Prince Harry spoke about mental health to farmers, but it could have been firefighters

Prince Harry has opened up to farmers about his own mental health struggles. “Asking for help was one of the best decisions that I ever made.”

Prince Harry and Meghan Markle
Prince Harry and Meghan Markle. From ABC News video.

While on a trip to Australia Prince Harry and Meghan Markle stopped to talk with farmers who are suffering through a severe drought which has led to a cascading series of hardships. In drawing upon his own experience with depression he implored them to find someone to talk to.

His words would have been very appropriate before an audience of wildland firefighters — from January 1, 2015 through November 1, 2017 at least 68 took their own lives.

If you substitute “firefighter” for “farmer” in Prince Harry’s address, it would still be very appropriate.

Help is available for those feeling really depressed or suicidal.

Firefighter physical exams can save lives

Physical exam firefighter save life
Screen grab from the video.

As we reported earlier today, the Bureau of Land Management is beginning to provide medical exams for federal Emergency Firefighters (EFFs) in Alaska. The goal is to increase safety by identifying pre-existing conditions that could be aggravated by the arduous duty of wildland firefighting.

These two videos, each about two minutes long, tell the stories of firefighters who discovered during the physicals that they had life-threatening medical conditions. They were then able to take actions which probably saved their lives.

Alaska emergency firefighters to undergo medical exams starting in November

Alaska EFF firefighters
The Kobuk River #2 Type 2 EFF Crew working on a fire in the Lower 48 in 2018. AFS photo.

The Bureau of Land Management Alaska Fire Service in partnership with the Department of Interior Medical Standards Program (DOI MSP) will soon provide medical exams to federal Emergency Firefighters (EFF). The goal of the exams is to increase safety by identifying pre-existing conditions that could be aggravated by the arduous duty of wildland firefighting.

The medical exams will be provided in approximately 28 Alaska villages through mobile medical units and by scheduled appointments at 18 facilities throughout the state.

Starting in November EFFs in Alaska who are hired on an as-needed basis will need medical exams once every three years and self-certify in between years. The medical screening established by the DOI MSP will screen EFFs for any disqualifying medical conditions prior to participating in the Work Capacity Test (WCT), otherwise known as the pack test. Only wildland firefighters performing arduous duties are required to undergo medical exams and pass the WCT.

Schedules for the exams will be posted on the BLM AFS EFF webpage .

For the past two years, Alaska EFFs were granted exemptions to these medical screening requirements. The first phase of implementation of the medical exams began in 2015 and only included regularly employed Department of the Interior wildland firefighters. Applying the requirements to Alaska EFFs was originally planned to begin in 2017, but implementation was delayed until measures were in place to provide mobile units in rural Alaska to conduct the medical examinations. The exams do not include drug testing or affect State of Alaska EFFs.

There is no cost to the EFF for the examination, however, if the individual chooses a location other than their local village BLM AFS will not cover the associated travel costs. After the exam is completed, a determination will be made regarding the candidate’s eligibility to participate in the pack test and the arduous duty of wildland firefighting.

The BLM AFS provides wildland fire management for the Department of the Interior and Native Corporation lands in Alaska and provides oversight of the BLM Alaska aviation program. Firefighter safety and the safety of the public are core values and are fundamental in all areas of wildland fire management.

For more information, EFF candidates can email AFS_EFF@blm.gov or call EFF Program at 1-833-532-8810 or (907)356-5897.

 

Pneumonia and other hazards on the fireline

White Draw Fire, South Dakota
White Draw Fire, South Dakota, June, 2012.

(UPDATED at 4:24 p.m. PDT September 5, 2018)

The U.S. Fire Administration has designated the death of Erick Aarseth a line of duty death (LODD). The agency posted a notice on their web site that indicates Mr. Aarseth was released from the Horns Mountain Fire at 6 p.m. on August 27. The next day he was found unconscious in his apartment.

From the US Fire Administration:

“Firefighter II Eric Aarseth worked the Horns Mountain Fire in Washington on August 27 and was released at 6:00 p.m.  On August 28, Aarseth was found unresponsive at his home in Oregon. Reports indicate that Aarseth developed pneumonia which became septic. Aarseth was treated at Sacred Heart Medical Center in Springfield, Oregon, but was taken off life support on September 3 after suffering irreversible damage to his organs. Aarseth passed away early the following morning on September 4.

“Incident Location: Horns Mountain Fire near Northport, Washington (U.S. National Grid: 11U MQ 42732 18414 (DD: 48.916, -117.782))

“Department information
Miller Timber Services
PO Box 638
24745 Alsea Hwy.
Philomath, Oregon 97370

“Chief: President Lee Miller”


(Originally published at 12:59 p.m. PDT September 4, 2018)

Yesterday, September 3, 20-year-old Eric Aarseth passed away after he was found unconscious the day after he returned from a fire assignment.

His family said he returned home from the fire Monday August 27 and the next day was found unconscious in his apartment suffering from pneumonia. He was taken to a hospital but never woke up. KGW8 reported that he had vomited, obstructed his airway and developed sepsis. When it was discovered he was brain dead the family made the difficult decision to turn off the life support. He passed away Monday September 3.

The Centers for Disease Control reports that the incubation period of pneumococcal pneumonia is about 1 to 3 days. This makes it possible, or even likely, that Mr. Arseth was exposed to the conditions that led to the disease while still on the fire assignment or in travel status.  This could be a line of duty death, an LODD.

Mr. Aarseth was a member of a contractor’s hand crew fighting the Horns Mountain Fire in southern Washington. In July their crew was on the Garner Complex of Fires in southern Oregon.

Working on a hand crew is very hard work. It often means inadequate sleep, nutrition, and hygiene. An ongoing study of smokejumpers found that over the course of a season they lost muscle mass, added fat, their weight remained about the same, and often had impaired reaction time. A study we wrote about in February found firefighters’ exposure to smoke increases their disease risk. Depending on the type of work performed and the number of years of exposure, the increased risk can be 22 to 39 percent.

Wildland firefighters have enough to worry about from the fire itself, avoiding dangerous situations that could lead to being overrun by the fire, hit by a falling tree or rock, cut by a chain saw, exposed to toxic smoke, or being in a vehicle or helicopter accident. Trying to prevent something you can’t see that apparently can kill you in a matter of hours or days, like sepsis and pneumonia, is scarier than all of the above.

Thanks and a tip of the hat go out to Alex.
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Study showed over a season smokejumpers lost muscle mass and often had impaired reaction time

Nine of them were monitored by University of Idaho researchers

firefighters wildfire smoke
Firefighters arrive at the White Tail Fire in South Dakota, March 8, 2017. Photo by Bill Gabbert.

This study conducted by researchers at the University of Idaho followed 9 smokejumpers over the course of a fire season. This is not a representative sample of wildland firefighters and the many different jobs they perform, but it is interesting nonetheless. This year they are monitoring 18 additional smokejumpers and hope to expand it to more firefighters in the future.


University of Idaho study looks at firefighter diet, sleep in an effort to curb impaired work

By Sara Zaske, U. of I. College of Natural Resources

Wildland firefighters are working long shifts this summer all across the West. And they are getting really tired.

Randy Brooks knows exactly how tired. The University of Idaho professor is closely tracking 18 smokejumpers with the help of advanced motion monitors that use an algorithmic fatigue model originally developed for the U.S. military.

This is not just an academic exercise — Brooks is aiming to save lives.

“Wildland firefighters need to be alert and vigilant of their surrounding situation because something could happen at any moment,” he said.

Both of Brooks’ sons fight fires. And the need for great situational awareness hit close to home in 2015 when a fire shifted directions on one of his sons.

It started with a late-night text — his son, Bo Brooks, let him know the crew was heading to work the next day on the Twisp fire in north central Washington. He was nervous because high winds were forecast.

The next day, Brooks got a phone call instead of his typical text.

“My son called me at 4 in the afternoon,” Brooks said. “I knew something was wrong because they usually just text me to let me know they were all right.”

Randy BrooksThis time everything was not all right. The winds kicked up suddenly, and the fire crew had to “bug out” – run out of an area as quickly and efficiently as possible. Not all of them made it. Three firefighters died and another was badly burned.

After the tragedy, some members of the team quit firefighting. Bo Brooks stayed on but wanted things to change: “He said ‘Dad you’re a forestry researcher — is there anything you can do to help us?’” Randy Brooks said.

So Brooks, who works in U of I’s College of Natural Resources, and Callie Collins, a doctoral student in environmental science, conducted a survey of more than 400 wildland firefighters. The majority indicated that the main contributors to accidents in fire operations were inadequate sleep and fatigue, both mental and physical.

The researchers followed the survey with a pilot study of nine firefighters to closely assess sleep, fatigue and body composition.

They outfitted the smokejumpers, firefighters who parachute from planes to battle wildland fires in remote areas, with Readibands — motion monitors made by Fatigue Science that keep detailed data on sleep and activity. The data was then analyzed using the algorithm model developed by the U.S. Army Research Laboratory to obtain an “alertness score,” which quantifies the wearers’ reaction times and relative accident risk.

In the pilot study, Brooks and Collins found firefighters spent more than 42 percent of one month working in impaired conditions with reaction times slowed by as much as 34 to 100 percent – equivalent to having a blood-alcohol concentration of 0.05 to 0.11 or higher. That’s on the cusp of the legal limit for driving at 0.08.

Professor Randy Brooks wearing a Fatigue Fitness Readiband holds a tablet that is monitoring the alertness scores of 18 wildland firefighters currently in the field.

The researchers also had the firefighters’ body composition measured, before and after the fire season, and looked at their hydration and diet. Despite their high level of physical activity, the smokejumpers maintained their weight but gained fat over the summer — and lost muscle mass.

Brooks and Collins believe this may be because of the quality of their diet, which is high in carbohydrates and sugar and lower in protein and healthy fats like those found in eggs, nuts and fish. They hope to test that hypothesis in future studies.

Always a challenging profession, wildland firefighting has become even more difficult in recent years as the wildfire season in the West continues to grow in intensity and duration – today the fire season is about 30 days longer than it was three decades ago.

“It’s like they used to be running a 100-yard dash 30 years ago and now they’re running a marathon with the longer fire seasons,” Brooks said.

And if they are running a firefighting marathon, he argues, the crews may need to eat and drink like elite athletes do as well.

This summer, Brooks doubled the sample size of his pilot study to 18 smokejumpers. He wants to expand the project further in the future, and nearly 200 firefighters have volunteered to participate in his studies. His research was only limited by the expense of the motion trackers, which cost close to $1,000 each at the start of the study.

Still, Brooks hopes whatever data he gathers will help make this dangerous profession safer.

“I think we need a paradigm shift in the way we think about fighting wildfires at all cost and place a greater emphasis on personal safety over protecting resources,” Brooks said. “Trees grow back, homes can be rebuilt, but lives can’t be replaced.”




New rhabdomyolysis resources for firefighters

If left untreated, severe rhabdo may be fatal or result in permanent disability.

Too many wildland firefighters have suffered from rhabdomyolysis (often referred to as rhabdo) in recent years. In some cases they could have been treated much earlier if the victims and those around them had recognized the symptoms.

Rhabdo informationFirefighting, both structural and wildland, involves tasks in environments that place fire fighters at increased risk for this condition. Rhabdo is a breakdown of muscle tissue that releases proteins and electrolytes into the blood stream and can cause heart and kidney damage. If left untreated, severe rhabdo may be fatal or result in permanent disability. Heat exposure and intense physical effort are just two of many known risk factors for rhabdo.

NIOSH has developed two sets of factsheets and wallet cards—one for structural firefighters and their healthcare providers and another for wildland firefighters and their healthcare providers—to increase awareness about the signs and symptoms of rhabdomyolysis and help fire fighters get early treatment to prevent more serious medical problems.

Factsheets for wildland firefighters and their healthcare providers:

What Wildland Fire Fighters Need to Know about Rhabdomyolysis

Rhabdomyolysis in Wildland Fire Fighters: A Patient Population at Risk

Wallet cards for wildland fire fighters

 

Factsheets for structural firefighters and their healthcare providers:

What Structural Fire Fighters Need to Know about Rhabdomyolysis

Rhabdomyolysis in Structural Fire Fighters: A Patient Population at Risk

Wallet cards for structural fire fighters

Thanks and a tip of the hat go out to Bryan.
Typos or errors, report them HERE.