Research shows male firefighters may be stronger - but overall work performance can be the same or better for women

Dr. Joy MacDermid from the Canadian research institute Firewell.ca discusses the challenges and solutions to considering sex and gender in firefighter studies. What these limited studies found could be groundbreaking: Men and women may be different, but each sex have weaknesses as well as strengths. 

One of the more groundbreaking results of this study show that even though men are generally stronger in terms or raw manhandling power, women firefighters´ overall output is not necessarily lower, when measuring maximum aerobic capacity (VO2 Max). This can result in many advantages for the female firefighters , if their strengths are understood and compensated for with the correct fitting equipment and new approaches to tasks.  

For instance , when studying the biomechanical modelling of how men and women approached a simple task of dragging a hose, the women seemed more prone to certain types of injuries, where as the men were more prone to completely different types of injuries. While the men may have climbed stairs faster, they may have been slower at pulling hose line. Men actually had more shoulder and knee problems, whereas women had more problems in other areas of the body. 

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These and other issues concerning women´s roles and development in the fire services, is always on the agenda for Mira Leinonen, chair of the CTIF Commission for Women in Fire & Rescue: 

"This research supports what we have always said in our Commission: Instead of looking at just weaknesses, we should look the strengths of both sexes. With that perspective in mind we can put together a much more effective workforce", says Mira Leinonen. 

She continues: 

"Also the world of firefighting has changed over the decades. We have tools and equipments instead of raw manpower to help us to approach the different kind of incidents and situations that we face. In the near future the world of firefighting is going to change in just like the rest of the world changes, and perhaps the most tangible examples are in the fields of Artificial Intelligence and technical development. We need to look also into the future and make sure that we have the best workforce in the future as well".

The video below is 12 minutes. Below we have also provided a transcript of the video. The transcript is made with the support of AI software and may contain small mistakes.

"There might be differences in the way that men and women firefighters approach a task or a duty - but sometimes there are strengths and weaknesses in the way each task would be performed."

One study showed that the way that the women were doing the task resulted in less compression forces on their spine than the way that the men were doing the task.

However, what is really interesting, is that while the women were thought to be "weaker" over all, they approached the task from that point of view, and for one reason or the other, this resulted in a similar VO2 Max: the women had less cardiovascular response to many tasks; so in other words, their heart rates and blood pressure didn´t change as much during the performance of the task as it did for the men.  

This led the researchers to conclude that given the right circumstance and understanding of innate strengths and weaknesses in both sexes, the overall performance output doesn´t have to differ - both sexes could achieve similar results and energy output, but in different ways and approaches to the same task.      

Editor´s Note: V̇O2 max  (or maximal aerobic capacity) is the maximum rate of oxygen consumption measured during incremental exercise; that is, exercise of increasing intensity.

The researchers stressed that there were not enough women in their studies to make all of the results entirely conclusive - however, they chose to include them anyway, so that other researchers and future studies can complete the gaps later on, based on these preliminary results. 

Perhaps the most important analysis from this research is that it is important to acknowledge that women may be weaker in some areas - however, in some areas women are the same or even better, and by understanding these differences, an employer can utilize their staff much more efficiently, regardless if they are men or women.

Another aspect which was stressed is that individual differences between individuals, regardless of sex, are often greater than those found in comparison between groups of people approaching the same task.  

The video below is from the virtual conference  State of Science: Research on Women in the Fire Service Conference from November 18, 2020.

Photo Credit (Cover shot above) Clip art of a male and a female firefighter from cleanpng.com.

"The first challenge is this: why are women still just 3% of the firefighter workforce? We know that it has a lot to do with social attitudes about what work roles men and women should occupy."

Transcript of the video

Below we have provided a transcript of the video. The transcript is made with the support of AI software and may contain small mistakes. The video is 12 minutes

00:00

"My name is Joy MacDermid.  I'm glad to join you today I'm going to be talking about sex and gender and firefighter health research, some challenges and solutions. I have no disclosures other than research funds that have gone to support the work that we'll be talking about today's objectives are to describe the importance and challenges in conducting health research addressing women firefighters and give some examples from Firewell studies and some solutions to challenges.

This slide just reminds us the difference between what we mean when we say sex and gender. Sex is biological, it has to do with our genes and our anatomy and our structure, and how our bodies function. Gender is a socially constructed idea that can change over time and between different societies, and even within families. It's about how society sees us and how we see ourselves.



0:57

It is surprising that only recently has there been emphasis on how important it is to understand the difference that sex and gender can make when it comes to health research.



This slide illustrates a problem in pain research. The blue shows how much of the research has focused on males only and only a very small percentage is focused on females, or looked at sex differences. As a result, most of our understanding of pain physiology is the understanding of male pain physiology.



That leads directly into some of the challenges and solutions that we have to face when we're doing research on firefighter health for women.

1:41

The first challenge is why are women still just 3% of the firefighter workforce? We know that it has a lot to do with social attitudes about what work roles, men and women should occupy.



Women firefighter organizations are very busy and some of the work solutions have been things like changing societal attitudes,  targeted recruitment, and making the fire service a good place to work from a research perspective.

We've been adopting strategies like qualitative studies, where we do an in depth analysis of a smaller number of participants of pooling data across different studies and targeted recruitment.  

One of our first studies was this small qualitative unfunded study,  which despite being on only four of the five firefighters in Hamilton,  gave us a lot of information. What amazes me about this study is how useful the themes are and how they have continued to inform our work. We heard from the women firefighters that they recognize that firefighting was a physically demanding job, and they already knew there were gender related physiological differences with women not being a strong, and a little bit of confusion about whether they actually had a lower VO2 Max than men.

Editor´s Note: V̇O2 max  (or maximal aerobic capacity) is the maximum rate of oxygen consumption measured during incremental exercise; that is, exercise of increasing intensity.



2:54

An important theme that will show up later again is compensated regarding strategies. When the women talked about their bio mechanics, it was very important to them that guys can usually manhandle things, but they had to learn to their bodies, a bit more effectively. They also talked about problems with equipment not fitting correctly, the boots and bunker pants being often too big.  Everything is kind of too large, and we identified this problem during the study. 

When the Hamilton Fire Service heard this feedback from the women, they immediately found a vendor who was able to provide firefight fighting equipment designed specifically with women in mind, and this illustrates how research can sometimes solve a problem before the research is even published.

3:36

Women talked about how important it was to earn respect, and there was a lot of conversations about the attitudes of male counterparts. Some people have attitudes that aren't going to change no matter what you do, no matter how good a firefighter you are, they think "you're a woman in a man's job and you shouldn't be here".



3:52

They also illustrated the importance of attitudes on team collaboration and training. Some said "the men refused to train us, because they didn't want us to be good. If we were good...  I guess they wouldn't look masculine."



4:06

Another problem we have - and this has been highlighted by many women firefighters -  is that often they're often excluded from research. When researchers do a research project on firefighters they usually exclude the women,  and some of the common excuses are: "There's just too few women for us to do statistical analysis" - Women's results are too variable, they ruin our results" -  or - "women have menstruation cycles".



4:32

Of course those examples of excuses are ridiculous, but they're actually things that are being said. So in response, there have been documents created that say how sex and gender should be coded research in order for it to be equitable for both men and women. And this document talks about how sex and gender have to be considered in all phases of the research, including why there might be differences between men and women, how the data is collected and how it's analyzed and presented. 

In the next couple of slides, I'm going to illustrate a couple of our projects on musculoskeletal health to indicate in what way there were challenges, and how we tried to address them.

5:16

Here's a study we published on looking at the prevalence and distribution of musculoskeletal problems among firefighters. And you can see here, that we were dealing with a fire service that has 300 firefighters, but only eight of them are women.



5:33

Here's the data showing that there were high rates of upper and lower limb problems and back problems in one third.



Even though we didn't have enough women to be confident of our results you'll see in the paper, we still presented the results for the women. That's so that this data could be used later by others, or we could at least get an idea whether the women looked like they might be having the same or different kind of problems.

Even though the numbers were very small and there was very insufficient data, we feel here that maybe the women had higher numbers of musculoskeletal disorders. So we use targeted recruitment, we repeated the study, and in this time we recruited 118 females by going all across Canada to do recruitment.  When we did this, we found out that women firefighters had 1.6 times greater likelihood of having painful areas. 

Even after we controlled for differences in age and years of service, and the solution we used was combining multiple studies, so we looked at not only our own study, but we combined it with other studies, so that we could retrieve from all of the literature. And then we found out that not only were men and women different, but this difference was not the same for different areas of the body.

Men actually had more shoulder and knee problems, whereas women had more problems in other areas of the body. This illustrates how important it is to combine data, because the more data, we have, the more detailed our analysis can be, and we can find results that are more meaningful.

This study illustrates that it's important to look at things from different perspectives. So when one study we looked at,  people were self reporting how much physical problems they were having. In this study we actually measured Canadian firefighters in health matched controls and looked at their physiological data in terms of strength and VO2 Max, and we found out - not shockingly - that men firefighters were stronger than women. But we also found that women did not have lower VO2 Max levels, and this will be important as you see in our next studies.



7:45

We did find however that the VO2 Max decreases with age for both men and women. These next couple of studies  show us why it's important to confirm results using different methods and across multiple studies, particularly when you only have a small number of women in each study.



8:03

So in this study we asked not how we know there's physiological differences between men and women, how how does that relate to performing firefighter tasks? We were particularly looking at a hose dragging task. And this was done in full bunker gear: the only thing that's not very realistic is that we were inside doing this testing so the hose is not charged.



8:31

We looked at a variety of individual factors like age, sex height, weight, etc. We measured their cardiovascular response you measured strength, and we measured  how long it took them to do the task. Again, we only had five women and 100 men, but what we did see in this data was that women did the uncharged hose drag  faster than the men, but they climbed the stairs slower.  

Men were stronger, which was consistent with our previous study. However, we found that women actually had a lower cardiovascular response. Their blood pressure didn't change as much, and their heart rate didn't change as much as the men, during performance of the task.



9:14

So next, we wanted to look at how men and women may be doing the task differently. So for this we used a different kind of research where we do virtual modeling. Now we're doing biomechanical modeling and the same pose drag task.



9:28

We had six men and six women in this study, and we used a motion capture Connect system where data was fed into biomechanical models. And we actually use three different approaches to analyze that data.



 9:43

What we found  amazing is that when we looked at the biomechanical modeling, the way that the women were doing the task resulted in less compression forces on their spine than the way that the men were doing the task. This is consistent with what women said in the qualitative study where they said they really had to be mindful of their body mechanics.



10:07

So in summary;  Firewell.ca has a number of strategies:  Our idea is that we should always include as many women firefighters as possible in the research.  The ways that we do this, are that we partner with women firefighters, we collect their data, and we listen.



10:22

We present women´s data in published research, even when the numbers are small - even when we cannot be sure about the conclusions - because we know eventually we'll be able to combine that data. We always do analysis of women separately.



10:36

And it's important to know that we report when men and women are the same, and when they are different.  Sometimes researchers are too excited about differences, but it's very important to acknowledge when men and women are the same and respond the same as just as much as it is to know when they are different.

 

10:53

We also think it's very important not to just study weaknesses and negative predictors, but also study strengths and positive predictors.  I think we can acknowledge that there might be differences in the way that men and women firefighters would approach a task or duty, but sometimes there are strengths and weaknesses in the ways that that each of these would be performed.

Finally, it's also important to always acknowledge that when you're looking at a group, it never means that the results refer to an individual. There are variations between individual people that are sometimes bigger than the variations between groups.



Unknown 11:39

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Transcribed by https://otter.ai