Intra-Tour Variation of Firefighter Sleep Duration and Sleep-Wake Cycle within the 24/48 and 48/96 Shift Schedules.

OBJECTIVE: The purpose of this paper is to investigate intra-tour variation in total sleep time (TST) and sleep-wake cycle among US firefighters working the 24 hours on and 48 hours off shift schedule (24/48) and the 48 hours on and 96 hours off shift schedule (48/96). METHODS: Twenty-four firefighters were recruited for this sleep study and were evaluated over 18 days during a 24/48 shift schedule and again 6 months after firefighters transitioned to a 48/96 shift schedule. The primary outcome variables included TST, measured by actigraphy, and sleep-wake cycle (in-bed time and sleep offset) using the Emergency Services Sleep Diary. RESULTS: Firefighters experienced intra-tour variations in TST and sleep offset. The least TST occurred at home prior to starting shift on the 24/48 and 48/96 schedules (5.80 hours and 5.66 hours, respectively). The second least TST occurred the night preceding shift end (5.84 hours and 5.81 hours, respectively). In contrast to in-bed time, sleep offset varied throughout the schedule and was found to correlate with TST. In addition, shift start/end time appears to be responsible for advanced sleep offset. CONCLUSION: Results indicate that firefighters' sleep is complex and should not be reduced to singular averages. In both schedules, firefighters arrived at work with insufficient sleep, received insufficient sleep while on shift, and would commute home with insufficient sleep. These findings can inform future firefighter sleep research by accounting for intra-tour variations.

Veterans' views on military tobacco use and tobacco control policy.

National military and veteran service organizations (MVSOs) have the potential to be advocates for stronger military tobacco control. This study consisted of qualitative analysis of interviews with 5 MVSO leaders (or their designees) and 6 focus groups conducted with veterans, to explore the opinions of MVSO leaders and veterans about military tobacco use and tobacco control policy, and to assess their current knowledge, attitudes, and likelihood of engaging with civilian tobacco control. Themes discussed include the impact of tobacco use on the military mission and on veterans; the possibility of stronger military tobacco control policies; and the idea that such policies would affect the rights of military personnel. Participants considered whether tobacco use impacts the military mission in the most literal sense (e.g., giving away patrol locations), ignoring larger scale effects on long term health and costs. While familiar with tobacco's impacts on veterans' health, MVSO leaders did not endorse stronger policies, although some veterans did. Participants were largely unaware of the impact of tobacco use on military readiness. Establishment of better alliances among MVSOs and civilian public health groups for mutual education about tobacco's many negative effects on the military's mission may be necessary to achieve a tobacco-free military.

Accuracy of self-reported weight, height and BMI in US firefighters.

BACKGROUND: Obesity is of increasing concern especially among firefighters. Bias in self-reported body weight, height and body mass index (BMI) has received a great deal of attention given its importance in epidemiological field research on obesity. AIMS: To determine the validity of self-reported weight, height and BMI and identify potential sources of bias in a national sample of US firefighters. METHODS: Self-reported and measured weight and height (and BMI derived from them) were assessed in a national sample of 1001 career male firefighters in the USA and errors in self-reported data were determined. RESULTS: There were 1001 participants. Self-reported weight, height and BMI were significantly correlated with their respective measured counterparts, i.e. measured weight (r = 0.990; P < 0.001), height (r = 0.961; P < 0.001) and BMI (r = 0.976; P < 0.001). The overall mean difference and standard deviation between self-reported weight, height and BMI were 1.3±2.0kg, 0.94±1.9cm and 0.09±0.9kg/m(2), respectively, for male firefighters. BMI-based weight status (P < 0.001) was the most consistent factor associated with bias in self-reported BMI, weight and height, with heavier firefighters more likely to underestimate their weight and overestimate their height, resulting in underestimated BMIs. Therefore, using self-reported BMI would have resulted in overestimating the prevalence of obesity (BMI ≥ 30.0) by 1.8%, but underestimating the prevalence of more serious levels of obesity (Class II and III) by 1.2%. CONCLUSIONS: Self-reported weight and height (and the resulting BMI) were highly correlated with measured values. A primary and consistent source of error in self-reported weight, height and BMI based on those indices was BMI-based weight status.

Obesity and incident injury among career firefighters in the central United States.

OBJECTIVE: Firefighting is a dangerous profession with high injury rates, particularly musculoskeletal (MS), but limited longitudinal data is available to examine predictors of MS injuries in this population. DESIGN AND METHODS: The relationship between personal individual, nonoccupational factors (e.g., demographic characteristics, body composition, fitness, and health behaviors) and incident injury and incident MS injury in a prospective cohort of 347 firefighters from the central United States was examined. RESULTS: Baseline weight status was a significant predictor of incident MS injury, with obese (BMI ≥ 30 kg m(-2)) firefighters 5.2 times more likely (95% CI = 1.1-23.4) to experience a MS injury than their normal weight (BMI = 18.5-24.9 kg m(-2)) colleagues over the course of the study. Similarly, firefighters who were obese based on WC (>102.0 cm) were almost three times as likely (OR = 2.8, 95% CI = 1.2-6.4) to have a MS injury at follow-up. CONCLUSIONS: Findings highlight the importance of focusing on firefighters' body composition, nutrition and fitness as a means of decreasing risk for injury.

Alcohol use among firefighters in the Central United States.

BACKGROUND: Although the US National Fire Service is concerned about alcohol use among firefighters, little research has been conducted on the topic. AIMS: To survey alcohol use patterns among career and volunteer firefighters. METHODS: Data were from a population-based cohort study of male firefighters conducted in randomly selected career and volunteer departments. Data were collected from 2008 to 2010. RESULTS: There were 656 participants from 11 career and volunteer 13 departments included in the study with a response rate of 97%. Career firefighters drank approximately 10 days per month (just about half of their off duty days) and drank relatively heavily on those days. Fifty-eight per cent of career and 40% of volunteer firefighters averaged three or more drinks and similar percentages reported binge drinking on the days they consumed alcohol. In general, firefighters who drank but did not binge drink tended to have the best health outcomes, while those who binge drank typically were at highest risk of negative health outcomes. Nine per cent of career and 10% of volunteer firefighters who drank self-reported driving while intoxicated in the previous 30 days. CONCLUSIONS: Given the high rates of heavy and binge drinking, local and nationally coordinated efforts to increase the surveillance of drinking behaviour among firefighters and the development of targeted prevention interventions are critically needed.