Sponsor
This work was supported by the Oregon Healthy Workforce Center, a National Institute for Occupational Safety and Health (NIOSH) Total Worker Health Center of Excellence [grant number: U19OH010154] and The Northwest Center for Occupational Health and Safety Professional Training Opportunities Program (PTOP) grant (grant number: T42OH008433-19- 00)
Published In
BMJ Public Health
Document Type
Article
Publication Date
8-2-2025
Subjects
Work -- Psychological aspects -- Firefighters
Abstract
Firefighters face frequent physical and psychosocial stressors, increasing their risk for hypertension. Rising call volumes with a stable workforce have heightened occupational burdens. To meet their occupational demands while increasing time off-duty, fire departments across the country have switched from a 24 hours on 48 hours off (termed ‘24/48’) work schedule to one that increases the number of consecutive days off (eg, 1 day on, 3 days off, 2 days on, 3 days off (termed ‘1/3/2/3’) or 48 hours on 96 hours off (termed ‘48/96’)). However, these schedule changes come at the expense of increasing time on-duty, which may have negative health and safety consequences. This paper provides the framework and methods to investigate how these schedules (24/48, 1/3/2/3 and 48/96) impact hypertension risk, well-being and safety among firefighters. Methods and analysis This quasi-experimental study assesses hypertension risk (primary outcome) markers, including 48-hour ambulatory blood pressure and safety (secondary outcome) using the psychomotor vigilance test and incidence of injuries. The study encompasses a cross-sectional analysis that examines three distinct schedules (24/48, 1/3/2/3 and 48/96) and a prospective analysis, capitalising on a pre-planned schedule transition from a 24/48 to a 1/3/2/3, as a natural experiment without any intervention from the study team. Additionally, the mediating role of sleep (assessed objectively using actigraphy and subjectively using questionnaires) and daily stress in the relationship between work schedule and hypertension risk or sustained attention is investigated to inform both mechanisms and general considerations for developing and promoting a healthy work design for firefighters. The feasibility and acceptability of the three schedules are assessed using validated surveys and qualitative interviews.
Rights
Copyright (c) 2025 The Authors
This work is licensed under a Creative Commons Attribution 4.0 International License.
DOI
10.1136/bmjph-2024-002427
Persistent Identifier
https://archives.pdx.edu/ds/psu/44067
Citation Details
Abdelmoaty, W. F., Watkins, S. L., Ayeni, A., Hurtado, D. A., McHill, A. W., Biggs, J. J., ... & Bowles, N. P. (2025). Impact of firefighters’ work schedule on cardiovascular disease risk, wellbeing and safety in firefighters: protocol for the SWIFT study, a multidisciplinary prospective and cross-sectional study. BMJ Public Health, 3(2).