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Sudden Cardiac Death in the Fire Service

Haller, H.M. and Smith D.L. (2019). Examination of strenuous activity preceding cardiac death during firefighting duties. Safety. DOI: 10.3390/safety5030050

Smith, D.L., Haller, J.M., Korre, M., Sampani, K., Grossi Porto, L.G., Fehling, P.C., Christophi, C.A., Kales, S.N. (2019). The relation of emergency duties to cardiac death among United States firefighters. American Journal of Cardiology. 123(5):736-741.

Smith, D.L., Haller, J.M., Korre, M., Fehling, P.C., Sampani, K., Porto, L.G.G., Christophi, C.A., Kales S.N. (2018). Pathoanatomic findings associated with duty-related cardiac death in US firefighters: a case-control study. Journal of the American Heart Association. 7:e009446.

Smith, D.L., DeBlois, J.P., Kales, S.N., Horn, G.P. (2016). Cardiovascular strain of firefighting and the risk of sudden cardiac events. Exercise and Sport Sciences Reviews. 44(3): 90–97.

Farioli A., Yang, J., Teehan, D., Baur, D.M., Smith D.L., Kales S.N. (2014). Duty-related risk of sudden cardiac death among young U.S. firefighters. Occupational Medicine. 64(6): 428–435.

Yang, J., Teehan, D., Farioli, A., Baur, D.M., Smith, D., Kales, S.N. (2013). Sudden cardiac death among firefighters ≤45 years of age in the United States. American Journal of Cardiology, 112(12): 1962–1967.

Smith, D.L., Barr, D, Kales, S.N. (2013). Extreme sacrifice: sudden cardiac death in the US Fire Service. Extreme Physiology & Medicine, 2: 6.

Contamination From the Scene: Absorbtion and Decontamination

Fent, K., Toennis, C., Sammons, D., Robertson, S., Calafat, A., Pleil, J., Wallace, A.G., Kerber, S., Smith, D., Horn, G. (2019). Firefighters’ and instructors’ absorption of PAHs and benzene during training exercises. International Journal of Hygiene and Environmental Health. DOI: 10.1016/j.ijheh.2019.06.006

Fent, K.W., Mayer, A., Bertke, S., Kerber, S., Smith, D., Horn, G.P. (2019). Understanding airborne contaminants produced by different fuel packages during training fires. Journal of Occupational and Environmental Hygiene. DOI: 10.1080/15459624.2019.1617870

Mayer, A.C., Fent, K.W., Bertke, S., Horn, G.P., Smith, D.L., Kerber, S., La Guardia, M.J. (2019). Firefighter hood contamination: efficiency of laundering to remove PAHs and FRs. Journal of Occupational and Environmental Hygiene. 16(2):129-140, DOI: 10.1080/15459624.2018.1540877

Fent, K.W., Evans, D.E., Babik, K., Striley, C., Bertke, S., Kerber, S., Smith, D., Horn, G.P. (2018). Airborne contaminants during controlled residential fires. Journal of Occupational and Environmental Hygiene. 15(5):399-412.

Fent, K.W., Alexander, B., Roberts, J., Robertson, S., Toennis, C., Sammons, D., Bertke, S., Kerber, S., Smith, D., Horn, G. (2017). Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures. Journal of Occupational and Environmental Hygiene. 14(10): 801–814.

Cancer and Disease

Smith, D.L., Friedman, N.M.G., Bloom, S.I., Armero, W.L., Pence, B.D., Cook, M.D., Fernhall, B., Horn, G.P., Woods, J. (2019). Firefighting Induces Acute Inflammatory Responses that are not Relieved by Asprin in Older Firefighters. Journal of Occupational and Environmental Medicine. DOI: 10.1097/JOM.0000000000001626

Gainey, S.J., Horn, G.P., Towers, A.E., Oelschlager, M.L., Tir, V.L., Drnevich, J., Fent, K.W., Kerber, S., Smith, D.L., Freund, G.G. (2018). Exposure to a firefighting overhaul environment without respiratory protection increases immune dysregulation and lung disease risk. PLoS One. 13(8): e0201830.

Kales, S.N., Smith, D.L. (2017). Firefighting and the heart: Implications for prevention. Circulation. 135(14): 1296–1299 (editorial).

Korre, M., Sampani, K., Porto, L., Farioli, A., Christiani, D.C., Christophi, C.A., Lombardi, D.A., Smith, D.L., Kales, S.N. (2016). Cardiac enlargement in US firefighters: Prevalence estimates by echocardiography, cardiac magnetic resonance and autopsies. Journal of Clinical & Experimental Cardiology. 7:7; DOI: 10.4172/2155–9880.1000459.

Korre, M., Christiani, D.C., Christophi, C.A., Lombardi, D.A., Kovacs, R.J., Abbasi, Siddique, Steigner, M., Moffatt, S., Smith, D., Kales, S.N. (2016). "A review of left ventricular mass and heart weight assessment by cardiac MRI, echo, and autopsies in normal and diseased hearts." Journal of Integrative Cardiology. 2(6): 432–440.

Smith, D.L., Fehling, P.C., Frisch, A., Haller, J.M., Winke, M, Dailey, M.W. (2012). The prevalence of cardiovascular disease risk factors and obesity in firefighters. Journal of Obesity, Volume 2012, Article ID 908267, 9 pages.

Soteriades, E.S., Smith, D.L., Tsismenakis, A.J., Baur, D.M., Kales, S.N. (2011). Cardiovascular disease in US firefighters: a systematic review. Cardiology in Review, 19(4): 202–215.

Thermal Response to Firefighting

Horn, G.P., Kesler, R.M., Kerber, S., Fent, K.W., Schroeder, T.J., Scott, W.S., Fehling, P.C., Fernhall, B., Smith, D.L. (2017). Thermal response to firefighting activities in residential structure fires: impact of job assignment and suppression tactic. Ergonomics. 61(3): 404–419.

Ives, S.J., Lefferts, W.K., Wharton, M., Fehling, P.C., Smith, D.L. (2016). Exercise-induced heat stress disrupts the shear-dilatory relationship. Experimental Physiology. 101(12): 1541–1551.

Smith D.L., DeBlois, J.P., Wharton, M., Rowland, T. (2015). Myocardial functional responses do not contribute to maximal exercise performance in the heat. Extreme Physiology and Medicine. 4:11.

Smith D.L., DeBlois, J.P., Wharton, M., Fehling, P.C., Randive, S. (2015). Effects of moderate exercise-induced heat stress on carotid wave intensity. European Journal of Applied Physiology. 115(10): 2223–2228.

Lefferts, W.K., Heffernan, K.S, Hultquist, E.M., Fehling, P.C., Smith, D.L. (2015). Vascular and central hemodynamic changes following exercise-induced heat stress. Vascular Medicine. 20(3): 222–229.

Fehling, P.C., Haller, J.M., Lefferts, W.K., Hultquist, E.M., Wharton, M., Rowland, T.W., Smith, D.L. (2015). Effect of exercise, heat stress and dehydration on myocardial performance. Occupational Medicine. 65(4): 317–323.

Smith, D.L., Arena, L., DeBlois, J.P., Haller, J.M., Hultquist, E.M., Lefferts, W.K., Russell, T., Wu, A., Fehling, P.C. (2014). Effect of base layer materials on physiological and perceptual responses to exercise in personal protective equipment. Applied Ergonomics, 45(3): 428–436.

Horn, G., Blevins, S., Fernhall, B., and Smith, D. (2013). Core temperature and heart rate responses to repeated bouts of firefighting activity. Ergonomics, 56(9): 1465–1473.

Horn G.P., DeBlois J., Shalmyeva I., Smith D.L. (2012). Quantifying dehydration in the Fire Service using field methods and novel devices. Prehospital Emergency Care, 16: 347–355.

Smith, D.L., Shalmiyeva, I., DeBlois, J., Winke, M. (2012). Use of salivary osmolality to assess dehydration. Prehospital Emergency Care, 16: 128–135.

Petruzzello, S.J., Gapin, J.I., Snook, E., Smith, D.L. (2009). Perceptual and physiological heat strain: examination in firefighters in laboratory- and field-based studies. Ergonomics, 52(6): 747–754.

Fitness, Exercise, and Obesity

Porto, L.G.G., Schmidt, A.C.B., de Souza, J.M., Nogueira, R.M., Fontana, K.E., Molina, G.E., Korre, M., Smith, D.L., Junqueira, L.F., Kales, S.N. (2019). Firefighters’ basal cardiac autonomic function and its associations with cardiorespiratory fitness. Work. 62(3):485-495.

Korre, M., Smith, D., Kales, S.N. (2018). Obesity and health in the North American Fire Service: Research points the way to positive culture change. (Editorial). Occupational Medicine. 68(3):160-162.

Korre, M., Porto, L.G.G., Farioli, A., Yang, J., Christiani, D.C., Christophi, C.A., Lombardi, D.A., Kovacs, R.J., Mastouri, R., Abbasi, S., Steigner, M., Moffat, S., Smith, D., Kales, S.N. (2016). Effect of body mass index on left ventricular mass in career male firefighters. American Journal of Cardiology. 118(11): 1769–1773.

Smith D.L., DeBlois, J.P., Wharton, M., Rowland, T. (2015). Myocardial functional responses do not contribute to maximal exercise performance in the heat. Extreme Physiology and Medicine. 4:11.

Smith, D.L., Horn, G.P., Petruzzello, S.J., Freund, G.G., Fernhall, B. (2014). Effect of obesity on acute hemostatic responses to live-fire training drills. American Journal of Cardiology. 114(11): 1768–1771.

Smith, D.L. (2011). Firefighter fitness: improving performance and preventing injuries and fatalities. Current Sports Medicine Reports, 10(3): 167–172.

Park, K., Rosengren, K.S., Horn, G.P., Smith, D.L., Hsiao-Wecksler, E.T. (2011). Assessing gait changes in firefighters due to fatigue and protective clothing. Safety Science, 49(5): 719–726.

Fahs, C.A., Smith, D.L., Horn, G.P., Agiovlasitis, S., Rossow, L.M., Echols, G., Heffernan, K.S., Fernhall, B. (2009). Impact of excess body weight on arterial structure, function, and blood pressure in firefighters. American Journal of Cardiology, 104: 1441–1445.

Physiological Response to Firefighting

Horn, G.P., Stewart, J.W., Kesler, R.M., DeBloise, J.P., Kerber, S., Fent, K.W., Scott, W.S., Fernhall, B., Smith, D.L. (2019). Firefighter and fire instructor’s physiological response and safety in various training fire environments. Safety Science. 116:287-294.

Kesler, R.M., Ensari, I., Bollaert, R.E., Motl, R.W., Hsiao-Wecksler, E.T., Rosengren, K.S., Fernhall, B., Smith, D.L., Horn, G.P. (2018). Physiological response to firefighting activities of various work cycles using extended duration and prototype SCBA. Ergonomics. 61(3):390-403.

Smith, D.L., Horn, G.P., Woods, J., Ploutz-Snyder, R., Fernhall, B. (2016). Effect of aspirin supplementation on hemostatic responses in firefighters aged 40 to 60 years. American Journal of Cardiology. May 5 [Epub].

Lane-Cordova, A.D., Ranadive, S.M., Yan, H., Kappus, R.M., Sun, P., Bunsawat, K., Smith, D.L., Horn, G.P., Ploutz-Snyder, R., Fernhall, B. (2015). Effect of aspirin supplementation on hemodynamics in older firefighters. Medicine & Science in Sports & Exercise. 47(12): 2653–2659.

Smith, D.L., Haller, J.M., Benedict, R., Moore-Merrell, L. (2015). Cardiac strain associated with high-rise firefighting. Journal of Occupational and Environmental Hygiene. 12(4): 213–221.

Greenlee, T.A, Horn, G., Smith, D.L., Fahey, G., Goldstein, E., Petruzzello, S.J. (2014). The influence of short-term firefighting activity on information processing performance. Ergonomics. 57(5): 764–773.

Smith, D.L., Horn, G.P., Petruzzello, S.J., Fahey, G., Woods, J., Fernhall, B. (2014). Clotting and fibrinolytic changes after firefighting activities. Medicine & Science in Sports & Exercise. 46(3): 448–454.

Horn, G., Blevins, S., Fernhall, B., and Smith, D. (2013). Core temperature and heart rate responses to repeated bouts of firefighting activity. Ergonomics, 56(9): 1465–1473.

Smith, D.L., Haller, J.M., Hultquist, E.M., Lefferts, W.K., Fehling, P.C. (2013). Effect of clothing layers in combination with fire fighting personal protective clothing on physiological and perceptual responses to intermittent work and on materials performance test results. Journal of Occupational and Environmental Hygiene, 10: 259–269.

Yan, H., Fahs, C.A., Ranadive, S., Rossow, L.M., Lane, A.D., Agiovlasitis, S., Echols, G., Smith, D., Horn, G., Rowland, T., Fernhall, B. (2012). Evaluation of carotid wave intensity in firefighters following firefighting. European Journal of Applied Physiology, 112(7): 2385–2391.

Fernhall, B., Fahs, C.A., Horn, G.P., Rowland, T., Smith, D.L. (2012). Acute effects of firefighting on cardiac performance. European Journal of Applied Physiology, 112(2): 735–741.

Smith, D.L., Petruzzello, S.J., Goldstein, E., Ahmad, U., Tangella, K., Freund, G.G., Horn, G.P. (2011). Effect of live-fire training drills on firefighters’ platelet number and function. Prehospital Emergency Care, 15(2): 233–239.

Fahs, C.A., Yan, H., Ranadive, S., Rossow, L.M., Agiovlasitis, S., Echols, G., Smith, D., Horn, G.P., Rowland, T., Lane, A., Fernhall, B. (2011). Acute effects of firefighting on arterial stiffness and blood flow. Vascular Medicine, 16(2): 113–118.

Rehabilitation

Edmonds, R.C., Wilkinson, A. F., Fehling, P.C. (2017). Novel cooling device enhances autonomic nervous system recovery from live fire training: a pilot study. International Journal of Innovative Research in Medical Science. 2(1): 455–460.

Barr, D., Haigh, C.A., Haller J., Smith, D.L. (2016). Medical monitoring during firefighter incident scene rehabilitation. Prehospital Emergency Care. March 8 [Epub].

Smith, D.L., Haller, J.M., Benedict, R., Moore-Merrell, L. (2016). Firefighter incident rehabilitation: interpreting heart rate responses. Prehospital Emergency Care. 20(1): 28–36.

Smith, D.L., Haller, J.M., Benedict, R., Moore-Merrell, L. (2015). Firefighter incident rehabilitation: interpreting heart rate responses. Prehospital Emergency Care. May 15 [Epub ahead of print].

Horn, G., Gutzmer, S., Fahs, C.A., Petruzzello, S.J., Goldstein, E., Fahey, G.C., Fernhall, B., Smith, D.L. (2011). Physiological recovery from firefighting activities in rehabilitation and beyond. Prehospital Emergency Care, 15(2): 214–225.

Personal Protective Equipment and Technology in the Fire Service

Kerber, S., Regan, J.W., Horn, G.P., Fent, K.W., Smith, D.L. (2019). Effect of firefighting intervention on occupant tenability during a residential fire. Fire Technology. DOI: https://doi.org/10.1007/s10694-019-00864-2

Banerjee, R.K., Kalathil, R.T., Zachariah, S.A., Paul, A.K., Amit Bhattacharya, A., Horn, G.P., Smith, D.L. (2018). Comparison between experimental and heart rate-derived core body temperatures using a three-dimensional whole body model. Journal of Thermal Science and Engineering Applications. 11(2):024502-024502-6.

Ensari, I., Motl, R.W., Klaren, R.E., Fernhall, B., Smith, D.L., Horn, G.P. (2016). Firefighter exercise protocols conducted in an environmental chamber: developing a laboratory based simulated firefighting protocol. Ergonomics. 60(5): 657–668.

Dolezal, B.A., Barr, D.A., Boland, D., Smith D.L., Cooper C.B. (2015). Validation of the firefighter WFI treadmill protocol for predicting VO₂max. Occupational Medicine. 65(2): 143–146.

Dolezal, B.A., Boland, D., Carney, J., Abrazado, M., Smith D.L., Cooper C.B. (2014). Validation of heart rate derived from a physiological status monitor-embedded compression shirt against laboratory ECG. Journal of Occupational and Environmental Hygiene. 11(12): 833–839.

Dolezal, B.A., Abrazado M., Batalin M.A., Smith D., Cooper C.B. (2014). Deployment of remote advanced electrocardiography for improved cardiovascular risk assessment in career firefighters. Telemedicine and e-Health. 20(7): 1–4.

Hur, P., Rosengren, K.S., Horn, G.P., Smith, D.L., Hsiao-Wecksler, E.T. (2013). Effect of protective clothing and fatigue on functional balance of firefighters. Journal of Ergonomics. S2: 004.

Smith, D.L., Fehling, P.C., Hultquist, E.M., Lefferts, W.K., Barr, D.A., Storer, T.W., Cooper, C.B. (2012). Firefighter’s personal protective equipment and the chronotropic index. Ergonomics, 55(10): 1243–1251.

Smith, D.L., Shalmiyeva, I., DeBlois, J., Winke, M. (2012). Use of salivary osmolality to assess dehydration. Prehospital Emergency Care, 16: 128–135.

Park, K., Rosengren, K.S., Horn, G.P., Smith, D.L., Hsiao-Wecksler, E.T. (2011). Assessing gait changes in firefighters due to fatigue and protective clothing. Safety Science, 49(5): 719–726.

Scientific Peer-Reviewed Publications

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