Layoffs, Drug-related Responses Contribute to Fire Department's Job Stress: Report
Personnel with NIOSH’s Health Hazard Evaluation program recently visited a municipal fire department to investigate possible post-traumatic stress disorder and exposure to bloodborne pathogens among firefighters. The visit was requested by the department’s fire chief, who was concerned about the department’s increased volume of responses to drug overdoses. From 2011 to 2016, the number of medical-related responses conducted by the fire department increased 65 percent. The department is located in a state that has one of the highest rates of death from drug overdoses, and overdoses in the area have reportedly involved the opioid fentanyl, which is 50 to 100 times more potent than morphine, and carfentanil, which is approximately 10,000 times stronger than morphine. Several months prior to NIOSH’s visit, firefighters from the department responded to a mass overdose involving 26 people at the same location over several hours.  “In the United States, over 33,000 opioid overdose deaths occurred in 2015,” NIOSH’s report reads. “This is part of a 15-year increase in overdose deaths involving prescription opioid pain relievers and a more recent surge in deaths from illicit opioids. During this epidemic, firefighters face new challenges such as administering naloxone, a medication that reverses the effects of opioids, and increased call volumes, which might lead to a ‘personal toll’ on responders.” At the time of NIOSH’s visit in April 2017, the department had recently laid off seven firefighters in response to budget cuts. NIOSH investigators administered an anonymous questionnaire that asked firefighters to rate their job stress and solicited responses to an open-ended question about job stressors. Of the 53 firefighters who completed the questionnaire, 7 (13 percent) were found to have possible post-traumatic stress disorder and 28 (53 percent) screened positive for depression. NIOSH immediately informed the fire chief that 2 firefighters (4 percent) reported having suicidal thoughts, and encouraged the department to share information about resources on suicide prevention. Interviews with firefighters revealed that their concerns about job security, pay, and benefits also contributed to job stress, which NIOSH defines as the harmful physical and emotional responses that occur when job demands do not match the capabilities, resources, or needs of employees. Being understaffed due to recent layoffs and budget cuts by the city were also frequently mentioned as job stressors. NIOSH determined that job stress at the fire department was high, and recommended that the department provide an annual training on suicide prevention, psychological first aid, and signs of stress. NIOSH also recommended that the department provide training at least annually on topics related to opioids, the administration of naloxone, and bloodborne pathogens. Firefighters should be provided with nitrile gloves to wear during opioid overdose response activities. For more information, read the HHE report (PDF) and visit the NIOSH web page on stress at work. A NIOSH publication intended to help employers encourage first responders to report bloodborne pathogen exposures is available as a PDF.