Health Risks and Fitness in Firefighting Professions

Firefighting demands extreme physical exertion in thermally stressful, smoke-filled environments, placing personnel at heightened risk of acute cardiovascular events, chronic respiratory disorders and cancer. Repeated exposure to heat, particulate matter and combustion toxicants such as polycyclic aromatic hydrocarbons compounds the physiological strain associated with intermittent bursts of high‐intensity activity. Fitness and wellness programmes have been shown to improve cardiovascular resilience, body composition and behavioural health, yet persistent challenges include tobacco and alcohol use, musculoskeletal injuries and variable programme uptake. Current research efforts focus on characterising pollutant absorption pathways, quantifying exposure in real-world and simulated operations, refining personal protective equipment and developing targeted interventions to mitigate both immediate and long-term health burdens.

Research from Nature Portfolio

One foundational investigation quantified firefighters’ dermal and environmental exposure to multiple polycyclic aromatic hydrocarbons on skin, personal protective equipment and work surfaces, estimating cancer risks elevated above general population baselines. The study identified benzo[a]pyrene and other potent carcinogens deposited on helmets, clothing and station environments, underscoring the primacy of skin absorption as a route of systemic uptake. These findings support the need for rigorous monitoring of contamination, long-term health follow-up and enhancement of decontamination practices to reduce chronic disease burden.

Health Risks and Fitness in Firefighting Professions publication trend

The graph below shows the total number of articles in health risks and fitness in firefighting professions across all publications each year (not limited to Nature Index journals).

Technical terms

Polycyclic aromatic hydrocarbons (PAHs): Organic compounds formed during incomplete combustion, many of which are carcinogenic and mutagenic.

Particulate matter (PM): Airborne solid or liquid particles, classified by aerodynamic diameter (e.g., PM2.5, ultrafine), linked to respiratory and cardiovascular harm.

VO2max: The maximal rate of oxygen consumption during incremental exercise, reflecting cardiovascular fitness and endurance capacity.

Thrombus formation: The process of blood clot development within vessels, which can precipitate acute cardiovascular events.

Fibrinolysis: The enzymatic breakdown of blood clots, a key regulator of thrombosis and haemostatic balance.

References

1. Occupational Exposure to Polycyclic Aromatic Hydrocarbons and Elevated Cancer Incidence in Firefighters. Scientific Reports (2018).
2. Biomonitoring of firefighting forces: a review on biomarkers of exposure to health-relevant pollutants released from fires. Journal of Toxicology and Environmental Health Part B (2023).
3. Firefighters' personal exposure to gaseous PAHs during controlled forest fires: A case study with estimation of respiratory health risks and in vitro toxicity. The Science of The Total Environment (2023).
4. Fire Simulation and Cardiovascular Health in Firefighters. Circulation (2017).
5. An examination of the benefits of health promotion programs for the national fire service. BMC Public Health (2013).