Occupational Health Screening Behaviors and Barriers Among Volunteer Firefighters: Results from a Cross-Sectional Survey in Texas

BACKGROUND: Volunteer firefighters face occupational exposures that increase risks for cardiovascular disease, respiratory illness, mental health conditions, and cancer. Although the National Fire Protection Association (NFPA) recommends regular, comprehensive occupational health screenings, the standard lacks a clear protocol and implementation is voluntary; therefore adherence to these recommendations among volunteer firefighters remains unclear. This study examined occupational health screening behaviors and perceived barriers among volunteer firefighters in Texas. METHODS: An online, cross-sectional survey was conducted from August-September 2024 to assess demographics, occupational health screening behaviors, and perceived barriers. Multiple logistic regression was used to identify factors associated with frequently reported barriers.FindingsThree hundred and twenty-six volunteer firefighters completed the survey. Only 86 (26.4%) volunteer firefighters reported that th:ey currently receive an annual occupational health screening. The barriers most frequently reported were cost, followed by lack of knowledge about screening locations, lack of insurance, medical providers, and time constraints. Full-time employment, rurality, older age, and higher levels of education were associated with reporting barriers at a statistically significant level. Older age and insurance status were also associated with significantly lower odds for other barriers. CONCLUSIONS: Despite NFPA recommendations, most volunteer firefighters do not receive regular occupational health screenings, highlighting a significant gap between national standards and practice. Addressing structural and access-related barriers is essential to improve screening uptake among volunteer firefighters.Applications to Practice:These findings highlight an urgent need for targeted interventions to address barriers to occupational health screenings and work toward improving the health and longevity of volunteer firefighters.