Firefit Conference 2008 Fit for Service, Fit for the Future Physical Fitness in the Fire Service Kevin Sykes Professor of Occupational Health & Fitness 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 Youve got to be fit to handle this type of Job 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 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 2 firefighters same job! FitUnfit Youve got to be in good shape to handle this type of cardiovascular stress Intense physical activity is a strong triggering factor for heart attack, especially among physically inactive and unfit individuals. 100%HRMax 85%HRMax 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 causes 45% of the deaths that occur while on duty (US study). Heart Disease 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. Emergency Duties and Deaths from Heart Disease among Firefighters in the United States ( ) Kales, Soteriades, Christophi & Christiani New England Journal of Medicine, 2007 Deaths from Heart Disease among US Firefighters ( ) Kales et al. (2007) New England J. Med 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 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. Exercise in the Prevention of Heart Disease Regular exercise can reduce the incidence of heart disease by as much as 50% ! Aerobic fitness Key measure of health-related fitness Low level = risk of premature death & illness High level = risk of premature death & illness VO 2 Max is criterion measure In terms of health-related fitness - mlsO 2 /kg/min more important than litres/min Fit v Unfit Relative Health Risk Heart Disease Type 2 Diabetes Colon Cancer Fit GoodUnfit Below Average aerobic fitness category 1.5 Stroke Breast Cancer Osteoporosis WHO (2003) 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 For general health: 30 minutes per day (or 3x10mins) Moderate intensity physical activity 5 or more days per week Department of Health 2004 6 7 Very, very light 8 9 Very light Fairly light Somewhat hard Hard Very hard 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. Fitness for Firefighting VO 2 Max has been consistently shown to be the best predictor of performance in simulated firefighting tasks (Heyman, 2002; Sykes, 2002) What is VO2 VO 2 /min = oxygen uptake per minute Often termed Metabolic Rate Measured in litres/min or mlsO 2 /kg/min How is it Calculated? VO 2 /min = Minute Ventilation x O 2 % absorbed by body e.g. Rest VO 2 /min = 10 x 3% = 0.3l/min Typical values l/min males l/min - females Body Weight a key factor Rest VO 2 /min = 3.5 mlsO 2 /kg/min = 1MET Approximate Energy Cost of Selected Activities ActivitymlsO 2 /kg/minMET Rest3.51 Dressing/undressing7.02 Walking 3mph10.53 Walking 4mph144 Cycling 10mph17.55 Jogging 5mph Jogging 8min/mile319 Running 7min/mile4212 Running 6min/mile5315 Bricklaying257 Police Public Order3510 Fire Fighting3510 Y - 42 ? Typical aerobic cost of fire fighting = 35mlsO 2 /kg/min To be working at 80% of maximum, aerobic capacity needs to be at least 42mlsO 2 /kg/min Proposed minimum aerobic fitness standard = 42mlsO 2 /kg/min Firefit Steering Group (2007). Aerobic Fitness & Firefighting 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 11-min 8-min pace Fm Phil Turner MSc MSc Thesis 2007 Metabolic Cost of Hose Running Results N = 40 Mean SD Height (cm) 5.98 Weight (kg)83.78 9.29 Age (yrs)37.75 5.25 Predicted VO 2 max (mlsO 2 /kg/min)48.46 Repetition Bench Press (kg)83.83 Body Mass Index (BMI)26 2 Turner 2007 mlsO 2 /kg/min 11 min (paced)8 min (paced) Mean SD34 341 4 CST MSSRT CHESTER TREADMILL WALK TEST TREADMILL RAMP PROTOCOL WITH GAS ANALYSIS Suggested Order for In-Service CR Fitness Testing Gas Analyser Available No Gas Analyser Available Multi-Stage Shuttle Run Test (Bleep Test) Recommended standard achieved at Level 8-6 (42mlsO 2 /kg/min) Stop Test when this Level is reached A 12-minute progressive, treadmill walk test designed to identify individuals capable (or not) of reaching the proposed fitness standard of 42mlsO 2 /kg/min. Chester Treadmill Walk Test 6.2km/hr (3.75mph) Sykes (2007) VO 2 Max Testing 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 Fitness Testing & Healthy Lifestyles advice must be conducted by knowledgeable, skilled and well-motivated advisers height weight Underweight Normal Range Overweight Obese