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  1. The current issue and full text archive of this journal is available on Emerald Insight at: www.emeraldinsight.com/1560-6074.htm RJTA 23,2 A critical review of female firefighter protective clothing and equipment workplace challenges 94 Meredith McQuerry Retail Entrepreneurship, Florida State University, Tallahassee, Florida, USA Received 24 January 2019 Revised 24 January 2019 Cassandra Kwon Accepted 5 March 2019 Textile Protection and Comfort Center (T-PACC), North Carolina State University, Raleigh, North Carolina, USA, and Heather Johnson Retail Entrepreneurship, Florida State University, Tallahassee, Florida, USA Abstract Purpose – The purpose of this paper is to identify the challenging barriers faced by female firefighters, which limit workplace entrance and performance. Design/methodology/approach – Occupational barriers from both psychological and physiological viewpoints were explored based on previous literature and the reported experiences of female firefighters. Findings – A comprehensive review of literature synthesizes previous studies pertaining to gender anthropometric differences, female firefighters’ experiences in the work environment and protective clothing issues. The physical capabilities of men and women in specific relation to performing firefighting activities are also examined. Issues of greatest concern are identified for personal protective clothing (PPC) and equipment, which have traditionally been designed for the male human form. This leads to a lack of protection, an increased risk of onsite injury, reduction in mobility and poorer comfort for female firefighters. Originality/value – This review provides an original overview of the critical workplace challenges faced by female firefighters. The need for female-specific PPC and equipment is specifically addressed to retain the growing number of women entering the male-dominated firefighting profession. Keywords Firefighter, Female, Anthropometrics, Protective clothing, Protective equipment, Sizing, Fit, Functional clothing Paper type General review 1. Introduction According to the National Fire Protection Association (NFPA), there are approximately 10,300 full-time career female firefighters in the USA (Haynes and Stein, 2014; Campbell, 2017; National Fire Protection Association, 2017). When considering volunteer, part-time and part-on-call female first responders, this number may quickly approach 40,000 (International Association of Women in Fire and Emergency Services, 2018). The percentage of female firefighters in the USA has increased over the past decade, making up as much as 7 per cent of the total firefighter population (Haynes and Stein, 2014). Firefighting, however, Research Journal of Textile and Apparel still has one of the lowest rates of female employment for occupations that are classified as Vol. 23 No. 2, 2019 pp. 94-110 physically demanding (Hulett et al., 2008; McCoppin et al., 2018). This may be due to the © Emerald Publishing Limited 1560-6074 physical and psychological barriers women face when entering the fire service. Historically, DOI 10.1108/RJTA-01-2019-0002 female firefighters have battled discrimination related to their perceived ability to meet the
  2. strenuous physical demands of the job. Proving that their physical strength, endurance and A critical mechanical aptitude matches that of their male colleagues has become a consistent challenge review of for women in the fire service (Shuster, 2000). With the number of women joining the fire service on the rise, the demand for gender- female specific personal protective clothing (PPC) and personal protective equipment (PPE) has firefighter increased. Traditionally, firefighter gear was designed for a single-sex, male workforce. Female firefighters, however, experience protection and mobility restrictions due to the male-centered design of firefighter gear (Boorady et al., 2013b). The lack of appropriate 95 fitting PPC to accommodate women’s smaller frames adds to their physical and psychological stress (Chetkovich, 1997). Some PPE manufacturers have attempted to address these issues by offering “female-sized” turnout suits, however, in most cases, it is a simple “downscaling” of the male proportioned gear and does not take into account physical anthropometric differences between the male and female human forms. Therefore, an investigation of the specific fit and function needs of PPE for female firefighters is necessary to reduce their risk of injury, which is 33 per cent higher than their male colleagues (Liao et al., 2001). The purpose of this review article is to identify the challenging barriers faced by female firefighters, which limit workplace entrance and hinder performance on the job. A comprehensive review of literature synthesizes previous studies pertaining to female firefighters’ experiences, gender anthropometric differences, protective clothing issues and the work environment. This review addresses the need for female-specific structural firefighter protective clothing and equipment by exploring and highlighting preceding research, which compares the physical capabilities of men and women in specific relation to performing firefighting activities. 1.1 Hazardous environment of firefighting To assess the greater risk that female firefighters face by wearing ill-fitting PPC and PPE, one must understand the dangerous environment in which they operate. Firefighters face numerous hazards, especially heat, flame and high-temperature exposure. In the USA, the risk of thermal exposure tends to be greater, compared to other parts of the world, as USA firefighting tactics have adopted a more aggressive fire suppression approach, including indoor attack (Den Hartog, 2010). Other safety concerns include liquid (water and steam) and chemical (carcinogen causing contaminants) exposure, trips and falls, sharp objects (to avoid punctures) and heat stress. Heavy, bulky gear and equipment, especially if ill-fitting, exacerbates heat strain and drastically reduces physical performance leading to a quicker onset of fatigue (Rossi, 2003; Ciesielska-Wrobel et al., 2017; McQuerry et al., 2018). In addition to heat stress, reducing carcinogenic exposure is of utmost importance as firefighters are at greater risk for digestive and respiratory cancers (Daniels et al., 2014). Bunker gear designs must also consider garment interfaces (i.e. sleeve and glove, pant leg and boot, collar and hood and coat hem and waistline), as illustrated in Figure 1, where the turnout suit meets equipment that makes up the turnout ensemble. Gaps in these interface areas increase thermal and chemical exposure risks (Park et al., 2014a, 2014b). Wearing proper fitting protective clothing and equipment is crucial to minimize interface gaps and exposure to environmental hazards, ultimately ensuring wearer safety. 2. Workplace challenges for the female firefighter 2.1 Psychological barriers Psychological stressors are present for both male and female firefighters; however, the type of stressor varies significantly between the two genders. For female firefighters, these
  3. RJTA 23,2 96 Figure 1. Turnout ensemble interface areas including: (a) collar and hood; (b) coat and pant; (c) sleeve and glove; and (d) pant leg and boot stressors often include self-doubt, skepticism of abilities by others, performance pressure, sexual harassment and social ostracism (Shuster, 2000). In a study by Shuster (2000), female firefighters reported significantly higher scores than males for job skill concerns and discrimination factors. Women in the fire service oftentimes face especially high-stress levels due to discrimination and doubt that may be directly linked to male firefighter colleagues (Shuster, 2000). According to a survey for the “National Report Card on Women in Firefighting”, female firefighters consistently cite gender-related discrimination and harassment more frequently than male firefighters (Hulett et al., 2008). In response to the broad question: “I have experienced different treatment because of my gender,” an overwhelming 84.7 per cent of women agreed, compared to only 12.4 per cent of men (Hulett et al., 2008). Research suggests there are ways to minimize psychological stressors by participating in sensitivity and social skills training, stress management and assertiveness
  4. training and task-specific physical conditioning (Shuster, 2000). The overall findings of the A critical Shuster (2000) study indicate that male and female firefighters have a nearly identical review of “amount” of stress, albeit the stressors are different for each gender. However, it should be noted that this study was limited by a significantly imbalanced ratio of male to female female respondents (670 men versus 41 women) (Shuster, 2000). firefighter 2.2 Physical challenges The psychological barriers cited above are frequently related to the physical strength of 97 female firefighters, as they often face self-doubt and skepticism of their abilities because of perceptions of male versus female physical capabilities. Previously, the overall strength of the average woman was thought to be approximately 60 per cent of that of the average man (Jacobs and Bettencourt, 1995; Shuster, 2000). Past studies also report that females have less absolute strength and cardiovascular endurance than males (Wilmore, 1974; Wilmore and Brown, 1974; Clarke, 1986; Misner, Plowman and Boileau, 1987). This perceived difference is a common barrier faced by women who enter the field of firefighting (Shuster, 2000). Many male members of the fire service often question whether the physical demands are too much for the female physiology to handle. A widely-held stereotype is that women are not strong enough to meet the job’s physical requirements and, consequently, departments employing women are endangering public safety by lowering their physical standards. This assumption, however, often misapplies generalizations about the average population of women to highly fit women who are equipped and trained for the job (Hulett et al., 2008). Physical factors that may affect a woman’s successful performance on the job include: upper body strength, endurance, physical conditioning, ability to operate power tools and ill- fitting PPE (Shuster, 2000). Previous studies indicate that women overall may not be as strong or physically capable as men (Wilmore, 1974; Wilmore and Brown, 1974; Clarke, 1986; Heyward et al., 1986; Misner et al., 1987; Findley et al., 2002; Sinden et al., 2013). However, past work has focused on the female population as a whole, as opposed to the specific physical fitness of female firefighters. The few female firefighting specific studies were significantly limited by participant selection and sample size. A physiological study by Findley et al. (2002) assessed the peak and mean anaerobic power of incumbent female firefighters. Anaerobic power reflects the maximal energy output necessary to produce high muscular force quickly that is sustained for a short period of time (Antolini, 2014). The measurement of anaerobic power has been found to correlate highly with firefighting performance tasks (Findley et al., 2002). Results of the Findley et al. (2002) study indicate the incumbent female firefighters possessed anaerobic power levels similar to that of the control group, which represented the general female population outside of firefighting (Findley et al., 2002). According to these findings, physically trained female firefighters are no stronger than non-firefighting women (Findley et al., 2002). However, this work was limited as the females selected were incumbent firefighters, with little experience and findings were based on an extremely small sample size (n = 10). The measurement of anaerobic power was also a limitation as it was assessed by a 30 s Wingate test, which does not represent real job task performance capabilities. Previous work conducted by Misner et al. (1987) assessed the magnitude of sex-related differences on physical performance between men and women when conducting firefighting-related tasks such as stair climb, hose couple, ladder lift, dummy drag and forcible entry (Misner et al., 1987). Misner et al. (1987) found female participants required greater time to complete each task, which correlated to their lower percentage of fat-free weight, implying females are not capable of producing an absolute force (strength) equal to their male colleagues. This potentially limits lifting, carrying and striking task
  5. RJTA performances (Misner et al., 1987). With their higher body fat percentage, females were 23,2 found to be significantly hindered while performing tasks that required body weight to be translocated at higher speeds. While the Misner et al. (1987) protocol assessed firefighting specific tasks, unlike the Findley et al. study, the findings still cannot be generalized to the greater female firefighter population as participants were not firefighters. In addition, regardless of physical performance based on gender, the level of anaerobic power and 98 strength necessary to perform firefighting tasks remains unknown (Findley et al., 2002; Antolini, 2014). Qualitative research does support the argument that individuals with low muscle mass, such as women, may struggle to perform fire-fighting activities (Barr et al., 2010; Sinden et al., 2013). Interviews with female firefighters have revealed: [. . .] for a woman it is difficult because you are working above your head and our upper body strength is not the same as a man’s because that is just the way we are built [. . .] (p.100), Moreover, “females are already 20 per cent not as strong as their male counterparts [. . .] so you really have to maintain that or you’re going to be weaker” (p. 100) (Sinden et al., 2013). Such findings often contribute to the perception that females are not as physically equipped for the profession, further intertwining the physical challenges of the job with the unique psychological barriers female firefighters face in a male-dominated field. Given the conclusions from previous research, it is not surprising that the firefighting profession has one of the lowest rates of female employment of all physically demanding occupations (Hulett et al., 2008; McCoppin et al., 2018). The assumption that female firefighters are not physically capable of adequately performing their job duties is supported by limited previous work that fails to assess the physical capabilities of experienced female firefighters under realistic scenarios. Beyond the physical challenges, female firefighters have expressed that they face significant emotional stress in the workplace and cite frequent sexual harassment in the male-dominated profession (Shuster, 2000; Tavernise, 2018). This stress and harassment has even lead to suicide under extreme circumstances (Jouvenal, 2016; Dvorak, 2018). The concern and perception by others of a lack of physical capability, along with workplace harassment, discourages women from entering the field and makes it more difficult to command respect from their fellow colleagues (McCoppin et al., 2018; Tavernise, 2018). All of these factors combined create physical and psychological barriers for women considering and entering the male-dominated profession. 3. Firefighter personal protective equipment, anthropometrics and fit 3.1 First responder personal protective equipment The physical and psychological barriers that female firefighters encounter in the fire service are often caused by in-part or exacerbated by the protective clothing and equipment they wear. NFPA 1971 Standard on Protective Ensembles for Structural Fire Fighting sets the minimum design, sizing and performance requirements for turnout suits and the full PPE ensemble for structural firefighting (National Fire Protection Association, 2018). A traditional, USA, structural firefighter turnout ensemble consists of the coat, pants, helmet, hood, self-contained breathing apparatus (SCBA), SCBA mask, gloves and boots. The turnout coat and pants consist of three component layers: (1) a durable, protective outer shell that serves as the first line of protection; (2) a thin inner layer is known as the moisture barrier, which prevents water and low- level chemicals from penetrating through; and
  6. (3) the thermal liner, which is directly in contact with the firefighter's base layers or A critical skin (McQuerry, 2016). review of Ensemble elements such as gloves, boots, the thermal hood, SCBA and helmet contribute to female the overall physical performance of firefighters. The integrity of interface protection firefighter (Figure 1) between the turnout suit and these ensemble elements has been identified as a major factor for ensuring adequate protection, mobility and comfort (Park et al., 2014a). Ergonomic PPE design issues recognized by firefighters include limited mobility of the head 99 and arms while wearing the helmet and SCBA, restricted access to coat pockets, back pain and soreness (Park et al., 2014a, 2014b; Sinden et al., 2013). PPE sizing and fit issues, such as the excessive length and bulkiness of glove fingers, have also been frequently cited as major concerns, especially for female firefighters. Oversized gloves limit dexterity and mobility, making it difficult to handle equipment (Park et al., 2014a, 2014b; Sinden et al., 2013). Female firefighters report that the compromised grip and dexterity caused by wearing oversized gloves adds additional physical strain to their already stressful jobs (Park et al., 2014a, 2014b; Sinden et al., 2013). This is an example of the need for and importance of individualized, gender-specific sizing and fit of PPC and PPE for protection, mobility and comfort. 3.2 Female versus male anthropometrics To understand the limitations of male-centered turnout ensembles, the physical anthropometric differences between male and female human forms should be considered. Anthropometrics is the study of physical characteristics (i.e. sizes and shapes) of the human body using measurements (Pheasant, 1990). Previous research demonstrates that women and men differ in their physical shapes and proportions, with the average woman having a body size that is only 93 per cent of the average man’s (Hulett et al., 2008). Figure 2 depicts three-dimensional body scanning silhouettes that illustrate anthropometric differences between female and male forms when wearing base layers (t-shirt and shorts). Differences between the two human forms can even be seen when wearing thick, bulky structural turnout ensembles, as shown in Figure 3. Anthropometric differences are especially prominent between males and females in the waist to hip proportions (Hulett et al., 2008; Boorady et al., 2013a; Langseth-Schmidt, 2014). Previous research has demonstrated that waist and hip circumferences for females may vary by as much as 12.34 inches, whereas the male hip variation was only 5.08 inches (Textile Clothing Technology Corporation, 2003; Boorady et al., 2013a). Based on three-dimensional body scanning, female firefighters have a proportionally larger hip circumference than male firefighters. The male torso is typically longer than that of the female body, where the waistline is lower and not as tapered; the hips are not as prominent; and the pelvis is narrower (Langseth-Schmidt, 2014). Females, on the other hand, generally have prominent hips, with a waist circumference that is tapered relative to hip circumference (Langseth-Schmidt, 2014). Therefore, when female firefighters select turnout pants designed for males, they may select a larger waist size disproportionate to their actual waist circumference to accommodate their proportionally wider hips, leading to oversized waist and thigh areas. Similar issues can occur in the turnout jacket as female firefighters may accommodate the bust area by sizing up in the chest, which could lead to excessive bulk in the shoulders and arms. Ultimately, wearing a pattern designed for the opposite sex results in overall poor fit, which reduces mobility and increases exertion. To improve the safety, comfort and mobility of female firefighters, PPE product developers must change the way turnout suits are
  7. RJTA 23,2 100 Figure 2. Three-dimensional body scan silhouettes of a female (a) versus a male (b) firefighter when wearing t-shirt and shorts designed. For such design changes to be implemented, governing standard documents, including NFPA 1971, must be revised as they specify the required design and sizing criteria for product certification. 4. Sizing standards for firefighter protective clothing NFPA 1971 specifies the sizing parameters of the turnout suit, mandating the garments be offered in a range of chest, sleeve, waist and inseam measures for men and women, individually. For the turnout coat, the chest circumference may be between 34-60 inches for men and 28-50 inches for women, with no more than a 2-inch increment between sizes; the sleeve length must be between 32-38 inches for men and 28-34 inches for women, with no more than a 1-inch increment for each size (National Fire Protection Association, 2018). For the pants, the standard specifies a waist circumference between 30-60 inches for men and 28- 50 inches for women and an inseam between 26-36 inches for men and 24-34 inches for women, with a 2-inch increment between sizes for both measurements (National Fire Protection Association, 2018). As currently specified above, the turnout coat and pant sizing requirements for females are a simple downscaling of regular turnout suit designs, proportions and sizes for males. Females, however, are not merely smaller versions of men (Hulett et al., 2008), as Figures 2 and 3 illustrate. 4.1 Impact of male personal protective equipment sizing on female firefighters The impact of providing female firefighters with male-centered garments that are merely “scaled down” per NFPA 1971 sizing requirements is evident in the population’s feedback regarding fit and mobility issues. Almost 80 per cent of female firefighters indicate problems in the neck circumference and hip breadth of their turnout suits (Hulett et al., 2008). Three-
  8. A critical review of female firefighter 101 Figure 3. Male versus female structural firefighters wearing the same PPE turnout suit design dimensional body scanning data has confirmed anatomical sex differences in baseline body measurements linked directly to landmark areas that cause discomfort for female firefighters when wearing structural turnout gear (Langseth-Schmidt, 2014). To compensate for poor fit, mobility and comfort related to their larger bust and hip circumferences, female firefighters tend to order larger sized turnout coats and pants. However, wearing oversized gear sacrifices appropriate fit in the sleeve, crotch and pant length, adding to the bagginess of the turnout suit (Langseth-Schmidt, 2014). Excessive bulk is also created in the upper body, torso and thigh regions when sizing up, which can lead to restricted movement and increased heat buildup during intense bouts of exercise. Incorrect sizing of ensemble elements, beyond the coat and pants, was also one of the most critical issues for female firefighters identified in previous studies (Hulett et al., 2008; Boorady et al., 2013a). In a survey by Hulett et al. (2008), 79.7 per cent of female firefighters reported problems with ill- fitting equipment, nearly four times higher than the 20.9 per cent reported by male firefighters (Hulett et al., 2008).
  9. RJTA 4.2 Selection of personal protective equipment sized for women 23,2 Some PPE manufacturers have attempted to address the needs of female firefighters by offering “female-sized” turnout gear. However, studies show that female firefighters are generally unaware of such options or are not offered the opportunity within their departments to select these types of gender-specific gear. In fact, almost 40 per cent of departments surveyed in the Hulett et al. (2008) study indicated they had not purchased size- 102 adapted clothing or personal equipment for female employees (Hulett et al., 2008). This demonstrates a lack of departments’ responsiveness, as size-specific gear has been manufactured since 1995 and departmental budgets were not noted as a limiting factor (Hulett et al., 2008). In addition, a major limitation beyond the lack of awareness and department responsiveness for female-specific gear is its ineffectiveness to meet the needs of the female firefighter population. If given the opportunity to purchase gender specific gear, female firefighters have indicated that they find it to be inadequate as it is not designed according to their body shape and proportions (Boorady et al., 2013a). Current female-cut turnout coats are made without understanding body proportion differences between genders in the torso, limb length, shoulder and chest regions. Based on the lack of information in the current body of literature, there exists a need for future research to further develop and evaluate firefighter PPC (turnout coat and pants) and PPE (gloves, boots, SCBA, etc.) designed specifically for women. As discussed above, NFPA 1971 details the required size ranges for males and females in the chest, sleeve, waist and inseam areas for the turnout coat and pants (Mordecai and Freeman, 2012; National Fire Protection Association, 2018). During the most recent revision of NFPA 1971, language was added to suggest that sizing should be adapted using individual patterns for men and women (National Fire Protection Association, 2018). This revision demonstrates awareness by the fire service and standards bodies for the need to design and develop female-specific firefighting PPE. However, the specificity of the language in the standard is lacking, as this statement is vague and does not provide detailed requirements. Differences in anthropometrics or body shapes between or within genders should be captured. To accomplish such a change, NFPA 1971 must move beyond current requirements. 5. Common protective clothing issues for female firefighters Previous research indicates, and current standards bodies acknowledge, that there is an apparent need for female-specific firefighter protective clothing and equipment. To design and develop PPC and PPE that will improve the protection and performance of women in the fire service, the user needs of this population should be well understood. Female firefighters have reported the following five major factors that should be addressed regarding the function and comfort of their turnout gear: garment design, sizing, fit, mobility and fabrication (Boorady et al., 2013b). Some female participants in a previous study by Boorady et al. (2013a, 2013b) likened wearing turnout suits designed for men as “like wearing my dad’s coat,” (p. 7) as they are too big and disproportionate (Boorady et al., 2013b). Other issues specific to the female form were reported including suspender placement in relation to the fit of the turnout pants: “they run up over your boobs” (p.6) and “it rubs, so I’ve had to wear like my little sports bra underneath” (p. 6) (Boorady et al., 2013b). Suspender placement was also found to conflict with the straps of the SCBA air pack, causing further discomfort in the bust area, which relates to equipment and gear interface issues with the turnout suit. The crotch area of the pants was also found to be extremely ill-fitting for female firefighters
  10. as the trousers hang far too low, leading to reduced mobility. Other studies have collected A critical similar feedback related to the bunker pants being too big (Sinden et al., 2013). review of Participants in the Boorady et al. (2013a, 2013b) study also expressed how heavy the ill- fitting gear is for women, especially when it is new and stiff, which is an added stressor. female Therefore, lighter weight materials should be explored to enhance the performance of firefighter women in the fire service. Further suggestions from the literature include altering fit and sizing (Shuster, 2000), changing the location of the pockets and enhancing the overall functionality, especially that of the suspenders (Boorady et al., 2013a). While the Boorady 103 et al. study was the first to delve into female firefighter PPE issues, it was limited by a small sample size of female firefighter focus group participants only. Therefore, additional work must be done to determine the current, widespread and specific user needs for female first responders. A study by Park et al. (2014a, 2014b) identified the following concerns that female firefighters have about their uniforms: significantly lower satisfaction scores than males with the fit and functionality of the turnout coat; the sleeves (sleeve length, sleeve fit and armhole); and the coat length. Assessments to measure specific body motions including walking, extreme limb movement and reaching overhead, revealed lower satisfaction and comfort ratings for women (Park and Hahn, 2014). Some female firefighters in this study reported that the female-cut turnout coat, with a shorter length ending above the hips, provided more comfortable movement around the hips; however, the shorter coat length increases the potential for burn injuries in the interface area (Park and Hahn, 2014). This concern is particularly relevant when performing such activities as lifting overhead during pike-pull overhaul operations or bending over while kneeling and crawling. Twenty female firefighters reported that the sleeve length was too long (nine responses) or the cuffs were too wide (five responses) or bulk in the upper arm caused folds in the extra fabric and lining that resulted in discomfort and restricted arm movement (Park and Hahn, 2014). Similar to the research conducted by Boorady et al. the Park et al. study was also limited by its small sample size of female firefighter participants. The findings of these previous studies further emphasize the need to develop turnout suits that are designed with female anthropometric differences and body proportions in mind. Initial background research has been conducted, but more work is necessary to gain a better understanding of the PPC needs of the growing female firefighter population across various regions of the USA. It can be dangerous for women to endure the environmental hazards of firefighting while wearing cumbersome and inadequately fitting uniforms that increase their risk of injury and fatality. 5.1 Challenges in firefighting equipment for female firefighters In addition to oversized turnout coats and pants, female firefighters also face issues while wearing male-centric equipment such as boots, gloves, helmets, SCBAs and SCBA masks. Problems with ill-fitting equipment have been reported by women at a rate nearly four times greater than their male firefighter counterparts (Hulett et al., 2008). This is most likely because firefighting equipment has traditionally been designed for the single-sex male workforce. Ill-fitting ensemble elements make work more uncomfortable, difficult and dangerous, especially for female firefighters (Chetkovich, 1997). Specifically, the Hulett, et al. (2008) study found that females experienced the most fit issues with gloves (57.8 per cent of female respondents) followed by boots (46.8 per cent of female respondents), helmets (28.4 per cent of female respondents) and SCBA masks (25.6 per cent of female respondents) (Hulett et al., 2008).
  11. RJTA According to previous research, female firefighters are aware that some PPE equipment 23,2 designed for women exists and is commercially available, however, it is not always provided as an option by their department or it is not economically feasible (Hulett et al., 2008). One participant of the Sinden et al. (2013) study noted: The boots are always too big on me and the bunker pants [. . .] everything is just kind of big and fits more loosely because it’s suited more for a man. They do have female gear out there but we 104 don’t have it (p. 100) (Sinden et al., 2013). The participants of this study also expressed that the face piece component of the SCBA was too large and required modification: [. . .] we have a breathing apparatus that includes a face piece and the face piece was too big so I let them know and they got me a smaller one and that happened with three other girls as well, (Sinden et al., 2013). More importantly, of those women in the fire service, who have had the opportunity to wear female-sized gear, it was found to be insufficient from a sizing and fit perspective. Female- sized turnout coats on the market are often smaller, shorter versions with the length ending above the hips (Park and Hahn, 2014). This increases the risk of thermal exposure in the interface areas such as the coat and pant overlap. While some manufacturers offer “women sizing”, this PPE is often a simple down-sizing from a male-centric pattern or design. Female firefighters have acknowledged that critical elements of their firefighting equipment are too large and are better suited for their male counterparts. Not all women in the fire service, however, feel as empowered to voice their concerns regarding ill-fitting and poor functioning PPC and PPE. Therefore, female-specific gear should not be perceived as or only offered as, an additional option. Instead, firefighter protective clothing and equipment should be standardized, designed, produced and selected according to gender. 6. Influence of personal protective equipment on female firefighter performance 6.1 Mobility and ergonomics Improper fitting structural turnout suits for female firefighters can lead to restricted range- of-motion (ROM) and mobility when performing critical tasks; especially in the chest and hip areas, where body dimensions vary greatly between men and women (Textile Clothing Technology Corporation, 2003). Excessive material in the crotch and leg areas may lead to trips, falls and difficulty performing certain tasks such as kneeling and crawling (Boorady et al., 2013a). Studies have demonstrated the negative impact that excessively bulky clothing has on constraining movement, such as altering gait and increasing physiological stress (O’Hearn et al., 2005; Norkin and White, 2009; Coca et al., 2010; Son et al., 2010; Ciesielska- Wrobel et al., 2017). Female firefighters experienced a 2.34 per cent greater loss of motion in hip flexion compared to their male colleagues when ROM was tested in structural turnout suits (Langseth-Schmidt, 2014). Knee ROM was also reduced for female firefighters at the bending and stepping levels for both station pants and turnout pants in the range of 0.42-5.72 per cent (Langseth-Schmidt, 2014). Guidotti (1992) found that female firefighters experience significant mobility issues when climbing ladders, dragging hoses and entering/exiting emergency vehicles due to the improper fit of the turnout pants (Guidotti, 1992; Langseth-Schmidt, 2014). Compared to their male counterparts, female firefighters reported significantly lower satisfaction with the pant leg length when walking and bending, and with the pants’ fit around the crotch, hips and waist (Langseth-Schmidt, 2014). Discomfort in the chest area is another common
  12. problem, with movement being restricted, especially due to inconvenient placement of the A critical chest pockets in the bust area (Park and Hahn, 2014). While the chest region is overly review of restrictive, the shoulders are found to be too broad and bulky, as well as the sleeves and neckline (Park and Hahn, 2014). For these reasons, female firefighters are more likely to female make alterations to their PPE compared to male firefighters, which supports findings from firefighter previous literature that females are dissatisfied with the overall fit and comfort of their uniforms (Boorady et al., 2013b; Park and Hahn, 2014; Park et al., 2014a). More research is needed regarding ensemble mobility, as previous studies (Park et al., 105 2011; Langseth-Schmidt, 2014) have not considered female firefighter user needs for the full structural turnout ensemble, including turnout coat, pants, thermal hood, helmet, and SCBA. Considering the negative impacts of improper fitting PPE, the design and sizing system for female firefighters should be analyzed and improved based upon a more thorough understanding of the anthropometric data of the female human form (Park et al., 2014b). 6.2 Comfort and heat stress While improper fitting gear has a direct impact on mobility and range of motion, it has an indirect, but significant effect on thermal comfort. Wearing ill-fitting and heavy PPE leads to a greater physiological burden, especially for female firefighters, as their gear is excessively bulky due to its male-centered design. This increases the risk of fatigue and exhaustion, as evidenced by injury reporting rates: female firefighters report 33 per cent more injuries than their male counterparts (Liao et al., 2001; Hulett et al., 2008; Sinden et al., 2013). Ill-fitting PPE restricts body motion, requiring more energy to perform the same movement. This increases metabolic heat production as the wearer must work harder to perform the physical activity when restricted. The increased exertion required to crawl, kneel, climb stairs and move overhead, etc. can lead to an earlier onset of fatigue and heat stress. Oversized, heavy, ill-fitting protective garments also create larger air gaps within the clothing microclimate or the atmosphere between the body and the garment (Havenith, 2001; Frackiewicz-Kaczmarek et al., 2015). As these gaps of air thicken or increase in size, clothing insulation also increases, thereby reducing heat transfer and effective evaporation of sweat leading to overheating (Havenith, 2001; Bouskill et al., 2002; McQuerry et al., 2017). Areas of the turnout suit that are oversized and bulky not only elevate the risk of trips and falls but also increase the thermal and evaporative resistance as heat must travel farther away from the body to be effectively released through the clothing ensemble to the external environment (Havenith, 2001; McQuerry et al., 2017). For female firefighters who often select oversized turnout gear, to accommodate their bust and hips, large air gaps due to excessive bulk may be prominent throughout their clothing microclimate. 6.3 Thermal, liquid and chemical protection The first priority of a structural firefighting ensemble is to protect the wearer from heat and flame exposure. For females, the risk of thermal exposure is often greater than their male colleagues due to improper fitting PPE. When worn on the female body, improperly proportioned turnout gear provides greater opportunity for burn injuries in the interface areas, especially when performing activities overhead and while kneeling, crawling, etc. Female firefighters have reported that the cuff of their sleeve is too wide, which may create gaps in the sleeve and glove interface area, allowing for burns and hazardous chemical exposure to occur (Park and Hahn, 2014). An illustration of the potential risk that interface gaps pose is provided in Figure 4, which depicts the smoke particulates
  13. RJTA 23,2 106 Figure 4. Firefighter gloves glow after an aerosol test – the fluorescence shown is used to assess the behavior of smoke particulates in a hazardous environment found on structural firefighting gloves after exposure. Similar concerns are present in the neckline where additional bulk may leave gaps for liquid, chemicals and heat to enter the clothing system (Park and Hahn, 2014). Therefore, the impact of improper sizing and fit on the protection of the turnout ensemble, for female firefighters specifically, should be explored and addressed. 7. Conclusion Firefighting is widely known as a hazardous occupation – regardless of gender. For females, unique psychological and physical barriers exist when entering and working within the fire service. The physical environmental threats that all firefighters face while on duty are combated by their turnout suits and protective equipment. As the first barrier of defense, it is vital that the donned PPE is of satisfactory fit and function to protect the wearer and minimize the risk of injury. Amongst the female firefighting population, ill- fitting turnout gear and protective equipment has become increasingly prevalent as traditional turnout suit designs are developed and patterned around the male form. This creates a bulky and unsafe silhouette for most female forms, including gaps in interfaces such as, the gloves and cuffs of the jacket and the hem of the turnout pant and boot. In this case, it is possible that smoke particulates and chemicals can make their way to the skin, as the openings are not properly sealed. In addition, female firefighters are more prone to increased exhaustion from heat and physical stress, compared to their male colleagues, due to the ergonomics of the male-centric form of the turnout suit. Quick solutions such as shortening or resizing the jacket and pants to be smaller are ineffective. Female firefighters continue to face discomfort in areas that are commonly associated with the female form, such as the chest, bust and hips. The fire service should look to other industries such as military, law enforcement and sports apparel for successful examples of female-focused PPC and equipment designs. These other physically demanding professions have specifically designed uniforms and
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