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August 28, 2018
Study highlights stresses of firefighting

According CareerCast’s 2018 annual survey of the most stressful occupations, firefighting ranks second only to working in the military. The survey found support in an October 2017 report by two researchers with the Health Hazard Evaluation Program (HHEP) of the National Institute for Occupational Safety and Health (NIOSH), who examined many occupational stresses firefighters experienced at one unnamed fire department.

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Key findings of the investigation include the following:

  • On a job-stress scale of 0 (as low as it can be) to 10 (as high as it can be), the average score was 8.7. One firefighter indicated low job stress, three indicated moderate job stress, and 50 indicated high job stress.
  • Fifty-three firefighters were screened for symptoms of post-traumatic stress disorder (PTSD). Of these, 7 (13 percent) screened positive for possible PTSD. Firefighters who had been physically attacked on the job had a significantly higher prevalence of positive PTSD screenings. No other types of traumatic events were associated with a positive PTSD screen.
  • Two firefighters (4 percent) reported having suicidal ideation. Since the questionnaire was anonymous, the investigators could not directly intervene with these individuals to ensure they received mental health care. “However, we immediately alerted the fire chief about the suicidal ideation responses and provided the fire chief with local and national resources for suicide prevention and mental health,” said the investigators.
  • Of the 53 firefighters who completed the items necessary to screen for symptoms of generalized anxiety disorder, 25 (47 percent) screened negative, 15 (28 percent) met the screening criterion for mild anxiety, 11 (21 percent) met the screening criterion for moderate anxiety, and 2 (4 percent) met the screening criterion for severe anxiety. Firefighters who had been in a situation on the job where they believed they would be killed by another person had a significantly higher prevalence of positive anxiety screenings.
  • Of 54 firefighters, 23 (43 percent) reported that they would “somewhat” or “very much” like to receive training at work to help them cope with stress; 46 (85 percent) indicated they were “somewhat satisfied” or “very satisfied” with the amount of social support they receive from coworkers; and 27 (50 percent) reported they were “somewhat satisfied” or “very satisfied” with the amount of social support they receive from their supervisor(s).
  • Most of the firefighters did not perceive stigma associated with receiving mental health care, but only 61 percent disagreed with the statement that receiving care would be “too embarrassing.” The greatest barriers to seeking mental health care was cost of services and skepticism about whether treatment would be effective.
  • Forty-one firefighters (91 percent) reported receiving the three-part hepatitis B vaccine series; 2 (4 percent), who reported having worked at the fire department for more than 2 months reported not being offered the hepatitis B vaccine and were not vaccinated against hepatitis B.
  • All interviewed firefighters reported always wearing gloves when attending to an individual who is “down” or “unconscious.” All 32 firefighters who reported handling needles or other sharps in the past 12 months reported wearing gloves when doing so.
  • Having received training ranged from 27 percent for “what to do if there are drugs seen on-site” to 69 percent for “ways to reduce exposure to bloodborne pathogens on the job.”
  • Two-thirds of the firefighters reported handling used needles or sharps within the past 12 months—13 (29 percent) reported handling them every shift, 9 (20 percent) every week, 6 (13 percent) every month, and 2 (4 percent) several times.
  • Seven (16 percent) firefighters reported some type of potential bloodborne pathogen exposure during the past 12 months. Most of the potential exposures involved blood, vomitus, or urine coming into contact with gear or skin that was not covered. No reported exposure involved a needlestick.
  • Nineteen firefighters (42 percent) reported coming into contact with drugs as part of their job duties in the past 12 months. One firefighter reported that the number of times this occurred was too numerous to count. The others reported a median of 11 times (range: 1 to 75 times). In general, firefighters described moving drugs or drug paraphernalia with drug residue away from the patient with gloved hands to perform job duties.
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