Previous Firefighter Health & Safety Studies

Our firefighter studies focus on five main areas: Exposures and Respiratory Protection, Respiratory Studies, Cardiovascular Studies, Injuries and Work Practices, and Infections.

SampleThe Firefighter Breast Milk Study – Pilot Study

Pilot Study, UA funded

Purpose and Objectives

Female firefighters who return to work postpartum are confronted by the question of when it is safe to breast feed their newborn after fighting a fire. This pilot project will investigate the concentration of contaminants in firefighter breast milk at baseline and for up to 72 hours post fire fighting.


Study Design and Sampling:


  • Phoenix Fire Department and surrounding area firefighters will be contacted by email/listserve/newsletters through their respective departments and asked if they are interested in participating if they are a nursing mother on active fire duty. Following informed consent, participating firefighters will fill out a baseline occupational and environmental exposure questionnaire.
  • Baseline breast milk sample will be collected after breast feeding of nursling is completed, stored in the subject’s freezer, and transferred on ice to the Phoenix Fire Department Safety Section, where it will be stored until transfer to the University of Arizona.
  • Post fire fighting incident, the participating firefighter will fill out an exposure questionnaire and repeat the breast milk sample collection, collecting the breast feeding post fire samples immediately post-fire, at 8-10 hours, 24 hours, and again 72 hour post fire incident. Samples will be stored in the subject’s freezer until all samples have been collected for that fire incident and then transferred on ice to the PFD Safety Section and then at a later time to the University of Arizona.
  • Non-firefighting breast-feeding mothers will be recruited from the Phoenix and surrounding area to act as controls for the baseline sample only.

We have enrolled and consented 5 breastfeeding firefighters and 5 breast-feeding controls from the Phoenix area.


Given the substantial and well-established benefits of breastfeeding, we fully support breastfeeding by firefighters during active duty. The results of this pilot study are very limited and could potentially be influenced by exposures outside firefighting activities, such as chemicals in food. However, until further studies are performed, we believe that firefighters wanting to limit potential exposures to their breastfeeding infants should pump and discard their breastmilk following a structural fire for 72 hours, and supplement using an alternative source, such as previously frozen breastmilk, during this time.


Cardiovascular Studies

Determination of Risk Factors for Cardiovascular Disease in Firefighters.

Grant: Federal Emergency Management Agency 2008 - 2010.

Sudden cardiac deaths account for 44% of the line of duty deaths in firefighters, and generally occur in firefighters with underlying cardiovascular disease, many of whom have been previously asymptomatic. Current screening tests are therefore not adequate to identify firefighters at high risk of an on-duty cardiovascular event. Measurement of carotid artery intimal-medial thickness (IMT) is used in research studies as a screening test for atherosclerotic heart disease, but it has never been tested for its utility in the fire service. Fire suppression carries the highest risk for cardiovascular deaths, and yet we do not understand the effects of this activity, including the contribution of smoke and heat exposure, on pathways involved in the development of a myocardial infarction. Our proposed study objectives are to evaluate the use of carotid IMT as a medical surveillance tool in firefighters, to determine the acute effects of fire suppression on biomarkers associated with heart attacks and to evaluate a new cooling method.

For more information, visit the current studies Cardiovascular section of the Public Safety Institute

  • Burgess JL, Kurzius-Spencer M, Gerkin R, Fleming J, Peate W, Alison M. Risk factors for subclinical atherosclerosis in firefighters. Journal of Occupational and Environmental Medicine 2012;54:328-335.
  • Burgess JL, Duncan M, Hu C, Littau SR, Caseman D, Kurzius-Spencer M, Gorman G, McDonogh P. Acute cardiovascular effects of firefighting and active cooling during rehabilitation. Journal of Occupational and Environmental Medicine (in press).

“Firefighter Statin Trial: Reducing Atherosclerotic Disease and Risk Factors.”

Grant: FEMA Assistance to Firefighters Grant Program - Fire Prevention and Safety 2010 - 2013.

Carteriod Intima-Media Thickness (CIMT) is a measure of atherosclerosis, and increasing CIMT is associated with a higher risk of cardiac events. We have identified that firefighters with LDL-C > 100 mg/dl have increased CIMT. Statin therapy reduces future cardiac events and CIMT. However, firefighters without hypercholesterolemia rarely receive statins.

For more information, visit the current studies Cardiovascular section of the Public Safety Institute


Exposures & Respiratory Protection

Development of Test Methods for Evaluating Air Purifying Respirator Cartridges for Firefighting Operations.

Grant: National Institute for Occupational Safety and Health 2005 - 2006

Other Publications


Respiratory Studies

Biomarkers of smoke exposure among firefighters.

Grant: NIOSH Special Emphasis Research Career Award (K01) 1998 - 2001

Genetic Susceptibility to Accelerated Loss of Pulmonary Function in Firefighters.

Grant: University of Southern California/NIOSH ERC Pilot Project Grant 2000 - 2001

Does rapid lung function decline in firefighters predict respiratory morbidity during their retirement?

Grant: University of California at Los Angeles /NIOSH ERC Pilot Project Grant 2007

Other Publications

  • Burgess JL, Brodkin CA, Daniell WE, Pappas GP, Keifer MC, Stover BD, Edland SD, Barnhart S. Longitudinal decline in measured firefighter single-breath diffusing capacity of carbon monoxide values: A respiratory surveillance dilemma. American Journal of Respiratory and Critical Care Medicine 1999;159:119-124.
  • Gerkin R, Burgess JL. Firefighters. In: Greenberg MI, Hamilton RJ, Phillips SD McCluskey GJ (eds.) Occupational, Industrial, and Environmental Toxicology 2nd edition, Mosby, Philadelphia, PA. 2003:162-173.
  • Burgess JL and Crutchfield CD. Tucson fire fighter exposure to products of combustion: A risk assessment. Applied Occupational and Environmental Hygiene  1995;10:37-42.
  • Bolstad-Johnson DM, Burgess JL, Crutchfield CD, Storment SB, Gerkin RD. Characterization of firefighter exposures during fire overhaul. American Industrial Hygiene Association Journal  2000;61:636-641.
  • Burgess JL, Nanson CJ, Bolstad-Johnson DM, Gerkin R, Hysong TA, Lantz RC, Sherrill DL, Crutchfield CD, Quan SF, Bernard AM, Witten ML. Adverse respiratory effects following overhaul in firefighters. Journal of Occupational and Environmental Medicine  2001;43:467-473. 
  • Burgess JL, Nanson CJ, Gerkin R, Witten ML, Hysong TA, Lantz RC. Rapid decline in sputum IL-10 concentration following occupational smoke exposure. Inhalation Toxicology  2002;14:133-140.
  • Burgess JL, Witten ML, Nanson CJ, Hysong TA, Sherrill DL, Quan SF, Gerkin R, Bernard AM. Serum pneumoproteins: a cross-sectional comparison of firefighters and police. American Journal of Industrial Medicine  2003;44:246-253.
  • Burgess JL, Fierro MA, Lantz RC, Hysong TA, Fleming JE, Gerkin R, Hnizdo E, Conley SM, Klimecki W. Longitudinal decline in lung function: evaluation of interleukin-10 genetic polymorphisms in firefighters. Journal of Occupational and Environmental Medicine  2004;46:1013-1022. 
  • Burgess JL and Crutchfield CD. Quantitative respirator fit tests of Tucson fire fighters and measurement of negative pressure excursions during exertion. Applied Occupational and Environmental Hygiene  1995;10:29-36.
  • †Josyula AB, Kurzius-Spencer M, Littau SR, Yucesoy B, Fleming J, Burgess JL. Cytokine genotype and phenotype effects on lung function decline in firefighters. Journal of Occupational and Environmental Medicine  2007;49:282-288.
  • Anthony TR, Joggerst P, James L, Burgess JL, Leonard SS, Shogren ES. Method development study for APR cartridge evaluation in fire overhaul exposures. Annals of Occupational Hygiene  2007;51,703-716.
  • Robinson M, Anthony TR, Littau SR, Herckes P, Nelson X, Poplin GS, Burgess JL. Occupational PAH exposures during prescribed pile burns. Annals of Occupational Hygiene  2008;52:497-508.
  • Jones L, Lutz EA, Burgess J. Respiratory protection for firefighters – evaluation of CBRN canisters for use during overhaul. Journal of Occupational & Environmental Hygiene. 2015;12(5):314-22. doi: 10.1080/15459624.2014.989363.


Injury Prevention Studies

Implementing Risk Management Strategies to Prevent Injuries among Firefighters.

Grant: National Institute for Occupational Safety and Health 2009 - 2013

  • Griffin SC, Regan TL, Harber P, Lutz EA, Hu CC, Peate WF, et al. Evaluation of a fitness intervention for new firefighters: injury reduction and economic benefits. Inj Prev. 2016;22(3):181-8.
  • • Poplin GS, Roe DJ, Burgess JL, Peate WF, Harris RB. Fire fit: assessing comprehensive fitness and injury risk in the fire service. Int Arch Occup Environ Health. 2016;89(2):251-9.
  • Poplin GS, Pollack KM, Griffin S, Day-Nash V, Peate WF, Nied E, et al. Establishing a proactive safety and health risk management system in the fire service. BMC Public Health. 2015;15(1):1-12.
  • Poplin GS, Roe DJ, Peate W, Harris RB, Burgess JL. The association of aerobic fitness with injuries in the fire service. American Journal of Epidemiology  2014;179:149-155.
  • Peña J, Griffin S, West G, Peate W, Burgess JL, Cost analysis of injury claims in the fire service.  International Fire Service Journal of Leadership and Management 2015;9:29-40

For more information:

Occupational Carcinogenic Exposures in Native American Firefighters.

Grant: National Cancer Institute, NIH 2006 - 2007 Pilot project within the Native American Cancer Research Partnership.

  • Robinson M, Anthony TR, Littau SR, Herckes P, Nelson X, Poplin GS, Burgess JL. Occupational PAH exposures during prescribed pile burns. Annals of Occupational Hygiene 2008;52:497-508. Wildland Firefighters.

Injuries among the Tucson Firefighting Population: Identifying Root Causes and Areas for Intervention.

Grant: University of California at Los Angeles /NIOSH ERC Pilot Project Grant 2007

  • Poplin GS, Harris RB, Pollack KL, Peate W, Burgess JL. Beyond the Fireground: Injuries in the Fire Service. Injury Prevention. 2012; 18: 228-233.

Comparison of Firefighter Work Practices and Injury Rates in Japan and the U.S.

Grant: The Japan-United States Educational Commission Fulbright research grant 2010

Fireground Injuries: An International Evaluation of Causes and Best Practices.

Grant: FEMA Assistance to Firefighters Grant Program - Fire Prevention and Safety 2009 - 2012

  • Burgess J, Duncan M, Mallett J, LaFleur B, Littau S, Shiwaku K. International Comparison of Fire Department Injuries. Fire Technol. 2014;50(5):1043-59.
  • Duncan MD, Littau SR, Kurzius-Spencer M, Burgess JL. Development of best practice standard operating procedures for prevention of fireground injuries. Fire Technology  2014;50:1061-76.  
Other Injury Prevention Publications
  • Wayne F Peate, Linda Lundergan, Jerry J Johnson. Fitness self-perception and Vo2max in firefighters. Journal of Occupational and Environmental Medicine 2002;44(6):546-50.
  • Peate WF, Bates G, Lunda K, Francis S, Bellamy K. Core strength: A new model for injury prediction and prevention. Journal of Occupational Medicine and Toxicology 2007; 2:3



MRSA Prevalence and Exposure Potentials in Paramedic Environments.

Industry: The Clorox Company. $164,817; 2005-09

  • Sexton, J.S., K.A. Reynolds. 2010. Emergency healthcare responders and environmental exposure routes of methicillin resistant Staphylococcus aureus (MRSA). American Journal of Infection Control. 38(5):368-373.
  • Peate, W., Sexton, J., Reynolds, K. Nied, E. 2009. Methicillin-resistant Staphylococcus aureus (MRSA) in fire facilities: a guide for firefighter management. International Fire Service Journal of Leadership and Management. 3(2): 13-17 (plus appendices).
Other Publications
  • Gecosala, R. R. MD, MS; Peate, W. F. MD, MPH. 1998. Prevalence Rate of Hepatitis C Among Firefighters in A Municipal Fire Department. Journal of Occupational and Environmental Medicine. 40:11