Female firefighter putting on PPE

Journal Article Compares Blood Clotting Potential in Male vs. Female Subjects Following Firefighting Activities

March 8, 2022

The Hemostatic Responses to Multiple Bouts of Firefighting Activity: Female vs. Male Differences in a High Demand, High Performance Occupation peer-reviewed journal article, led by FSRI Advisory Board Member Denise Smith and FSRI Research Engineer Gavin Horn, was recently published in the “Interdisciplinary Aspects of Women’s Physiology and Physical Fitness” special issue of the International Journal of Environmental Research and Public Health.

While firefighters routinely perform dangerous work and face multiple occupational risks, according to the NFPA, approximately 50% of duty-related deaths among firefighters are due to sudden cardiac events (SCE). Because of this, it was important to specifically research hemostatic responses (specifically, key changes in firefighters’ blood that are important in the process of blood clot formation) as enhanced clotting potential is one plausible mechanism that may at least partially explain the risk of experiencing a SCE following firefighting activities. The fire service has long been a male-dominated occupation, but women’s participation has increased in recent years. Previous research has shown that males have increased blood clotting potential following firefighting activities, but there was no data showing the effect on female firefighters. 

Because of the low representation of women in the fire service in general, they have often been excluded from firefighter research studies. Alternately, some female firefighters may have participated in studies, but the number of women was so low (maybe 1-2 females vs. 20 males) that their data was included with the men and it was assumed that there would be no difference between male and female firefighters. Given our understanding of the physiological strain of firefighting and the increasing number of female firefighters, there is a pressing need to understand if the hemostatic responses to firefighting differed among men and women. 

"We would like to thank the large number of female firefighters who joined us for this study, which allowed a large enough number to conduct these important analyses for the first time.  We also thank the many students from Illinois and Skidmore College who supported this work."

– Gavin Horn, Research Engineer, FSRI

The purpose of this study conducted at Illinois Fire Service Institute (IFSI Research) with Skidmore College, and the University of Illinois-Chicago was to determine the effects of multiple bouts of firefighting on hemostatic responses and this secondary analysis allowed the team to compare those responses in male and female firefighters. The initial hypothesis was that multiple bouts of firefighting would lead to an increased blood clotting potential (a procoagulatory state) in both male and female firefighters and that females would experience a greater procoagulatory shift than men. The results of this study disproved that hypothesis and showed that following firefighting activities, there was a similar increased procoagulatory response for both male and female firefighters. The change was not severe enough to be clinically significant for our “healthy” participants who did not have any known pre-existing conditions and were in good physical condition. However, firefighters who have pre-existing conditions and are not in good physical condition may experience more of a clinically significant difference with a higher potential for a cardiac event following firefighting activities. This is a great reminder of the importance of being both physically and medically prepared for the job of firefighting and to have annual medical evaluations and to pay careful attention to the results. 

This foundational research highlights the need for additional studies to describe the physiological strain of firefighting and reinforces the need to include female firefighters, including women of different ages and hormonal status, in research investigating the health and safety implications of firefighting. 

This project was supported by the Department of Homeland Security Fire Prevention and Safety Grants EMW-2007-FP-02328.

Click here to download the article. 


About International Journal of Environmental Research and Public Health:

International Journal of Environmental Research and Public Health (IJERPH) (ISSN 1660-4601) is a peer-reviewed scientific journal that publishes original articles, critical reviews, research notes, and short communications in the interdisciplinary area of environmental health sciences and public health. It links several scientific disciplines including biology, biochemistry, biotechnology, cellular and molecular biology, chemistry, computer science, ecology, engineering, epidemiology, genetics, immunology, microbiology, oncology, pathology, pharmacology, and toxicology, in an integrated fashion, to address critical issues related to environmental quality and public health. Therefore, IJERPH focuses on the publication of scientific and technical information on the impacts of natural phenomena and anthropogenic factors on the quality of our environment, the interrelationships between environmental health and the quality of life, as well as the socio-cultural, political, economic, and legal considerations related to environmental stewardship, environmental medicine, and public health.

Assessing the Cardiovascular and Chemical Risks Faced by Firefighters