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You’ve got to be fit to handle this type of Job

Firefit Conference 2008 ‘Fit for Service, Fit for the Future’ Physical Fitness in the Fire Service Kevin Sykes Professor of Occupational Health & Fitness Director Centre for Exercise & Nutrition Science University of Chester. You’ve got to be fit to handle this type of Job.

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You’ve got to be fit to handle this type of Job

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  1. Firefit Conference 2008‘Fit for Service, Fit for the Future’Physical Fitness in the Fire ServiceKevin SykesProfessor of Occupational Health & FitnessDirectorCentre for Exercise & Nutrition ScienceUniversity of Chester

  2. You’ve got to be fit to handle this type of Job

  3. Fitness for Firefighting • Aerobic Endurance – exercise for prolonged periods at moderate/high intensity (e.g. running out numerous hoses) • Strength – lifting & shifting heavy objects over short distances/time periods (e.g. lifting 1.35m ladder onto appliance) • Local Muscle Endurance – lifting & shifting heavy objects over longer periods (e.g. carrying LPP to external water source) • Flexibility – good range of joint movement (e.g. allowing work in cramped positions, crawling through small openings, etc) • Agility & Balance – working in hostile, ever-changing environments • Body Composition – excess fat can influence job performance & is strongly linked to hypertension, heart disease and Type-2 diabetes. 1 stone excess fat adds 10% loading on body

  4. Physiological Stresses of Operational Firefighting • Hazardous environment - heat, humidity, smoke, noise, toxic, danger, etc. • Fast response needed • Physically strenuous • Burdensome protective clothing • Breathing Apparatus • Carry & work with heavy tools • Fitness level • Body composition

  5. 2 firefighters – same job! Unfit Fit

  6. You’ve got to be in good shape to handle this type of cardiovascular stress

  7. 100%HRMax 85%HRMax Intense physical activity is a strong triggering factor for heart attack, especially among physically inactive and unfit individuals.

  8. Firefighting is well known to be a dangerous occupation. What is less well known is that the most frequent cause of death among firefighters is not burns, accidents or smoke inhalation. …..but is…. Heart Disease Heart Disease causes 45% of the deaths that occur while on duty (US study). Firefighters are x2 as likely to die from a heart attack in the line of duty than police officers and x3 more likely than paramedics.

  9. Emergency Duties and Deaths from Heart Diseaseamong Firefighters in the United States(1994-2004) Kales, Soteriades, Christophi & Christiani New England Journal of Medicine, 2007

  10. Deaths from Heart Disease among US Firefighters (1994-2004) • Fire suppression is associated with the highest risk, up to 100 times as high as that for non-emergency duties. • Good Aerobic Fitness is a key factor in ‘prevention’ Kales et al. (2007) New England J. Med • Firefighters may be required to work at maximal levels of exertion. • To someone not in good shape this presents serious risk. • Firefighters with low aerobic fitness have a 90% greater risk • of MI than those who are aerobically fit. Peate et al (2002) J.Occ. & Environ. Med.

  11. Exercise in the Prevention of Heart Disease • Regular exercise can reduce the incidence of heart disease by as much as50% !

  12. Aerobic fitness • Key measure of health-related fitness Low level = risk of premature death & illness High level = risk of premature death & illness • VO2Max is criterion measure • In terms of health-related fitness - mlsO2/kg/min more important than litres/min

  13. Fit v Unfit Relative Health Risk Heart Disease Breast Cancer Type 2 Diabetes Colon Cancer Stroke Osteoporosis 2.0 1.5 1.0 Unfit – ‘Below Average’ aerobic fitness category Fit – ‘Good’ WHO (2003)

  14. Health Benefits of Exercise • Reduce risk of heart disease & stroke • Improve blood pressure control • Reduce high cholesterol & improve blood lipid profile • Reduce body fat (particularly abdominal) • Enhance mental well-being • Reduce stress, anxiety & depression • Fortify the immune system - less prone to illness and disease • Sleep better • Increase bone density, helping prevent osteoporosis • Reduce risk of certain cancers (e.g. colon cancer) • Reduce risk of type-2 diabetes • Helps mobilise joints & alleviate osteoarthritis • Improve strength, flexibility & co-ordination • Reduce risk of falls • Improve & maintain healthy lung function • Give more energy & vitality • Improve fitness • Improved healthspan and lifespan BHF 2005

  15. For general health: • 30 minutes per day (or 3x10mins) • Moderate intensity physical activity • 5 or more days per week Department of Health 2004

  16. How Hard? 6 7 Very, very light 8 9 Very light 10 11 Fairly light 12 13 Somewhat hard 14 15 Hard 16 17 Very hard 18 19 Very, very hard 20 Maximal LIGHT EXERCISE Some health benefits but minimal fitness improvement MODERATE EXERCISE Health & fitness benefit - minimal risk INTENSE EXERCISE For those who want high fitness. Can cause heart attack in high risk individuals.

  17. Fitness for Firefighting • VO2Max has been consistently shown to be the best predictor of performance in simulated firefighting tasks (Heyman, 2002; Sykes, 2002)

  18. What is VO2 • VO2/min = oxygen uptake per minute • Often termed ‘Metabolic Rate’ • Measured in litres/min or mlsO2/kg/min How is it Calculated? • VO2/min = Minute Ventilation x O2% absorbed by body e.g. Rest VO2/min = 10 x 3% = 0.3l/min Typical values 0.3-0.5 l/min – males 0.2-0.4 l/min - females • Body Weight a key factor • Rest VO2/min = 3.5 mlsO2/kg/min = 1MET

  19. Approximate Energy Cost of Selected Activities

  20. Y - 42 ?

  21. Aerobic Fitness & Firefighting Typical aerobic cost of fire fighting = 35mlsO2/kg/min To be working at 80% of maximum, aerobic capacity needs to be at least 42mlsO2/kg/min Proposed minimum aerobic fitness standard = 42mlsO2/kg/min Firefit Steering Group (2007).

  22. Metabolic Cost of Hose Running Run out Under-run Make-up Question: Run-out, under-run & make-up 23m lay flat delivery hose, 6 repeats ≤ 11 mins? Method: 40 firefighters completed task: @ 11-min & @ 8-min pace Fm Phil Turner MSc MSc Thesis 2007

  23. Metabolic Cost of Hose Running Turner 2007

  24. Suggested Order for In-Service CR Fitness Testing CST MSSRT No Gas Analyser Available Gas Analyser Available CHESTER TREADMILL WALK TEST TREADMILL RAMP PROTOCOL WITH GAS ANALYSIS

  25. Multi-Stage Shuttle Run Test (Bleep Test) • Recommended standard achieved at Level 8-6 (42mlsO2/kg/min) • Stop Test when this Level is reached

  26. Chester Treadmill Walk Test6.2km/hr (3.75mph) A 12-minute progressive, treadmill walk test designed to identify individuals capable (or not) of reaching the proposed fitness standard of 42mlsO2/kg/min. Sykes (2007)

  27. VO2Max Testing

  28. Health & Safety • Complications associated with fitness testing are relatively low, however: • Ability to maintain high level of safety depends on knowing when NOT to perform a fitness test (ACSM 2006) • Pre-participation health screening – test administrator should ensure there are no medical contraindications to performing the test • Higher risk with maximal fitness test • Need for knowledgeable, highly competent testers

  29. Fitness Testing & Healthy Lifestyles advice must be conducted by knowledgeable, skilled and well-motivated advisers

  30. height weight

  31. Body Mass Index (BMI) Underweight Normal Range Overweight Obese <18 18 – 25 25.1-30 30+

  32. Jonah Lomu: BMI = 33 = OBESE!

  33. All fat is not equal Body Mass Index (BMI) Underweight Normal Range Overweight Obese <18 18 – 25 25.1-30 30+ Ideal Increased Risk Greater Risk <37ins 37-40ins 40+ ins <94cms 97-101cms 102+ cms <32ins 32-35ins 35+ ins <80cms 80-87cms >88+ cms Males Females Increased risk of Type 2 diabetes, dyslipidaemia, high blood pressure, heart disease, stroke, liver disease, respiratory problems, gout, cancer, osteoarthritis

  34. Importance of maintaining a good body weight for firefighter fitness • Excess body fat or additional weight carried adds extra strain on CVR systems – approx 10% loading for every 1 stone. • PPE/BA weighs approx 3 stones! • Major impact on ‘operational’ physical fitness

  35. Weight Control Strategy • Healthy Eating • 3-5x /week of LSD Exercise (30mins, brisk) • Resistance exercise 10% reduction in weight can convey significant health benefits 90% of successful long-term slimmers take regular exercise

  36. Physical Fitness in the Fire Service • Recognition of importance • Support at all levels • Structured approach • Multidimensional • Multisectoral • Firefit

  37. Firefit Conference 2008‘Fit for Service, Fit for the Future’Physical Fitness in the Fire ServiceKevin SykesProfessor of Occupational Health & FitnessDirectorCentre for Exercise & Nutrition ScienceUniversity of Chester 'Healthy Working'

  38. Firefit Conference 2008‘Fit for Service, Fit for the Future’Physiology of Ageing- and possible effects on firefightersKevin SykesProfessor of Occupational Health & FitnessDirectorCentre for Exercise & Nutrition ScienceUniversity of Chester

  39. “So, Mr Jones, how old are you?” “32?” If you didn’t know how old you are…….. ….how old would you think you are ?

  40. Health Many of us are health-conscious But many still take their health for granted….. … until they lose it! Prevention is better than cure

  41. Increase in Life Expectancy Females live 5yrs longer than males 1950-2005 2005 We can now expect to live 10 years longer than in the 1950s

  42. UK Life Expectancy • Females: Average 82yrs Highest 86yrs Kensington, Chelsea, E.Dorset Lowest 70yrs Glasgow • Males: Average 77yrs • Highest 81yrs Kensington, Chelsea, E.Dorset • Lowest 65yrs Glasgow • 75% of females will be alive after the age of 75 • 50% of males will be alive after the age of 75

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