Saving lives through science

July 20, 2012

There’s a technical term for all the gear that firefighters wear when they battle a blaze -- the helmet, the hood, the multi-layered jacket and trousers, the gloves, the boots, the self-contained breathing apparatus, and more.

It’s “personal protective equipment” – or “PPE.”

Ironically, PPE actually adds to the physiological burden of the firefighter. The problem is both its sheer weight – as much as 50 pounds or more -- and its insulating properties, which severely limit the body’s ability to cool itself through sweat evaporation. The weight of the PPE and physical work that the firefighter must perform, and the resultant heat stress and dehydration places enormous strain on a firefighter’s cardiovascular, thermoregulatory, and respiratory systems. This strain, coupled with underlying cardiovascular disease, can trigger a cardiac event. About 45 percent of all firefighter line-of-duty deaths are caused by heart attacks – the highest rate among all occupations. An additional 800 to 1000 firefighters suffer non-fatal cardiac events on a yearly basis. Sweltering summer temperatures make July and August a time of particular risk.

As Prof. Denise Smith (center rear) looks on, three student members of her team monitor a firefighter's performance on a treadmill.
As Prof. Denise Smith (center rear) looks on, three
student members of her team
 monitor a
firefighter's performance on a treadmill.

How to reduce this toll among the nation’s one million professional and volunteer firefighters is the singular question that has motivated Denise Smith, professor of exercise science at Skidmore, in her research for 20 years. It was in 1991 that the Illinois Fire Institute – having observed that firefighters wearing the more protective “bunker gear” newly mandated by National Fire Protection Association were being hospitalized for stress- and heat-related reasons at a higher rate -- asked Smith to investigate. Assisted by Skidmore undergraduate Sally Warner ’92, Smith put ten local firefighters on a treadmill and showed conclusively that, while the new gear provided enhanced protection against burn injuries, it imposed more strain on the cardiovascular system than did the lighter, more “breathable” gear they wore previously.

In 2005, Smith teamed up with Skidmore colleague Pat Fehling, chair and professor of exercise science, and together they established Skidmore’s First Responder Health and Safety Laboratory. Securing more than $3 million in support from federal agencies (including the Federal Emergency Management Agency (FEMA), Department of Homeland Security Science and Technology, and Department of Defense) the Skidmore lab is one of the few in the country devoted to improve firefighter health and safety.

Assisted by the seven Skidmore undergraduates they typically employ at any given time, Smith and Fehling have:

“We read about the stresses that our jobs impose on us, but until we actually see numbers we tend to think it can’t happen to us,” says Santiago Lasa, a lieutenant in the Boston Fire Department’s Rescue 1 unit, with which Smith and Fehling conducted one of their major studies. “When they give us the data, we’re able to see exactly what’s going on with our bodies.”

Communities that take to heart the Skidmore researchers’ conclusions have been pleased to discover that taking action not only can reduce the rate of injuries and fatalities among their professional and volunteer firefighters, but also cut costs. For example, when the fire department in Hanover Park, Illinois, a few years ago created a volunteer team to implement a formalized rehab process in all situations where a firefighter is likely to experience heat stress, claims for workers’ compensation dropped from $127,000 to $25,000 in a single year.

“We thought it was a fluke,” says Craig Haigh, chief of the department. “We had no idea we would see a cost-savings from doing this.”

The department runs the volunteer rehab team with annual grants totaling $4000 from Sam’s Club and the Academy of Certified Hazardous Materials, says Haigh. The amount he estimated his department annually saves on average: $100,000.

Not surprisingly, fire departments across the country are now establishing rehab teams, whose main assignment is to periodically check vital signs of firefighters as they’re exposed to hot, stressful conditions. Those whose signs approach dangerous levels are removed from action hydrated, and reevaluated at ten, 20 and 30-minute intervals. If their vital signs return to normal ranges, they’re permitted to return to action. If they don’t, they’re transported to the nearest hospital emergency room and given more aggressive treatment.

It’s only a matter of time, Haigh believes, before firefighters’ vital signs are continually transmitted to the rehab team by wireless physiological status monitors worn against the skin, probably in a chest strap or vest. Such devices will be of “phenomenal assistance,” he predicts, giving the rehab team a clear snapshot of a firefighters’ condition as soon as he or she walks out of the fire.

In fact, Smith and Fehling are already working on two projects exploring the use of technology to assist firefighters. One project, Skidmore is partnering with Globe manufacturing on a projected titled “Wearable Sensory Platform" (WASP) which is funded by the Department of Defense and involves integrating physiological monitoring and location tracking into a single system that can be worn by first responders. The other major technology project has Skidmore partnering with University of California at Los Angeles on a Department of Homeland Security funded project called PHASER – physiological health assessment systems for Emergency Responders.

“Our goals include helping to identify policies and medical screening that can ensure that individuals can safely perform the arduous task of firefighting and to explore the deployment of technology to further ensure the safety of firefighters during operations,” says Smith.