DALLAS — Protecting the health and safety of firefighters both on and off the job leads to significant cost savings, said Kerry Kuel, a doctor and researcher at the Oregon Health and Science University, during a session at Fire-Rescue International. Kuel spearheaded a multi-year study that showed educating firefighters about healthful eating and exercise habits can reduce both the number of injuries on the job and illnesses, such as diabetes and heart disease.

Kuel developed PHLAME, a health-education research program, to teach firefighters how to live a healthful lifestyle. The system was implemented at two Oregon fire departments with approximately 600 firefighters enrolled in the study. The program educates firefighters about nutrition and exercise and creating new habits to keep themselves healthy. It is supported by a National Institute of Health grant, Kuel said.

“The importance of implementing a health program is that you are not only going to get the benefit of reduced health-care costs but you’ll also create a healthier work force,” Kuel said. “In the fire service, our data shows that for every dollar put into a wellness program you get a $1.62 back. In the short term, you get this immediate reduction of cost in illness and injury.”

Kuel said initially, the study set out to establish the benefits of nutrition, including five servings of fruit and vegetables a day, reducing calories 30% and reducing saturated fat to less than 10%. In addition, it established a 30-minute daily exercise routine. But he was surprised that there was also a 30% reduction in injury rate of those who went through the PHLAME program.

However, cultural issues have affected adoption rate of such a healthful lifestyle. When PHLAME first began, Kuel said firehouse chefs were resistant to changing menus from meatballs to low-fat, vegetarian options.

“They told us they weren’t going to cook ‘plant food,’ and so you have to be sensitive to some of the older firefighters who have the culture of steak and eggs,” Kuel said. “But now, younger firefighters are being entrenched early on. If we can get the young firefighters, then you’ve got a lifelong healthy firefighter.”

Sleep deprivation severely affects the health of firefighters, Kuel said. He was commissioned by the International Association of Fire Chiefs and U.S. Fire Administration to look at the impact of sleep deprivation on firefighters. Studies showed that firefighters and EMTs are at risk of sleep deprivation

“It’s profound,” he said. “I personally believe that 50% of illness and injury seen in the fire service may be due to sleep deprivation.”

Kuel said there are inherent risks because firefighting is shift work, meaning night shift workers have greater illnesses and are going against the biological alarm clock.

To stave off the dangers of sleep deprivation, Kuel said fire chiefs should assess those firefighters’ threat risk for sleep apnea. He said 2% nationally have reported sleep apnea, although he believes that percentage is much higher at 10 to 15%.

“If you are overweight, have high blood pressure, have a neck size greater than 17 cm, and you snore that’s sleep apnea and your risks of pulmonary disease are much higher,” he said.

The second is to develop mitigation strategies for the number of hours worked. In addition, firefighters on the job should take steps to ensure healthful sleeping strategies. Firefighters should do mild to moderate exercise, not to use stimulants such as caffeine or energy drinks after noon and not eat two hours before going to sleep. It also is important to take naps in less than 20 and no longer than 90 minute intervals.

“Find times to nap, a 15 minute to 20 minute power nap will go a long way in restoring your sleep deprivation,” he said.