Serving the Whole Community: Including Women in Your R&R Efforts
October 22, 2024
Practical tips for diversity, equity, and inclusion in your community
October is Breast Cancer Awareness Month. While anyone can get breast cancer, the disease predominantly effects women. Like men, female firefighters are at an increased risk of a variety of cancers and other reproductive health issues; they also face other physical and behavioral health issues. Brittany Hollerbach, a researcher at NDRI-USA, Inc., discusses the health issues specific to female firefighters and how it can impact your department’s recruitment and retention efforts.
Tell us about yourself and your work in this area.
I come from a firefighting background. I was a volunteer firefighter in a career organization for four years before I went back to school. I love the fire service, and I am blessed to continue to work with firefighters as a researcher. However, looking at the fire service through a research lens has confirmed some of what I experienced as a female firefighter. Women may not view the fire service as a career or volunteer option, unless they know someone. And once they’re in the fire service, they may not always feel supported or know who to go to with questions. How do I train physically? What should I eat? What do I wear at night?
I had no idea firefighting was an option until the local fire department reached out to my high school to ask for volunteers for a training drill. A friend and I got to go to the local training center and get all dressed up (and learned the term ‘moulage’, which is the art of applying realistic injuries to train medical, military, and emergency response teams – who knew we have our own term for makeup?). We spent time with firefighters, EMTs, paramedics, and training staff during multiple scenarios. I was amazed by their knowledge and skills as well as their lighthearted nature and ability to joke with their peers even while completing serious tasks. After the drills were done, the EMS chief pulled me aside. He could see my enthusiasm for the work and told me that if this was something I was interested in, I could start with classes like First Responder and EMT, offered through our local community college. Much to my surprise, when looking at college courses, I ended up enrolling in First Responder and it changed my life. First Responder led to EMT, which led to the Fire Academy. I was lucky to be in a very supportive environment, but I know not every woman is so lucky.
What should departments know about women’s health in the fire service?
Women have been a part of the fire service since its inception. One of the first known female firefighters in the U.S., Molly Williams, was an enslaved woman who worked with the Oceanus Engine Company No. 11 in New York City during the early 1800s. She fought fires alongside men, despite the harsh conditions and lack of recognition. Somehow, over 200 years later, women are still fighting for recognition and equal, safe working conditions. Women still face physical challenges related to unrealistic physical expectations and equipment not designed for smaller frames (this is an issue for men as well – not everyone is 6’2” and 200 pounds!).
Despite progress, women in the fire service still face challenges related to discrimination, harassment, and underrepresentation. In a recent study of 1,773 women firefighters, women reported experiencing verbal (37.5%) and written (12.9%) harassment, hazing (16.9%), sexual advances (37.4%), and assaults (5.1%) in the fire service. NO ONE SHOULD BE EXPERIENCING ASSAULT in the fire service. And those that suffered the most severe discrimination and harassment reported 40% more poor health days in the last 30 days. Those with moderate and severe discrimination/harassment had negative mental health outcomes including higher prevalence of depressive symptoms, anxiety, and PTSD symptoms. There are very real consequences to not being accepted as part of the team.
Women firefighters are also more at risk compared to the general public for miscarriage and preterm labor. In fact, miscarriage rates among women firefighters were at least 2.3 times higher compared to the national average. Miscarriage rates among volunteer women firefighters were at least 1.42 times higher compared to career firefighters. This held true for wildland/wildland-urban interface (WUI) firefighters as well; volunteer wildland/WUI firefighters had 2.53 times higher risk of miscarriage compared to career firefighters. A recent study from Davidson and colleagues found that women firefighters had 33% lower AMH (anti-mullerian hormone) levels compared to non-firefighters. AMH is a marker of ovarian reserve and can indicate fertility. While many factors can impact reproductive health, it is important the department support its members and provide education on how the job can impact reproductive health and the ability to conceive.
Factors that impact reproductive health:
- Toxic products of combustion
- Intense thermal environment
- Loud noises
- Psychological & physical strain
- Ill-fitting PPE
- Shift work
In 2023, the International Agency for Research on Cancer (IARC) designated firefighting as carcinogenic to humans (Group 1) on the basis of sufficient evidence for cancer in humans. This is applicable to career and volunteer firefighters, men and women. Firefighters face complex occupational exposures due to the wide variety of emergencies they respond to, including structure, wildland/WUI, and vehicle fires, as well as non-fire events like vehicle accidents, medical emergencies, hazardous material spills, and building collapses. Additionally, they are affected by shift work, ultraviolet (UV) radiation, and evolving hazards linked to changing building materials, protective equipment, and operational roles. Over time, these factors have significantly altered the nature and extent of firefighter exposures.
Among the cancers with higher incidence in women firefighters are breast, thyroid, cervical, and bladder cancers, with some studies noting a significantly higher risk compared to the general population. For example, women firefighters have been found to have up to four times the risk of cervical cancer and three times the risk of thyroid cancer compared to non-firefighters.
How can departments implement practices to better protect female firefighters?
Does your department order personal protective gear measured to fit each firefighter? While this may not be feasible for most volunteer fire departments, what grants and partnerships exist that could assist in ensuring your firefighters have the best fitting gear possible? Does your department have a pregnancy policy? What about maternity/parental leave? Develop comprehensive pregnancy policies that offer reasonable accommodations for pregnant firefighters, such as light duty or modified shifts. Ensure maternity and paternity leave policies are inclusive for all firefighters as this is important for men and women starting or growing their family. How can your organization support its members when they need a break from volunteering/serving in a firefighter role to focus on their family? Does your department have a cancer awareness policy/program? By promoting cancer awareness and implementing protective measures, fire departments can better support all firefighters, reduce health risks, and enhance overall well-being.
Some things to think about to better protect women firefighters include:
- Provide properly fitting personal protective equipment.
- Implement anti-harassment and discrimination policies.
- Develop pregnancy and family leave policies.
- Offer reproductive health and wellness programs.
- Promote inclusive leadership and mentorship opportunities.
- Initiate recruitment and retention strategies focused on gender equity.
How could these efforts lead to greater recruitment and retention?
Women are generally more likely to volunteer in their communities than men, both in formal and informal capacities. Globally, about 57% of volunteer work is performed by women, compared to 43% by men. In the U.S., approximately 34% of women volunteer, compared to 26.5% of men. Women also tend to volunteer more hours and participate in a broader range of activities than men.
With the fire service facing an unprecedented personnel shortage, recruitment and retention are keys to ensuring the safety of our communities with appropriately staffed fire departments. Promoting diversity and gender equality in volunteer fire departments can lead to better recruitment and retention by creating a more inclusive, sustainable, and high-performing organization. Teams with diverse members tend to approach challenges from different angles, leading to more creative solutions, particularly in high-stress, dynamic environments like firefighting. Women bring unique perspectives that can improve team decision-making and adaptability. Studies suggest that mixed-gender teams often foster better communication and collaboration, which can enhance group cohesion and efficiency during complex emergency responses.
Actively recruiting women expands the available pool of volunteers, addressing staffing shortages. Many younger women are drawn to roles where they feel they can make a difference. By promoting gender inclusivity, departments can tap into this demographic, particularly as more young people seek careers aligned with social impact and community service. Fire departments that are representative of the communities they serve build greater public trust and engagement. Women firefighters can serve as role models, showing other women and girls that firefighting is a viable career or volunteer opportunity. A more inclusive and supportive workplace tends to reduce burnout and increase job satisfaction for all members. By prioritizing the recruitment and retention of women in the volunteer fire service, departments gain operational, cultural, and community benefits.
What do you recommend for departments looking to take the first step to incorporating women’s health considerations in their health and safety plans?
Improving support and safety for women in the fire service through policies, procedures, and organizational culture can foster higher recruitment and retention, benefiting both women and the organizations they serve. Utilize resources that currently exist – while policies and procedures may need to be adapted to fit within your organization, you don’t have to recreate the wheel. Take advantage of the wealth of material the National Volunteer Fire Council provides. For example, check out Recruitment and Retention Planning and Funding. Make Me A Firefighter™ is a national recruitment campaign with ready-to-use, customizable resources and tools.
Science to the Station: A Health and Wellness Alliance (or Science to the Station for short) is a community of scientists, health care, and fire service professionals dedicated to providing critical information needed to improve the safety and health of firefighters and other first responders. There are numerous resources, infographics, videos and more including a Women’s Health Workgroup for those interested in learning more about supporting women in their organization.
Take a look at The Beltane Guild, a private, nonprofit focused on firefighter reproductive health. The Beltane Guild, led by president Maia Earle, partners with researchers to gather materials to assist firefighters with education and advocacy. The 2022 edition of NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, has a section specifically addressing Pregnancy and Reproductive Health with more information found in the Annex. The Pregnant Workers Fairness Act requires a covered employer to provide a “reasonable accommodation” to a qualified employee’s or applicant’s known limitations related to, affected by, or arising out of pregnancy, childbirth, or related medical conditions.
Incorporating women’s health considerations starts with policy adjustments, access to evidence-based resources, and creating supportive environments. Departments that take these steps will not only improve the well-being of their women firefighters but also enhance recruitment, retention, and overall department performance.
References
Davidson, S., Jahnke, S., Jung, A. M., Burgess, J. L., Jacobs, E. T., Billheimer, D., & Farland, L. V. (2022). Anti-Müllerian hormone levels among female firefighters. International Journal of Environmental Research and Public Health, 19(10), 5981.
Hollerbach, B. S., Heinrich, K. M., Poston, W. S., Haddock, C. K., Kehler, A. K., & Jahnke, S. A. (2017). Current female firefighters’ perceptions, attitudes, and experiences with injury. International fire service journal of leadership and management, 11, 41.
Jahnke, S. A., Haddock, C. K., Jitnarin, N., Kaipust, C. M., Hollerbach, B. S., & Poston, W. S. (2019). The prevalence and health impacts of frequent work discrimination and harassment among women firefighters in the US fire service. BioMed research international, 2019(1), 6740207.
Jahnke, S. A., Poston, W. S., Jitnarin, N., & Haddock, C. K. (2018). Maternal and child health among female firefighters in the US. Maternal and child health journal, 22, 922-931.
Jung, A. M., Jahnke, S. A., Dennis, L. K., Bell, M. L., Burgess, J. L., Jitnarin, N., … & Farland, L. V. (2021). Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters. Environmental Health, 20, 1-13.
McQuerry, M. (2020). Effect of structural turnout suit fit on female versus male firefighter range of motion. Applied Ergonomics, 82, 102974.
https://togetherwomenrise.org/wp-content/uploads/2023/11/Women-and-Philanthropy-2023.pdf
https://techjury.net/blog/volunteering-statistics/
