These programs are essential investments for ensuring well-being, resilience, and operational effectiveness
By David Picone, Health and Safety Officer, San Diego Fire-Rescue Department
First responders, including firefighters, lifeguards, dispatchers, police officers, ambulance workers, and civilian staff, shoulder an enormous responsibility. We are the first line of defense in emergencies, facing immense physical, psychological, and environmental challenges daily. Beyond the immediate hazards, our roles expose us to long-term health risks such as chronic injuries, cancer, PTSD, and other behavioral health issues.
At the San Diego Fire-Rescue Department (SDFD), our firefighters, lifeguards, dispatchers, and civilian personnel team have developed and implemented a comprehensive health and safety program to address these risks. This program’s success demonstrates that such an initiative is not a luxury, but an essential investment in every first responder’s health, resilience, and operational readiness.
The Case for Comprehensive Programs
A comprehensive health and safety program addresses the full spectrum of risks all first responders encounter. It aligns with national standards like NFPA 1500 and OSHA’s General Duty Clause, emphasizing the need for safe and healthy workplaces. But more importantly, it enhances wellness, reduces long-term costs, and ensures that teams are prepared to meet the demands of their critical roles.
Reducing Risks and Building Resilience
First responders face unique hazards in the field, at the dispatch center, or patrolling the streets. These include exposure to carcinogens, repeated physical strain, and the psychological toll of trauma. In California, presumptive injury laws recognize these risks, covering conditions such as cancer, PTSD, and infectious diseases. Our data at SDFD reveals that early detection and prevention significantly reduce the severity of these conditions.
Despite an 8% increase in full-time employees (FTEs) over the past decade and growing operational demands, SDFD’s injury claim rates have remained stable. This achievement underscores the effectiveness of proactive health and safety measures.
Behavioral Wellness: A Critical Component
Behavioral wellness is essential for all first responders, from firefighters and lifeguards to police officers and dispatchers. These professionals often encounter traumatic situations, which can lead to PTSD, anxiety, and substance abuse if left unaddressed.
Since PTSD became a presumptive injury in 2020, SDFD has seen a 500% increase in PTSD-related claims. However, this increase also highlights the success of our behavioral health initiatives in identifying and treating these issues early.
Our program includes peer support, chaplain services, and culturally competent counseling, providing critical resources to first responders, their families, and retirees. These efforts ensure no one must face the mental health challenges of their profession alone.
Physical Wellness and Injury Prevention
Annual physicals, fitness initiatives, and injury prevention programs are cornerstones of SDFD’s approach. Our new wellness center supports these efforts by offering state-of-the-art rehabilitation and recovery resources. These programs help all first responders stay in peak condition, reducing the risk of long-term disability and keeping them ready to serve.
The Financial Case for Health and Safety Programs
A comprehensive program is an investment that pays for itself over time. At SDFD, we’ve maintained an average of 345 injury claims annually over the past decade despite a growing workforce and increased operational demands. This stability in claims and associated costs directly results from our proactive health and safety measures.
Cancer Awareness and Prevention
Cancer is a significant risk for first responders, particularly firefighters exposed to carcinogens and lifeguards frequently in the sun. Over the past decade, SDFD has reported 152 cancer claims, averaging 15 new cases per year. Our Cancer Awareness and Prevention Program (CAPP) has been instrumental in keeping these numbers stable despite rising FTEs. Early detection and treatment have saved lives and reduced time lost to injury and associated costs.
Managing PTSD Costs
PTSD-related claims have increased due to presumptive injury laws, yet proactive behavioral wellness measures have mitigated their financial impact. Addressing PTSD through early intervention and comprehensive care has prevented untreated issues from escalating into more severe conditions, saving resources and ensuring that first responders can return to work sooner.
Long-Term Disability and Workers’ Compensation
From 2014 to 2023, SDFD’s average annual workers’ compensation costs remained steady at $8.4 million. Despite increased FTEs, call volumes, and presumptive injuries, this stability demonstrates the value of comprehensive programs. By focusing on prevention, early detection, and effective rehabilitation, we’ve controlled costs while improving outcomes for first responders.
A Holistic Model: The Biopsychosocial Approach
SDFD’s Health and Safety Program is guided by the biopsychosocial model, which addresses the biological, psychological, and social factors that impact health and recovery. This approach ensures a continuum of care, from prevention and early detection to treatment and long-term support.
For example, physical wellness initiatives focus on fitness, nutrition, and injury prevention, while behavioral health programs provide counseling, peer support, and stress management resources. Risk management strategies include long-term disability insurance, preferred treatment facilities, and confidential access to care. This holistic approach ensures that all first responders receive the support they need to thrive on and off duty.
The Broader Impact
The benefits of a comprehensive health and safety program extend beyond individual first responders. By prioritizing their health and safety, we ensure they can continue serving their communities effectively. Families benefit from improved well-being and stability, and taxpayers see the long-term savings from reduced injury costs and improved operational efficiency.
A Call to Action
To all first responder organizations: the risks our teams face daily are undeniable, but so are the benefits of a comprehensive health and safety program. Whether you lead a fire department, a police force, an EMS unit, or a communications center, investing in wellness, prevention, and support is not just the right thing to do, it is the smart thing to do.
The evidence is clear: when we prioritize the health and safety of our personnel, we protect the heart of our operations and honor their commitment to serve and protect. Let’s work together to make comprehensive health and safety programs the standard for all first responders.
If you have questions or need guidance, please don’t hesitate to contact us. Together, we can build stronger, healthier teams.
