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Effect of Protective Clothing and Fatigue on Functional Balance of Firefighters

Pilwon Hur, Elizabeth T Hsiao-Wecksler, Karl S Rosengren, Gavin P Horn and Denise L Smith

We investigated the effects of wearing personal protective equipment (PPE), design of PPE (Standard vs. Enhanced), and fatigue during a simulated firefighting activity on the functional balance of firefighters. We defined functional balance as the ability to prevent a loss of balance and maintain body posture while performing functional tasks. A novel Functional Balance Test (FBT) was used to assess functional balance of firefighters while stepping up, stepping down, turning, walking along a beam, and passing under an obstacle. Data are presented from fifty-seven male firefighters, who were randomly divided into two groups: Standard PPE (n=28) and Enhanced PPE (n=29). The specially designed Enhanced PPE was lighter, more breathable, and capable of air circulation, compared to traditional Standard PPE. Each participant performed the FBT at three time periods (baseline with station uniform, pre-activity with PPE, and post-activity with PPE after a live-fire simulated firefighting activity). The firefighting activity involved alternating 2-minute rest- work cycles of four stations: stair climb, forcible entry, room search, and hose advancement. The FBT had four trials each with and without an overhead obstacle. Performance errors (major and minor), performance time, and a composite performance index were recorded. Wearing PPE significantly impaired functional balance, as noted by increases in all performance metrics. Following the firefighting activity, performance time increased by 3% but the number of minor and major errors decreased by 13% and 32%, respectively, suggesting that firefighters may trade-off between speed and accuracy depending on perceived threat to balance safety. There was no significant difference in functional balance between the Enhanced PPE and Standard PPE groups, suggesting that Enhanced PPE with a passive cooling system and an external circulating hose is not effective in improving functional balance of firefighters. A better designed PPE, with an improved cooling system and minimal (or no) protruding attachments may be of benefit in terms of firefighter functional balance.