{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:48:36Z","timestamp":1792093716915,"version":"4.4.0"},"reference-count":78,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> Firefighters are often placed in situations that require high levels of physical exertion, leading to significant strain on firefighters\u2019 musculoskeletal system, predisposing them to musculoskeletal discomfort (MSD) and\/or musculoskeletal injury (MSI). Physical fitness programs are often recommended and justified, in part, to prevent injuries. The aim of this study was to determine the association between physical fitness and musculoskeletal health (MSH) in firefighters.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A total of 308 full-time firefighters took part in the study conducted in Cape Town, South Africa. Physical fitness tests encompassed a non-exercise estimation for cardiorespiratory fitness, grip and leg strength for upper and lower body strength, push-ups and sit-ups for muscular endurance, and sit-and-reach for flexibility. The Nordic Musculoskeletal Questionnaire and Cornell Musculoskeletal Discomfort Questionnaire were used to determine MSIs and MSD, respectively. A <jats:italic>p<\/jats:italic>-value &amp;lt;0.05 indicated statistical significance.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Every one-unit increase in AbVO2max, push-ups, sit-ups, and sit-and-reach decreased the odds of firefighters reporting MSIs by 5% (<jats:italic>p<\/jats:italic> = 0.005), 3% (<jats:italic>p<\/jats:italic> = 0.017), 3% (<jats:italic>p<\/jats:italic> = 0.006), and 3% (<jats:italic>p<\/jats:italic> = 0.034), respectively. Every one repetition increase in push-up capacity increased the odds of firefighters reporting neck, elbow and forearm, wrist and hand, and thigh discomfort by 3% (<jats:italic>p<\/jats:italic> = 0.039), 4% (<jats:italic>p<\/jats:italic> = 0.031), 5% (<jats:italic>p<\/jats:italic> = 0.002), and 5%` (<jats:italic>p<\/jats:italic> = 0.007), respectively. Every one repetition increase in sit-up capacity increased the odds of firefighters reporting upper back discomfort and thigh discomfort by 5% (<jats:italic>p<\/jats:italic> = 0.045) and 7% (<jats:italic>p<\/jats:italic> = 0.013), respectively.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Maintenance of physical fitness is likely beneficial in reducing MSIs, which, however, may increase the feeling of MSD in firefighters. In addition, it may be noticed that there is an ideal level of physical fitness that is conducive to the reduction of MSIs and should be studied further.<\/jats:p>","DOI":"10.3389\/fphys.2023.1210107","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T15:33:25Z","timestamp":1688484805000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":25,"title":["Association between physical fitness and musculoskeletal health in firefighters"],"prefix":"10.3389","volume":"14","author":[{"given":"Jaron","family":"Ras","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elpidoforos S.","family":"Soteriades","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise L.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre P.","family":"Kengne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd","family":"Leach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,7,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"283","DOI":"10.5350\/sleep.hypn.2018.20.0163","article-title":"Factors affecting sleep quality in firefighters","volume":"20","author":"Abbasi","year":"2018","journal-title":"Sleep Hypn."},{"key":"B2","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1111\/sms.13411","article-title":"The effects of exercise interventions on health and fitness of firefighters: A meta-analysis","volume":"29","author":"Andrews","year":"2019","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"B3","article-title":"Work-related musculoskeletal disorder (WMSDs) and functional status of firefighters in Klang Valley. Healthscope: The Official Research Book of Faculty of Health Sciences, UiTM, 2","author":"Azmi","year":"2019"},{"key":"B4","doi-asserted-by":"publisher","first-page":"710903","DOI":"10.1155\/2012\/710903","article-title":"Age-related decline in cardiorespiratory fitness among career firefighters: Modification by physical activity and adiposity","volume":"2012","author":"Baur","year":"2012","journal-title":"J. Obes."},{"key":"B5","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1300\/J094v10n03_04","article-title":"Neck, back, and shoulder pain complaints in urban firefighters: The benefits of aerobic exercise","volume":"10","author":"Beaton","year":"2002","journal-title":"J. Musculoskelet. Pain"},{"key":"B6","doi-asserted-by":"publisher","first-page":"S119","DOI":"10.1097\/00005768-200105001-00672","article-title":"Is the international physical activity questionnaire (IPAQ) valid and reliable in the South African population?","volume":"33","author":"Bohlmann","year":"2001","journal-title":"Med. Sci. Sports Exerc"},{"key":"B7","first-page":"293","article-title":"Physiological monitoring systems for firefighters (A short review)","volume-title":"Occupational and environmental safety and health III [internet]","author":"Bustos","year":"2022"},{"key":"B8","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3233\/WOR-121545","article-title":"Modifiable risk factors predict injuries in firefighters during training academies","author":"Butler","year":"2013","journal-title":"Work"},{"key":"B9","first-page":"269","article-title":"Strength and fitness and subsequent back injuries in firefighters","volume":"21","author":"Cady","year":"1979","journal-title":"J. Occup. Med."},{"key":"B10","doi-asserted-by":"crossref","first-page":"100","DOI":"10.26911\/the7thicph-FP.05.06","article-title":"Validity and reliability test of the nordic musculoskeletal questionnaire with formal and informal sector workers","volume-title":"Childhood stunting, wasting, and obesity, as the critical global health issues: Forging cross-sectoral solutions","author":"Chairani","year":"2020"},{"key":"B11","doi-asserted-by":"publisher","first-page":"11733","DOI":"10.3390\/ijerph182211733","article-title":"Fitness fights fires: Exploring the relationship between physical fitness and firefighter ability","volume":"18","author":"Chizewski","year":"2021","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B12","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1093\/occmed\/kqm036","article-title":"The nordic musculoskeletal questionnaire","volume":"57","author":"Crawford","year":"2007","journal-title":"Occup. Med. (Chic Ill)"},{"key":"B13","doi-asserted-by":"publisher","first-page":"3218","DOI":"10.1519\/JSC.0000000000002174","article-title":"Systematic review of the association between physical fitness and musculoskeletal injury risk: Part 2\u2014muscular endurance and muscular strength","volume":"31","author":"de la Motte","year":"2017","journal-title":"J. Strength & Cond. Res."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1519\/JSC.0000000000002382","article-title":"Systematic review of the association between physical fitness and musculoskeletal injury risk: Part 3\u2014flexibility, power, speed, balance, and agility","volume":"33","author":"de la Motte","year":"2019","journal-title":"J. Strength & Cond. Res."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1752","DOI":"10.1249\/MSS.0b013e318215cf25","article-title":"Firefighters\u2019 physical activity: Relation to fitness and cardiovascular disease risk","volume":"43","author":"Durand","year":"2011","journal-title":"Med. Sci. Sports Exerc"},{"key":"B16","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1016\/j.pmr.2017.06.004","article-title":"Physiologic changes of the musculoskeletal system with aging: A brief review","volume":"28","author":"Frontera","year":"2017","journal-title":"Phys. Med. Rehabil. Clin. N. Am. [Internet]"},{"key":"B17","doi-asserted-by":"publisher","first-page":"835","DOI":"10.3233\/wor-152111","article-title":"Firefighter injuries are not just a fireground problem","volume":"52","author":"Frost","year":"","journal-title":"Work"},{"key":"B18","doi-asserted-by":"publisher","first-page":"497","DOI":"10.3233\/WOR-162420","article-title":"The cost and distribution of firefighter injuries in a large Canadian Fire Department","volume":"55","author":"Frost","year":"2016","journal-title":"Work"},{"key":"B19","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3233\/WOR-141902","article-title":"The predictive value of general movement tasks in assessing occupational task performance","volume":"52","author":"Frost","year":"","journal-title":"Work"},{"key":"B20","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1097\/JOM.0000000000002592","article-title":"Examining the usability of workload monitoring in firefighter recruits","volume":"64","author":"Giuliani-Dewig","year":"2022","journal-title":"J. Occup. Environ. Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1080\/17461390801954794","article-title":"Nutrition, sleep and recovery","volume":"8","author":"Halson","year":"2008","journal-title":"Eur. J. Sport Sci."},{"key":"B22","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1097\/JES.0b013e318201f601","article-title":"A role for myokines in muscle-bone interactions","volume":"39","author":"Hamrick","year":"2011","journal-title":"Exerc Sport Sci. Rev."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1080\/001401399184983","article-title":"Effects of keyboard tray geometry on upper body posture and comfort","volume":"42","author":"Hedge","year":"1999","journal-title":"Ergon. [Internet]"},{"key":"B24","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1111\/j.1744-6570.2007.00079.x","article-title":"Field measures of strength and fitness predict firefighter performance on physically demanding tasks","volume":"60","author":"Henderson","year":"2007","journal-title":"Pers. Psychol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1097\/JOM.0000000000001918","article-title":"Injury correlates among a national sample of women in the US fire service","volume":"62","author":"Hollerbach","year":"2020","journal-title":"J. Occup. Environ. Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1177\/216507991206001203","article-title":"Occupational injuries, duty status, and factors associated with injuries among firefighters","volume":"60","author":"Hong","year":"2012","journal-title":"Workplace Health Saf."},{"key":"B27","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1136\/injuryprev-2012-040662","article-title":"Injury among a population based sample of career firefighters in the central USA","volume":"19","author":"Jahnke","year":"2013","journal-title":"Inj. Prev."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1056\/NEJMoa060357","article-title":"Emergency duties and deaths from heart disease among firefighters in the United States","volume":"356","author":"Kales","year":"2007","journal-title":"N. Engl. J. Med. [Internet]"},{"key":"B29","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.shaw.2018.05.004","article-title":"The relationship between firefighters\u2019 work demand and work-related musculoskeletal disorders: The moderating role of task characteristics","volume":"10","author":"Kodom-Wiredu","year":"2019","journal-title":"Saf. Health Work"},{"key":"B30","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1002\/(sici)1097-0274(199908)36:2<248::aid-ajim4>3.0.co;2-q","article-title":"Cross-sectional study of the relationship between repetitive work and the prevalence of upper limb musculoskeletal disorders","volume":"36","author":"Latko","year":"1999","journal-title":"Am. J. Ind. Med. [Internet"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/ijerph17217906","article-title":"Firefighter overexertion: A continuing problem found in an analysis of non-fatal injury among career firefighters","volume":"17","author":"Le","year":"2020","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B32","doi-asserted-by":"publisher","first-page":"42","DOI":"10.3389\/fphys.2019.00042","article-title":"Role of myokines in regulating skeletal muscle mass and function","volume":"10","author":"Lee","year":"2019","journal-title":"Front. Physiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1002\/ajim.22929","article-title":"The relationship between physical fitness and occupational injury in emergency responders: A systematic review","volume":"62","author":"Lentz","year":"2019","journal-title":"Am. J. Industrial Med."},{"key":"B34","article-title":"ACSM\u2019s Guidelines for Exercise Testing and Prescription; American College of Sports Medicine Series","volume-title":"American College of Sports medicine series","author":"Liguori","year":"2021"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1744","DOI":"10.1519\/JSC.0000000000001855","article-title":"A systematic review of the association between physical fitness and musculoskeletal injury risk: Part 1\u2014cardiorespiratory endurance","volume":"31","author":"Lisman","year":"2017","journal-title":"J. Strength & Cond. Res."},{"key":"B36","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1007\/s00420-014-0968-z","article-title":"Sleep disturbances predict long-term changes in low back pain among Finnish firefighters: 13-year follow-up study","volume":"88","author":"Lusa","year":"2015","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"B37","doi-asserted-by":"publisher","first-page":"165","DOI":"10.4278\/ajhp.130228-QUAN-89","article-title":"Impact of a supervised worksite exercise program on back and core muscular endurance in firefighters","volume":"29","author":"Mayer","year":"2015","journal-title":"Am. J. Health Promot."},{"key":"B38","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1108\/rjta-01-2019-0002","article-title":"A critical review of female firefighter protective clothing and equipment workplace challenges","volume":"23","author":"McQuerry","year":"2019","journal-title":"Res. J. Text. Appar."},{"key":"B39","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1016\/j.ijnurstu.2004.03.012","article-title":"The physical workload of nursing personnel: Association with musculoskeletal discomfort","volume":"41","author":"Menzel","year":"2004","journal-title":"Int. J. Nurs. Stud."},{"key":"B40","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1080\/02701367.2008.10599513","article-title":"Predicting performance on a firefighter's ability test from fitness parameters","volume":"79","author":"Michaelides","year":"2008","journal-title":"Res. Q. Exerc Sport"},{"key":"B41","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1589\/jpts.27.581","article-title":"Effects of exercise therapy on muscular strength in firefighters with back pain","volume":"27","author":"Moon","year":"2015","journal-title":"J. Phys. Ther. Sci."},{"key":"B42","first-page":"40","article-title":"Correlation between physical activity, fitness, and musculoskeletal injuries in police officers","volume":"90","author":"Nabeel","year":"2007","journal-title":"Minn Med."},{"key":"B43","doi-asserted-by":"publisher","first-page":"185","DOI":"10.3233\/WOR-203264","article-title":"Prevalence of musculoskeletal symptoms among Canadian firefighters","volume":"67","author":"Nazari","year":"","journal-title":"Work"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1942513","DOI":"10.1155\/2020\/1942513","article-title":"Distribution of number, location of pain and comorbidities, and determinants of work limitations among firefighters","volume":"2020","author":"Nazari","year":"","journal-title":"Rehabil. Res. Pract."},{"key":"B45","doi-asserted-by":"publisher","first-page":"13","DOI":"10.5114\/areh.2018.77933","article-title":"Physical activity and injuries relating to physical fitness of professional firefighters","volume":"32","author":"Nowak","year":"2018","journal-title":"Adv. Rehabilitation"},{"key":"B46","doi-asserted-by":"publisher","first-page":"3931","DOI":"10.3390\/ijerph16203931","article-title":"A profile of injuries sustained by firefighters: A critical review","volume":"16","author":"Orr","year":"2019","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B47","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/1745-6673-2-3","article-title":"Core strength: A new model for injury prediction and prevention","volume":"2","author":"Peate","year":"2007","journal-title":"J. Occup. Med. Toxicol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1007\/s11332-015-0236-y","article-title":"Age-related changes in upper body strength and lower limb power of professional Italian firefighters","volume":"11","author":"Perroni","year":"2015","journal-title":"Sport Sci. Health"},{"key":"B49","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1177\/2165079917740595","article-title":"Characteristics and predictors of occupational injury among career firefighters","volume":"66","author":"Phelps","year":"2018","journal-title":"Workplace Health Saf."},{"key":"B50","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1136\/injuryprev-2011-040149","article-title":"Beyond the fireground: Injuries in the fire service","volume":"18","author":"Poplin","year":"2012","journal-title":"Inj. Prev."},{"key":"B51","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s00420-015-1068-4","article-title":"Fire fit: Assessing comprehensive fitness and injury risk in the fire service","volume":"89","author":"Poplin","year":"2016","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"B52","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1093\/aje\/kwt213","article-title":"Original contribution the association of aerobic fitness with injuries in the fire service","volume":"10","author":"Poplin","year":"2013","journal-title":"Am. J. Epidemiol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"2076","DOI":"10.1038\/oby.2011.147","article-title":"Obesity and injury-related absenteeism in a population-based firefighter cohort","volume":"19","author":"Poston","year":"2011","journal-title":"Obesity"},{"key":"B54","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1097\/JOM.0b013e3182554b11","article-title":"Lifestyle factors predicting changes in aerobic capacity of aging firefighters at 3-and 13-year follow-ups","volume":"54","author":"Punakallio","year":"2012","journal-title":"J. Occup. Environ. Med."},{"key":"B55","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1080\/00140139508925198","article-title":"Upper limb musculoskeletal disorders in highly repetitive industries: Precise anatomical physical findings","volume":"38","author":"Ranney","year":"1995","journal-title":"Ergon. [Internet]"},{"key":"B56","doi-asserted-by":"publisher","first-page":"061435","DOI":"10.1136\/bmjopen-2022-061435","article-title":"Effects of cardiovascular health, musculoskeletal health and physical fitness on occupational performance of firefighters: Protocol for a systematic review and meta-analysis","volume":"12","author":"Ras","year":"","journal-title":"BMJ Open"},{"key":"B57","doi-asserted-by":"publisher","first-page":"84485","DOI":"10.1177\/00469580221084485","article-title":"Relationship between physical activity, coronary artery disease risk factors and musculoskeletal injuries in the city of Cape Town fire and rescue service","volume":"59","author":"Ras","year":"2022","journal-title":"Inq. J. Health Care Organ. Provis. Financing"},{"key":"B58","doi-asserted-by":"publisher","first-page":"7346408","DOI":"10.1155\/2022\/7346408","article-title":"Cardiovascular disease risk factors, musculoskeletal health, physical fitness, and occupational performance in firefighters: A narrative review","volume":"2022","author":"Ras","year":"","journal-title":"J. Environ. Public Health"},{"key":"B59","doi-asserted-by":"publisher","first-page":"1703","DOI":"10.3390\/ejihpe12110120","article-title":"A pilot study on the relationship between cardiovascular health, musculoskeletal health, physical fitness and occupational performance in firefighters","volume":"12","author":"Ras","year":"","journal-title":"Eur. J. Investig. Health Psychol. Educ. [Internet]"},{"key":"B60","doi-asserted-by":"publisher","first-page":"56","DOI":"10.2478\/humo-2014-0003","article-title":"Prediction of VO2max based on age, body mass, and resting heart rate","volume":"15","author":"Rexhepi","year":"2014","journal-title":"Hum. Mov. [Internet]"},{"key":"B61","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1519\/R-12812.1","article-title":"Physical fitness and job performance of firefighters","volume":"18","author":"Rhea","year":"2004","journal-title":"J. Strength Cond. Res. [Internet]"},{"key":"B62","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.7205\/MILMED-D-14-00467","article-title":"Relationships between physical fitness, demands of flight duty, and musculoskeletal symptoms among military pilots","volume":"180","author":"Rintala","year":"2015","journal-title":"Mil. Med."},{"key":"B63","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1080\/10803548.2018.1442401","article-title":"Physical workload and musculoskeletal disorders in back, shoulders and neck among welders","volume":"26","author":"Shahriyari","year":"2020","journal-title":"Int. J. Occup. Saf. Ergonomics"},{"key":"B64","doi-asserted-by":"publisher","first-page":"97","DOI":"10.3233\/WOR-121549","article-title":"A qualitative study on the experiences of female firefighters","volume":"45","author":"Sinden","year":"2013","journal-title":"Work"},{"key":"B65","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/2046-7648-2-6","article-title":"Extreme sacrifice: Sudden cardiac death in the US fire service","volume":"2","author":"Smith","year":"2013","journal-title":"Extrem Physiol. Med."},{"key":"B66","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1249\/JES.0000000000000081","article-title":"Cardiovascular strain of firefighting and the risk of sudden cardiac events","volume":"44","author":"Smith","year":"2016","journal-title":"Exerc Sport Sci. Rev."},{"key":"B67","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1249\/JSR.0b013e31821a9fec","article-title":"Firefighter fitness: Improving performance and preventing injuries and fatalities","volume":"10","author":"Smith","year":"2011","journal-title":"Curr. Sports Med. Rep."},{"key":"B68","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1016\/j.amjcard.2018.11.049","article-title":"The relation of emergency duties to cardiac death among US firefighters","volume":"123","author":"Smith","year":"2019","journal-title":"Am. J. Cardiol."},{"key":"B69","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1080\/10803548.2017.1411666","article-title":"Injury-related hospital admission of female firefighters in South Korea","volume":"25","author":"Song","year":"2019","journal-title":"Int. J. Occup. Saf. Ergonomics"},{"key":"B70","doi-asserted-by":"publisher","first-page":"1","DOI":"10.46889\/jcmr.2022.31009","article-title":"Cross-validation of non-exercise estimated cardiorespiratory fitness: The NHANES study","volume":"2022","author":"Sun","year":"2022","journal-title":"J. Surg. Res. Pract."},{"key":"B71","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s10926-009-9176-1","article-title":"Work-related musculoskeletal symptoms in surgeons","volume":"19","author":"Szeto","year":"2009","journal-title":"J. Occup. Rehabil."},{"key":"B72","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1007\/s10926-006-9019-2","article-title":"Perceived effort and low back pain in non-emergency ambulance workers: Implications for rehabilitation","volume":"16","author":"Tam","year":"2006","journal-title":"J. Occup. Rehabil."},{"key":"B73","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1080\/00140139.2014.897374","article-title":"Physical fitness improvements and occupational low-back loading \u2013 An exercise intervention study with firefighters","volume":"57","author":"Taylor","year":"2014","journal-title":"Ergonomics"},{"key":"B74","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.apergo.2015.12.007","article-title":"Physical exercise and burnout facets predict injuries in a population-based sample of French career firefighters","volume":"54","author":"Vaulerin","year":"2016","journal-title":"Appl. Ergon."},{"key":"B75","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1080\/00140139.2014.887790","article-title":"The ageing Australian firefighter: An argument for age-based recruitment and fitness standards for urban fire services","volume":"57","author":"Walker","year":"2014","journal-title":"Ergonomics"},{"key":"B76","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1080\/001401399185063","article-title":"Relationship between fire fighting suppression tasks and physical fitness","volume":"42","author":"Williford","year":"1999","journal-title":"Ergonomics"},{"key":"B77","doi-asserted-by":"publisher","first-page":"1546","DOI":"10.3346\/jkms.2016.31.10.1546","article-title":"Characteristics of workplace injuries among nineteen thousand Korean firefighters","volume":"31","author":"Yoon","year":"2016","journal-title":"J. Korean Med. Sci."},{"key":"B78","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.shaw.2015.02.004","article-title":"Association between leisure time physical activity, cardiopulmonary fitness, cardiovascular risk factors, and cardiovascular workload at work in firefighters","volume":"6","author":"Yu","year":"2015","journal-title":"Saf. Health Work"}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2023.1210107\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T15:33:32Z","timestamp":1688484812000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2023.1210107\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,4]]},"references-count":78,"alternative-id":["10.3389\/fphys.2023.1210107"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2023.1210107","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,4]]},"article-number":"1210107"}}