Contributed by Nicholas E. Blonien, D.O.

Cancer remains a leading cause of firefighter mortality. Despite marvelous advances in diagnostic technologies and therapeutics, healthy lifestyle choices are still a powerful prevention strategy, especially for those in the higher-risk firefighting field.

Earlier in 2023, leaders in firefighter research published a review of current evidence supporting the effectiveness of lifestyle interventions in preventing cancer in the fire service. Here are the main lifestyle interventions they recommend:

1. Target obesity

Obesity increases risk of many cancers by as much as 30-80%, including some that already impact the fire service disproportionately. By decreasing body fat percentage, we can decrease risk of cancer. This starts with nutrition and exercise.

2. Get moving

With increasing rank within the fire department comes increased risk of sedentary behavior, especially when the job calls for more time at a desk behind a computer. By intentionally replacing inactivity with movement, such as “exercise snacks,” cancer risk can go down.

3. Prioritize sleep

Getting a good night’s sleep during a busy shift is impossible, but the negative health effects of this can be limited by optimizing sleep when it’s available, both at the fire station and at home. Establishing a bedtime routine, eating during times when your body is prepared for it, limiting nightly snacking and managing stress will make a huge difference.

4. Minimize alcohol

While there continues to be debate about the harmful effects of alcohol on the cardiovascular system, evidence for alcohol consumption as a risk factor for cancer development is much clearer. And rates of alcohol consumption and binge drinking are high among firefighters. Less is better, none is ideal.

5. Dial in the diet

Firefighters tend to follow a standard Western diet, consisting of processed foods and comfort food snacking. This type of eating has been clearly associated with increased cancer risk. Alternatively, a nutrition plan resembling the Mediterranean diet has been associated with decreased cancer risk. Sticking to mostly plants, healthy oils, nuts/seeds, fish and minimal meat/dairy is the best fuel plan for tactical athletes like firefighters.

A cultural shift is needed to tackle these issues, and a unified firehouse can be powerful. Talk with family and friends, engage leadership, partner with colleagues and ask healthcare providers questions. Little improvements can make a difference and add up to bigger change.

Protect your department from cancer

Learn more about shifting the culture in MnFIRE’s cancer deep-dive training. In this class, firefighters learn the 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. Sign up your department for a FREE training here.

Contributed by Paul J. Anderson, M.D.

Getting quality sleep is tough. Anticipation of a call at night is like watching the alarm clock when you know you need to get up early. Your sleep quality suffers. Then a call comes in, and your sympathetic “fight-or-flight” response is activated. This sharpens your focus and primes your body to perform, but makes it incredibly difficult to fall back asleep once the run is complete.

Plus, sharing your sleeping quarters with others, like in a firehouse, can limit the ability to personalize one’s sleep environment when time for sleep is available. And at home, firefighters tend to prioritize time with family and other personal obligations over resolving “sleep debt” accrued from a busy night on duty. Understandably so.

Sleep is the most restorative and rejuvenating element of human life. During sleep, the body clears waste products of metabolism and cellular function and builds neural networks in the brain that are responsible for learning and memory. Sleep replenishes our immune systems, balances our hormones and repairs our bodies so that we are primed for work and activity when we wake the following morning.

According to renowned sleep expert Dr. Matthew Walker, there may not be a single cellular process that doesn’t benefit from a good night’s sleep. Lack of routine quality sleep for seven to eight hours per night has been associated with performance deficits and increased risk of cardiometabolic disease, mental illness, cognitive decline, cancer and early death. But nighttime calls are inevitable, whether you are a full-time, part-time, on-call or volunteer firefighter. Therefore, firefighters must do all they can to maximize sleep quality when sleep opportunity is available.

Here are some considerations to optimize your sleep:

1. Build a sleep sanctuary

The ideal sleep environment is cool, dark and quiet. If you are utilizing shared sleeping quarters, aim to set the temperature somewhere between 60 to 67°. Avoiding screen use for two hours before bed is incredibly important, as the light emitted from electronic screens has a powerful impact on the body’s internal clock. Fans and other generators of “white noise” may help create a restful environment in an otherwise noisy environment. It also may be worth considering lighting sleeping rooms with light that are less stimulating to the eyes. Think red or dimmer light.

2. Develop a bedtime routine

The brain needs to associate the bed with sleep only. Common techniques to help calm the body and recruit the parasympathetic “rest and digest” system include warm showers, gentle stretching, meditation, and structured breathing. Consider a pre-bed routine that starts with taking a hot shower, followed by some reading under dim light on a non-electronic source, then five to ten minutes of “cyclic sighing” in bed (four seconds deep inhale, eight seconds slow exhale). These behaviors can calm the nervous system and set the stage for sleep.

3. Nap strategically

Napping can improve daytime alertness and help resolve sleep debt, but it has to be done properly. Napping at the wrong time of day or for too long can compromise nighttime sleep quality. Naps for less than 30 minutes in the early afternoon (around 1 p.m. to 3 p.m.) are best, when the body’s circadian rhythm yields a natural dip in arousal. But only nap if you feel the need, because oversleeping is also harmful to overall health.

4. Live an active and healthy life

Daily exercise leads to the increased accumulation of adenosine, the primary molecule responsible for tiredness, or “sleep drive,” at the end of the day. Exercise will also help with weight loss, which can prevent the development of sleep disorders like obstructive sleep apnea (OSA). Limiting caffeine intake to the morning and less than 400 mg daily is ideal. Aim for minimal alcohol intake as well, and know that a drink is less disruptive to sleep if had earlier in the day versus evening. Meal timing can also affect the body’s internal clock, so avoiding eating for the first one to two hours after waking and two to three hours before bed can be helpful.

5. Promote a pro-sleep culture

The machismo “I’ll sleep when I’m dead” mentality needs to end. Research tells us that education, awareness, and implementation of sleep programs in fire departments are effective in improving overall sleep quality. Address fatigue and sleep status often, discuss it with other firefighters and make sleep a priority at home. To help set the tone, consider reading Walker’s book Why We Sleep. It will reaffirm that quality sleep is a foundation of overall wellness and perhaps motivate you to make favorable changes to your sleeping routine.

Chronic sleep deprivation is likely to accelerate the development of illnesses that are already all too prevalent in the fire service. While high-quality sleep may be a challenge for firefighters, some of these simple adjustments can help you prioritize better sleep techniques and your overall health.

Put your department on a path to better sleep

MnFIRE now offers a training specifically focused on sleep. Help your team get a better night’s sleep – register your department today for this free sleep training here.

Contributed by Dr. Nick Blonien, Occupational & Environmental Medicine

Poor sleep quality is a public health epidemic, and a problem estimated to burden nearly half of American adults. Decreased physical and cognitive performance, adverse health outcomes, decreased safety and lost productivity are some of the consequences seen in individuals who are underslept. And as we know all too well, the fire service is disproportionately impacted.

Traumatic experiences and hazardous exposures from firefighting contribute independently to increased risk of cardiovascular disease, emotional trauma and cancer. Quality sleep is a necessary component of firefighter resilience against these inherent threats. Unfortunately, shift work and nighttime disruptions prevent most firefighters, both career and non-career, from getting adequate sleep on a consistent basis. Such chronic sleep deprivation is likely to accelerate the development of illnesses that are already all too prevalent in the fire service.

In honor of Sleep Awareness Week, we’re sharing how crucial sleep is to your health and well-being, and steps you can take to promote better sleep.

Consistent poor sleep could be as harmful as the carcinogens you’re exposed to on the scene

Since 2019, the International Agency for Research on Cancer (IARC) has recognized night shift work as a group 2A carcinogen, meaning probably carcinogenic. Sleep disorders are also widely underdiagnosed across the fire service, and lead to 2-3 times higher odds of motor vehicle crash, work injury, diabetes, heart disease and mental illness.

In adults, at least 7 hours of quality sleep per night is deemed sufficient, but getting quality sleep in the fire service can be difficult. Anticipation of a call at night prevents restful sleep. Then a call comes in, and the sympathetic “fight-or-flight” response is activated. This sharpens focus and primes the body for action, but makes it incredibly difficult to fall back asleep once the run is complete. Plus, firehouses often have shared sleeping quarters, which limits the ability to personalize the sleep environment when time for sleep is available. At home, firefighters tend to prioritize time with family and other personal obligations over resolving “sleep debt” accrued from a busy night on duty.

The power of a good night’s sleep

Sleep is the most restorative and rejuvenating element of human life. During sleep, the body clears waste products of metabolism and cellular function, and builds neural networks in the brain that are responsible for learning and memory. Sleep replenishes the immune system, balances hormones and repairs the body so that it is primed for work and activity upon waking the following morning. There may not be a single biological function that doesn’t benefit from a good night’s sleep. Sleep quality is optimized when:

1. Circadian rhythms – the 24-hour cycles that are part of the body’s internal clock, running in the background to carry out essential functions and processes like the sleep-wake cycle – are synchronized with light/darkness and other rhythmic cues.
2. Homeostatic sleep drive – or tiredness – is high.
3. Environmental conditions are favorable.

It’s difficult for firefighters to get routine quality sleep on top of increased risk for adverse health outcomes due to work in extreme environments. So, here are five simple ways to improve your sleep as a firefighter:

1. Build a sleep sanctuary: The ideal sleep environment is cool, dark and quiet. Aim to set the temperature somewhere between 60-67° Avoiding screen use for two hours before bed is incredibly important, as the light emitted from electronic screens has a powerful impact on the body’s internal clock. Fans and other “white noise” may be helpful in creating a restful environment in an otherwise noisy firehouse or family home. Consider using light bulbs with red or dimmer light in sleeping quarters that are less stimulating to the eyes.
2. Develop a bedtime routine: The brain needs to associate the bed with sleep only. Common techniques to help calm the body and recruit the parasympathetic “rest and digest” system include warm showers, gentle stretching, meditation and structured breathing. Consider a pre-bed routine that starts with taking a hot shower, followed by some reading under dim light on a non-electronic source, then 5-10 minutes of “cyclic sighing” in bed (4-second deep nasal inhale, 8-second slow oral exhale). These behaviors can calm the nervous system and set the stage for sleep.
3. Nap strategically: Napping can improve daytime alertness and help resolve sleep debt, but it has to be done properly. Napping at the wrong time of day or for too long can compromise nighttime sleep quality. Naps for less than 30 minutes in the early afternoon are best, when the body’s circadian rhythm yields a natural dip in arousal. But only nap if needed, because oversleeping is also harmful to overall health.
4. Live an active and healthy life: Daily exercise leads to the increased accumulation of adenosine, the primary molecule responsible for tiredness. Exercise will also help with weight loss, which can prevent development of sleep disorders like obstructive sleep apnea (OSA). Limit caffeine intake to the morning (less than 400 mg daily is ideal), and aim for minimal alcohol intake as well. A drink is less disruptive to sleep if had earlier in the day versus evening. Meal timing can also affect the body’s internal clock, so avoiding eating for the first 1-2 hours after waking and 2-3 hours before bed can be helpful.
5. Promote a pro-sleep culture: The machismo “I’ll sleep when I’m dead” mentality needs to end. Address fatigue and sleep status often (perhaps daily), discuss it with other firefighters and make sleep a priority off duty.

It will always be challenging for career and volunteer firefighters to get sufficient sleep on a routine basis. But with a culture that prioritizes quality sleep and these techniques, firefighters can minimize the effects of insufficient sleep on performance and overall health, keeping them healthier for their families, colleagues and the public they proudly serve.

Put your department on a path to more ZZZs

We’re excited to announce we’ll be offering a new MnFIRE training session on the topic of sleep. If you’re interested in hosting a sleep training for your department soon, register here.