The impact of fire suppression tasks on firefighter hydration: A critical review with consideration of the utility of reported hydration measures

BACKGROUND: Firefighting is a highly stressful occupation with unique physical challenges, apparel and environments that increase the potential for dehydration. Dehydration leaves the firefighter at risk of harm to their health, safety and performance. The purpose of this review was to critically analyse the current literature investigating the impact of fighting ‘live’ fires on firefighter hydration. METHODS: A systematic search was performed of four electronic databases for relevant published studies investigating the impact of live fire suppression on firefighter hydration. Study eligibility was assessed using strict inclusion and exclusion criteria. The included studies were critically appraised using the Downs and Black protocol and graded according to the Kennelly grading system. RESULTS: Ten studies met the eligibility criteria for this review. The average score for methodological quality was 55 %, ranging from 50 % (‘fair’ quality) to 61 % (‘good’ quality) with a ‘substantial agreement’ between raters (k = .772). Wildfire suppression was considered in five studies and structural fire suppression in five studies. Results varied across the studies, reflecting variations in outcome measures, hydration protocols and interventions. Three studies reported significant indicators of dehydration resulting from structural fire suppression, while two studies found mixed results, with some measures indicating dehydration and other measures an unchanged hydration status. Three studies found non-significant changes in hydration resulting from wildfire firefighting and two studies found significant improvements in markers of hydration. Ad libitum fluid intake was a common factor across the studies finding no, or less severe, dehydration. CONCLUSIONS: The evidence confirms that structural and wildfire firefighting can cause dehydration. Ad libitum drinking may be sufficient to maintain hydration in many wildfire environments but possibly not during intense, longer duration, hot structural fire operations. Future high quality research better quantifying the effects of these influences on the degree of dehydration is required to inform policies and procedures that ensure firefighter health and safety

The impact of body armor on physical performance of law enforcement personnel: A systematic review

Abstract Background The law enforcement officer profession requires performance of arduous occupational tasks while carrying an external load, consisting of, at minimum, a chest rig, a communication system, weaponry, handcuffs, personal protective equipment and a torch. The aim of this systematic review of the literature was to identify and critically appraise the methodological quality of published studies that have investigated the impacts of body armour on task performance and to synthesize and report key findings from these studies to inform law enforcement organizations. Methods Several literature databases (Medline, CINAHL, SPORTDiscus, EMBAS) were searched using key search words and terms to identify appropriate studies. Studies meeting the inclusion criteria were critically evaluated using the Downs and Black protocol with inter-rater agreement determined by Cohen’s Kappa. Results Sixteen articles were retained for evaluation with a mean Downs and Black score of 73.2 ± 6.8% (k = 0.841). Based on the research quality and findings across the included studies, this review determined that while effects of body armour on marksmanship and physiological responses have not yet been adequately ascertained, body armour does have significant physical performance and biomechanical impacts on the wearer, including: a) increased ratings of perceived exertion and increased time to complete functional tasks, b) decreased work capability (indicated by deterioration in fitness test scores), c) decreased balance and stability, and d) increased ground reaction forces. Conclusions Given the physical performance and biomechanical impacts on the wearer, body armour should be carefully selected, with consideration of the physical fitness of the wearers and the degree to which the armour systems can be ergonomically optimized for the specific population in question

Effects of water-based exercise on bone health of middle-aged and older adults:A systematic review and meta-analysis

Background: Age-related bone loss is a major health concern. Only exercises associated with high-impact and mechanical loading have been linked to a positive effect on bone turnover; however, these types of exercises may not always be appropriate for middle-aged and older adults due to physical decline or chronic disorders such as osteoarthritis. Water-based exercise (WBE) has been shown to affect different components of physical fitness, has lower risks of traumatic fracture, and applies less stress to joints. However, the effects of WBE on bone health are unclear. Objective: This study aimed to explore whether WBE is effective in preventing age-related bone deterioration in middle-aged and older adults. Methods: A search of relevant databases and the references of identified studies was performed. Critical narrative synthesis and meta-analyses were conducted. Results: Eleven studies, involving 629 participants, met all inclusion criteria. All participants were postmenopausal women. Eight studies compared WBE to a sedentary control group, and four studies had land-based exercise (LBE) participants as a comparison group. Meta-analyses revealed significant differences between WBE and control group in favor of WBE for changes in bone mineral density (BMD) at the lumbar spine (mean difference [MD] 0.03 g/cm2 ; 95% confidence interval [CI]: 0.01 to 0.05) and femoral neck (MD 0.04 g/cm2 ; 95% CI: 0.02 to 0.07). Significant differences were also revealed between WBE and LBE in favor of LBE for changes in lumbar spine BMD (MD -0.04 g/cm2 ; 95% CI: -0.06 to -0.02). However, there was no significant difference between WBE and LBE for changes in femoral neck BMD (MD -0.03 g/cm2 ; 95% CI: -0.08 to 0.01). Conclusion: WBE may have benefits with respect to maintaining or improving bone health in postmenopausal women but less benefit when compared to LBE. Further research is required on this topic

An Analysis of Reported Dangerous Incidents, Exposures, and Near Misses amongst Army Soldiers

Occupational health and safety incidents occurring in the military context are of great concern to personnel and commanders. Incidents such as “dangerous incidents”, “exposures”, and “near misses” (as distinct from injuries, illnesses, and fatalities) indicate serious health and safety risks faced by military personnel, even if they do not cause immediate harm. These risks may give rise to harm in the future, if not adequately addressed, and in some cases the incidents may cause latent harm. The purpose of this study was to ascertain the rates and patterns of incidents of these types reported by full time (ARA) and part time (ARES) Australian Army personnel. A retrospective cohort study was performed using self-reported incident data from the Workplace Health, Safety, Compensation and Reporting (WHSCAR) database over a two-year period. Data were analysed descriptively. Of 3791 such incidents, 3636 (96 percent) occurred in ARA and 155 (4 percent) in ARES personnel, somewhat consistent with the proportions of total army person-years served in each (ARA 93 percent; ARES 7 percent). In ARA, 84 percent of these incident types were exposures, 14 percent near misses, and 2 percent dangerous incidents. In ARES, 55 percent of incidents were exposures, 38 percent near misses, and 7 percent dangerous incidents. Soldiers at the rank of ‘private’ experienced the highest rates of these incident types, in both ARA and ARES. Driving gave rise to more near misses than any other activity, in both populations. Exposures to chemicals and sounds were more common in the ARA than ARES. The ARES reported higher proportions of vehicle near misses and multiple mechanism dangerous incidents than the ARA. The findings of this study can usefully inform development of risk mitigation strategies for dangerous incidents, exposures, and near misses in army personnel