Epidemiology of SARS-CoV-2 Antibodies Among Firefighters/paramedics of a US Fire Department: A Cross-sectional Study

Objectives: We estimate the point seroprevalence of SARS-CoV-2 antibodies in the frontline firefighter/paramedic workforce of a South Florida fire department located in the epicentre of a State outbreak. Methods: A cross-sectional study design was used to estimate the point seroprevalence of SARS-CoV-2 antibodies using a rapid immunoglobulin (Ig)M-IgG combined point-of-care lateral flow immunoassay among frontline firefighters/paramedics collected over a 2-day period, 16-17 April 2020. Fire department personnel were emailed a survey link assessing COVID-19 symptoms and work exposures the day prior to the scheduled drive-through antibody testing at a designated fire station. Off-duty and on-duty firefighter/paramedic personnel drove through the fire station/training facility in their personal vehicles or on-duty engine/rescue trucks for SARS-CoV-2 antibody testing. Results: Among the 203 firefighters/paramedics that make up the fire department workforce, 18 firefighters/paramedics (8.9%) tested positive for SARS-CoV-2 antibodies, of which 8 firefighters/paramedics (3.9%) were IgG positive only, 8 (3.9%) were IgM positive only and 2 (0.1%) were IgG/IgM positive. The positive predictive value (PPV) of the serological test is estimated to be 33.2% and the negative predictive value is 99.3%. The average number of COVID-19 case contacts (ie, within 6 feet of an infected person (laboratory-confirmed or probable COVID-19 patient) for ≥15 min) experienced by firefighters/paramedics was higher for those with positive serology compared with those with negative (13.3 cases vs 7.31 cases; p=0.022). None of the antibody positive firefighters/paramedics reported receipt of the annual influenza vaccine compared with firefighters/paramedics who tested negative for SARS-CoV-2 antibodies (0.0% vs 21.0%; p=0.027). Conclusion: Rapid SARS-CoV-2 IgM-IgG antibody testing documented early-stage and late-stage infection in a firefighter workforce providing insight to a broader medical surveillance project on return to work for firefighters/paramedics. Given the relatively low PPV of the serological test used in this study back in April 2020, caution should be used in interpreting test results

COVID-19 Vaccination Perspectives and Illnesses among Law Enforcement Officers, Firefighters, and Other First Responders in the US, January to September 2021

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Abstract 25: Per- and polyfluoroalkyl substances and obesity in Florida firefighters

Abstract Background/Objective: Per- and polyfluoroalkyl substances (PFASs) are hazardous synthetic chemicals that have been linked to adverse human health effects such as cancer and endocrine disruption. Firefighters have been shown to be occupationally exposed to PFAS through aqueous film-forming foam (AFFF) used during difficult-to-suppress fires, and in the textile liners of their safety turnout gear. PFASs have both hydrophobic and hydrophilic chemical structures, giving them strong thermal stability and making them resistant to environmental and physiological degradation. Studies of human exposures to PFAS have observed associations between some PFAS and increased risk of obesity or elevated body mass index (BMI). Given the unique occupational exposures of firefighters to PFAS, we examine the association between obesity and PFAS in a sample of Florida firefighters. Methods: A cross-sectional study design was used to collect a health survey and a blood sample from a non-probabilistic sample of career Florida fighters between June and October 2021. The health surveys, administered on REDCap using tablet devices, assessed information on firefighter socio-demographic and work characteristics. We quantified 7 distinct PFASs using a solid-phase extraction-high-performance liquid chromatography-isotope dilution-tandem mass spectrometry approach; the limit of detection was between 0.5 and 0.05 ng/mL, depending on the analyte. All 7 PFASs, including Perfluorobutanesulfonic Acid (PFBS), Perfluoroheptanoic Acid (PFHpA), Perfluorohexanesulfonic Acid (PFHxS), Perfluorooctanoic Acid (PFNA), Perfluorononanoic Acid (PFNA), Perfluorooctanesulfonic Acid (PFOS), and Perfluoroctanesulfonamide (PFOSA), were detected in the blood samples; concentrations below the limit of detection were replaced by the limit of detection/√2.35. Results: Among the 208 firefighters who completed the survey and provided a blood sample, 92.8% were male, 16.2% Hispanic/Latinx, 81.7% White, 89.8% used AFFF at their fire department, with a group mean age 40.2±10.3 standard deviation. Approximately 15.8% of firefighters were of healthy weight, 51.5% overweight, and 32.7% obese. Firefighter body mass index was positively correlated with serum concentrations of PFHxS (rs=.17;p=.020) and PFBS (rs=.60;p=.26). Group geometric mean of each PFAS congener (in ng/mL): PFBS (0.09), PFHpA (0.08), PFHxS (2.17), PFOA (1.38), PFNA (0.42), PFOS (2.69), and PFOSA (0.10). Total serum PFAS concentrations was highest among obese firefighters (7.62 ng/mL) and lowest in healthy weight firefighters (6.55 ng/mL). Conclusions: Firefighters who were overweight and obese, based on body mass index, had higher total serum PFAS concentrations than those firefighters of healthy weight. Both long- and short-chain PFASs, PFHxS and PFBS respectively, were positively correlated with firefighter body mass index. Citation Format: Alberto J. Caban-Martinez, Paola Louzado Feliciano, Simi Oduwole, Natasha Schaefer Solle, Catalina Gonzalez-Umana, Thomas Stone, Erin N. Kobetz. Per- and polyfluoroalkyl substances and obesity in Florida firefighters [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 25.</jats:p

Safety Gear Decontamination Practices Among Florida Firefighters: Analysis of a Text-Based Survey Methodology

Despite the National Fire Protection Association (NFPA) 1851 Personal Protective Equipment Care and Maintenance guidelines, little is known about the routine cleaning of firefighter bunker gear. In collaboration with a large Florida firefighter union, a mobile phone text survey was administered, which included eight questions in an item logic format. In total, 250 firefighters participated in the survey of which 65% reported cleaning their bunker gear in the past 12 months. Approximately 32% ( n = 52) indicated that they had above average confidence in gear cleaning procedures. Arriving at a fire incident response was a significant predictor of gear cleaning in the 12 months preceding survey administration. Using mobile phone-based texting for periodic queries on adherence to NFPA cleaning guidelines and safety message distribution may assist firefighters to increase decontamination procedure frequency

A comparative analysis of histologic types of thyroid cancer between career firefighters and other occupational groups in Florida.

Florida Firefighters experience a higher risk of thyroid cancer than non-firefighters. This study examines whether the histologic types and tumor stage of thyroid cancer is different among firefighters compared to other occupational groups. Eligible cases were firefighters (n = 120) identified in a linkage of Florida Cancer Data System (FCDS) registry records (1981-2014) and Florida State Fire Marshal's Office employment and certification records, and non-firefighters classified into: blue-collar (n = 655), service (n = 834), white-collar (n = 4,893), and other (n = 1,789). Differences in thyroid histologic type (papillary, follicular, and rare/other less common forms of thyroid cancer), tumor stage, and age at diagnosis were evaluated using multinomial logistic regression models comparing blue-collar, service, white-collar, and other occupational groups with firefighters. Univariate odds ratios as well as odds ratios adjusted for age, gender, race, tumor stage, and year of diagnosis (aOR) and 95% confidence intervals (95%CI) were reported. Service (aOR = 4.12; 95%CI: 1.25-13.65), white-collar (aOR = 3.51; 95%CI: 1.08-11.36), and blue-collar (aOR = 4.59; 95%CI: 1.40-15.07) workers had significantly higher odds of being diagnosed with rare histologic types of thyroid cancer vs papillary type compared to firefighters. Service (aOR = 0.42; 95%CI: 0.27-0.66), white-collar (aOR = 0.39; 95%CI: 0.26-0.59), blue-collar (aOR = 0.36; 95%CI: 0.23-0.56), and other (aOR = 0.34; 95%CI: 0.22-0.53) occupational groups have a significantly lower odds of being diagnosed with rare vs papillary type at a younger age (30-49 years) vs 50-69 years compared to firefighters. However, stage at diagnosis was not significantly different among occupational groups. Firefighters diagnosed with thyroid cancer experience a higher odds of papillary compared to rare histologic types of thyroid cancer relative to other workers; there is no evidence of an increased odds of late-stage diagnosis in firefighters relative to other worker groups. Firefighters may benefit from routine screening and active surveillance of suspected thyroid tumors especially given the excellent treatment outcomes available for those diagnosed with early-stage papillary thyroid tumors. © 2022. The Author(s).</CopyrightInformation

Weight Status and Binge Drinking among Male and Female Florida Firefighters

OBJECTIVEExamine the association between weight status and binge drinking among Florida firefighters. METHODSHealth survey data collected between 2015 and 2019 among Florida firefighters participating in the Annual Cancer Survey were analyzed for weight class (healthy, overweight, obese) and binge-drinking behaviors. Binary logistic regression models were fit and stratified by sex while controlling for socio-demographic and health characteristics. RESULTSAmong 4,002 firefighter participants, 45.1% binge drink, 50.9% are overweight, and 31.3% are obese. Among male firefighters, being overweight (adjusted odds ratio = 1.34; 95%CI [1.10-1.64]) or obese (1.29; [1.04-1.61]) was significantly associated with binge drinking compared to healthy weight counterparts. In female firefighters, being obese (2.25; [1.21-4.22]) was significantly associated with binge drinking but being overweight was not. CONCLUSIONSBeing overweight or obese is selectively associated with binge drinking among male and female firefighters

Firefighter Skin Cancer and Sun Protection Practices

This survey study examines skin cancer history, skin cancer screening, and sun protection habits among active Florida firefighters

The “Warm Zone” Cases: Environmental Monitoring Immediately Outside the Fire Incident Response Arena by Firefighters

Hazardous work zones (i.e., hot, warm, and cold) are typically established by emergency response teams during hazardous materials (HAZMAT) calls but less consistently for fire responses to segment personnel and response activities in the immediate geographic area around the fire. Despite national guidelines, studies have documented the inconsistent use of respiratory protective equipment by firefighters at the fire scene. In this case-series report, we describe warm zone gas levels using multigas detectors across five independent fire incident responses all occurring in a large South Florida fire department. Multigas detector data collected at each fire response indicate the presence of sustained levels of volatile organic compounds in the “warm zone” of each fire event. These cases suggest that firefighters should not only implement strategies for multigas detector use within the warm zone but also include respiratory protection to provide adequate safety from toxic exposures in the warm zone. Keywords: Firefighters, Multigas detectors, Respiratory protection, Warm zon