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 to 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.