Workers in the Fire and Rescue Service (FRS) operate in the most dangerous and high pressure environments imaginable. According to statistics from the University of Stirling, the period between 2004/05 and 2013/14 saw the deaths of 14 service personnel in the UK – more than double the number of fatalities compared to the previous period (six deaths between 1993/94 and 2003/04). This might not seem a large number but, when considering the relatively small workforce, these figures are significant.
According to the National Fire Protection Association in the US, overexertion and physical stress accounted for 59 per cent of firefighter deaths in 2015 with 51 per cent of those deaths caused by sudden cardiac death – potentially due to being exposed to extreme heat stress.
Per Stirling University’s report, many risks can be avoided if appropriate management, regulation, training, and a host of other procedures are properly implemented. Whilst regulatory disparity persists and funding continues to be cut (particularly in the UK), the threat to life will grow. Training and equipment budgets have been severely affected; directly impacting on firefighter safety. Training is designed to prepare firefighters to deal with the extreme and unpredictable risks they will soon face; high levels of heat, smoke and toxins, dangerous terrain, and significant psychological strain. Monitoring of individual firefighter performance and health is, therefore, becoming ever more imperative. To-date, however, accurate and real time monitoring of firefighters has not been possible to a satisfactory level.
The FRS sector is ready for a new breed of monitoring technology, backed by cloud-based analytics, which will enable service leaders, and their crews to prepare and equip themselves for any extreme environment and reduce loss of life.
Heat Stress: Enemy Number One
Among the many threats that firefighters face daily, heat stress is perhaps the most dangerous. Firefighters are routinely exposed to temperatures exceeding 500 degrees Fahrenheit in training, with temperatures in the average house fire often rising to 1500 degrees Fahrenheit. In larger incidents where there’s a risk of flashover or backdraft, firefighters can encounter 2000 degrees Fahrenheit or more.
Personal Protective Equipment (PPE), breathing apparatus and hoses add additional strain on the body; stress and temperature put pressure on the heart, while the inability to thermoregulate effectively and lose heat (perspiration is of no benefit when fully suited as the body cannot make use of evaporative cooling) results in overheating and associated symptoms including delirium. Another factor is a firefighter’s determination to get their job done, being single-minded in their desire to ensure the safety of anyone trapped inside and get the fire under control. Consequently, firefighters aren’t always focused on their own well-being, which makes them vulnerable to the onset of heat stress. This can seriously affect performance and, if not closely monitored, can be fatal.
The human body regulates an average temperature of 37 degrees Celsius / 98 degrees Fahrenheit. A couple of degrees too low and key motor skills are impaired, a few degrees too high and cardiac arrest can occur. As all firefighters know, heat stress significantly impairs mental performance; slowing reaction and decision times. Those suffering from the onset of heat stress find that completing tasks requiring concentration and attention to detail becomes difficult. Errors are more common, and it takes longer to complete basic tasks. Impaired performance puts lives in jeopardy.
Advances in Technology and Regulation
The importance of preventing heat stress in firefighters is being taken more seriously than ever before. Technological advances have seen the introduction of sophisticated breathing apparatus and advances in PPE. Heat resistance in PPE has improved, while monitoring methods such as a heart rate chest strap and temperature pill have found their place in training scenarios. These are not comprehensive solutions, though; only measuring one factor per device. They are also uncomfortable and, in the case of the pill, expensive (especially at scale), invasive and a single-use solution.
In terms of UK regulation around heat exposure, the picture is inconsistent. Guidelines are interpreted differently by individual services and, while tympanic measurements are sometimes taken prior and post exposure to heat, this is not mandatory.
Presently, tympanic temperature spot (single) monitoring is most commonly used in training across UK FRS, although it is not mandated. It’s a medically approved, easy and economical method of monitoring a reference of body temperature, but limitations exist to the ability to record in real-time. In some instances, a tympanic reading is taken before entering a training fire and again upon exit. A major drawback to this methodology, is that you can’t monitor mid-exercise, and it requires firefighters to have their temperature monitored whilst not in full PPE gear. Therefore, readings are not representative of the highest level of stress and are instead only representative of pre- and post-stress levels, which only provides limited benefit. This means there is currently no way to accurately monitor ongoing vital sign measurements while fighters are in a blaze. Until now.
Bodytrak; A New Methodology
Bodytrak is the first and only in-ear body monitoring platform to accurately measure multiple vital signs – Core Body Temperature (CBT), Heart Rate (HR), Vo2, speed, distance, cadence – continuously, and in real-time. Bodytrak is being trialled by several of the UK’s hard-working FRSs as well as industrial and defence organisations.
Bodytrak provides firefighters, for the first time, a highly accurate and effective way to monitor physical well-being and performance, both in training and operationally. Bodytrak measures multiple vital signs in a single compact wearable earpiece, whereas alternative devices measure just one or two. Bodytrak also provides the only way to accurately measure the all-important metric of CBT unobtrusively in the field.
For fire trainers, accurate, ongoing monitoring of multiple vital signs has the potential to significantly improve the physical performance of their crew members, reduce injury, detect illness, and improve recovery time. It is designed to fit securely and unobtrusively in the ear – the only body site from which a combination of CBT and HR can be measured accurately together.
Using the ear as a measuring site, due to its proximity to the brain, Bodytrak can pick up very accurate and immediate changes in the body, resulting in faster intervention by appropriate personnel in critical circumstances than current traditional monitoring technologies. All data is sent from Bodytrak wirelessly and in real-time to a cloud-based analytics platform via a smartphone, digital radios, tablet, smartwatch, or internet hub. This allows for physiological changes to be detected rapidly for earlier intervention.
Cloud analytics give squad leaders and trainers a unique way to track performance over time, and to view tiny changes in physiology that could reduce the risk of injury and, even, save lives. To enhance the user experience, Bodytrak integrates with current digital radios used by firefighters. A final benefit sees Bodytrak digitally relays ambient sound to the user so they retain their hearing and overall situational awareness required for safety.
Maintaining Brigade Health and Improving Performance
For busy brigades, having a way to monitor teams more accurately could enable the selection of the fittest and more appropriate fighters at any given time. The priority is always to send the right person to an incident at the right time, while allowing those in regular service to recuperate quickly and effectively. By using a monitoring platform like Bodytrak, trainers can see those who are coping well and those who are more stressed; adjusting training and recovery programs accordingly.
Crucially, when looking at performance-dependant industries, there’s real value to be found in real-time performance data. To preserve health in extreme environments, crew leaders and trainers have to be quick to respond and well informed. In some cases, personnel may not be medically trained and so deeper physiological metrics, provided ‘as it happens’ alongside motion data can give the medically uninitiated a set of clear insights as to the well-being of each individual firefighter. A RAG (red-amber-green) status alert can then provide the right tools for operational leaders to provide early intervention; maintaining the health and effectiveness of the team. Examples of these clear insights include monitoring firefighters for the onset of hyper/hypothermia.
Capturing individual firefighters’ vital sign data provides a deeper understanding of how to improve the overall health of a brigade. Short-term analytics detect rapid physiological changes which can be used to detect individual tolerances to situational training and aid in refining training requirements which improves operational performance. Longer-term, Bodytrak’s machine learning capabilities assess the user’s normal circadian profile; revealing behaviours and patterns that inform training methodologies.
A Look to the Future
Soon, we’ll see the emergence of more integrated, connected and, therefore, sophisticated network of UK emergency services; with FRS sitting at the heart of this more collaborative approach.
On the technology front, smart ‘second skin’ suits will integrate with connected vests and in-ear monitoring technologies, like Bodytrak. Earpieces fit neatly underneath hoods and helmets, connected to communications devices and other sensors to give highly accurate operational insights. When services become integrated and a connected emergency services network is in place with multiple technology and equipment partners working together, firefighters will benefit from a full-service ecosystem that equips them to operate with greater capability.
Already, fully-integrated systems are emerging, comprising GPS communications systems and a central display unit for the crew leader – enabling them to see everyone’s health data all together and in real-time. Statistics for each firefighter are displayed on one device; leaders see red, amber, and green flags to indicate a firefighter’s current physiological status. The accuracy of data across vital signs in real-time means even the smallest of changes can lead to faster interventions. The future is here.
Conclusion
With heat exposure posing such an obvious risk in the everyday work of a firefighter and with limited government regulation in the monitoring of this area, the need for ongoing health monitoring both in training and in operation is evident. Technology has finally caught up and, now, with the use of data analytics, FRS’ can reduce illness and improve the performance of individual firefighters both in the short and long term. Through measuring multiple vital signs with one device and in real-time, fire crews can identify physiological warning signs and intervene earlier; improving crews’ overall well-being and allowing for the fine-tuning of service policies.
For more information, go to www.bodytrak.co
About the Author
Leon Marsh is the inventor of Bodytrak and the driving force behind the innovation, technology and patent development at Inova Design Solutions Ltd. Inova was founded to design, engineer and commercialise innovative products for use in sport, emergency services, defence and healthcare.
