By Dr. Margaret Gavian, Medical Director, MnFIRE

Stress, and particularly traumatic stress, is an occupational hazard of being a firefighter.

All first responders have a particularly high exposure rate to traumatic stress inducing incidents. Doing chest compressions on an unconscious child, working to free a mother trapped in her vehicle after a collision, being with someone as they die, or recovering a body from a variety of unpleasant situations, are the daily realities of this job.

Industry leaders agree that being a firefighter today is vastly different than it was in years past; firefighters are being asked to do more with less, and with the net effect being more exposure to traumatic incidents, more stress, and more fatigue. Call volume has increased beyond fighting fire, with more medical and mental health calls, and increased exposure to motor vehicle accidents, violent crime, and medical complexity.

Providing round the clock service, firefighters often witness trauma in a disrupted sleep state, already fatigued. This is true for both career and non-career firefighters. Non career firefighters are often busy serving their community at night, only to have to work their “regular” job during the day while continuing to fulfill their roles as parent, friend and spouse. More than 90 percent of Minnesota’s fire service is non-career.

Support and services available to Minnesota’s 22,000 firefighters is scarce, leaving the burden of care on the individual and resulting in an overall department loss. Additional systemwide solutions are vital to keeping firefighters on the job and able to fulfill their deep commitment to service. They’re also essential to reducing turnover and healthcare costs when stress related disorders become chronic and to alleviating the havoc mental health disorders can wreak on families, children, and generations to come. If we expect firefighters to show up for us on our worst days, it is our responsibility to care and assist them on theirs.

Funding for additional training and development of behavioral health programming is critical. Focus on prevention, education, access to quality services and ongoing support is crucial. Existing mental health awareness training and peer support is a positive start, but so much more is required to provide our firefighters with the internal gear they need to protect themselves from the emotional risks of doing what we ask of them.

Another suicide, broken family or hero suffering in silence is simply unacceptable. We can and must do something before burying another public servant.

Note: This blog post is excerpted from “Beyond the Fire: The Mental & Emotional Cost of Being A Firefighter,” from MnFIRE’s Taking the Lead report. The full article can be found here.

There is a crisis in our fire service – more and more Minnesota firefighters are tragically losing their lives due to cancer, cardiac and emotional trauma issues.

Sadly, this crisis doesn’t seem to be coming to an end anytime soon – and with COVID-19, we can only expect it to get worse. Beyond the virus itself, we know COVID-19 is causing Americans to pursue less preventative care, that isolation is exacerbating mental health issues, and that the spike in unemployment means fewer Americans have employer-sponsored health insurance – and we can assume these will have ripple effects when it comes to the health of firefighters.

While the statistics may be grim, here’s the good news: knowing what to look for, methods of prevention, and living a healthy lifestyle, can make a big difference when it comes to your likelihood of experiencing the big three health issues (cancer, cardiac and emotional trauma) for firefighters.

The first step? Signing up to become more become “MnFIRE Aware” of your occupational health risks as soon as possible. Below is some info on MnFIRE’s free training offerings for your department:

MnFire Awareness Training

This training is ideal for departments who have not had previous MnFIRE trainings and is taught by firefighters and other health experts. Thanks to a grant from the Fire Service Advisory Committee (FSAC), this training is being offered both online and in-person at no cost to MN fire departments through June 30, 2021.
Register Now

New! Deep Dive Sessions

These two-hour sessions are catered toward those who have already completed our MnFIRE Awareness Training and want further education on the different health risks facing firefighters. These trainings are available whenever it’s convenient for your department, either in-person or virtually. These classes are tailored to both department leadership, and firefighters themselves.

Cancer Training
More than 68% of firefighters will develop some form of cancer in their lifetimes. This tragic reality underscores the critical need for more Minnesota firefighters to be aware of their higher risks for cancer – and what they can do to help prevent it. In our cancer deep-dive class, we’ll educate firefighters on activities that put them at higher risk for developing cancer, proper PPE strategies for mitigating cancer risks, and what types of screenings can be done to catch cancer early.
Register Now

Cardiac Training
After just three hours of fighting fires, firefighters experience hardened arteries and impaired heart function. With that level of health risk, every firefighter deserves to be given the resources needed to protect their cardiovascular health. In this class, we’ll look at heightened risk factors, the types of cardiovascular diseases that most commonly impact firefighters, and prevention strategies to help firefighters lessen their risk.
Register Now

Emotional Wellness Training
The emotional and disturbing calls we go on can stick with us – and it’s important to recognize how the stresses of the job can negatively impact our mental health. Sadly, too many in the fire service are ashamed or afraid to ask for the help they need. This class will help de-stigmatize talking about mental health in your department, as well as provide practical information around how to properly debrief after a difficult call with your team, ways to maintain emotional well-being and what resources are available for those who need help.
Register Now

Firefighters experience higher rates of certain types of diagnoses and cancer-related deaths compared to the general U.S. population, according to a multi-year study from the Centers for Disease Control and Prevention (CDC). More than 68% of firefighters will develop some form of cancer in their lifetimes.

The rate of line-of-duty deaths from cancer-related illness is rapidly increasing and is on pace to overtake cardiac disease as the leading killer of firefighters nationwide. The most frequently diagnosed cancers in firefighters are found in the digestive, respiratory and urinary systems, as well as orally, including the salivary glands and throat. Specific cancers related to carcinogen exposure – such as malignant mesothelioma – are more than twice as prevalent in firefighters as in the general population. The chance of lung cancer and leukemia diagnoses, and cancer-related death increases with the amount of time spent at fires.

This tragic reality underscores the critical need for more Minnesota firefighters to be aware of their higher risks for cancer – and what they can do to help prevent it.

Why are firefighters at such increased risk for developing cancer?

1. Building and homes contain synthetic and other harmful materials that create more smoke than natural materials – and they release polycyclic aromatic hydrocarbons (PAHs), many of which can cause cancer.
2. Firefighters may also encounter other known carcinogens, like asbestos and diesel exhaust, when on the job.
3. Carcinogens are both inhaled and absorbed through the skin. Even when wearing the proper gear, carcinogens can still penetrate the gear and expose the skin.

There are some proven ways firefighters, with the support of their departments, can take to reduce the risk:

1. Change clothes and wash them immediately after exposure to products of combustion or other contaminates. Do this as soon as possible and/or isolate in a trash bag until washing is available.
2. Shower as soon as possible after being exposed to products of combustion or other contaminates.
3. PPE, especially turnout pants, must be prohibited in areas outside the apparatus floor (i.e. kitchen, sleeping areas, etc.) and never in the household.
4. Fully document ALL fire or chemical exposures on incident reports and personal exposure reports.
5. Get an annual physical, as early detection is the key to survival.

If you’re interested in learning more about how to protect yourself and others in your department, consider registering for MnFIRE’s cancer deep-dive class. In it, we’ll educate firefighters on activities that put them at higher risk for developing cancer, proper PPE strategies for mitigating cancer risks, and what types of screenings can be done to catch cancer early.

Cardiovascular disease is the number-one killer of firefighters nationwide and is by far the leading cause of line-of-duty deaths in the fire service.

According to the International Association of Firefighters, more than 12 percent of all firefighters will develop heart disease at some point in their lives. Even young and healthy firefighters suffer from hardened arteries and impaired heart function after just three hours of prolonged firefighting, according to a 2010 study from the Illinois Fire Service Institute.

So how can you be a more heart-healthy firefighter this year for yourself, your department and your loved ones ? Below are six places to start:

1. Commit to a Healthy Diet

Eating a diet rich in whole foods, lean proteins and vegetables can be one of the biggest influencers on improving your heart health. The first step to pursuing a healthy diet is educating yourself on what constitutes as a healthy dish and how you can prepare it. Check out our Chef Marshall O’Brien trainings for resources that can help you pursue nutrition and that are specifically catered toward firefighters. Finally, explore the tracking applications available on your phone or smart devices that will allow you to document your eating habits, improve portion control and food selections.

2. Get Moving

Working out regularly has so many benefits, but even 30 minutes of exercise 3-4 times per week can help you lose weight, improve cholesterol, and even lower your blood pressure substantially. Commit to get moving at least a couple times per week and your heart will thank you. For those who already maintain a physical activity regimen, try incorporating some high intensity interval training that mimics firefighting duties on a weekly basis to improve your readiness for the extreme physical challenge of the job. Strength training is also a critical element of physical readiness for firefighters because muscular fitness and capacity reduces cardiovascular demand.

3. Find Healthy Ways to Manage Your Stress

Traumatic stress can also increase your risk of heart attack. A study from the University of California – San Francisco found that even limited exposure to trauma can boost inflammation in the body, a key risk factor for heart disease. Finding healthy ways to manage your stress and reduce the effects of the trauma firefighters experience everyday will be key to keeping your cardiovascular system strong. Look into methods like meditation, regular exercise or therapy to support your emotional wellness, and ultimately, improve your physical health.

4. Commit to Quit Smoking

With the cardiovascular stress already inflicted on firefighters, smoking can be especially detrimental to your health. The chemicals in cigarettes are proven to cause the cells that line your blood vessels to be swollen and inflamed. This causes the blood vessels to narrow and can result in multiple life-threatening cardiovascular issues, including stroke, coronary heart disease and aortic aneurysms. It’s never too late to quit, and the sooner you do, the better off your heart will be for it. Call 1-800-QUIT-NOW and work with a trained coach who can partner with you on a plan to kick the habit.

5. Sleep

Sleep also plays a crucial role in limiting cardiac issues. If firefighters do not get enough quality sleep, resting metabolic rates decrease and cause weight gain, increasing the risk of heart attack and stroke. It’s critical to maintain work schedules – by providing proper staffing – and allow firefighters to get enough sleep in order to help prevent cardiac disease.

6. Be an Advocate for Heart Health in Your Firehouse

Changing the culture of your firehouse to promote heart health can be helpful not only for your own personal wellness, but also for your firefighting colleagues. Small actions like swapping a donut spread for a healthier alternative, inviting others into fitness challenges, removing ash trays and leading through example can really go a long way in changing your department’s culture toward wellness and heart health.