Norms about Alcohol Use among US Firefighters

Background@#Problem drinking is a perennial concern in the US fire service. A large literature has documented the importance of addressing alcohol norms in intervention research. The purpose of this study was to explore alcohol norms in a national cohort of firefighters (FFs) to inform intervention development in this occupational group. @*Methods@#Data were from a national online survey of career and volunteer FFs (N = 674). Participants were recruited through national fire service listservs and a database of FFs who had agreed to be contacted for research. @*Results@#When asked about “acceptable” levels of alcohol consumption, FFs on average suggested levels which exceeded public health guidelines. Further, approximately half of career and volunteer FFs believed that, at least under some circumstances, drinking until intoxicated was normative. When asked how long should elapse between a FFs last drink and reporting for duty, the average suggested lag was 11.2 hours (sd = 4.6). However, among male volunteer FFs who reported heavy drinking, the average was 6.68 hours (sd = 4.77). @*Conclusions@#Given the high prevalence of heavy and binge drinking in the fire service, it is not surprising that the alcohol norms found in this study were consistent with a culture of drinking. Participants' reports of alcohol use among their peers were consistent with the actual prevalence of problem drinking. Thus, education and prevention efforts in this occupation should focus on changing norms about alcohol use, including linking heavy drinking to other health and safety issues they face.

Cancer Perceptions Among Smokeless Tobacco Users: A Qualitative Study of US Firefighters

Background@#Prevalence rates of smokeless tobacco (SLT) use among firefighters are remarkably high and substantially higher than similar occupational groups and the general U.S. population. The purpose of this study was to explore the perspectives of fire service personnel regarding cancer and its associations with tobacco and SLT use. @*Methods@#This descriptive study used a qualitative approach. Key informant interviews were conducted in 39 career firefighters and fire service administration from across the U.S. Discussion were recorded, transcribed verbatim and transferred to NVivo software for narrative analysis. Topics explored included cancer perceptions, attitudes and beliefs, and cultural factors related to SLT use behaviors. Results: Major themes that emerged among fire service personnel included concerns about cancer and its risk factors including firefighting tasks, such as fire overhaul operations, and from their lifestyle behaviors, such as alcohol and tobacco use. Firefighters also suggested a number of reasons for their increased SLT use, such as fire department tobacco-free policy and fire service culture. @*Conclusion@#The current study provides a rich foundation for future research, prevention, and intervention efforts for the fire service and research communities regarding tobacco and SLT use and cancer risk. Additional research on firefighters' cancer beliefs deserves future research in order to improve messaging about the risks of cancer due to firefighting.

High-intensity Fitness Training Among a National Sample of Male Career Firefighters

Obesity and fitness have been identified as key health concerns among USA firefighters yet little is known about the current habits related to exercise and diet. In particular, high-intensity training (HIT) has gained increasing popularity among this population but limited quantitative data are available about how often it is used and the relationship between HIT and other outcomes. Using survey methodology, the current study evaluated self-reported HIT and diet practice among 625 male firefighters. Almost one-third (32.3%) of participants reported engaging in HIT. Body composition, as measured by waist circumference and percentage body fat, was significantly related to HIT training, with HIT participants being approximately half as likely to be classified as obese using body fat [odds ratio (OR) = 0.52, 95% confidence interval (CI) = 0.34-0.78] or waist circumference (OR = 0.61, 95% CI = 0.37-0.98). Those who engaged in HIT were more than twice as likely as those who did not (OR = 2.24, 95% CI = 1.42-3.55) to meet fitness recommendations. Findings highlight directions for future prevention and intervention efforts.

Accuracy of Body Mass Index-defined Obesity Status in US Firefighters

Obesity is a significant problem affecting United States (US) firefighters. While body mass index (BMI) is widely used to diagnose obesity, its use for this occupational group has raised concerns about validity. We examined rates and types of misclassification of BMI-based obesity status compared to body fat percentage (BF%) and waist circumference (WC). Male career firefighters (N = 994) from 20 US departments completed all three body composition assessments. Mean BMI, BF%, and WC were 29 kg/m2, 23%, and 97 cm, respectively. Approximately 33% and 15% of BF%- and WC-defined obese participants were misclassified as non-obese (false negatives) using BMI, while 8% and 9% of non-obese participants defined by BF% and WC standards were identified as obese (false positives) using BMI. When stratified by race/ethnicity, Pacific Islanders showed high rates of false positive misclassification. Precision in obesity classification would be improved by using WC along with BMI to determine firefighters' weight status.

Coping Responses as Predictors of Satisfaction with Life amongst a Group of Patients Diagnosed with Diabetes Mellitus

The purpose of this study was to investigate the extent to which coping responses could predict the level of life satisfaction experienced by patients suffering from diabetes mellitus. A non-experimental; cross-sectional design was adopted. The sample consisted of 154 individuals (62 Type I diabetics; 80 Type II diabetics; and 12 individuals for whom diagnostic information was not available) recruited from the outpatient diabetes clinic at a large state hospital. All participants completed the Coping Responses Inventory - Adult Version; as well as the Satisfaction with Life Scale. Initially; Pearson product-moment correlation coefficients were calculated to examine the relationship between the predictor variables (coping responses) and the criterion variable (satisfaction with life). Hierarchical regression analyses were conducted to determine the amount of variance in the satisfaction with life scores that was explained by coping responses. The combination of approach and avoidance coping subscales accounted for 33of the variance in the participants' satisfaction with life scores. However; upon further analysis; the avoidance coping subscales were found to account for 28of the variance in the sample's satisfaction with life. The cognitive avoidance subscale and the acceptance or resignation subscale were found to correlate negatively with satisfaction with life at the 1level of significance. It appears that approach coping responses do not predict the satisfaction with life experienced by individuals suffering from diabetes. However; avoidant coping responses; particularly cognitive avoidance and acceptance or resignation; are predictive of lower levels of satisfaction with life

The relationship between smoking, BMI, physical activity, and dietary intake among Thai adults in central Thailand.

OBJECTIVE: Evaluate dietary intake, physical activity, and BMI in adult Thais stratified by smoking status, living in the central region of Thailand. MATERIAL AND METHOD: Participants (n = 1,027) were administered a health questionnaires, 24-h dietary recall, and anthropometric measurements were obtained. RESULTS: Compared to ex-smokers (24.5 +/- 4.3 kg/m2) and non-smokers (24.8 +/- 4.0 kg/m2), current smokers (22.6 +/- 3.8 kg/m2) had significantly lower BMIs, regardless of gender (p < 0.001). In addition, male smokers had smaller waist circumferences than non-smokers. There were no statistically significant differences in nutrient intake or physical activity based on smoking status. Results from this study are consistent with others reports showing that smoking is associated with lower weights and BMI when compared to non-smokers. The mechanism for this association may be related to the potential for nicotine to increase metabolic rate rather than appetite suppression in smokers. CONCLUSION: Because the substantial negative health consequences of smoking are far stronger than those associated with modest weight differences, smoking cannot be viewed as an appropriate weight management strategy.

Factors associated with size and proportionality at birth in term Jamaican infants.

The objective of this study was to identify the factors associated with size and proportionality at birth in a cohort of term infants established to investigate their growth and development. One hundred and forty term low-birth-weight (birth-weight < 2,500 g) infants and 94 normal birth-weight infants (2,500- < 4,000 g) were recruited within 48 hours of birth at the main maternity hospital, Kingston, Jamaica. Birth anthropometry and gestational age were measured, and maternal information was obtained by interview and from hospital records. Controlling for gestational age, variables independently associated with birth-weight were rate of weight gain in the second half of pregnancy, maternal height, haemoglobin level < 9.5 microg/dL, time of first attendance in antenatal clinic, birth order, pre-eclampsia, and consumption of alcohol, with 33% of the variance in birth-weight explained. Birth length was associated only with maternal height and age, while measures of proportionality (ponderal index and head/length ratio) were associated with characteristics of the environment in late pregnancy, including rate of weight gain, weight in late pregnancy, and pre-eclampsia. The variation in maternal characteristics associated with size or proportionality at birth may reflect the times during gestation when different aspects of growth are most affected.

Nutritional status of older adults in urban Jamaica

The aim of the study was to determine the energy intake and nutritional status of a sample of Jamaican adults, and to compare them among different age groups. Measured height and weight data from a survey in Spanish Town, Jamaica, consisting of 2100 adults aged 25-74 years, with 22 per cent over age 60 years, were used to calculate body mass index (BMI). Using BMI cut-off points of 20 and 27, the prevalence of underweight and overweight, respectively, were determined for different age groups. Energy intake was calculated from a food frequency questionnaire from 967 of the respondents. Among males, mean daily energy intake declined from a high of 3681 kcal (15,401 kJ) for 25-29 year-olds, to a low of 2227 kcal (9318 kJ) for those aged 70-74 years. Corresponding numbers among females were 2935 kcal (12,280 kJ) and 1844 kcal (7715 kJ), respectively. Among those aged 65-74 years, 26.9 per cent of males and 50 per cent of females report daily energy intakes of less than 1600 kcal (6694 kJ) (below the lowest recommended dietary allowance (RDA)), compared to 4.5 and 13.7 per cent of males and females aged 25-34 years. While there are moderate declines in the prevalence of overweight, the prevalence of male underweight increased from 4 per cent among 50-54 year-olds to over 35 per cent among those 65 years and older; and among females the corresponding numbers are from 2 per cent to 10 per cent. All trends with age were significant (p < 0.005). There are significant declines in energy intake, and alarming increases in the prevalence of underweight with increasing age among males. These results are cause for concern and further research in this area is warranted

The nutritional status of rural Jamaican school children

Three thousand, eight hundred and eighty-two (3,882) children in grades 2-5, attending 16 rural primary and all-age schools in central Jamaica were weighed and their weight-for-age standard deviation scores calculated using the World Health Organization/National Center for Health Statistics (WHO/NCHS) references. Heights were also measured in a random sample of the grade 5 children (n = 793) and height-for-age and body mass index (BMI-kg/m2) calculated. Sixty-nine per cent of the total sample were of normal weight-for-age, 2were moderately undernourished (weight-for-age > -3 Z-score, -2 Z-score, < or = -1 Z-score). Few children were overweight. The frequency distribution of weight-for-age was similar in girls and boys. In the subsample of children in whom heights were measured, 25.8were < or = -1 Z-score height-for-age, and of these 4.9were < -2 Z-score. Compared with a survey conducted in a similar rural area in the 1960s, the children's mean weights for age group categories were 1.1 to 3.7 kg heavier. Children who were older than appropriate for their grade were more likely to be undernourished (Odds ratio 3.94, 95CI 3.21, 4.83), which suggests that undernourished children may be more likely to repeat a grade or start school later.

Growth and development of West Indian children; Part I: growth

The growth of Caribbean infants is comparable to the NCHS standards until approximately 3 months of age despite somewhat lower bithweights. After this, growth rates dcline. This pattern is similar to that seen in other developing countries (Condon-Paolini et al, 1977; Whitehead, 1979; Rowland et al, 1988). By 18 months of age, average weights and heights of Jamaican children approached the 10th centile of the NCHS standards and remained below the 40 th centile the NCHS standards and remained below the 40 th centile throughout childhood. Ashocroft's studies of growth in childhood showed that the pattern of growth was similar in a number of countries in the Region but, in more recent nutricional surveys, differences between countries can be detected. For example, the prevalence od undernutrition is lower in Barbados but conversely obesity, especially in older girls, is be becoming a significant problem. Most of the growth data on which this review is based was collected in the 1960s and early 1970s. Only a few studies provoded longitudinal data. These were primarily those concerned with growth in the first year of life and the Lawrence Tavern study in which in which children were measured up to 4 years of age. there is clearly a need for more recent data, particularly longitudinal, since the available data suggest that secular changes are occuring. Surveys of nutritional status provide some information on the adequacy of growth but cannot be a substitute for measurements of normal grosth patterns