Stress Relief
For several decades, the Forest Service's Missoula Technology and Development Center and the University of Montana have been conducting field studies on wildland firefighters health and safety.
During this time, incident management team members have asked when the center was going to focus on their health and safety concerns. Increased fire complexity; the pressures of multiple assignments during longer fire seasons; and the political, budgetary, and legal concerns of fighting wildfire are just a few of the increasing pressures that IMT members must face. Moreover, the IMT members represent the collective history of wildland firefighting. They hold much of the practical institutional knowledge about wildland firefighting. In this context, it is critically important that agencies promote good health habits to maintain the IMT work force.
As a first step in addressing this need, the center gathered data from IMT members during the summer of 2006. The data were used to evaluate members' health status and their risk for coronary artery disease. One finding confirmed what one might expect, namely, that individuals with jobs requiring more physical activity exhibited fewer risk factors for coronary artery disease than those in more sedentary positions. Indirectly, this finding highlighted the need for a closer examination of IMT work practices and health-related conditions for firefighters in more sedentary roles.
During the 2007 fire season, the center collected additional data on IMT members. It determined daily physical activity of individuals at fire camp, measured aerobic fitness of IMT members, evaluated risks as indicated by the presence of risk factors for coronary artery disease and inflammatory markers in blood samples, and evaluated the level of stress associated with IMT duties.
The data from 2006 and 2007 suggest the need for coronary artery disease risk- and stress-reduction interventions, both in fire camp and elsewhere, especially for individuals whose IMT job description requires little or no physical activity. Of the 56 IMT members surveyed in 2007, 17 (30%) reported that above average or severe stress was associated with their IMT position. Additional work is needed to determine the magnitude of stress on IMT members, the effects that stress has on work performance and health, and to identify successful interventions and methods for risk reduction.
Phase III of the Wildland Firefighter Safety Awareness Study conducted by Tri-Data Systems in 1998 highlighted the importance of training IMT members to cope with stressors during fire assignments:
“Firefighters, especially those in supervisory and Incident Management Team positions, often have problems with stress, fatigue, and mental overload. There is little training or advice given on how to mentally prepare oneself for what is ahead, how to avoid the impacts of fatigue, or how to mentally “reload” during stress. Ways to mentally refresh have generally not been considered part of training, even for supervisors and senior managers … everyone from firefighters on up needed to be taught how to deal with large amounts of information in the field and how to recognize when critical pieces of information are missing, especially under stress.”
This raises the question of whether improvements have been made that address training on stress and coping for IMT members.
Stress has been implicated in the deterioration of job performance and the incidence and severity of disease. There is little doubt that IMT members are exposed to stress. They must perform their duties while living and working in fire camps or other temporary facilities. These conditions present a variety of day-to-day hassles, challenges, and annoyances that combine to create potentially stressful situations for team members. IMT members also must respond to the challenges of fighting fire in the wildland-urban interface. Beyond actually fighting the fire, there's the additional possibility of criminal and civil complaints against fire personnel. Because of these conditions, it is reasonable to suggest that effectively coping with stress is an important part in maintaining IMT members' health and performance.
Stress occurs when IMT members evaluate their social and physical environments and conclude that there is an imbalance between the demands of the situation and their ability to respond. This definition of stress focuses on individuals' perceptions and appraisals of their environment. Looking at stress this way differs from approaches that define stress as either an internal state or as an external event.
As an internal state, stress research focuses on the emotional or physiological reaction a person has to certain stimuli, such as emotional responses to daily events such as road rage or the relationship between lifestyle stress and heart disease. As an external event, the focus of stress research is on the types of stressors individuals experience at different times in life — loss of a spouse, change in career, marriage, divorce, major relocations and so forth — rather than the everyday annoyances most likely to be experienced while on fire assignments. Looking at stress as an ongoing transaction between the demands of the situation and a person's resources to meet those demands is a perspective that has been applied to examining stress in a wide variety of work settings.
Coping behaviors are all those things individuals do to restore the balance between environmental demands and personal resources. Research on stress in work settings has identified at least three major coping strategies: changing one's own behavior, making adjustments to the way one thinks about a situation, or taking direct action to change the environment that poses a challenge to one's resources. If firefighters are to continue working in incident management they will need to improve their ability to deal with the stress of those jobs. They will need to cope with stress to maintain operational effectiveness, and avoid some of the negative mental and physical effects that stress can have on them.
The relationship between stress and physiological consequences also has a long history of research. Other linkages between minor stressors and the hassles associated with particular environments also have been linked to physical ailments: upper respiratory tract infections, impaired immune function, and elevated blood pressure. Recent examinations of firefighters also suggest that decision-making may be adversely affected by the demands experienced by firefighters in field-command roles. A recent study of incident-related stressors and psychological distress among firefighters in Northern Ireland highlighted the importance of certain coping strategies to mediate psychological distress in incident staff responding to large disasters or incident staff exposed to repeated incidents.
Many believe that stress has become a major health problem. Physiological responses necessary for the survival of primitive peoples may be unhealthy in highly complex societies. Stress, tension and reactive behavior patterns have been associated with heart disease, hypertension, immune system suppression, and a variety of other ills. The emotional response to life events is mediated by structures in the brain, including the hypothalamus. When something excites or threatens us, the hypothalamus tells the anterior pituitary gland to secrete adrenocorticotropic hormone, a chemical messenger that travels to the adrenal cortex and orders the release of hormones such as cortisol. The hormones are necessary for the body's response to stressful situations. In this context, stress is understood as anything that increases the release of ACTH or cortisol. (See figure on page 13.)
Stressful situations also elicit a response in the sympathetic nervous system that leads to secretion of hormones from the adrenal medulla, including epinephrine (adrenaline) and norepinephrine. These hormones mobilize energy and support the cardiovascular response to stress. This aspect of the stress response is called the fight-or-flight mechanism. The hormones prepare the body to fight or run, but they have other effects that can be bad for the health of the individual. Epinephrine makes the blood clot faster and increases blood pressure — advantages in a fight but disadvantages in the workplace where they can precipitate a heart attack or a stroke.
The stress response is necessary to prepare an athlete, firefighter or soldier for a maximal effort in a physical challenge, but it can be unhealthy if it occurs too often in the wrong setting. If one becomes stressed on the job when a natural physical catharsis is improper or impossible, the circulating hormones can be a problem. Recent research suggests that some people are hot reactors, exhibiting exaggerated blood pressure responses to everyday stressors.
Hot reactors become enraged when a driver cuts them off in traffic or as a result of other psychosocial stressors. This hostility elicits a flood of hormones designed for combat. Blood pressure and heart rate increase, arteries constrict, clotting time shortens, and blood flow to the heart is impaired, contributing to an increased risk of a heart attack. Hot reactors stew in their own juices, setting the stage for immediate or future health problems. While occasional stress is not a threat, prolonged exposure to stress hormones eventually suppresses the immune system and reduces resistance to infection.
This year the center plans to study the relationship of stress to performance and health in incident management teams. The results of this study will point to ways that overall team performance might be enhanced by reducing the adverse effects of stress on cognitive function, decision-making, team cohesion, or its ability to take in new information and respond appropriately to changing conditions.
The long-range goal of this study is to understand the range of behavioral responses to stress that IMT members use while on assignment. As a first step it is important to document the level of perceived stress and overall effectiveness of their coping strategies. If, for example, the level of perceived stress is high and the coping strategies employed by team members are deemed to be highly effective, then the next step would be to explore the specific work practices team members use to deal with stress. If perceived stress is high, but team members report an inability to cope with the stress of their jobs, then it is important to examine in more detail what the stressful conditions are and to explore alternative work practices available for dealing with the stress of IMT assignments.
Therefore, the center plans to measure the level of perceived stress and the effectiveness of coping by IMT members during incident assignments. A survey of stress and coping will be administered to a sample of IMT members during their deployment. The teams will be selected from the Northern Rockies area during the 2008 fire season. Selected individuals also will participate in an in-depth interview to further probe their experience of stress and coping. Additional data will be collected concerning fire experience, IMT position, and number of assignments in the current fire season. Measures of physiological stress and immune function (cortisol, testosterone, salivary immunoglobulin A) will be sampled. This information, along with basic demographics of age and gender, will help provide a context for the stress and coping measurements.
The 2009 season will include evaluation of the effectiveness of coping strategies on stress, job performance and health. When completed, the findings will be disseminated to incident management teams.
Brian J. Sharkey is with the Forest Service's Technology & Development Center in Missoula, Mont. He has worked with the center and firefighters since 1994 when he joined the University of Montana faculty and now is professor emeritus and finishing long association with the center and wildland fire. Sharkey has a Ph.D. in exercise physiology from the University of Maryland and is the author of several books and numerous scientific papers.
Theron Miller also is with the Forest Service's Technology & Development Center, where he is project leader in the fire and aviation, safety and health, and recreation programs. He earned his Ph.D. in forestry from the University of Montana in 1997 with an emphasis in natural resources social science. Miller worked as a research and teaching professor at the University of Montana's Bolle Center for People and Forests, and in the National Center for Landscape Fire Analysis.
Charles Palmer completed his Ed.D. in 2002 from the University of Montana and is currently an assistant professor in the Department of Health and Human Performance. He has 10 years of experience as a Missoula smokejumper for the Forest Service and since 2003 also has worked with the U.S. Fish and Wildlife Service. Palmer has also worked with Mission-Centered Solutions as a private contractor, and has taught L-380 Fireline Leadership and L-381 Incident Leadership courses.
