities. The willingness to participate in nuclear disaster activities among firefighters might be improved by facilitating activities that can build their self-confidence, providing sufficient incentives, and helping their families understand their work. Therefore, not only direct education for responders but also educational activities for the general public and their families are essential.


Assuntos
Planejamento em Desastres/métodos , Bombeiros/educação , Liberação Nociva de Radioativos , Engajamento no Trabalho , Adulto , Comunicação , Desastres , Família , Feminino , Humanos , Intenção , Japão , Masculino , Estado Civil , Motivação , Análise Multivariada , Estudantes , Inquéritos e Questionários , Adulto Jovem
10.
Toxicol Lett ; 331: 102-111, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32464238

RESUMO

Firefighting instructors in live fire training are inevitably exposed to emissions containing, carcinogenic PAH. The study investigated PAH uptake in a group of firefighting instructors during short-term exposure in live fire training by urinary biomonitoring. Six firefighting instructors (non-smokers) completed five 2 h-training sessions each in a carbonaceous-fired simulation unit using self-containing breathing apparatuses (SCBA). Complying with a minimum time interval of six days between the individual training sessions, the participants provided urine samples before and immediately after, as well as 1, 3, 6, 9, 11, and 18 h after each training session. Samples were analyzed for 10 mono-hydroxylated metabolites of the PAH naphthalene, fluorene, phenanthrene and pyrene using gas chromatography/tandem mass spectrometry. A significant effect of the training sessions on the time course of internal exposure was found (p < 0.0001). The concentration of all parameters clearly increased at the latest 3 h after end of training. After peaking, the concentrations dropped with half-lives between 3.5 and 9.3 h but did not reach the initial levels within 18 h again. Compared to pre-training levels, the increase in metabolite excretion was between 546-933 %. During peak excretion reference values for hydroxynaphthalene (35 µg/L, sum of 1- and 2-isomer) and 1-hydroxypyrene (0.30 µg/L) were exceeded in 64 % (maximum: 381.3 µg/L) and 73 % of the samples (maximum: 1.88 µg/g crea.), respectively. Live fire training is associated with an additional uptake of PAH. Due to the consequent use of SCBA, dermal absorption is assumed as major exposure route. Further measures to reduce PAH exposure should be considered, in particular since higher internal loads caused by accumulation effects are to be expected with daily or more frequent training.


Assuntos
Poluentes Ocupacionais do Ar/urina , Monitoramento Ambiental , Bombeiros , Exposição Ocupacional/análise , Hidrocarbonetos Policíclicos Aromáticos/urina , Ensino , Adulto , Bombeiros/educação , Incêndios , Humanos , Masculino , Exposição Ocupacional/prevenção & controle , Dispositivos de Proteção Respiratória , Pele/efeitos dos fármacos , Pele/metabolismo , Absorção Cutânea
11.
J Spec Oper Med ; 20(1): 81-86, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32203611

RESUMO

BACKGROUND: Early hemorrhage control using resuscitative endovascular balloon occlusion of the aorta (REBOA) can save lives. This study was designed to evaluate the ability to train Quick Response Team Fire Fighters (QRT-FF) to gain percutaneous femoral artery access and place a REBOA catheter in a model, using a comprehensive theoretical and practical training program. METHODS: Six QRT-FF participated in the training. SOF medics from a previous training served as the control group. A formalized training curriculum included basic anatomy and endovascular materials for percutaneous access and REBOA placement. Key skills included (1) preparation of an endovascular toolkit, (2) achieving vascular access in the model, and (3) placement and positioning of REBOA. RESULTS: QRT-FF had significantly better scores compared with medics using endovascular materials (P = .003) and performing the procedure without unnecessary attempts (P = .032). Basic surgical anatomy scores for QRT-FF were significantly better than SOF medics (P = .048). QRT-FF subjects demonstrated a significantly higher overall technical skills point score than medics (P = .030). QRT-FF had a median total time from start of the procedure to REBOA inflation of 3:23 minutes, and medics, 5:05 minutes. All six QRT-FF subjects improved their procedure times-as did four of the five medics. CONCLUSIONS: Our training program using a task training model can be utilized for percutaneous femoral access and REBOA placement training of QRT-FF without prior ultrasound or endovascular experience. Training the use of advanced bleeding control options such as REBOA, as a secondary occupational task, has the potential to improve outcomes for severely bleeding casualties in the field.


Assuntos
Bombeiros/educação , Hemorragia/prevenção & controle , Aorta , Oclusão com Balão , Cateterismo Periférico , Procedimentos Endovasculares , Estudos de Viabilidade , Artéria Femoral , Humanos , Avaliação de Programas e Projetos de Saúde , Ressuscitação
12.
Appl Ergon ; 82: 102966, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31600711

RESUMO

Firefighting is a dangerous occupation and even training carries substantial risks. Self-contained breathing apparatus confidence courses (SCBACC) are a common type of training. PURPOSE: Compare the physiological strain of SCBACC to live-fire training (LFT) and circuit training (CT) among academy cadets. METHODS: Cadets wore physiologic status monitors to assess heart rate (HR) and estimated core temperature (ECT) during CT, LFT, and SCBACC of similar duration (33-38 min). RESULTS: Data from 52 cadet firefighters (28 ±â€¯4 yrs old) were analyzed. ECT (38.6 ±â€¯0.4 vs 39.3 ±â€¯0.7 vs. 39.3 ±â€¯0.6ᵒC), peak HR (182.6 ±â€¯9.1 vs. 192.7 ±â€¯9.5 vs 195.9 ±â€¯9.6 bpm), and age-predicted maximal HR (APMHR%; 94.6 ±â€¯4.6 vs 99.9 ±â€¯4.9 vs. 101.5 ±â€¯4.8%) were significantly (p < 0.05) lower for CT than SCBACC and LFT, respectively. CONCLUSIONS: SCBACC produced physiological strain greater than CT and similar to LFT. SCBACC resulted in sustained HR at 100% of age-predicted maximal values, a peak ECT of 39.3 °C, and should be considered as physiologically stressful as LFT.


Assuntos
Exercícios em Circuitos , Bombeiros/educação , Esforço Físico/fisiologia , Adulto , Temperatura Corporal/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino
13.
BMJ Open ; 9(11): e030895, 2019 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-31753873

RESUMO

OBJECTIVES: The objective of this study was to explore firefighters' and police officers' experiences of responding to out-of-hospital cardiac arrest (OHCA) in a dual dispatch programme. DESIGN: A qualitative interview study with semi-structured, open-ended questions where critical incident technique (CIT) was used to collect recalled cardiac arrest situations from the participants' narratives. The interviews where transcribed verbatim and analysed with inductive content analysis. SETTING: The County of Stockholm, Sweden. PARTICIPANTS: Police officers (n=10) and firefighters (n=12) participating in a dual dispatch programme with emergency medical services in case of suspected OHCA of cardiac or non-cardiac origin. RESULTS: Analysis of 60 critical incidents was performed resulting in three consecutive time sequences (preparedness, managing the scene and the aftermath) with related categories, where first responders described the complexity of the cardiac arrest situation. Detailed information about the case and the location was crucial for the preparedness, and information deficits created stress, frustration and incorrect perceptions about the victim. The technical challenges of performing cardiopulmonary resuscitation and managing the airway was prominent and the need of regular team training and education in first aid was highlighted. CONCLUSIONS: Participating in dual dispatch in case of suspected OHCA was described as a complex technical and emotional process by first responders. Providing case discussions and opportunities to give, and receive feedback about the case is a main task for the leadership in the organisations to diminish stress among personnel and to improve future OHCA missions.


Assuntos
Despacho de Emergência Médica/organização & administração , Bombeiros/psicologia , Parada Cardíaca Extra-Hospitalar/terapia , Polícia/psicologia , Adulto , Reanimação Cardiopulmonar/educação , Reanimação Cardiopulmonar/métodos , Feminino , Bombeiros/educação , Primeiros Socorros/métodos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Estresse Ocupacional/etiologia , Estresse Ocupacional/psicologia , Polícia/educação , Polícia/organização & administração , Pesquisa Qualitativa , Suécia
14.
Health Secur ; 17(5): 393-402, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31593509

RESUMO

Little is known about first responders' knowledge of radiation exposure and the training they receive regarding radiological events. Firefighters and emergency medical services (EMS) personnel were surveyed in July 2018 to February 2019 regarding their knowledge of radiation exposure and the radiological event training they had received. Knowledge was assessed using 15 true-false questions. Five types of radiological event training were assessed. A Mann-Whitney test assessed differences in training received by occupation. A linear regression identified predictors of knowledge scores. A total of 433 individuals completed the survey (response rate = 82.9%). Knowledge scores ranged from 5 to 13, with an average of 8.6. Predictors of knowledge included having received more training on radiological transportation incidents or improvised nuclear devices, and being a firefighter. About a quarter (23.6%, n = 102) had not received any of the 5 types of radiological event training. Firefighters received more training than EMS personnel except on nuclear reactor incidents. Only 14% had participated in a radiological event exercise. First responders' knowledge of radiation exposure and prevention measures is low, and many have received either no or very little training on radiological events. The lack of radiation exposure knowledge and radiological event training received, as identified in this study, could result in increased mortality rates. First responder agencies should provide additional radiological event training and exercise opportunities.


Assuntos
Auxiliares de Emergência/educação , Socorristas/educação , Bombeiros/educação , Conhecimentos, Atitudes e Prática em Saúde , Exposição à Radiação , Liberação Nociva de Radioativos , Adolescente , Adulto , Planejamento em Desastres/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
15.
Int J Hyg Environ Health ; 222(7): 991-1000, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31272797

RESUMO

INTRODUCTION: Training fires may constitute a major portion of some firefighters' occupational exposures to smoke. However, the magnitude and composition of those exposures are not well understood and may vary by the type of training scenario and fuels. OBJECTIVES: To understand how structure fire training contributes to firefighters' and instructors' select chemical exposures, we conducted biological monitoring during exercises involving combustion of pallet and straw and oriented strand board (OSB) or the use of simulated smoke. METHODS: Urine was analyzed for metabolites of polycyclic aromatic hydrocarbons (PAHs) and breath was analyzed for volatile organic compounds (VOCs) including benzene. RESULTS: Median concentrations of nearly all PAH metabolites in urine increased from pre-to 3-hr post-training for each scenario and were highest for OSB, followed by pallet and straw, and then simulated smoke. For instructors who supervised three trainings per day, median concentrations increased at each collection. A single day of OSB exercises led to a 30-fold increase in 1-hydroxypyrene for instructors, culminating in a median end-of-shift concentration 3.5-fold greater than median levels measured from firefighters in a previous controlled-residential fire study. Breath concentrations of benzene increased 2 to 7-fold immediately after the training exercises (with the exception of simulated smoke training). Exposures were highest for the OSB scenario and instructors accumulated PAHs with repeated daily exercises. CONCLUSIONS: Dermal absorption likely contributed to the biological levels as the respiratory route was well protected. Training academies should consider exposure risks as well as instructional objectives when selecting training exercises.


Assuntos
Poluentes Ocupacionais do Ar/análise , Benzeno/análise , Bombeiros , Exposição Ocupacional/análise , Hidrocarbonetos Policíclicos Aromáticos/urina , Poluentes Ocupacionais do Ar/urina , Monitoramento Biológico , Testes Respiratórios , Expiração , Feminino , Bombeiros/educação , Incêndios , Humanos , Masculino , Ensino
16.
J Occup Environ Hyg ; 16(8): 532-543, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31169466

RESUMO

Fire training may expose firefighters and instructors to hazardous airborne chemicals that vary by the training fuel. We conducted area and personal air sampling during three instructional scenarios per day involving the burning of two types (designated as alpha and bravo) of oriented strand board (OSB), pallet and straw, or the use of simulated smoke, over a period of 5 days. Twenty-four firefighters and ten instructors participated. Firefighters participated in each scenario once (separated by about 48 hr) and instructors supervised three training exercise per scenarios (completed in 1 day). Personal air samples were analyzed for polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs), and hydrogen cyanide during live-fire scenarios (excluding simulated smoke). Area air samples were analyzed for acid gases, aldehydes, isocyanates, and VOCs for all scenarios. For the live-fire scenarios, median personal air concentrations of benzene and PAHs exceeded applicable short-term exposure limits and were higher among firefighters than instructors. When comparing results by type of fuel, personal air concentrations of benzene and PAHs were higher for bravo OSB compared to other fuels. Median area air concentrations of aldehydes and isocyanates were also highest during the bravo OSB scenario, while pallet and straw produced the highest median concentrations of certain VOCs and acid gases. These results suggest usage of self-contained breathing apparatus (SCBA) by both instructors and firefighters is essential during training fires to reduce potential inhalation exposure. Efforts should be taken to clean skin and clothing as soon as possible after live-fire training to limit dermal absorption as well.


Assuntos
Poluentes Ocupacionais do Ar/análise , Bombeiros/educação , Exposição Ocupacional/análise , Fumaça , Adulto , Benzeno , Feminino , Gases/análise , Humanos , Cianeto de Hidrogênio/análise , Masculino , Pessoa de Meia-Idade , Hidrocarbonetos Policíclicos Aromáticos/análise , Compostos Orgânicos Voláteis/análise
17.
J Occup Environ Hyg ; 16(7): 432-439, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31021707

RESUMO

Firefighters are exposed to a variety of combustion products during operational fires but also during live-fire training. As part of an on-going project investigating firefighter operational and training environments, this study measured the atmospheric concentrations of volatile organic compounds and acid gases outside and inside the structural firefighting ensembles worn by instructors during compartment fire behavior training using particleboard as a fuel. Atmospheric concentrations of benzene, formaldehyde, and hydrogen cyanide within the firefighting environment were observed to exceed Australian workplace exposure standards; although, the use of self-contained breathing apparatus throughout the training meant that atmospheric concentrations measured were not representative of firefighter inhalation exposures. Concentrations of air contaminants inside the structural firefighting ensembles during compartment fire behavior training were substantially lower than outside the ensembles, and much lower than those documented as potentially causing acute toxic effects in humans by dermal absorption from vapor. Although this study is focused on the generation of air contaminants in compartment fires, dermal absorption in these types of training environments may still constitute a potential route of low-level exposure to some combustion products.


Assuntos
Poluentes Ocupacionais do Ar/análise , Bombeiros/educação , Exposição Ocupacional/análise , Equipamento de Proteção Individual , Benzeno/análise , Materiais de Construção , Formaldeído/análise , Humanos , Cianeto de Hidrogênio/análise , Queensland , Compostos Orgânicos Voláteis/análise
18.
Work ; 62(3): 459-467, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30909261

RESUMO

BACKGROUND: Muscular strength and endurance are important attributes for structural firefighting. Matching resistance exercises to firefighter job demands is not well-established. OBJECTIVE: This study compared the electromyographic (EMG) activity of major muscles during the Candidate Physical Ability Test (CPAT) and weight lifting exercises in firefighters. METHODS: A repeated measures study was conducted in 13 full-duty career firefighters (1 F, 12 M; age 18-44 years). Participants completed seven weight lifting exercises at a university laboratory. They separately completed the CPAT at a firefighting training grounds. During each activity, surface EMG (% maximum voluntary isometric contraction - MVIC) of major muscle groups was recorded and compared between exercises and CPAT. RESULTS: No difference in EMG activity was observed between exercises and CPAT for the deltoid, trapezius, lumbar multifidus, gluteal, and biceps femoris muscles. EMG activity was significantly greater during the CPAT for the abdominal obliques (32.3% ±27.7% vs. 12.1% ±8.3%, p <  0.001) and for the latissimus dorsi (21.8% ±25.1% vs. 11.4% ±7.7%, p <  0.001). CONCLUSIONS: Standard weight lifting and abdominal oblique exercises should be incorporated into resistance training programs for firefighters.


Assuntos
Bombeiros/educação , Aptidão Física/fisiologia , Levantamento de Peso/normas , Adolescente , Adulto , Estudos de Coortes , Eletromiografia/métodos , Feminino , Humanos , Masculino , Músculo Esquelético/fisiologia , Levantamento de Peso/estatística & dados numéricos
20.
J Occup Environ Hyg ; 16(1): 27-40, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30277854

RESUMO

Fire service instructors (FSI) regularly experience different types of fire exercises, however the strain experienced from these scenarios is not well understood. This study aims to identify the physiological and perceptual strain of Fire Service Instructors (FSI) to three training exercises: DEMO, ATTACK, COMPARTMENT, and the different roles performed: SETTER, INSTRUCTOR. The study also aims to assess the effect that different exercise patterns over a day (BOX, MULTI, COMBINATION) have on immunological responses. Sixteen FSI (age: 41 ± 8 years, body mass: 83.7 ± 6.7 kg, height: 177.0 ± 6.7 cm) were recruited, with 10 FSI completing the three exercises. Physiological and perceptual measures were collected prior to and immediately post each exercise. Venous blood samples were collected at the beginning and end of each day. One-way analysis of variance (ANOVA) were conducted to assess differences in physiological variables between exercise types, independent samples t-tests were conducted between roles. Day changes in hematological variables were assessed by paired sample t-tests and analyzed by one-way ANOVAs to identify differences between exercise patterns. The COMPARTMENT exercise resulted in a greater change in rectal temperature (ΔTre) (0.49 ± 0.28 °C) than both the DEMO (0.23 ± 0.19 °C, p = 0.045) and ATTACK (0.27 ± 0.22 °C, p = 0.016). Within the COMPARTMENT exercise, the SETTER resulted in a greater ΔTre and rating of perceived exertion than the INSTRUCTOR (0.67 ± 0.29 °C vs. 0.43 ± 0.18 °C, p = 0.027 and 14 ± 2 vs. 11 ± 2, p = 0.001, respectively). Following a day of fire exercises white blood cells (WBC), neutrophils, lymphocytes (LYMPH), monocytes (MONO), platelets (PLT), mean platelet volume (MPV), Interleukin (IL)-6, and cardiac troponin T (cTnT) all increased (p < 0.05). Exercise patterns containing a COMPARTMENT exercise resulted in greater PLT, MPV, and IL-6. Total daily variation in ΔTre was correlated with post-exercise WBC, MONO, and LYMPH. COMPARTMENT exercises produce the greatest physiological strain, with the SETTER role within this exercise causing the greatest ΔTre. Although predominately physiological responses remain within safe limits. Exercise patterns that include a COMPARTMENT exercise also generate a greater inflammatory response.


Assuntos
Bombeiros/educação , Incêndios , Exposição Ocupacional/efeitos adversos , Adulto , Contagem de Células Sanguíneas , Temperatura Corporal/fisiologia , Feminino , Temperatura Alta , Humanos , Inflamação/sangue , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Estresse Ocupacional/fisiopatologia , Troponina T/sangue , Reino Unido
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