The Metabolic Demand of Firefighting: A Systematic Review

Background: The aim of this systematic review was to collect, appraise, and synthesize the available information related to the cardiovascular and metabolic demands of commonly performed firefighting tasks while wearing personal protective equipment (PPE) inclusive of self-contained breathing apparatus (SCBA). Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, academic databases (PubMed, Embase, and SPORTDiscus databases) were searched for relevant records which were subjected to dedicated eligibility criteria with included articles quality appraised using the Critical Appraisal Skills Programme (CASP) checklist. Results: Of an initial 1463 identified records, 20 studies with a mean CASP of 8.26/11 informed the review. A myriad of varying field tests have been employed to determine physical preparedness and assess the metabolic demand of firefighting. Conclusions: The volume of evidence suggests that PPE and SCBA must be incorporated when assessing the demands of firefighting as they clearly increase the metabolic cost of combined simulated firefighting tasks. Although real-world scenarios are made up of a combination of individual firefighting tasks, there remains a clear need to determine the metabolic cost of isolated firefighting tasks such as forcible entry, hose drag, victim rescue, ladder raise, and stair climbing with and without PPE and SCBA. The quantification of the metabolic demand of these tasks may assist tactical trainers when designing simulated scenarios and training programs for firefighters.