Publications

A cross-sectional assessment of the individual- and fire department-level factors affecting volunteer firefighter cardiorespiratory fitness (Shah, NN et al., 2025)

A study of nearly 570 U.S. volunteer firefighters from 41 departments assessed associations between cardiorespiratory fitness (CRF) and both firefighter-level (e.g., years of service, firefighting calls, and firefighter rank) and department-level (e.g., department characteristics and fitness infrastructure). Findings included that 80% of the enrolled firefighters did not meet the recommended CRF level, which is important for safely doing firefighting work. The findings also included that less than 60% of the fire departments offered routine physical exams, and only about 40% offered other fitness resources. These findings highlight individual and structural challenges for physical fitness in the volunteer fire service, underscoring the need for targeted fitness support to protect firefighter health and community safety.

Cancer-Related Behavioral Risk Factors Among Volunteer and Career Firefighters Enrolled in the Cancer Assessment and Prevention Study (CAPS) and the Fire Fighter Cancer Cohort Study (FFCCS) (Graber, JM et al., 2024)

This study looked at volunteer firefighters in the U.S. to find out how many have personal habits that raise their cancer risk. The researchers found that compared to career firefighters, a higher proportion of volunteer firefighters reported health behaviors linked to cancers — like tobacco use, being overweight, lower levels of physical activity, and being overweight or obese. The findings suggest that besides the known risks of exposure to smoke and chemicals in firefighting, lifestyle factors may also play a big role in cancer risk. The findings of this study support the need to provide volunteer firefighters with overall and targeted health promotion and cancer prevention programs.

Firefighter- and fire department-level barriers and promoters of physical activity and fitness among volunteer firefighters: a qualitative study using semi-structured interviews (Shah, NN et al., 2024)

This study examined volunteer firefighters' perspectives on firefighter and department level barriers and promoters of physical activity and fitness. Through interviews with 28 volunteers across different experience levels, it identified five key themes: the importance of fitness for health and job performance; time constraints and availability; departmental responsibility to support fitness; use of training drills as functional exercise; and existing department level fitness initiatives. While views varied by years of service, overall participants agreed that embedding fitness discussions into meetings and training—and appointing fitness advocates within departments—could help overcome barriers and foster physical activity and fitness among volunteer firefighters.

Prevalence and predictors of colon and prostate cancer screening among volunteer firefighters: The United States Firefighter Cancer Assessment and Prevention Study (Shah, NN et al., 2024)

This study looked at colon and prostate cancer screening among volunteer firefighters in the U.S., who make up two-thirds of the fire service. The research found that the screening rates for colon and prostate cancer were about 52% and 49%, respectively, for those eligible based on national guidelines. Older firefighters and those with some college education were more likely to get screened, while fire service experience and cancer risk perception were not linked to screening rates. The study highlights gaps in cancer prevention efforts for volunteer firefighters and suggests that increased education and screening opportunities from fire departments, healthcare professionals, and public health groups could improve cancer prevention in this group.

Prevalence and predictors of skin cancer screening among a sample of US volunteer firefighters (Shah, NN et al, 2023)

This study examined skin cancer screening among U.S. volunteer firefighters, a group at higher risk for melanoma. It found that only 26% of volunteer firefighters received skin cancer screenings. Firefighters who used sunscreen, perceived their skin as likely to burn, were older, had some college education, or had a family history of skin cancer were more likely to be screened. Additionally, those with more firefighting experience were more likely to undergo screening. The study highlights gaps in skin cancer prevention within the volunteer fire service and suggests that increased focus on prevention and screening practices could help improve protection for these firefighters.

Prevalence and predictors of per- and polyfluoroalkyl sub-stances (PFAS) serum levels among members of a suburban US volunteer fire department (Graber, JM et al., 2021)

This study examined the levels of per- and polyfluoroalkyl substances (PFAS) in the blood of members of a suburban U.S. volunteer fire department. PFAS are synthetic chemicals used in various products, including firefighting foams, and have been linked to health problems. The study found that certain PFAS, such as perfluorododecanoic acid (PFDoA), were detected more frequently and at higher levels in firefighters compared to the general population. Additionally, the amount of PFDoA and perfluorodecanoic acid (PFDA) in the blood was higher in firefighters with more years of service. These results suggest that volunteer firefighters may be exposed to PFAS through their work, highlighting the need for further research and protective measures to reduce exposure.