Exploring the impact of the first responder lifestyle on the Central Nervous System and how creation of a personal wellness practice can help to expand the window of tolerance, reducing the likelihood of PTSD, Vicarious Trauma, Compassion Fatigue, and Burnout.

Firefighter wellness is a shared responsibility that involves the entire family; however, fire departments often struggle to effectively incorporate firefighter families into the discussion, leaving them ill-equipped to tackle the many additional stressors of marriage and managing this career. Dr. Rachelle Zemlok, a firefighter psychologist and fire spouse, will discuss the common stressors that challenge firefighter relationships, using a light and humorous approach to address some of the work skills firefighters inadvertently bring home that can be damaging to their connections with loved ones. This informative talk aims to raise awareness of the unique challenges firefighter families face while offering actionable strategies for supporting them effectively. Don’t miss this opportunity to learn while enjoying an engaging perspective on the complexities of firefighter family dynamics!

Tired of being called bossy when you’re just doing your job? Learn how to navigate the tightrope women often face between being perceived as too “masculine” (and therefore respected, but not liked) and too “feminine” (and therefore liked, but not respected). Building on her experience as a Lean In Circle Leader and based on the teachings of University of California profession Joan C. Williams, Preet will share how to spot tightrope bias in the workplace and share strategies for successfully navigating this form of bias. Lean In is a global community dedicated to helping foster leadership, advancement, and inclusion for women in the workplace.

This session will explore the use of systems thinking in leadership and how it can improve our understanding of the systems we live and work in. At its heart, systems thinking is the ability to see the big picture, to see the forest for the trees while understanding the details of the individual trees and their interconnectedness. Systems thinking can be seen as an interdisciplinary approach to organizational research that involves philosophy, engineering, psychology, mathematics among other disciplines. This research focuses on understanding the relationships between individuals and how those relationships impact the whole of a system. W.E. Deming said that the communities where we live and work are made up of a series of systems including, but not limited to, police, libraries, business, schools, and fire department etc. that form the larger system of the community. Recruitment and retention are two of the most talked about issues for fire departments across the country. Is the worker shortage an employee problem or a management problem? Are potential firefighters intrinsically or extrinsically motivated? Deming quite possibly would refer to this as a management problem or a problem that management controls.

As fire and EMS professionals are increasingly pulled into the complexities of behavioral health calls, mobile crisis response teams have emerged as a critical counterpart in the field. These teams respond directly to mental health emergencies and relieve pressure on traditional emergency services. This presentation draws from recent research and field experience to explore how mobile crisis systems are reshaping public safety and community care. Drawing on her work with Psych Crisis and her previous role helping launch Health 34 with the UC Davis Fire Department, Sarah Estes will discuss how mobile crisis units function as parallel systems that reduce strain on 911, prevent unnecessary hospitalizations, and most importantly, protect the mental health and physical safety of first responders and the communities they serve. This session draws on peer-reviewed research and national best-practice models, translating them into operational lessons from real-world mobile crisis response systems.

In high-stakes professions like the fire service and health services, excellence is expected, but what happens when your inner voice questions if you truly belong? Imposter Syndrome: Will the REAL You Please Stand Up is an empowering session designed to explore the quiet but common struggle of feeling like a fraud, despite years of dedication and achievement. Whether you're a seasoned officer, clinician, or an emerging leader, this session creates space to examine how imposter syndrome shows up in our culture, impacts our mental health, and limits our leadership potential. Through real talk, reflection, and interactive exercises, attendees will learn to recognize imposter thoughts, reframe their internal narrative, and develop strategies to step confidently into their roles. It’s time to stop second-guessing and start showing up as your authentic, capable self—because the real you is more than enough.

Recently, stretching and flexibility exercises have been increasingly utilized to enhance fire fighters' range of motion (ROM) and reduce the risk of occupational musculoskeletal disorders (MSDs). However, evidence indicates that even significant improvements in passive ROM may not translate to active, functional movements. While the effectiveness of passive mobility interventions alone is questionable, combining active and passive stretches may lead to greater acute ROM improvements in subsequent tasks. This study examined the acute effects of a combined passive and active hip flexion mobility intervention on fire fighters’ passive and active hip flexion ROM and lifting mechanics. Thirty (males = 24, females = 6) career on-duty firefighters completed a lifting task before and after the mobility intervention. The lifting task was conducted at the fire station and recorded using an eight-camera markerless motion capture system. Peak hip and spine flexion ROM during lifting was analyzed after data collection. The mobility intervention significantly increased passive mobility; however, peak hip and spine range of motion (ROM) while lifting and active hip flexion ROM were unaffected. These results highlight the need to better understand what influences active mobility. Accordingly, researchers, clinicians, and practitioners must look beyond passive stretching to address fire fighters’ occupational musculoskeletal disorders (MSDs).

In this engaging 12-minute talk, we will explore the profound impact of gratitude on the lives of first responders. Drawing on cutting-edge research, we’ll examine how cultivating a gratitude practice can enhance mental resilience, foster stronger team dynamics, and promote overall well- being in high-stress environments. Through personal stories and actionable insights, attendees will learn how simple practices of gratitude can shift perspectives, reduce stress, and improve emotional health. This talk will empower attendees to harness the power of gratitude not only to enhance their own lives but also to strengthen their connections with their crew and community.

A critical look at current testing and promotional practices and their effect on fire service culture. Are we selecting task managers or leaders?

The fire service is built on teamwork, trust, and leadership, but what happens when these values are challenged by toxic personality traits? This thought-provoking session delves into the concept of the Dark Triad — Machiavellianism, Narcissism, and Psychopathy — and their impact on individual and group dynamics within fire departments. Participants will explore the psychological underpinnings of these traits, learning how they can manifest in the workplace and disrupt team cohesion, morale, and performance. The session will emphasize the critical importance of recognizing the early warning signs of destructive behavior, understanding the subtle ways these traits can infiltrate leadership and peer relationships, and developing proactive strategies to mitigate their impact. Moral courage as a leader and group member will be discussed and its role in transforming team dynamics and values. Key topics will include: Defining the Dark Triad: Understanding Machiavellianism, Narcissism, and Psychopathy Identifying Red Flags: Psychological cues and behavioral patterns in the firehouse. Group Dynamics: How toxic traits ripple through teams and compromise trust and organizational safety. Leadership Vulnerabilities: Recognizing how these traits exploit gaps in leadership structures. Resilience and Prevention: Building psychological safety, fostering accountability, and establishing systems to safeguard team culture. This class is designed for firefighters, officers, and organizational leaders who are committed to strengthening team cohesion, promoting mental health, and cultivating a resilient organizational culture. Walk away with practical insights and tools to enhance your leadership capacity and protect your firehouse from the hidden threats posed by destructive personalities.

For decades, first responders have relied on Critical Incident Stress Management (CISM) as the standard approach for post-incident mental health care. But what if we’ve been getting resilience wrong? New research reveals that trauma is stored in both the mind and body, and in some cases, traditional CISM debriefings may even worsen mental health outcomes. Leading health organizations—including the WHO, NIMH, and the National Center for PTSD—now warn against one-size- fits-all debriefing models like CISD. So what comes next? This session introduces Tactical Readiness and Resilience (TR2), a firefighter-driven framework built from real-world experience and the latest evidence-based practices. Developed in response to firefighter feedback and operational needs, TR2 offers a structured yet adaptable approach to mental health that integrates: Decompression Breaks – Operationally approved recovery time focused on immediate physiological and mental reset after high- stress incidents. Peer-Led Incident Reviews – A structured, non-clinical alternative to CISM debriefings, designed to prevent cognitive distortions and misinformation while aligning team understanding. Readiness & Resilience Sessions (R² Sessions) – A proactive approach to mental health, ensuring firefighters develop resilience skills before a crisis ever happens. A PhD behavioral scientist will break down why trauma affects first responders differently, and why TR2 represents the next evolution of firefighter mental health strategy. At the core of this shift is a transformation in Peer Support itself—moving away from the “lifeguard” model (reactively rescuing those in crisis) to the “swim instructor” model (proactively equipping firefighters with the tools to navigate stress over their careers).

Firefighting may be one of the most physically demanding careers, but could the very training firefighters rely on for success put them at unnecessary risk? This brief review explores the physiological toll of performing physical fitness training in turnout gear, uncovering and underlining the often-overlooked dangers of biomechanical strain, heat stress, and carcinogen exposure. The widespread belief that fitness training in gear is essential for building familiarity and realism will be critically examined—and challenged—with real-world examples and research-backed insights.

Presentation will focus on the Neurofeedback Program imbedded in our department and located in our headquarters for over 5 years. Co-presenter Gabi Whitmer, LPC, BCN of Betabrain Performance will describe the modality science, how firefighters and paramedics enjoy the environment and benefit from the science with data. I will contribute the design and relationship of the collaboration and hw we normalized "brain camp" in a firefighter population.

Fire stations operate like second homes, shaped by shared experiences, traditions, and unspoken rules. But for some firefighters, integrating into this environment can be a challenge, impacting their sense of belonging and overall well-being. Building on national discussions and real-world case studies, we’ve worked with fire service leaders to identify key challenges and actionable solutions to improve station culture. Through structured collaborations with career and volunteer fire departments, we’re piloting tailored strategies to foster a more cohesive and supportive work environment. This talk will highlight real experiences from the field, evidence-based insights, and the practical tools we’re collecting to help departments create sustainable cultural shifts. By addressing the barriers that shape daily interactions and influence crew cohesion, we aim to strengthen the fire service from within—ensuring that every firefighter has the opportunity to thrive in their career.

This session offers a real-world example of how science can drive meaningful improvements in firefighter well-being. Whether you're considering schedule or shift time modifications in your own department or looking to apply research in operational decision-making, this presentation will provide valuable takeaways for fire service leaders, policymakers, and researchers alike. Chief Joe Pennino and Dr. Billings will explore how research guided Roswell Fire Department’s decision to adjust shift start times and how data-driven insights led to further operational changes. They will discuss the department’s initial motivation for change, the results of the before-and-after study, and the unexpected barriers that emerged—such as cultural and operational factors that limited firefighters’ ability to maximize additional sleep opportunity—and how the department used these findings to implement further improvements that enhanced firefighter sleep and health. Attendees will gain insights into the practical, political, and administrative challenges of implementing schedule and shift time changes, reinforcing the importance of evidence-based decision-making in fire service operations.

The Fire service Organizational Culture of Safety (FOCUS) survey is an assessment tool specifically for the United States fire and rescue service to measure the safety climate of a department. Prior to FOCUS, there was no industry-specific safety climate scale for the fire and rescue service. Through the FOCUS Beta-Test, FIRST collaborated with 12 departments and 123 firefighters to develop scale items. Then, the items were validated through testing with a geographically stratified random sample of 132 departments and 10,000 firefighters. The survey has moved from research in the beta- test phase to practice across three different assessment waves. To date, it has been taken by almost 600 fire departments and 70,000 firefighters in all 50 states. Safety climate has known associations with injuries, near-misses, line-of-duty deaths, and organizational outcomes like burnout, job satisfaction, work engagement, and mental health. Fire departments who improve their safety culture can expect to see increases in positive metrics and decreases in negative metrics. But, you cannot manage what you do not measure. A 30-page final report provides empirical insight into safety climate, allowing departments to lead with data as they advocate for gear, staffing, apparatus, and behavioral health resources. To ensure department leaders develop competency and confidence with their data, participants are then invited to FOCUS Culture Camp. These two-day trainings convey competencies in the design of the FOCUS survey; gathering FOCUS data; and analysis, interpretation, and use of the data. The goal is to help fire departments and labor unions develop confidence with their data and the skills to use it to become champions of culture. Instructors include a fire service member, FIRST Center staff, and affiliate faculty from the field of organizational science who have deep knowledge of safety culture interventions and how to implement them. Each camp includes 5-10 departments and 10-20 participants. The culminating experience is a Data Teach Back, performed by each department's labor-management team. Participants practice presenting their data to stakeholders such as city council, risk management, workers' compensation, and department union members. Our instructors provide feedback to ensure information is presented accurately. Other participating departments offer their practical suggestions. To date, 268 firefighters from 140 departments have graduated from FOCUS Culture Camp. Based on demand, Culture Camp evolved from an in-person experience to an online hybrid training that includes asynchronous lectures and interactive live Data Teach Back sessions. It now exists in an online learning management system, developed and maintained in collaboration with the Drexel University instructional Design and Media Services (IDMS).

Have you ever felt stuck between a rock and science? Many firefighters do—clinging to outdated myths and resisting the facts about what it truly takes to thrive in this challenging career. For years, I thought I could outwork the science and ignore the rules while still being the firefighter and person I wanted to be. I was wrong, and that mindset nearly cost me everything. This session is a wake-up call for firefighters to move beyond old crutches and embrace a more holistic approach to thriving—one rooted in science, vulnerability, and the human element. Let’s stop resisting the facts and embrace what we know works. When we blend science with the human element, we don’t just survive—we thrive. Together, we can step into a future where firefighters are stronger, smarter, and healthier—ready to tackle the challenges of this demanding profession head-on.

Cardiovascular issues continue to a leading cause of death in the fire service. Providing a comprehensive wellness program is essential to firefighter health and longevity and establishes a foundation for further testing and training. While imaging, such as ultrasound, CT scans and MRIs have become popular, their cost, and, more importantly, the chance of false positives, means that they must be used carefully. Strategically providing advanced imaging may reveal cardiac issues without creating unnecessary expense or worry. During this session we will discuss ways to provide screening and how to address various outcomes from the testing.

Cardiovascular disease (CVD) risk remains high among first responders, and there are numerous challenges to optimize health, fitness, and occupational readiness. Our research team has assessed and monitored novel physiological stress, oxidative stress, and inflammatory biomarkers that may offer a more comprehensive clinical health assessment than conventional clinical assessments. This session will cover the importance of annual clinical health, wellness, and fitness testing to screen and monitor firefighter health and disease risk. Particularly, the session will highlight the importance of early detection of cardiovascular disease (CVD) risk and ways in which departments could leverage assessment and monitoring methods to optimize their health, wellness, and fitness, with the goal of improving performance and readiness. In addition, this session will cover the underlying mechanisms of atherosclerotic CVD risk, how the stress of the occupation factors in, and how first responder groups can easily monitor their health, fitness, and CVD risk via several simple metrics that our research has identified.

Ruthann Rudel will discuss her two recently published relevant peer-reviewed scientific papers. The first contains a new list of chemicals likely to increase breast cancer risk based on their biological activity (Kay et al., 2024), and the second lays out the evidence that firefighter exposures are likely to increase breast cancer risk (Cardona et al., 2024). Studies of firefighters have shown increased exposures to carcinogenic compounds and elevated rates of certain cancers compared to the general population, yet this research has focused almost exclusively on men. To address this gap, the Women Firefighters Biomonitoring Collaborative created a biological sample archive and analyzed levels of perfluoroalkyl substances (PFAS) and flame retardants among women firefighters (N = 86) and office workers (N = 84) in San Francisco. Previously published work in this cohort documented elevated exposures to PFAS and to several halogenated flame retardants in the firefighters, and ongoing work is using non-targeted analyses (LC-HRMS) to identify novel exposures by comparing serum samples collected longitudinally following fire events. Firefighters are co- investigators in this community-based participatory research project, and translation of the research to reduce risks has been a priority. Translational activities have included developing new training materials that support individual behavioral changes to reduce exposures as well as policy advocacy to support systemic changes such as replacing PFAS with less toxic alternatives. We have also compiled evidence documenting that firefighting involves elevated exposures to chemicals likely to increase risk of breast cancer, to target exposure reduction efforts and inform presumptive disease policies. Some exposures documented for firefighters and that also are linked to breast cancer include polycyclic aromatic hydrocarbons; volatile aromatics, such as benzene and styrene; PFAS; persistent organohalogens, such as polychlorinated biphenyls; and halogenated organophosphate flame retardants. Common sources of exposure included combustion byproducts, diesel fuel and exhaust, firefighting foams, and flame retardants. Heather Buren will bring her cultural understanding of the fire service and her passion for firefighter health to this presentation. With nearly three decades of experience in the SFFD and extensive work in occupational health and peer support, she will bridge the gap between research findings and real-world firefighter behavior. She will speak hard truths about the persistent challenges in reducing toxic exposures—emphasizing that the responsibility for cancer prevention must come from all directions: bottom-up, top-down, and all around. She will illustrate how individual choices, crew culture, and leadership decisions collectively impact firefighter health and safety. Despite the availability of best practices and cancer reduction training throughout the fire service today, many still overlook simple, effective, and inexpensive steps that can significantly reduce harmful exposures. Buren will revisit these critical practices with a refreshing mix of honesty, humor, and practical guidance, ensuring the message resonates with both new firefighters and seasoned leaders alike.

In July of 2024, the National Fallen Firefighters Foundation marked the 20th anniversary of the first Life Safety Summit by conducting the Firefighter Behaviors and Viewpoints survey. The different NFFF summits have been critical to the development of the 16 Firefighter Life Safety Initiatives and this study is intended to assess the effectiveness of the initiatives. This presentation represents an initial cut at a convenience sample of almost two thousand firefighters across the United States. The project uses factor analysis to isolate their views toward training resources, proper tactics, and SCBA use. It then models them versus a number of individual-, departmental-, and state-level explanations. Results suggest that views on training are associated with individual attributes like education and past risk exposure to mayday calls, near misses, significant injuries and line of duty deaths. Proper tactics have more contextual roots and can be tied to population size, poverty levels and ideological heterogeneity. Finally, the SCBA model suggests aspects of Bradley effects, or socially acceptable responses, on typical practices. Considering these results, we sketch out future paths and strategies to monitor and understand the broader safety climate around firefighting.

South Metro Fire Rescue implemented coronary computed tomography angiography (CCTA) as part of its annual occupational physical examinations beginning in 2024. A significant amount of clinically advanced disease was detected and treated -- 11 members were referred to interventional cardiology for PTCA and possible stent placement. This session will discuss the project, it's findings, and potential implications. It will also discuss how the CCTA screening impacted Fit For Duty decisions and Return to Duty after a cardiac procedure. Members who underwent the screening will discuss their experience with having a CCTA and its impact on themselves and the organization.

This session will highlight how collaboration with the academia (University of Arizona) helped drive a voter funded initiative to rebuild and remodel fire stations with a focus on health and safety upgrades. We will share the framework of the FEMA funded study, methodology and results which helped drive large changes in how the Department approached station design and care for the employees. The session will showcase 5 station rebuilds and 11 remodels, and how the lesson gleaned from the study influenced the design strategy. We will also discuss future changes and current topics related to PAH exposure reduction, PPE cleaning and the PFOA/PFAS dilemma.

This insightful 45-minute seminar is specifically designed for first responders, where we will delve into the vital research on resilient habits. This session will explore how adopting practices like self-care, mindfulness, social connections, gratitude, self-awareness, and humor can greatly enhance resilience in the demanding environments first responders face. Participants will explore the latest research that underscores how these habits positively influence mental health and enhance job performance. This seminar is designed to provide attendees with practical strategies and actionable insights to easily integrate these resilience-building habits into their daily lives. By cultivating a resilient mindset, first responders will not only boost their well-being but also empower themselves to face any challenge with confidence, ultimately inspiring others in their communities to do the same. Attending this seminar is an invaluable opportunity to equip yourself with the tools and knowledge necessary to thrive in high-pressure situations, fostering a stronger, more supportive environment for both yourself and your colleagues.

This session will discuss the changes and improvements that come from an improved and modernized incident data collection system, specifically as it relates to future research and knowledge of risk and performance.

There is an ongoing debate in the fire service community: Is Stationwear part of PPE? Does it provide any real protection under turnout gear? A common misconception is that today’s turnout gear is so advanced that it doesn’t matter what’s worn underneath—or worse, that if conditions get extreme enough, survival is unlikely anyway. This session will address why this mindset persists and how it leads to preventable firefighter injuries. We’ll examine the critical role of Stationwear and base layers, demonstrating how a systems-based approach to PPE—building protection from the inside out—can significantly minimize burn injuries and improve overall safety.

Volunteer firefighters face intense physical and mental demands, making health and wellness a critical priority for both individual well-being and overall department effectiveness. The Sullivan180 Healthiest Fire Department Challenge was developed to address these needs through a community-driven initiative grounded in science and evidence-based research. The program integrates the latest firefighter health research to improve nutrition, physical activity, stress management, and mental health support. Scientific studies on firefighter health have highlighted the increased risks of cardiovascular disease, cancer, and mental health challenges due to occupational hazards. The challenge leverages these research findings to create targeted wellness strategies that directly address the unique health risks firefighters face. By translating scientific data into practical applications, this initiative ensures departments adopt strategies that are both effective and sustainable. This session will explore how this initiative engaged departments, improved firefighter health and wellness, and positively impacted recruitment and retention. Attendees will gain insights into how community collaboration, research-based strategies, and family involvement have played a pivotal role in driving sustainable health improvements in volunteer fire departments.

Have you ever assaulted a concession stand worker with a hot dog? Well, I have, and I was nearly arrested for it. This incident was just one of the frequent anger outbursts I’ve experienced. The anger and extreme irritability I felt caused my family to walk on eggshells around me. They were growing weary of trying to anticipate my moods, and avoid stepping on the invisible landmines that surrounded me. I knew that it was only a matter of time before my wife and kids left me, and I wouldn’t have blamed them. I had been struggling with my mental health for a while. Despite my willingness to try any intervention available, I was still a ticking time bomb.

Building on previously presented research, this session will delve into program design, initial findings, and West Metro's efforts to put these insights into action. We’ll explore how the department has investigated shift change start times, utilized dynamically placed resources informed by biometric data, and explored alternative deployment models aimed at optimizing responder recovery and readiness. Additionally, we’ll discuss the integration of internal KPI dashboards to analyze on- duty injuries, vehicle accidents, and medical or clinical errors—specifically examining how biometric factors like fatigue may contribute to these incidents. Most critically, we’ll address the big question: what the heck do you do about it?!

Firefighter health and occupational readiness are priorities in the fire service. Unfortunately, institutional barriers often exist in conducting high-quality research to inform health and safety practices. This informative and engaging session will provide a macro perspective to describe one of the most prominent university-fire department research models (Univ of Kentucky - Lexington Fire Dept) in the United States. This symbiotic relationship was developed over 15 years to address pressing concerns in the fire service. As such, this session will describe how to foster a strong partnership that meets the needs of all stakeholders and provides evidence-based recommendations for the department and fire service at large. We will also provide a micro perspective describing findings from a collaborative research line that has advanced fire service recommendations regarding appropriate types of on-duty exercise training to enhance operational safety and readiness. Researcher, firefighter, and fire administrator perspectives will be shared.

Firefighter wellness is a shared responsibility that involves the entire family; however, fire departments often struggle to effectively incorporate firefighter families into the discussion, leaving them ill-equipped to tackle the many additional stressors of marriage and managing this career. Dr. Rachelle Zemlok, a firefighter psychologist and fire spouse, will discuss the common stressors that challenge firefighter relationships, using a light and humorous approach to address some of the work skills firefighters inadvertently bring home that can be damaging to their connections with loved ones. This informative talk aims to raise awareness of the unique challenges firefighter families face while offering actionable strategies for supporting them effectively. Don’t miss this opportunity to learn while enjoying an engaging perspective on the complexities of firefighter family dynamics!

This presentation will discuss outcomes from research projects and initiatives since 2012 that have leveraged a collaboration between researchers, practitioners, and fire department personnel to develop knowledge, programs, and tools to directly address the health and fitness needs of members from injury care to high performance training across an entire career. Impactful human performance components of firefighter health and safety, both physical and mental, will be discussed and connected to the value of collaboration and partnership strategies that support workability and career longevity. Attendees will learn of tools that can help shift the health & and fitness conversation from generic to meaningful within a fire department, optimizing the ability of firefighter personnel to serve the needs of their residents while also being well at work and well at home across a career.

Over the last three years, successful implementation of a confidential behavioral health screening tool during annual firefighter physicals has reinforced the importance of integrating parameters of both physical and behavioral health into our conceptualization of firefighter well-being. Aggregate data from a national sample of firefighters reveals that nearly half (49.6%) screen positive for impaired sleep, far exceeding the percentages of those who screen positive for depression (29.4%), worry-based anxiety (28.6%), alcohol use disorder (17.4%), and post-traumatic stress disorder (6.6%). More importantly, firefighters with impaired sleep are six times more likely to screen positive for depression (50.8% vs 8.4%), almost 4.5 times more likely to screen positive for worry- based anxiety (46.8% vs 10.7%), more than twice as likely to screen positive for alcohol-use disorder (24.6% vs. 10.4%), and are more than eleven times more likely to screen positive for post- traumatic stress (12.2% vs 1.1%), relative to firefighters who do not meet screening criteria for impaired sleep. The goal of the current study is to evaluate the association between impaired sleep and symptoms of depression, worry-based anxiety, problematic alcohol use, post-traumatic stress and markers of physical health in firefighters. The following markers, routinely obtained during an annual physical, are known to vary with sleep quantity and/or quality: blood pressure, resting heart rate, body composition (ex: visceral fat, skeletal muscle mass), basal metabolic rate, cardiac risk, LDL "bad"/HDL "good" cholesterol, hemoglobin A1C, sex hormones (testosterone & estradiol), thyroid stimulating hormone, and vitamin D levels. Our data not only lends insight into the consequences of disrupted sleep on many risk factors for chronic disease(s) but identifies specific opportunities for the mitigation of chronic disease risk through preventive interventions.

Fire stations operate like second homes, shaped by shared experiences, traditions, and unspoken rules. But for some firefighters, integrating into this environment can be a challenge, impacting their sense of belonging and overall well-being. Building on national discussions and real-world case studies, we’ve worked with fire service leaders to identify key challenges and actionable solutions to improve station culture. Through structured collaborations with career and volunteer fire departments, we’re piloting tailored strategies to foster a more cohesive and supportive work environment. This talk will highlight real experiences from the field, evidence-based insights, and the practical tools we’re collecting to help departments create sustainable cultural shifts. By addressing the barriers that shape daily interactions and influence crew cohesion, we aim to strengthen the fire service from within—ensuring that every firefighter has the opportunity to thrive in their career.

This research presentation offers a holistic look at the current state of the science on wildland firefighter health and well-being. It discusses the dominant approaches researchers have used to understand wildland firefighter well-being, whether researchers have enough information about hazards and possible mitigations strategies, and the most important research gaps in this growing field. In recent years, wildland firefighters have confronted longer and hotter wildfire seasons and increasing fire activity in the wildland urban interface. Although research on some wildland firefighter health topics, such as smoke exposure, dates to the 1970s, wildland firefighters are now facing different work conditions that may demand updated data and methodologies. Other topics, such as community assets, hazard mitigation strategies and prevalence of adverse health effects such as PTSD in firefighters appear to have received less attention from researchers of wildland firefighting and wildfire management. This presentation, based on a scoping review of the field, highlights the past, present and future of wildland firefighter health and well-being research.

Firefighters face one of the fiercest, most relentless challenges today: the internal battle with stress. Your mind is your most powerful asset, yet it’s under constant siege by high-stakes emergencies and reactive trauma. Or is it? What if challenging this assumption could help us operationalize resilience once and for all. Turns out, we’ve been thinking about stress all wrong. It’s high time for an upgrade—the health of the fire service depends on it. Recent breakthroughs in cognitive science reveal something incredible: the same neurons responsible for navigating physical space are activated when we navigate the mental space of thoughts and ideas. This means that stress and resilience aren’t abstract concepts; they’re actual locations in your mind. Learn how to calibrate your responses to these "coordinates" and you can quickly shift from chaos to calm, target wellness on demand, and magnify your leadership abilities all with one reliable control system. Explore the key elements of this groundbreaking approach and discover how it can transform you and your fellow firefighters into the most durable professionals on Earth.

Firefighting may be one of the most physically demanding careers, but could the very training firefighters rely on for success put them at unnecessary risk? This brief review explores the physiological toll of performing physical fitness training in turnout gear, uncovering and underlining the often-overlooked dangers of biomechanical strain, heat stress, and carcinogen exposure. The widespread belief that fitness training in gear is essential for building familiarity and realism will be critically examined—and challenged—with real-world examples and research-backed insights.

This session will be a review of a nation-wide fire station survey recently conducted by F.I.E.R.O. The purpose of the survey was to create a database that the fire service, governing bodies, researchers, and architects can use to advance the design of fire stations. Research gaps and opportunities will be identified based on the results.

The data from the project was funded through a FEMA Early Career Investigator Grant (FEMA- EMW-2023-FP-00535) entitled, “Empowering Volunteer Firefighters: A Community-Based Approach to Enhancing Physical Activity and Nutrition.” This project is a collaboration between the South Dakota Volunteer Fire Service, South Dakota Firefighter’s and Fire Chief’s Associations, and South Dakota State University. South Dakota’s Fire Service is roughly 96% volunteer and 4% career. The state is predominately rural with 34/66 counties classified as frontier. The first phase of the study is to conduct a needs assessment on volunteer fire departments in South Dakota to gain a better understanding of health and wellness policies, accessibility, and practices. The talk will discuss the collaborative efforts between researchers and the fire service along with the results from the needs assessment and the next steps in the project.

Most structure fires happen in Winter, however this is no data on the effects that weather has on firefighters. With the effects of climate change resulting in the Polar Vortex, more and more regions are getting exposed to extreme winter weather. This session will review the first ever study on the physiological effects of cold weather firefighting.

Session will review recent findings related to the infection control training needs, gaps, and strengths, as well as current threats for infectious disease localized outbreaks and larger epidemics.

The Ruderman White Paper on Mental Health and Suicide of First Responders, published in 2018 through the Ruderman Family Foundation concluded "First responders are more likely to die by suicide than to die within the line of duty." This was both affronting and unnerving. My fundamental questions were "why" and "what" can I do to change this condition? Thus, the start of my personal research and investigation into the arena of how fire station design might be able to affect this condition.

Performance Redefined and Fit to Thrive (F2T) are finalizing a comprehensive and interactive eBook titled “Physical Activity, Exercise & Cancer: A Resource for Firefighters.” Following an introduction and overview explaining why physical activity and exercise are effective strategies for combating cancer in the fire service,

This presentation explores how organizational culture can mitigate burnout in the military fire service. A qualitative study examined the professional and personal stressors experienced by military firefighters and officers, and how leaders can influence culture to reduce burnout. Key findings highlight the importance of understanding team members to address professional stressors and the significant impact of financial constraints on personal stress and work-life conflict. The presentation concludes with recommendations for future research, including broader geographic scope, multi-organizational studies, and quantitative approaches to solution-based research.

Rescue 1 CBD was recently the subject of a study involving firefighters from Florida, North Carolina and California (male and female) that used sublingual CBD products at a range of of dosing and frequency. None of the participants using Rescue 1 CBD had quantifiable levels of THC or THC metabolites using HPLC methods at the Universities of Maryland and Arcadia. The study has yet to be published, but the test results speak for themselves: CBD can be made to be "safe for the job" and its potential benefits for sleep and inflammation should be studied further now that we know it can be used safely.

Firefighter health and occupational readiness are priorities in the fire service. Unfortunately, institutional barriers often exist in conducting high-quality research to inform health and safety practices. This informative and engaging session will provide a macro perspective to describe one of the most prominent university-fire department research models (Univ of Kentucky - Lexington Fire Dept) in the United States. This symbiotic relationship was developed over 15 years to address pressing concerns in the fire service. As such, this session will describe how to foster a strong partnership that meets the needs of all stakeholders and provides evidence-based recommendations for the department and fire service at large. We will also provide a micro perspective describing findings from a collaborative research line that has advanced fire service recommendations regarding appropriate types of on-duty exercise training to enhance operational safety and readiness. Researcher, firefighter, and fire administrator perspectives will be shared.

Cardiovascular issues continue to a leading cause of death in the fire service. Providing a comprehensive wellness program is essential to firefighter health and longevity and establishes a foundation for further testing and training. While imaging, such as ultrasound, CT scans and MRIs have become popular, their cost, and, more importantly, the chance of false positives, means that they must be used carefully. Strategically providing advanced imaging may reveal cardiac issues without creating unnecessary expense or worry. During this session we will discuss ways to provide screening and how to address various outcomes from the testing.

Dr. Jessica Trowbridge and Captain Heather Buren will highlight two recent studies linking firefighter exposures to increased breast cancer risk (Kay et al., 2024; Cardona et al., 2024). Sharing evidence connecting common firefighter exposures such as PAHs, benzene, PFAS, diesel exhaust, and flame retardants to breast cancer risk, and discuss how firefighters have been active partners in this research from day one. Despite growing awareness, many firefighters still overlook simple, low-cost strategies that can dramatically reduce these exposures. This session will revisit critical prevention practices with honesty, humor, and practical tips, challenging both individuals and organizations to take real action. Participants will leave with clear, science-backed steps they can implement immediately to reduce occupational exposure on the fireground, in the station, and beyond.

This session will highlight how collaboration with the academia (University of Arizona) helped drive a voter funded initiative to rebuild and remodel fire stations with a focus on health and safety upgrades. We will share the framework of the FEMA funded study, methodology and results which helped drive large changes in how the Department approached station design and care for the employees. The session will showcase 5 station rebuilds and 11 remodels, and how the lesson gleaned from the study influenced the design strategy. We will also discuss future changes and current topics related to PAH exposure reduction, PPE cleaning and the PFOA/PFAS dilemma.

The Fire service Organizational Culture of Safety (FOCUS) survey is an assessment tool specifically for the United States fire and rescue service to measure the safety climate of a department. Prior to FOCUS, there was no industry-specific safety climate scale for the fire and rescue service. Through the FOCUS Beta-Test, FIRST collaborated with 12 departments and 123 firefighters to develop scale items. Then, the items were validated through testing with a geographically stratified random sample of 132 departments and 10,000 firefighters. The survey has moved from research in the beta- test phase to practice across three different assessment waves. To date, it has been taken by almost 600 fire departments and 70,000 firefighters in all 50 states. Safety climate has known associations with injuries, near-misses, line-of-duty deaths, and organizational outcomes like burnout, job satisfaction, work engagement, and mental health. Fire departments who improve their safety culture can expect to see increases in positive metrics and decreases in negative metrics. But, you cannot manage what you do not measure. A 30-page final report provides empirical insight into safety climate, allowing departments to lead with data as they advocate for gear, staffing, apparatus, and behavioral health resources. To ensure department leaders develop competency and confidence with their data, participants are then invited to FOCUS Culture Camp. These two-day trainings convey competencies in the design of the FOCUS survey; gathering FOCUS data; and analysis, interpretation, and use of the data. The goal is to help fire departments and labor unions develop confidence with their data and the skills to use it to become champions of culture. Instructors include a fire service member, FIRST Center staff, and affiliate faculty from the field of organizational science who have deep knowledge of safety culture interventions and how to implement them. Each camp includes 5-10 departments and 10-20 participants. The culminating experience is a Data Teach Back, performed by each department's labor-management team. Participants practice presenting their data to stakeholders such as city council, risk management, workers' compensation, and department union members. Our instructors provide feedback to ensure information is presented accurately. Other participating departments offer their practical suggestions. To date, 268 firefighters from 140 departments have graduated from FOCUS Culture Camp. Based on demand, Culture Camp evolved from an in-person experience to an online hybrid training that includes asynchronous lectures and interactive live Data Teach Back sessions. It now exists in an online learning management system, developed and maintained in collaboration with the Drexel University instructional Design and Media Services (IDMS).

This insightful 45-minute seminar is specifically designed for first responders, where we will delve into the vital research on resilient habits. This session will explore how adopting practices like self-care, mindfulness, social connections, gratitude, self-awareness, and humor can greatly enhance resilience in the demanding environments first responders face. Participants will explore the latest research that underscores how these habits positively influence mental health and enhance job performance. This seminar is designed to provide attendees with practical strategies and actionable insights to easily integrate these resilience-building habits into their daily lives. By cultivating a resilient mindset, first responders will not only boost their well-being but also empower themselves to face any challenge with confidence, ultimately inspiring others in their communities to do the same. Attending this seminar is an invaluable opportunity to equip yourself with the tools and knowledge necessary to thrive in high-pressure situations, fostering a stronger, more supportive environment for both yourself and your colleagues.

This session offers a real-world example of how science can drive meaningful improvements in firefighter well-being. Whether you're considering schedule or shift time modifications in your own department or looking to apply research in operational decision-making, this presentation will provide valuable takeaways for fire service leaders, policymakers, and researchers alike. Chief Joe Pennino and Dr. Billings will explore how research guided Roswell Fire Department’s decision to adjust shift start times and how data-driven insights led to further operational changes. They will discuss the department’s initial motivation for change, the results of the before-and-after study, and the unexpected barriers that emerged—such as cultural and operational factors that limited firefighters’ ability to maximize additional sleep opportunity—and how the department used these findings to implement further improvements that enhanced firefighter sleep and health. Attendees will gain insights into the practical, political, and administrative challenges of implementing schedule and shift time changes, reinforcing the importance of evidence-based decision-making in fire service operations.

This presentation will discuss outcomes from research projects and initiatives over the last 13 years that leveraged a collaboration between researchers, practitioners, and fire department personnel to directly address the health and fitness needs of members from injury care to high performance training across an entire career. This work incorporated strategies that leaned on laboratory and field-based science as well as the science of innovation and design thinking to drive the development and implementation of best practices and knowledge dissemination for members to experience sustainable health and performance from entry into the academy to retirement. Research related to fitness testing, cardiovascular capacity, autonomic nervous system during recovery, and movement and mobility will be connected to the programs and products that emerged from the data such as a process for evaluating PPE, building a shift-friendly periodized exercise training program aimed at personal goals and job specific demands, educational tools for members, quantifying the physiological workload by call type, injury care and prevention programs, health and injury related policy adjustments, and a connection to creating a better transition to retirement approach that starts with awareness at the academy level. This presentation will demonstrate the value of translating the outcomes of meaningful questions to optimize the ability of firefighter personnel to serve the needs of their residents while also being well at work and well at home across a career. Attendees will become familiar with the key human performance components of firefighter health and safety and build an understanding of the value of collaboration and partnership strategies as well as integrative and holistic factors that support workability and career longevity. As a result, the attendees will become aware of tools that can help shift the health & and fitness conversation from generic to meaningful within a fire department.

Volunteer firefighters face intense physical and mental demands, making health and wellness a critical priority for both individual well-being and overall department effectiveness. The Sullivan180 Healthiest Fire Department Challenge was developed to address these needs through a community-driven initiative grounded in science and evidence-based research. The program integrates the latest firefighter health research to improve nutrition, physical activity, stress management, and mental health support. Scientific studies on firefighter health have highlighted the increased risks of cardiovascular disease, cancer, and mental health challenges due to occupational hazards. The challenge leverages these research findings to create targeted wellness strategies that directly address the unique health risks firefighters face. By translating scientific data into practical applications, this initiative ensures departments adopt strategies that are both effective and sustainable. This session will explore how this initiative engaged departments, improved firefighter health and wellness, and positively impacted recruitment and retention. Attendees will gain insights into how community collaboration, research-based strategies, and family involvement have played a pivotal role in driving sustainable health improvements in volunteer fire departments.

Have you ever felt stuck between a rock and science? Many firefighters do—clinging to outdated myths and resisting the facts about what it truly takes to thrive in this challenging career. For years, I thought I could outwork the science and ignore the rules while still being the firefighter and person I wanted to be. I was wrong, and that mindset nearly cost me everything. This session is a wake-up call for firefighters to move beyond old crutches and embrace a more holistic approach to thriving—one rooted in science, vulnerability, and the human element. Let’s stop resisting the facts and embrace what we know works. When we blend science with the human element, we don’t just survive—we thrive. Together, we can step into a future where firefighters are stronger, smarter, and healthier—ready to tackle the challenges of this demanding profession head-on.

There is an ongoing debate in the fire service community: Is Stationwear part of PPE? Does it provide any real protection under turnout gear? A common misconception is that today’s turnout gear is so advanced that it doesn’t matter what’s worn underneath—or worse, that if conditions get extreme enough, survival is unlikely anyway. This session will address why this mindset persists and how it leads to preventable firefighter injuries. We’ll examine the critical role of Stationwear and base layers, demonstrating how a systems-based approach to PPE—building protection from the inside out—can significantly minimize burn injuries and improve overall safety.

This session will discuss the changes and improvements that come from an improved and modernized incident data collection system, specifically as it relates to future research and knowledge of risk and performance.

In July of 2024, the National Fallen Firefighters Foundation marked the 20th anniversary of the first Life Safety Summit by conducting the Firefighter Behaviors and Viewpoints survey. The different NFFF summits have been critical to the development of the 16 Firefighter Life Safety Initiatives and this study is intended to assess the effectiveness of the initiatives. This presentation represents an initial cut at a convenience sample of almost two thousand firefighters across the United States. The project uses factor analysis to isolate their views toward training resources, proper tactics, and SCBA use. It then models them versus a number of individual-, departmental-, and state-level explanations. Results suggest that views on training are associated with individual attributes like education and past risk exposure to mayday calls, near misses, significant injuries and line of duty deaths. Proper tactics have more contextual roots and can be tied to population size, poverty levels and ideological heterogeneity. Finally, the SCBA model suggests aspects of Bradley effects, or socially acceptable responses, on typical practices. Considering these results, we sketch out future paths and strategies to monitor and understand the broader safety climate around firefighting.

Building on previously presented research, this session will delve into program design, initial findings, and West Metro's efforts to put these insights into action. We’ll explore how the department has investigated shift change start times, utilized dynamically placed resources informed by biometric data, and explored alternative deployment models aimed at optimizing responder recovery and readiness. Additionally, we’ll discuss the integration of internal KPI dashboards to analyze on- duty injuries, vehicle accidents, and medical or clinical errors—specifically examining how biometric factors like fatigue may contribute to these incidents. Most critically, we’ll address the big question: what the heck do you do about it?!

Cardiovascular disease (CVD) risk remains high among first responders, and there are numerous challenges to optimize health, fitness, and occupational readiness. Our research team has assessed and monitored novel physiological stress, oxidative stress, and inflammatory biomarkers that may offer a more comprehensive clinical health assessment than conventional clinical assessments. This session will cover the importance of annual clinical health, wellness, and fitness testing to screen and monitor firefighter health and disease risk. Particularly, the session will highlight the importance of early detection of cardiovascular disease (CVD) risk and ways in which departments could leverage assessment and monitoring methods to optimize their health, wellness, and fitness, with the goal of improving performance and readiness. In addition, this session will cover the underlying mechanisms of atherosclerotic CVD risk, how the stress of the occupation factors in, and how first responder groups can easily monitor their health, fitness, and CVD risk via several simple metrics that our research has identified.

Over the last three years, successful implementation of a confidential behavioral health screening tool during annual firefighter physicals has reinforced the importance of integrating parameters of both physical and behavioral health into our conceptualization of firefighter well-being. Aggregate data from a national sample of firefighters reveals that nearly half (49.6%) screen positive for impaired sleep, far exceeding the percentages of those who screen positive for depression (29.4%), worry-based anxiety (28.6%), alcohol use disorder (17.4%), and post-traumatic stress disorder (6.6%). More importantly, firefighters with impaired sleep are six times more likely to screen positive for depression (50.8% vs 8.4%), almost 4.5 times more likely to screen positive for worry- based anxiety (46.8% vs 10.7%), more than twice as likely to screen positive for alcohol-use disorder (24.6% vs. 10.4%), and are more than eleven times more likely to screen positive for post- traumatic stress (12.2% vs 1.1%), relative to firefighters who do not meet screening criteria for impaired sleep. The goal of the current study is to evaluate the association between impaired sleep and symptoms of depression, worry-based anxiety, problematic alcohol use, post-traumatic stress and markers of physical health in firefighters. The following markers, routinely obtained during an annual physical, are known to vary with sleep quantity and/or quality: blood pressure, resting heart rate, body composition (ex: visceral fat, skeletal muscle mass), basal metabolic rate, cardiac risk, LDL "bad"/HDL "good" cholesterol, hemoglobin A1C, sex hormones (testosterone & estradiol), thyroid stimulating hormone, and vitamin D levels. Our data not only lends insight into the consequences of disrupted sleep on many risk factors for chronic disease(s) but identifies specific opportunities for the mitigation of chronic disease risk through preventive interventions.

Firefighter wellness is a shared responsibility that involves the entire family; however, fire departments often struggle to effectively incorporate firefighter families into the discussion, leaving them ill-equipped to tackle the many additional stressors of marriage and managing this career. Dr. Rachelle Zemlok, a firefighter psychologist and fire spouse, will discuss the common stressors that challenge firefighter relationships, using a light and humorous approach to address some of the work skills firefighters inadvertently bring home that can be damaging to their connections with loved ones. This informative talk aims to raise awareness of the unique challenges firefighter families face while offering actionable strategies for supporting them effectively. Don’t miss this opportunity to learn while enjoying an engaging perspective on the complexities of firefighter family dynamics!

Have you ever assaulted a concession stand worker with a hot dog? Well, I have, and I was nearly arrested for it. This incident was just one of the frequent anger outbursts I’ve experienced. The anger and extreme irritability I felt caused my family to walk on eggshells around me. They were growing weary of trying to anticipate my moods, and avoid stepping on the invisible landmines that surrounded me. I knew that it was only a matter of time before my wife and kids left me, and I wouldn’t have blamed them. I had been struggling with my mental health for a while. Despite my willingness to try any intervention available, I was still a ticking time bomb.

Early Detection in Action: South Metro Fire Rescue's Pioneering CCTA Program. In 2024, South Metro Fire Rescue implemented coronary computed tomography angiography (CCTA) as a proactive screening tool for heart disease. This session will delve into the logistics of scanning over 300 firefighters, reveal the significant cardiac findings uncovered, and provide a one-year follow-up on their health journey. Importantly, hear firsthand accounts from firefighters who underwent the CCTA, sharing how the results empowered them to make informed decisions about their cardiac well-being.

In this engaging 12-minute talk, we will explore the profound impact of gratitude on the lives of first responders. Drawing on cutting-edge research, we’ll examine how cultivating a gratitude practice can enhance mental resilience, foster stronger team dynamics, and promote overall well- being in high-stress environments. Through personal stories and actionable insights, attendees will learn how simple practices of gratitude can shift perspectives, reduce stress, and improve emotional health. This talk will empower attendees to harness the power of gratitude not only to enhance their own lives but also to strengthen their connections with their crew and community.

Session will Introduce the CPSE Center for Innovation, Address the partnership with MOU with Science to the Station, Highlight the need for more evidence-based decision making in the fire and emergency services, Discuss how CPSE Center for Innovation programs will address this need

Cancer in the fire service does not have a silver bullet solution. No one thing will stop firefighters from getting cancer. It is a continuum of different points of attack that reduce cancer risks. Firefighter overall health and wellness is the same. There is an array of steps we can take to improve it: sleep, diet, exercise, avoiding bad behaviors (drinking, tobacco, etc.), stable personal relationships, purpose are just a few. Volunteering our time is another of those crayons in the crayon box to complete the health and wellness picture.

Explore how fire departments can use smartwatch technology to improve firefighter training, health monitoring, and emergency response. This session examines the science behind biometric data collection, focusing on heart rate, passivity monitoring, and location tracking to provide actionable insights during live fire scenarios and daily operations. The discussion will highlight the advantages of standalone LTE wearables, which reduce technical barriers by eliminating the need for additional devices, ensuring ease of use, and increasing compliance. Real-world examples, such as DC Fire’s use of biometrics to optimize training schedules and monitor performance, will demonstrate how wearables enable both acute incident responses and long-term health trend analysis. Attendees will gain a research-driven understanding of overcoming challenges like data collection and program adoption. This session will also outline practical strategies for implementing wearable programs, from building internal support to full operational deployment. A live demo will showcase real-time health and location data integration, offering a firsthand look at how this technology enhances situational awareness and firefighter safety.

Discussion sharing a program we implemented that allows busy crews to voluntarily spend one month at a low call volume station to rest and rehab from the beat down they get at their normally assigned busy station. The rehab station is outfitted with special equipment to help tired crews get some rest and feel normal again. After a one month stay, they return to their normal station rejuvenated and motivated to take better care of themselves so that they can take better care of those they've sworn to protect. I hope that you leave motivated to start a similar program at your department!

Exploring the impact of the first responder lifestyle on the Central Nervous System and how creation of a personal wellness practice can help to expand the window of tolerance, reducing the likelihood of PTSD, Vicarious Trauma, Compassion Fatigue, and Burnout.

Air pollution has been linked in observational studies to poor reproductive fitness, which in males is assessed by sperm quality characteristics such as morphology, motility and concentration as well as challenges with fertility or conceiving a child after 12 months of unprotected sex. Recently, wildfire smoke specifically has been studied in humans and animals to better understand if prolonged, repeated or extreme exposure may lead to negative impacts on reproductive health and what mechanistically drives these adverse outcomes. Wildland firefighters are especially at-risk for smoke-induced adverse outcomes and are thus an important occupational population to study and protect, but such studies may also help to inform public health initiatives. Our team has received funding from CDC NIOSH to conduct the Smoke and Wildfire Impact on Male Reproductive Success Study (SWIMRSS) project. We set out to recruit 100 male wildland firefighters and facilitate at-home collection of sperm samples across a fire season to assess how wildland fire activities impact sperm quality and to inform family planning. This presentation will cover our preliminary data collected from spring 2025 to fall 2025 which will include occupational, lifestyle and demographic data from our cohort as well as self-reported data on reproductive health and perceptions of risk as a result of being a wildland firefighter. We will also present interim findings from the self-administered sperm collection and analysis kits from pre-season and mid-season time points.

This NIH-funded study provides key insights into the role of alcohol in EMS culture, revealing its frequent use as a coping mechanism for job-related stress. Through qualitative interviews with non- fire-based EMS providers, we uncover how drinking is used for bonding, decompression, and stress relief. However, systemic challenges persist, including limited support for help-seeking, a lack of education on healthier coping strategies, and potential risks to job performance and patient care. As EMS grapples with recruitment and retention issues, how can the profession evolve to better support provider well-being? To build on these findings, a follow-up survey is currently underway, aiming to quantify alcohol use patterns and workplace norms. This session explores what we know, what’s next, and how we can move the conversation forward.

Firefighting demands split-second decision-making under uncertainty, time pressure, and adverse working conditions. Therefore, it is essential to identify the critical decisions influencing firefighters’ actions. Thus, the objective of this study is to identify critical cues and challenges in firefighting using the Critical Decision Method (CDM) and to create a decision map based on the criticality of decision points. Nineteen firefighters (n=18 males, n=1 female), with experience ranging from 15 to 41 years (M = 23.32, SD = 7.08), were recruited and asked to recall a past challenging incident. The qualitative data analysis was performed using the structured analysis method to extract critical cues and develop a cue inventory. Challenges associated with firefighting were analyzed using thematic coding. The 44 critical cues and 19 challenges were collated to determine the critical decision points. Finally, the identified critical decision points were visualized as a decision map to categorize the decision points based on their criticality. The findings provide a strategic guide for prioritizing actions during incidents, ensuring that decisions are made in alignment with the severity of the challenging situation. Future studies can be designed to assess the applicability of the findings by creating a simulated or virtual reality environment.

In this powerful video, we honor the life and legacy of Lieutenant Brian Kyono, a dedicated firefighter with 29 years of service to the San Francisco Fire Department. Brian's battle with stage 4 lung cancer highlights the serious risks firefighters face on the job. Diagnosed shortly after retiring, Brian bravely shared his story to raise awareness and help protect future generations of firefighters. Despite the challenges, Brian remained determined to give back, saying, “If it could impact one persons , then it was worth the Effort.” His journey is a reminder of the importance of cancer research, prevention, and firefighter health.

In a dynamic and inspiring TED-style talk, Dr. Zemlok, a clinical psychologist and the spouse of a firefighter, passionately underscores the critical yet often overlooked role that firefighter families play in the overall wellness of fire departments. She challenges the traditional narratives surrounding mental health support, emphasizing that while firefighters are frequently the focus of wellness initiatives, their families are equally vital to fostering a healthy department culture. Dr. Zemlok draws on her personal experiences and professional expertise to illustrate how the well- being of firefighters’ spouses and children directly impacts employee wellness, resilience, and retention. She argues that by investing in family support programs and resources, fire departments can significantly enhance morale and performance, ultimately aligning with their wellness goals.

The financial toll of behavioral health challenges among firefighters, paramedics, and EMS providers is staggering. Mental health-related claims cost $20 billion annually, while turnover costs agencies up to $71,613.75 per employee. Productivity losses linked to burnout contribute to a $190 billion annual burden on the healthcare system. These costs are compounded by the high prevalence of mental health issues: 17-37% of firefighters and paramedics suffer from depression, 15-30% from anxiety, and 20-22% from PTSD—rates far exceeding those in the general population. Additionally, 33.1% of first responders cite stigma as a barrier to seeking help, further exacerbating the economic and human costs. Despite these challenges, innovative solutions, from teletherapy platforms that engage 56% of at-risk firefighters to alternative response models—demonstrate that change is possible. By addressing behavioral health challenges proactively, we can not only alleviate the financial burden on fire departments and EMS agencies but also strengthen the ability of these critical providers to serve their communities effectively. This presentation will explore these economic impacts and actionable solutions, inspiring leaders and policymakers to invest in the well-being of those who protect us.