A total of 10,649 firefighters responded to the questionnaire, representing approximately 24% of the total UK firefighter workforce (Wolffe et al.18). The demographics of the participants were obtained from Wolffe et al. 18was not found to be significantly different from the UK firefighter population38 Regarding gender (p> 0.05), but appeared to underestimate younger age groups, retained firefighters, and those belonging to ethnic minorities (p< 0.05)18.
Approximately 19% (n = 2019) of firefighters self-reported at least one mental health condition. Figure 1 shows the range and frequency of mental health disorders selected by firefighters. This has been compared to the prevalence of these conditions in the general UK population (where possible).3). Note that firefighters were able to select multiple mental health states.
As shown in Figure 1, anxiety self-reports were most common among surveyed firefighters (~12%), followed by depression (~10%) and post-traumatic stress disorder (PTSD) (~5%). ) followed. Self-reported anxiety and depression were also significantly higher in surveyed firefighters than in the British population (Figure 1, ratio test difference). p< 0.05).
Fewer than 2% of firefighters surveyed have obsessive-compulsive disorder (OCD) (1.6%), attention deficit hyperactivity disorder (ADHD) (0.6%), eating disorder (0.4%), and bipolar disorder (0.3%) ), reported autism spectrum disorder (ASD). ) (0.2%), or schizophrenia (0.04%). A majority (0.4%) of firefighters who selected ‘other’ cited work-related ‘stress’ (40% of firefighters who answered ‘other’ or 0.2% of firefighters surveyed overall) ).
Of the 19% (n = 2019) of firefighters surveyed who suffer from some mental health condition, approximately 44% reported having multiple conditions (n = 878). Figure 2 shows the frequency of comorbid mental health conditions. Anxiety and depression coexisted most frequently.
Comorbid mental health conditions of firefighters. Percentage of firefighters with multiple mental health conditions who reported co-occurrence of a specific mental health condition (n = 878). Blank cells indicate that mental health conditions did not co-occur among surveyed firefighters.
From the logistic regression model (Supplementary File S2), coexisting mental health conditions had the greatest impact on reports of depression and anxiety. Firefighters with at least one comorbidity were approximately 16 times more likely to suffer from depression (OR = 15.6, 13.3–18.4) and more likely to suffer from anxiety compared with firefighters with approximately 13-fold higher (OR = 13.3, 11.5–15.5). No co-occurring mental health condition (i.e., people with depression only or anxiety only).
demographics
Except for the most senior roles (such as area or principal manager), similar proportions of firefighters in each role were found to suffer from mental health conditions, anxiety, or depression. Health status, anxiety, or depression generally increased with years of service. Figure 3. Firefighters with longer tenure (i.e., 15 years or more) were slightly more likely to report suffering from some mental health condition compared to firefighters with shorter tenure (or = 1.1, 1.0–1.3), anxiety (OR = 1.0, 0.9–1.2) or depression (OR = 1.0, 0.9–1.2).
mental health of firefighters By demographic.a) Percentage of firefighters in each demographic category suffering from any mental health condition, anxiety, or depression. (b) Odds ratios (95% confidence intervals) for specific demographic groups with mental health conditions, anxiety, or depression. The proportion of surveyed firefighters in each demographic category was found in Wolffe et al., 18Results for underpowered demographic groups (e.g. gender = ‘Other’ with a total of 4 firefighters) should be interpreted with caution. Odds ratios were adjusted for different mental health risk factors (Supplementary File S2).
Only full-time firefighters had better mental health (OR = 1.1, 1.0–1.3) and anxiety (OR = 1.2, 1.0–1.4) when compared with all other contract types of firefighters combined. ) were more likely (but not significantly more likely) to report ).
Firefighters who attended fires at least once a week were more likely to report depression than firefighters who attended fires infrequently (OR = 1.2, 1.0–1.4). However, there were no significant differences between these groups for mental health status (OR = 1.0, 0.9–1.1) or anxiety (OR = 1.0, 0.9–1.2).
health and lifestyle
Firefighters were also asked health and lifestyle questions that may be associated with mental health conditions such as anxiety and depression (Supplementary File S1, Wolffe et al.18). These questions were then included in the logistic regression model (Supplementary File S2) and further elaborated below.
sleep problems
Approximately 61% of all surveyed firefighters (n = 6490) reported having trouble sleeping (Figure 4a). Those who reported sleep disturbances were 4.2 times more likely to report mental health conditions (OR = 4.2, 3.7–4.9) and 2.9 times more likely to report anxiety (OR = 2.9, 2.4–3.5) , were 2.3 times more likely to report depression. (OR = 2.3, 1.9–2.8) compared with firefighters who did not report it, Fig. 4c.
Sleep disturbance in firefighters. (a) Percentage of surveyed firefighters who indicated whether they had sleep disturbances. (b) of sleep-deprived firefighters, citing reasons for their sleep deprivation. Note that firefighters could choose multiple reasons. (c) Adjusted odds ratios (95% confidence intervals) for firefighter mental health status due to sleep disturbance. (d) Firefighter-adjusted odds ratios (95% confidence intervals) for sleep disorders by demographic variables. ( Note the odds ratios indicated by .c) When (d) were adjusted for different sleep disturbance risk factors (Supplementary File S2).
Firefighters were also asked to elaborate further on sleep problems. More than 65% of her firefighters (n = 4228 out of 6490) indicated that shift work was the major sleep disorder (Fig. 4b). Mental health (46%, n = 3010) and workload (36%, n = 2313) were also frequently selected. The most common obstacles firefighters selected as ‘Other’ were for reasons related to home, personal, or family life (e.g., child disturbance, separation/divorce, etc.).
Multiple logistic regression analyzes (Supplementary File S2) revealed that managerial firefighters (OR = 1.1, 1.0–1.2), full-time firefighters (OR = 1.1, 1.0–1.2), firefighters at least on a weekly basis (OR = 1.2, 1.1–1.3), and firefighters with ≥15 years of service (OR = 1.1, 0.9–1.2), Fig. 4d. However, this increase was only significant for firefighters participating in incidents on a weekly basis. They were less likely to report sleep problems (OR = 0.9, 0.7–1.0).
Other health and lifestyle variables
Several other health and lifestyle variables were also found to be significantly associated with mental health in firefighters and are shown in Table 1.
Firefighters diagnosed with cancer were significantly more likely to report mental health conditions (OR = 1.5, 1.1–1.9), anxiety (OR = 1.2, 0.9–1.7), depression (OR = = 0.9, 0.6–1.3) or sleep disturbances (OR = 1.0, 0.8–1.3).
Excluding sleep disturbances and comorbid mental health conditions, the only health/lifestyle variable found to be significantly associated with depression was infrequent physical activity (OR = 1.4, 1.2–1.7). Excessive drinking, smoking, and blood pressure problems were found to be significantly associated with both mental health and sleep disturbances (Table 1).
Infertility problems were significantly associated with mental health status (OR = 1.4, 1.1–1.9), anxiety (OR = 1.3, 1.0–1.7) and sleep disturbances (OR = 1.3, 1.1–1.5).
Exposure to fire contaminants during or after a fire incident
Odds ratios for all mental health conditions were significantly increased in firefighters who noticed soot in their noses and throats more than 1 day after participating in the fire (OR = 1.8, 1.4–2.4), and firefighters who wore PPE for more than 2 days. He after 4 hours of fire (OR = 1.9, 1.2–3.1). The results are shown in Figure 5. Firefighters were also more likely to experience some mental health condition if they reported smelling fire smoke even after washing themselves (OR = 1.3, 1.1–1.5) or if they ate with sooty hands. significantly more likely to report (or = 1.3, 1.1–1.4).
Firefighter exposure to pollutants during/post-fire and mental health odds ratios. Odds ratios (95% confidence intervals) were adjusted for different mental health risk factors (Supplementary File S2).
Similar results were obtained for anxiety. firefighters who eat with sooted hands (for anxiety he OR = 1.2, 1.1–1.4), firefighters who notice soot on their nose/throat within 1 day after washing (OR = 1.4 ,anxiety).
Those who noticed the smell of fire smoke after washing were significantly more likely to report depression (OR = 1.3, 1.0–1.5).
Firefighter PPE and workplace fire contaminants
Firefighters wearing inappropriate PPE were significantly more likely to report psychiatric disorders (OR = 1.4, 1.2–1.7) and anxiety (OR = 1.4, 1.1–1.7), as shown in Figure 6. I was. Odds ratios also increased significantly. Found in firefighters who take PPE home (OR = 1.4, 1.2–1.6 mental health status, OR = 1.3, 1.1–1.6 anxiety, and OR = 1.3, 1.0–1.6 depression).
PPE/workplace pollution and mental health odds ratios for firefighters. Odds ratios (95% confidence intervals) were adjusted for different mental health risk factors (Supplementary File S2).
Furthermore, we found that the odds ratio increased significantly when firefighters were unable to store clean and dirty PPE separately (OR = 1.1, for mental health status between 1.0 and 1.3 (Figure 6 )).
Infrequent sending of fire gloves for professional decontamination was also associated with increased anxiety odds ratios (OR = 1.5, 1.0–2.3).
Firefighters working in fire stations without designated clean and dirty areas also had similar scores for mental health (OR = 1.2, 1.1–0.4), and anxiety (OR = 1.2, 1.0). –1.4) were more likely to report Smell of fire (OR = 1.2, 1.1–1.4 mental health and OR = 1.2, 1.0–1.4 anxiety), Figure 6.
Culture, fire pollutant awareness and training and culture
Firefighters who personally believe that contaminated PPE should be hailed as a “badge of honor” (Wolffe et al.18) were significantly more likely to report mental health status (OR = 1.5, 1.2–1.7) or anxiety (OR = 1.2, 1.0–1.5) (Figure 7). Perceiving peers to support this belief was also associated with slightly increased odds ratios for all mental health conditions (OR = 1.2, 1.0–1.3).
Odds ratios for firefighter training/culture and mental health. Odds ratios (95% confidence intervals) were adjusted for different mental health risk factors (Supplementary File S2).
Other variables significantly associated with mental health disorders and anxiety were perceptions that cleaning was not taken seriously at work (OR = 1.4, 1.3–1.6 for all mental health conditions, 1.3–1.6 for anxiety; OR = 1.2, 1.0–1.4). In addition, firefighters who were not trained in the health effects of fire pollutants were slightly (but not significantly) more likely to exhibit mental health conditions (OR = 1.1, 1.0–1.2).
