{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:57:36Z","timestamp":1760147856864,"version":"build-2065373602"},"reference-count":40,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T00:00:00Z","timestamp":1678233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Mid-America Transportation Center via a grant from the U.S. Department of Transportation\u2019s University Transportation Centers Program","award":["69A3551747107"],"award-info":[{"award-number":["69A3551747107"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>First responders lose their lives in the line of duty each year, and many of these deaths result from strenuous physical exertion and exposure to harmful environmental agents. Continuous health monitoring may detect diseases and alert the first responder when vital signs are reaching critical levels. However, continuous monitoring must be acceptable to first responders. The purpose of this study was to discover first responders\u2019 current use of wearable technology, their perceptions of what health and environmental indicators should be monitored, and who should be permitted to monitor them. The survey was sent to 645 first responders employed by 24 local fire department stations. A total of 115 (17.8%) first responders answered the survey and 112 were used for analysis. Results found first responders perceived a need for health and environmental monitoring. The health and environmental indicators that respondents perceived as most important for monitoring in the field were heart rate (98.2%) and carbon monoxide (100%), respectively. Overall, using and wearing monitoring devices was not age-dependent and health and environmental concerns were important for first responders at any stage of their career. However, current wearable technology does not seem to be a viable solution for first responders due to device expense and durability issues.<\/jats:p>","DOI":"10.3390\/ijerph20064787","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T02:01:47Z","timestamp":1678327307000},"page":"4787","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Exploring First Responders\u2019 Use and Perceptions on Continuous Health and Environmental Monitoring"],"prefix":"10.3390","volume":"20","author":[{"given":"Jacob","family":"Grothe","sequence":"first","affiliation":[{"name":"College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Tucker","sequence":"additional","affiliation":[{"name":"College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Blake","sequence":"additional","affiliation":[{"name":"College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandran","family":"Achutan","sequence":"additional","affiliation":[{"name":"College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1230-7996","authenticated-orcid":false,"given":"Sharon","family":"Medcalf","sequence":"additional","affiliation":[{"name":"College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Troy","family":"Suwondo","sequence":"additional","affiliation":[{"name":"College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann","family":"Fruhling","sequence":"additional","affiliation":[{"name":"College of Information Science & Technology, University of Nebraska-Omaha, Omaha, NE 68182, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4195-7469","authenticated-orcid":false,"given":"Aaron","family":"Yoder","sequence":"additional","affiliation":[{"name":"College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.2174\/1875399X01407010008","article-title":"Psychophysiological Responses of Firefighters to Emergencies: A Review","volume":"7","author":"Perroni","year":"2014","journal-title":"Open Sport. Sci. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1002\/ajim.22466","article-title":"Risk of cancer Among firefighters in california, 1988-2007","volume":"58","author":"Tsai","year":"2015","journal-title":"Am. J. Ind. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1097\/CRD.0b013e318215c105","article-title":"Cardiovascular Disease in US Firefighters","volume":"19","author":"Soteriades","year":"2011","journal-title":"Cardiol. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1097\/JOM.0b013e31822c9e47","article-title":"Cardiorespiratory Fitness Predicts Cardiovascular Risk Profiles in Career Firefighters","volume":"53","author":"Baur","year":"2011","journal-title":"J. Occup. Environ. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s00421-011-2033-x","article-title":"Acute effects of firefighting on cardiac performance","volume":"112","author":"Fernhall","year":"2011","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/JOM.0b013e31820af362","article-title":"The Prevalence of Overweight, Obesity, and Substandard Fitness in a Population-Based Firefighter Cohort","volume":"53","author":"Poston","year":"2011","journal-title":"J. Occup. Environ. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1136\/bmj.322.7291.912","article-title":"ABC of hypertension: The pathophysiology of hypertension","volume":"322","author":"Beevers","year":"2011","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"681","DOI":"10.3109\/10903127.2016.1168890","article-title":"Effect of Two Work-to-Rest Ratios on Cardiovascular, Thermal, and Perceptual Responses During Fire Suppression and Recovery","volume":"20","author":"Hostler","year":"2016","journal-title":"Prehospital. Emerg. Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1080\/00140130310001643283","article-title":"The physical demands upon (Dutch) fire-fighters in relation to the maximum acceptable energetic workload","volume":"47","author":"Bos","year":"2004","journal-title":"Ergonomics"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1080\/00140139.2014.997806","article-title":"Physiological responses to simulated firefighter exercise protocols in varying environments","volume":"58","author":"Horn","year":"2015","journal-title":"Ergonomics"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1080\/00140139.2013.818719","article-title":"Core temperature and heart rate response to repeated bouts of firefighting activities","volume":"56","author":"Horn","year":"2013","journal-title":"Ergonomics"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1249\/01.MSS.0000386311.64785.52","article-title":"A Comparison of Cooling Techniques in Firefighters After a Live Burn Evolution","volume":"42","author":"Colburn","year":"2010","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1080\/001401397188125","article-title":"The effects of different thermal environments on the physiological and psychological responses of firefighters to a training drill","volume":"40","author":"Smith","year":"1997","journal-title":"Ergonomics"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/j.1748-1716.2010.02119.x","article-title":"Cardiovascular function in the heat-stressed human","volume":"199","author":"Crandall","year":"2010","journal-title":"Acta Physiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1109\/MEMB.2003.1213623","article-title":"Predicting the potential of wearable technology","volume":"22","author":"Binkley","year":"2003","journal-title":"IEEE Eng. Med. Biol. Mag."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"16695","DOI":"10.3390\/s121216695","article-title":"Wearable and Implantable Sensors: The Patient\u2019s Perspective","volume":"12","author":"Bergmann","year":"2012","journal-title":"Sensors"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Dias, D., and Cunha, J.P.S. (2018). Wearable Health Devices\u2014Vital Sign Monitoring, Systems and Technologies. Sensors, 18.","DOI":"10.3390\/s18082414"},{"key":"ref_18","unstructured":"(2023, January 11). United States Environmental Protection Agency (EPA), Available online: https:\/\/www.epa.gov\/report-environment\/connection-between-environmental-exposure-and-health-outcomes."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1161\/CIR.0b013e3181dbece1","article-title":"Particulate Matter Air Pollution and Cardiovascular Disease","volume":"121","author":"Brook","year":"2010","journal-title":"Circulation"},{"key":"ref_20","unstructured":"(2023, January 11). Agency for Toxic Substances and Disease Registry (ATSDR), Available online: https:\/\/www.atsdr.cdc.gov\/."},{"key":"ref_21","unstructured":"(2023, January 11). United States Department of Labor (DOL), Available online: https:\/\/www.osha.gov\/SLTC\/hydrogensulfide\/hazards.html."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1080\/00039896.1979.10667410","article-title":"Carbon Monoxide: A Hazard to Fire Fighters","volume":"34","author":"Barnard","year":"1979","journal-title":"Arch. Environ. Health: Int. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/0022-4375(89)90046-7","article-title":"Health hazards of fire fighters: Exposure assessment","volume":"20","author":"Fallon","year":"1989","journal-title":"J. Saf. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1146\/annurev.pu.13.050192.001055","article-title":"Occupational Health Concerns of Firefighting","volume":"13","author":"Guidotti","year":"1992","journal-title":"Annu. Rev. Public Health"},{"key":"ref_25","unstructured":"(2023, January 11). United States Department of Labor (DOL), Available online: https:\/\/www.osha.gov\/index.php\/noise\/health-effects."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Hofmann, S., M\u00fcller, O., and Rossi, M. (2020). Designing for Digital Transformation. Co-Creating Services with Citizens and Industry, DESRIST 2020, Lecture Notes in Computer Science; Springer International Publishing.","DOI":"10.1007\/978-3-030-64823-7"},{"key":"ref_27","first-page":"188","article-title":"Requirements Gathering Through Focus Groups for a Real Time Emergency Communication System for HAZMAT Incidents (REACH)","volume":"5","author":"Medcalf","year":"2021","journal-title":"J. Public Health Issues Pract."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1080\/15459624.2017.1334904","article-title":"Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures","volume":"14","author":"Fent","year":"2017","journal-title":"J. Occup. Environ. Hyg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1021\/acs.est.5b04752","article-title":"Evaluation of Firefighter Exposure to Wood Smoke during Training Exercises at Burn Houses","volume":"50","author":"Fernando","year":"2016","journal-title":"Environ. Sci. Technol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.toxlet.2009.06.864","article-title":"Fire fighting trainers\u2019 exposure to carcinogenic agents in smoke diving simulators","volume":"192","author":"Laitinen","year":"2010","journal-title":"Toxicol. Lett."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.toxlet.2012.06.005","article-title":"Firefighters\u2019 multiple exposure assessments in practice","volume":"213","author":"Laitinen","year":"2012","journal-title":"Toxicol. Lett."},{"key":"ref_32","unstructured":"(2014). Systemic Exposure to PAHs and Benzene in Firefighters Suppressing Controlled Structure Fires. Ann. Occup. Hyg., 58, 830\u2013845."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.apergo.2018.03.004","article-title":"Relationship between novel design modifications and heat stress relief in structural firefighters\u2019 protective clothing","volume":"70","author":"McQuerry","year":"2018","journal-title":"Appl. Ergon."},{"key":"ref_34","first-page":"581","article-title":"Environmental Study of Firefighters","volume":"35","author":"Jankovic","year":"1991","journal-title":"Ann. Occup. Hyg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.ijhcs.2019.08.003","article-title":"Wearable technology for posture monitoring at the workplace","volume":"132","author":"Bootsman","year":"2019","journal-title":"Int. J. Hum.-Comput. Stud."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.ergon.2012.05.004","article-title":"Pilot task-based assessment of noise levels among firefighters","volume":"43","author":"Neitzel","year":"2013","journal-title":"Int. J. Ind. Ergon."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1097\/00043764-200107000-00013","article-title":"Firefighters\u2019 Hearing: A Comparison with Population Databases from the International Standards Organization","volume":"43","author":"Kales","year":"2001","journal-title":"J. Occup. Environ. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1093\/occmed\/kqr062","article-title":"Hearing losses in wholetime firefighters occurring early in their careers","volume":"61","author":"Ide","year":"2011","journal-title":"Occup. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/S0196-0644(85)80288-2","article-title":"Accelerated hearing loss in urban emergency medical services firefighters","volume":"14","author":"Pepe","year":"1985","journal-title":"Ann. Emerg. Med."},{"key":"ref_40","unstructured":"(2023, January 11). National Fire Protection Association (NFPA), Available online: https:\/\/www.nfpa.org\/News-and-Research\/Data-research-and-tools\/Emergency-Responders\/Firefighter-injuries-in-the-United-States."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/6\/4787\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:51:15Z","timestamp":1760122275000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/6\/4787"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,8]]},"references-count":40,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["ijerph20064787"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20064787","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2023,3,8]]}}}