Practical impact of research on firefighters: Reduced exposure levels through changes in firefighting training

Firefighters are occupationally exposed to smoke, soot and chemicals linked to significant health risks, including cancer and cardiovascular disease. Therefore, there is a need to reduce harmful occupational exposures for firefighters. Since 2015, we have studied conscripts undergoing smoke-diving training as part of their education as firefighters under the Danish Emergency Management Agency, focusing on exposure markers and health effects. Our findings from 2017-2018 led to changes in training practices, which we have observed and monitored continuously in follow-up studies. After these changes were implemented, we measured reduced levels of respiratory exposure to particles, decreased soot deposits on the skin and corresponding lower levels of the urine metabolite 1-hydroxypyrene, a biomarker of exposure to soot and smoke. We showcase the practical impact of research on firefighters and the crucial roles of stakeholder engagement, evidence-based communication, and translation of results into recommendations for change of practice to minimize exposure to smoke and soot during firefighting training.