Dietary Patterns Following a Firefighter Nutrition Education Programme (RESCUE)
Assessing Dietary Patterns and the Longer-term Impact of a Firefighter Nutrition Education Programme (RESCUE)
Firefighters may be at increased risk of poor dietary habits due to nature of shift work, extended duty periods, and reliance on food available within fire station environments. Irregular working patterns and limited access to healthy food options during shifts can contribute to poorer dietary intake. Previous research suggests that occupational environments and works schedules can significantly influence food choices and overall nutrition in emergency service personnel.
This study is being conducted to assess current dietary behaviours among firefighters and to evaluate changes following implementation of the RESCUE (Resilient Eating Strategies for Cancer-Risk in Uniformed Emergency workers) nutrition education programme, a structured programme designed to improve dietary knowledge and food choices. It will also explore the influence of station-based food provision on dietary intake.
The research is important as firefighters face increased occupational health risks, including elevated cancer risk, where diet may play a role in long-term health outcomes. Improving dietary habits in this group may improve health, occupational performance, and reduce the risk of chronic disease. The findings will provide evidence to inform the development of practical, targeted nutrition interventions within fire and rescue services.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Firefighters are exposed to a complex mixture of hazardous and carcinogenic substances through their work, including combustion products, diesel exhaust and contaminated fire effluent. Epidemiological evidence shows elevated risks for several cancers, and in 2022 the International Agency for Research on Cancer (IARC) classified occupational exposure in firefighting as carcinogenic (Group 1).
Risk is shaped not only by future exposure but by cumulative exposure over time, because some fire-related contaminants are persistent or bioaccumulative. Firefighters are also commonly exposed to shift work and circadian disruption, which has itself been associated with increased cancer risk. While improvements in personal protective equipment, decontamination practices, and operational procedures remain essential, evidence from exposure studies and biomonitoring research indicates that these measures alone cannot fully eliminate exposure-related risk, particularly for persistent and bioaccumulative contaminants.
There is therefore growing interest in additional, practical strategies that can support long-term health resilience in firefighters. Diet is one such area, with evidence linking dietary patterns to cancer-relevant processes such as inflammation, oxidative stress, xenobiotic metabolism, and DNA damage and repair; this evidence base is reflected in the guidance of major international cancer and public health organisations including the World Cancer Research Fund, World Health Organization, and International Agency for Research on Cancer.
Within the fire and rescue service, structured nutrition initiatives have historically been rare. Where dietary guidance exists, it usually mirrors general public health advice (healthy eating, weight and fitness) rather than firefighter-specific risks. This can limit engagement for those who already feel fit and for those uninspired by generic advice. In the context of dietary change for firefighter cancer-risk reduction, the limiting factor is often not lack of motivation, but the absence of education and a clear occupational rationale that connects everyday food choices to the specific risks of firefighting. Even if services are well informed regarding suitable dietary intake, dietary behaviours cannot be mandated or enforced within the workplace, and so suitable food choices relies on firefighters themselves.
This project addresses that gap by adopting a novel approach: explicitly framing dietary change around occupational cancer risk, aligned with the 2022 IARC classification. This approach is relevant to all firefighters, regardless of demographic factors, such as body composition or fitness level, and provides a clear basis for engagement. At present, there is little published data describing dietary patterns among UK firefighters, limiting the ability of services to design targeted, evidence-informed interventions.
The RESCUE programme is designed to be practical, culturally appropriate and scalable within real fire service settings. It centres on structured, firefighter-specific education delivered at watch level and reinforced with resources that translate evidence into actionable guidance within existing station "mess" culture. The approach does not rely on individual prescriptions or supplements.
The approach is informed by recent peer-reviewed work synthesising evidence on diet, firefighting exposures and cancer risk, co-authored by the principal investigator in collaboration with Dr Shelly Coe (Oxford Brookes University), which highlighted consistent evidence linking dietary patterns to cancer risk, supported by plausible underlying biological mechanisms, alongside the absence of practical firefighter-specific dietary frameworks. This project builds on that foundation by moving from evidence synthesis to real-world implementation and evaluation.
The project aligns with the objects of the Fire Service Research and Training Trust by supporting research into the prevention of fire and rescue service-related health risks and by contributing to the training of fire and rescue personnel through structured education and transferable resources. By focusing on practical, scalable dietary change, the project also addresses well-recognised determinants of workforce health and operational resilience, supporting a more stable and effective fire and rescue service while maintaining its primary focus on occupational cancer risk.
RESCUE is a service-wide nutrition education programme implemented across Avon Fire & Rescue Service independently of participation in the research evaluation. The observational evaluation comprises voluntary repeated cross-sectional questionnaire assessments among eligible wholetime operational firefighters before programme implementation and approximately 3, 6 and 12 months afterwards. Participation is invited separately at each assessment, and respondents are not required to have completed a previous questionnaire; the responding samples may therefore differ between assessment points. Participant-generated study codes permit linked longitudinal analyses where responses can be matched across assessments.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Ben R Jones, BSc (Hons)
- Phone Number: 07867555602
- Email: ben1jones@hotmail.com
Study Contact Backup
- Name: Shelly A Coe, PhD
- Phone Number: 07531435736
- Email: scoe@brookes.ac.uk
Study Locations
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Bristol, United Kingdom, BS20 8JJ
- Recruiting
- Avon Fire and Rescue Service
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Contact:
- Ben R Jones, BSc (Hons)
- Phone Number: + 44 7867555602
- Email: ben1jones@hotmail.com
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Principal Investigator:
- Ben R Jones, BSc
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
Wholetime (full-time) operational firefighters employed by Avon Fire & Rescue Service.
Aged 18 years or over. Able to provide informed consent.
Exclusion Criteria:
Individuals who are not full-time operational firefighters within Avon Fire and Rescue service (e.g. administrative staff, support roles, or part-time on-call firefighters, firefighters from other fire services)
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
|---|---|
|
Eligible AF&RS Wholetime Operational Firefighters
Wholetime operational firefighters employed by Avon Fire & Rescue Service who voluntarily complete one or more RESCUE evaluation questionnaires.
Participation is invited separately at each assessment, and respondents are not required to have completed a previous questionnaire.
RESCUE was implemented service-wide independently of participation in the research evaluation.
|
A firefighter-specific nutrition education programme implemented across Avon Fire & Rescue Service at watch level as a service-wide workforce initiative, independently of participation in the research evaluation.
The programme provides education on dietary strategies relevant to long-term health and cancer-risk reduction, supported by educational resources designed to encourage healthier dietary choices at home and within the workplace.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Difference in Mean RESCUE Protective Eating Pattern Score Between Baseline and 12 Months
Time Frame: Baseline before programme implementation and approximately 12 months after programme implementation
|
Difference in mean RESCUE Protective Eating Pattern Score between the service-wide baseline and 12-month questionnaire assessments following implementation of the RESCUE nutrition programme. The score measures the reported frequency of protective dietary behaviours, including consumption of fruit, vegetables, cruciferous and allium vegetables, legumes, wholegrains, nuts and seeds, and fish and seafood. Scores range from 0 to 28, with higher scores indicating more frequent reported consumption of the protective foods represented in the score. The primary comparison will include all respondents with valid scores in the baseline sample and all respondents with valid scores in the 12-month sample; completion of both assessments is not required. Where participant-generated study codes permit baseline and 12-month responses to be linked, within-participant change will also be examined as a supporting analysis. |
Baseline before programme implementation and approximately 12 months after programme implementation
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Participant-reported appraisal of the RESCUE nutrition programme
Time Frame: Approximately 12 months after programme implementation
|
Among respondents who report having engaged with at least one component of RESCUE, six investigator-developed items assess the programme's understandability, relevance to firefighters, practicality for station life and shift work, perceived educational benefit, and support for continued provision.
Responses are recorded on a five-point agreement scale from strongly disagree to strongly agree and summarised for each item.
Together, these item-level findings will provide a descriptive assessment of programme appraisal and perceived educational benefit at approximately 12 months.
|
Approximately 12 months after programme implementation
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in workplace messing practices (RESCUE Messing Questionnaire Score)
Time Frame: Baseline before programme implementation and approximately 12 months after programme implementation
|
Change in workplace food provision and station messing practices, assessed using the RESCUE Messing Questionnaire completed by watches at baseline and 3, 6 and 12 months.
The questionnaire assesses the frequency of healthier food provision during station meal preparation, including vegetables, legumes, wholegrains, cooking fats and oils, and protein choices.
Questionnaire responses will be combined to produce a RESCUE Messing Questionnaire Score, ranging from 0 to 24, with higher scores indicating healthier workplace food provision and messing practices.
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Baseline before programme implementation and approximately 12 months after programme implementation
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Collaborators and Investigators
Sponsor
Collaborators
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- RESCUE-DRAFT
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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