The ways Health is Impacted in the Fire Service Mission: Stress and Chemical Exposure Risks

Firefighters and Fire Investigators in the United States face significant health risks due to the inherent dangers of their profession, which include exposure to life-threatening situations, intense physical exertion, and the regular inhalation of toxic chemicals. The combination of psychological stress and chemical exposure not only impacts the immediate health and safety of firefighters but also has lasting effects on their physical and mental well-being. Chronic stress and chemical exposure are associated with increased rates of cardiovascular disease, cancer, respiratory issues, and mental health disorders, highlighting the urgent need for health monitoring and protective measures in fire service agencies. This article explores the health impacts of stress and chemical exposure on U.S. firefighters, identifies key areas for agency focus, and suggests measures for minimizing health risks.

Table of Contents

1. Stress in Fire Services

Sources of Stress

Firefighters and Fire Investigators are exposed to both acute and chronic stress from multiple sources, including life-threatening situations, high-stakes decision-making, sleep disruptions, and prolonged shifts. Emergency situations require firefighters to operate in environments that demand rapid responses, often under extreme physical and mental pressure (Haddock et al., 2019). The unpredictability of calls and the responsibility for the safety of both team members and civilians can lead to chronic stress, which may result in long-term mental health issues such as post-traumatic stress disorder (PTSD), anxiety, and depression (Jahnke et al., 2018).

1. Stress in Fire Services
2. Chemical Exposure Risks
3. Combined Effects of Stress and Chemical Exposure
4. Common Health Impacts on Firefighters
5. Preventive Measures and Recommendations for Agencies
6. Conclusion

Sleep disruption is another factor that significantly contributes to stress among firefighters. The requirement to remain on call for extended shifts often leads to sleep fragmentation and deprivation, which can result in impaired cognitive functioning, increased irritability, and a heightened risk of mental health issues (Patterson et al., 2019). Additionally, cumulative stress from repeated exposure to traumatic events can contribute to mental health conditions that extend beyond the professional sphere, affecting personal relationships and quality of life.

Healing the Hero

Healing the Hero, is a U.S. based nonprofit specializing in the stress mitigation of critical incidents through the Trauma Resiliency Protocol (TRP) developed by Dan Jarvis. TRP is a no cost non clinical intervention that removes the emotions from traumatic triggers allowing the brain to cognitively reprocess the memory allowing for healthier outcomes. (D. Jarvis, 2020) http://www.healingthehero.org A term coined by Donald Brucker, a Healing the Hero Board Member really makes sense. We should look at the need for a Mental Decon (Decontamination) after critical incidents. Donald has been in the Fire Services for over 30 years and leading the charge to crush the stigma in his field.

Health Impacts of Stress

The high-stress environment of firefighting can result in significant physiological impacts. Chronic stress contributes to elevated levels of cortisol and other stress hormones, which have been linked to cardiovascular disease, hypertension, and obesity (Kales et al., 2019). A study by Kales et al. (2019) found that stress-related cardiovascular incidents are one of the leading causes of on-duty fatalities among firefighters, accounting for nearly 45% of all line-of-duty deaths. Chronic stress also weakens the immune system, increasing susceptibility to illness and prolonging recovery times from injury or illness (Jahnke et al., 2018).

2. Chemical Exposure Risks

Types of Chemicals and Carcinogens

In addition to stress, firefighters and Fire Investigators are exposed to various chemicals and toxic substances in the line of duty, particularly carcinogens that are released during combustion. Common toxic chemicals include polycyclic aromatic hydrocarbons (PAHs), benzene, formaldehyde, and asbestos (Fent et al., 2020). Even with personal protective equipment (PPE), exposure to these chemicals is nearly unavoidable due to their pervasive presence in fire environments and the limitations of PPE in preventing all forms of chemical absorption.

Smoke contains a mix of toxic gases and particulates, including hydrogen cyanide and carbon monoxide, which can be inhaled during fire suppression activities. Additionally, firefighters face chemical exposure during non-fire-related tasks, such as hazardous materials cleanup and vehicle extrication, where chemicals are released from building materials, plastics, and fuels (Fent et al., 2020). Dermal absorption of chemicals is another significant risk, as carcinogens can penetrate the skin, particularly in areas where PPE may not provide complete protection.

Health Impacts of Chemical Exposure

Chemical exposure poses significant long-term health risks for firefighters, particularly regarding respiratory health and cancer. Research shows that firefighters have higher incidences of respiratory diseases, including chronic obstructive pulmonary disease (COPD) and asthma, due to inhalation of toxic particles and gases (Harrison et al., 2019). Furthermore, the International Agency for Research on Cancer (IARC) classifies firefighting as a “Group 1” occupation with carcinogenic risks due to high rates of exposure to known carcinogens (IARC, 2021).

Cancer is a major concern, with firefighters facing significantly higher rates of certain cancers, including lung, colorectal, and bladder cancers, compared to the general population. The Firefighter Cancer Support Network (2020) reports that cancer is responsible for approximately 61% of line-of-duty deaths among firefighters. Studies by Fent et al. (2020) also indicate that firefighters experience a higher prevalence of skin and liver cancers, suggesting that dermal absorption of toxic chemicals is a critical concern.

3. Combined Effects of Stress and Chemical Exposure

The combined impact of chronic stress and chemical exposure presents a unique challenge to firefighter and Fire Investigator health. Chronic stress can exacerbate the negative effects of chemical exposure, as prolonged elevated cortisol levels weaken the body’s ability to process and detoxify harmful substances (Jahnke et al., 2018). Additionally, stress can affect immune function, making firefighters more susceptible to the carcinogenic effects of toxic chemicals and impairing the body’s natural ability to repair cellular damage caused by chemical exposure (Fent et al., 2020).

This synergistic effect highlights the need for comprehensive health monitoring and intervention strategies that address both mental health and chemical exposure. Agencies must recognize that stress and chemical exposure are interrelated issues requiring an integrated approach to health and safety.

4. Common Health Impacts on Firefighters and Fire Investigators

Cardiovascular Disease

Firefighters and Fire Investigators have a high incidence of cardiovascular disease, attributed to both physical and emotional stress. The intense exertion required for firefighting activities places significant strain on the cardiovascular system, particularly during fire suppression and rescue tasks. Chronic stress compounds this risk, as prolonged exposure to stress hormones can lead to hypertension, arrhythmias, and even sudden cardiac events (Kales et al., 2019).

Cancer

Due to high exposure to carcinogens, Firefighters and Fire Investigators are at increased risk for various cancers. The Firefighter Cancer Support Network (2020) indicates that cancer is a leading cause of death among firefighters, with higher-than-average incidences of several types of cancer, including prostate, lung, and skin cancers. Efforts to reduce exposure through improved PPE, decontamination practices, and regular health screenings are essential in mitigating these risks.

Respiratory Disorders

Respiratory diseases such as asthma, COPD, and chronic bronchitis are more common in firefighters than in the general population, largely due to repeated exposure to toxic smoke and particulates. Even short-term exposure to smoke can cause acute respiratory symptoms, while chronic exposure increases the risk of developing long-term respiratory conditions (Harrison et al., 2019).

Mental Health Disorders

PTSD, depression, and anxiety are prevalent among firefighters due to repeated exposure to traumatic events, high-stress environments, and prolonged shifts. Mental health conditions are often exacerbated by stigma within fire service culture, which discourages firefighters from seeking help (Jahnke et al., 2018). Mental health interventions and peer support programs are critical for reducing the long-term impact of psychological stress on firefighters.

5. Preventive Measures and Recommendations for Agencies

To address the health risks associated with stress and chemical exposure, fire service agencies must adopt proactive measures that prioritize both physical and mental health. The following are key recommendations for reducing health risks among firefighters:

Regular Health Monitoring

Agencies should implement comprehensive health monitoring programs that track both physical and mental health indicators. Health screenings for cancer, respiratory disorders, and cardiovascular health are essential for early detection and intervention. Additionally, mental health screenings can help identify individuals at risk for PTSD or other psychological conditions, enabling timely access to support services (Haddock et al., 2019).

Improved Personal Protective Equipment (PPE)

While PPE cannot eliminate all risks, advancements in PPE design can reduce exposure to toxic chemicals. Fire service agencies should invest in high-quality PPE that includes full-body protection, particularly for areas like the neck and face, which are vulnerable to dermal absorption of carcinogens (Fent et al., 2020). Frequent decontamination of PPE after each incident is also essential for minimizing chemical exposure.

Mental Health Support and Peer Programs

Providing access to mental health resources, such as counseling and therapy, can help firefighters manage stress and prevent mental health conditions. Peer support programs are particularly effective, as they create a culture of openness and reduce stigma around seeking help for mental health issues (Jahnke et al., 2018). Training firefighters to recognize signs of PTSD and mental distress in their peers can also promote early intervention and support.

Implementing Decontamination Procedures

Effective decontamination protocols after exposure to smoke and chemicals are essential for reducing carcinogen exposure. Agencies should ensure that firefighters have access to decontamination equipment and supplies at the scene of a fire. Decontamination practices, such as wiping down exposed skin and changing out of contaminated gear immediately after a call, are recommended to reduce the risk of chemical absorption (Fent et al., 2020).

Training and Education

Training programs that emphasize health and wellness, safe handling of chemicals, and stress management can equip firefighters with the knowledge needed to protect themselves. Education on the risks of chemical exposure and stress, as well as training in safe practices and stress management techniques, can empower firefighters to make informed decisions about their health (Harrison et al., 2019).

Conclusion

The health impacts of stress and chemical exposure among U.S. firefighters are profound and multifaceted, leading to elevated risks of cancer, cardiovascular disease, respiratory disorders, and mental health conditions. Fire service agencies must prioritize health and wellness programs, including improved PPE, regular health monitoring, mental health support, and decontamination procedures. By implementing these preventive measures, agencies can reduce the long-term health risks for firefighters and create a safer, more supportive work environment.

As the demands of firefighting continue to grow, it is imperative that fire service agencies invest in both the physical and mental health of their members. The cumulative impact of chronic stress and chemical exposure not only affects the individual firefighter but also has broader implications for public health, resource allocation, and the sustainability of the fire service profession. By adopting a proactive and integrated approach to health and safety, fire service agencies can help protect the lives and well-being of those who risk their lives to protect others.

References

• Fent, K. W., Evans, D. E., Booher, D., Striley, C., Roegner, K., & Calafat, A. M. (2020). Inhalation and dermal exposure to polycyclic aromatic hydrocarbons among firefighters. Environmental Science & Technology, 54(1), 158-164. https://doi.org/10.1021/acs.est.9b03890
• Firefighter Cancer Support Network. (2020). Firefighter cancer statistics. https://www.firefightercancersupport.org
• Haddock, C. K., Poston, W. S., Jahnke, S. A., & Jitnarin, N. (2019). The health effects of occupational stress and workload on firefighters. Journal of Occupational Health, 61(1), 67-75. https://doi.org/10.1002/1348-9585.12079
• Harrison, T. R., Moore, J. L., & Brooks, J. R. (2019). Respiratory health risks in firefighting: An updated review of occupational exposure and prevention strategies. Annals of Occupational Hygiene, 63(3), 354-366. https://doi.org/10.1093/annweh/wxy115
• International Agency for Research on Cancer. (2021). Monographs on the identification of carcinogenic hazards to humans: Firefighting. https://www.iarc.who.int
• Jahnke, S. A., Haddock, C. K., Poston, W. S., Jitnarin, N., & Kaipust, C. M. (2018). The effects of repeated traumatic exposure and peer support on mental health among firefighters. Psychiatry Research, 268, 330-336. https://doi.org/10.1016/j.psychres.2018.08.045
• Jarvis, D. (2020). Trauma Resiliency Protocol: Helping veterans and first responders manage PTSD. Tactical Resiliency USA.
• Kales, S. N., Soteriades, E. S., & Christophi, C. A. (2019). Health risks associated with firefighting. American Journal of Industrial Medicine, 62(4), 305-315. https://doi.org/10.1002/ajim.22967
• Patterson, P. D., Weaver, M. D., & Frank, R. C. (2019). Sleep, fatigue, and performance in fire service personnel. Prehospital Emergency Care, 23(5), 579-587. https://doi.org/10.1080/10903127.2019.1591954