FIREFIGHTER HEALTH AND FITNESS ASSESSMENT:
ACALL TO ACTION
THOMAS W. STORER,
1
BRETT A. DOLEZAL,
1
MARLON L. ABRAZADO,
1
DENISE L. SMITH,
2
MAXIM A. BATALIN,
3
CHI-HONG TSENG,
4
AND CHRISTOPHER B. COOPER,
1
THE PHASER STUDY GROUP
1
Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine,
University of California Los Angeles, Los Angeles, California;
2
First Responder Health and Safety Laboratory, Department of
Health and Exercise Sciences, Skidmore College, Saratoga Springs, New York;
3
Institute for Technology Advancement, Henry
Samueli School of Engineering and Applied Science, University of California–Los Angeles, Los Angeles, California; and
4
Division of Biostatistics, Department of Medicine, David Geffen School of Medicine, University of California–Los Angeles,
Los Angeles, California
ABSTRACT
Storer, TW, Dolezal, BA, Abrazado, ML, Smith, DL, Batalin, MA,
Tseng, C-H, and Cooper, CB; The PHASER Study Group.
Firefighter health and fitness assessment: A call to action.
J Strength Cond Res 28(3): 661–671, 2014—Sudden cardiac
deaths experienced by firefighters in the line of duty account for
the largest proportion of deaths annually. Several fire service
standards for fitness and wellness have been recommended but
currently only 30% of U.S. fire departments are implementing
programs for this purpose. The Department of Homeland Security
Science and Technology Directorate has initiated the Physiolog-
ical Health Assessment System for Emergency Responders
(PHASER) program aiming to reduce these line-of-duty deaths
through an integration of medical science and sensor technolo-
gies. Confirming previous reports, PHASER comprehensive risk
assessment has identified lack of physical fitness with propensity
for overexertion as a major modifiable risk factor. We sought to
determine if current levels of fitness and cardiovascular disease
(CVD) risk factors in a contemporary cohort of firefighters were
better than those reported over the past 30 years. Fifty-one fire-
fighters from a Southern California department were characterized
for physical fitness and CVD risk factors using standard meas-
ures. Overall, physical fitness and risk factors were not different
from previous reports of firefighter fitness and most subjects did
not achieve recommended fitness standards. Considering the
lack of widespread implementation of wellness/fitness programs
in the U.S. fire service together with our findings that low physical
fitness and the presence of CVD risk factors persist, we issue
a call to action among health and fitness professionals to assist
the fire service in implementing programs for firefighters that
improve fitness and reduce CVD risk factors. Fitness profes-
sionals should be empowered to work with fire departments
lending their expertise to guide programs that achieve these
objectives, which may then lead to reduced incidence of sud-
den cardiac death or stroke.
KEY WORDS cardiovascular disease risk factors, line-of-duty
deaths, risk mitigation
INTRODUCTION
F
irefighters in the United States have only aver-
age physical fitness and, of particular concern,
have high rates of excess weight and obesity
(11,16,17,22,25,35–37,47). These characteristics are
incompatible with the well-characterized physical demands of
firefighting. These include high-intensity work in thermally
intense environments while wearing heavy (approximately 22
kg) and cumbersome personal protective equipment (PPE) and
carrying and using tools needed to perform specific job tasks
(8,10,16,17,22,25,36,39,43). In this context, suboptimal fitness
and excess body weight result in a mismatch with the high-
energy demands required by firefighters, a combination that
may provide a trigger for sudden line-of-duty cardiovascular
or cerebrovascular events (1). Indeed, recent data have revealed
that these events account for about 49% of firefighter line-of-
duty deaths (12) and remain the number 1 cause of firefighter
fatalities (50,51). Lack of physical fitness and the decondition-
ing, which lead to overexertion plus unrecognized cardiovas-
cular disease (CVD) risk factors, are among the prominent
contributory risks toward line-of-duty injuries and deaths (12).
A recent National Fire Protection Association (NFPA)
needs assessment continued to emphasize the need for health
and wellness programs and also reported that 70% of fire
departments still have no such programs (33). Consistent with
this finding, Soteriades et al. (42) reported that infrequent
amounts of physical activity are common in the fire service
and that most departments do not mandate regular exercise
Address correspondence to Thomas W. Storer, tstorer@mednet.ucla.edu.
28(3)/661–671
Journal of Strength and Conditioning Research
Ó 2014 National Strength and Conditioning Association
VOLUME 28 | NUMBER 3 | MARCH 2014 | 661
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.