The promotion of injury and illness prevention and reporting in the fire service

BACKGROUND: Injury prevention interventions are limited in the fire service due to a lack of widespread implementation and underreporting. This creates a significant challenge to improving occupational health. OBJECTIVE: To determine how fire chiefs are promoting reporting and the prevention of physical and mental injuries and illnesses. METHODS: We used an open-ended, qualitative instrument to assess the presence of prevention programs and actions to promote injury and illness reporting in the fire service. The instrument contained six content validated items related to the promotion of prevention interventions and reporting. RESULTS: A total of 54 fire chiefs (age = 51±8y; females = 4, males = 50, years of experience as fire chief = 7±6y) responded to the instrument. A majority (n = 37/54, 68.5%) of the fire chiefs indicated their department had an established health and wellness program. Most fire chiefs reported using established guidelines, education, and a supportive culture to promote prevention and reporting. The cultural stigma of being a firefighter and fear of repercussions were barriers to the promotion of reporting of illness and injury. Fire chiefs stated that they struggled to find ways to effectively promote reporting and prevention strategies. CONCLUSIONS: The success of a fire chief’s promotional efforts was greater in instances where multiple factors were addressed.

How we roll: A fire engine to every call? Fire department resource allocation and firefighter support in the United States

PurposeEmergency service departments face changing mission requirements, budget constraints and a demanding work environment. This study examined the perceptions of fire chiefs, officers and firefighters who attended the National Professional Development Symposium on the use of a tiered approach when responding to calls, the continued increase in medical calls and mental health services available to fire service personnel.Design/methodology/approachThis study examined the perceptions of fire chiefs, officers and firefighters who attended the National Professional Development Symposium on the use of a tiered approach when responding to calls, the continued increase in medical calls and mental health services available to fire service personnel.FindingsSurvey respondents indicated that they either are currently or would consider using a tiered approach to sending a fire engine and crew or a lighter vehicle to medical or other calls based requirements identified using a tiered approach.Research limitations/implicationsThis idea has future implications regarding the vehicle mix of fire stations as administrators seek to meet the needs of the public most effectively. Survey responses also noted the need for mental health services arguing that care seeking firefighters should have the option of getting mental health services within the station or at an external location. Calls involving babies or young children were overwhelming cited as the most difficult. Additionally, 95% of respondents indicated a belief that most firefighters suffer from PTSD.Practical implicationsRecommendations include: A larger scale survey and analysis of first responder perceptions based on this study. Identifying “best practices” of the most effective “tiered response” approaches to deploying emergency services resources to calls. Studying Mental Health services combating PTSD to identify best practices. Lastly, emergency services administrators should consider changes to the “vehicle mix” when equipping or reequipping stations.Social implicationsSocial implications include use of a “tiered response” approach to emergency calls and focusing how best to support the mental health needs of firefighters.Originality/valueFire Departments are only beginning to explore the idea of using a tiered response to respond to emergencies. This study identifies both short and long term implications of using a tired approach. A secondary emphasis of this study explores difficult calls and PTSD issues faced by firefighters.

What Does It Cost to Prevent On-Duty Firefighter Cardiac Events? A Content Valid Method for Calculating Costs

Cardiac arrest is a leading cause of mortality among firefighters. We sought to develop a valid method for determining the costs of a workplace prevention program for firefighters. In 2012, we developed a draft framework using human resource accounting and in-depth interviews with experts in the firefighting and insurance industries. The interviews produced a draft cost model with 6 components and 26 subcomponents. In 2013, we randomly sampled 100 fire chiefs out of >7,400 affiliated with the International Association of Fire Chiefs. We used the Content Validity Index (CVI) to identify the content valid components of the draft cost model. This was accomplished by having fire chiefs rate the relevancy of cost components using a 4-point Likert scale (highly relevant to not relevant). We received complete survey data from 65 fire chiefs (65% response rate). We retained 5 components and 21 subcomponents based on CVI scores ≥0.70. The five main components include, (1) investment costs, (2) orientation and training costs, (3) medical and pharmaceutical costs, (4) education and continuing education costs, and (5) maintenance costs. Data from a diverse sample of fire chiefs has produced a content valid method for calculating the cost of a prevention program among firefighters.

Volunteer Fire Department Perceptions of ICS and NIMS

A mail survey designed to explore perceptions of the Incident Command System (ICS) and the National Incident Management System (NIMS) was sent to volunteer fire fighters and department chiefs in Spring of 2008. The data demonstrated that both ICS and NIMS were not well perceived among responding volunteer fire chiefs and volunteer fire fighters in North Dakota. Rather than indicating issues with the ICS or NIMS systems themselves, respondents’ comments revealed concerns with the systems to be rooted in their status as volunteers and their residence in rural areas.