Kevin Haney stood on a mat as Joe Hicks gave him his latest instruction.
"You're going to pause in your squat and then jump," Hicks said.
Haney, a 47-year-old captain in the Duluth Fire Department, was in the midst of a fitness assessment last week at Fire Station 1. Hicks was one of a handful of graduate students putting Haney and a few of his colleagues through the paces for about 90 minutes apiece.
Haney, who leads the department's Rescue One unit, had just had his strength tested with an arm lift and a leg lift and would go on to the plank test - a muscular endurance segment in which he would try (successfully) to support his body in an elevated position for four minutes.
First he would jump as high as he could from the squat position, which is an assessment of power, said Joe Warpeha, an associate professor and director of The College of St. Scholastica's exercise physiology laboratory.
It's the third year the CSS program and the Fire Department have collaborated in the voluntary assessment. Haney, a 19-year veteran of the department and a member of its wellness and fitness committee, has been a gung-ho participant from the start.
"It's beneficial for both sides," he said. "We get to see where we're at, and they get to ... use us as a specimen to test their skills in the field they're going into."
Hicks, who will intern this summer in cardiac rehab at Essentia Health in Superior after graduating from the program, agrees.
"I think it's wonderful," he said. "I wish we had more opportunities, to be honest, because I think it'd be beneficial for every student to get more hands-on preparation for real-world jobs."
The assessment is part of a concerted effort by the Duluth Fire Department - and departments across Minnesota - to counter alarming findings about firefighters' mental and physical health.
In terms of cardiac health, certain kinds of cancer and mental well-being, the statistical picture for firefighters is far grimmer than that of the general population.
"We're about (double) on all of that bad stuff," said George Esbensen, who is chief of the Eden Prairie, Minn., Fire Department and president of a nonprofit known as the Minnesota Firefighter Initiative or, simply MnFIRE.
The data bear that out:
- About twice as many firefighters have malignant mesothelioma as in the general population, and firefighters younger than 65 have more bladder and prostate cancers than would be expected, according to a study led by the National Institute for Occupational Safety and Health.
- More than 12 percent of all firefighters will develop heart disease at some point in their lives, according to the International Association of Firefighters.
- Nearly 47 percent of firefighters had had thoughts of suicide, according to a study published in 2015 in the Journal of Affective Disorders. The yearly rate of firefighter suicide in Minnesota is between 22 and 25 per 100,000, Esbensen said - compared with 13 per 100,000 for the general population.
Firefighters "have a lot of their own stories about friends who are no longer in the room, people they came on with that are no longer with us or people that are battling cancer or people that maybe have taken their own lives," Esbensen said.
MnFIRE takes a three-pronged approach against heart disease, cancer and mental illness, he said.
Those are also the areas the city of Duluth is focused on, said Angel Hohenstein, the city's wellness coordinator.
"We've been looking at ... ways to proactively help our Fire Department make sure that they don't succumb to the statistics," she said.
Part of MnFIRE's work is to do battle with the chemicals industry, Esbensen said. Flame retardants are only minimally effective at slowing the spread of flames, he said, but when flames occur they release carcinogens.
"The thing about these flame retardants is their chemical compounds are such that one of the things they gravitate (to) most lovingly is warm, moist skin," he said. "And I don't know if you know this, but firefighters have a lot of that."
The industry has a different take on the risks.
"Flame retardants are an important part of the fire safety toolbox," said Bryan Goodman, spokesman for the American Chemistry Council's North American Flame Retardant Alliance. "They can provide consumers with an important layer of protection, helping to prevent or stop the spread of fire, which may also help protect first responders.
"We all want to protect firefighters who put their lives on the line to protect us, and it's important to better understand why firefighters appear to have increased rates of some cancers. But generalizations about products or chemicals, like flame retardants, is not the answer."
Firefighters can do their part to minimize the cancer risk, Esbensen said, and MnFIRE has been working to change the culture that filthy gear is "a badge of honor" and "instilling some of those behaviors that clean gear is happy gear."
Following a model that has been successful in Illinois, MnFIRE also set up a peer support network in which a firefighter who is struggling can call a specially trained firefighter from another department. During a recent 19-week period the peer line received 20 calls, Esbensen said. Seven of those were serious enough to be referred for additional help.
"And a couple of the people had a plan, had a means and basically had told us we were their last call for help," he said. "So it's making a difference."
A challenge is overcoming the perception among firefighters that they are supposed to be tough and able to handle things, said Dan Smith, a Duluth firefighter who is chairman of the department's wellness and fitness committee.
"So it's beating that stigma and changing the cultural norm within the fire service to say, 'Hey, it's OK to ask for help; it's OK to talk about this stuff,' " Smith said.
Although the fitness assessments with the St. Scholastica students particularly applies to heart health, it also has a mental health component, Haney said.
"We have a lot of things to overcome, and the only way to do that is to keep ourselves in the best physical shape possible," he said. "Because it helps on the mental side of it, too, because we do see trauma and things that can be disturbing."
The partnership between the CSS students and the Fire Department grew out of a conversation Hohenstein and Warpeha had when his students were doing fitness assessments at the city's health fair.
"She brought up the idea that the Fire Department is looking to promote some of their own fitness and wellness initiatives, and that's when I volunteered our services," Warpeha said.
The collaboration "is a real nice win-win for us because our students can actually apply the skills they're learning in the real world for real people," he said. "And the Fire Department has a real need for these sorts of tests to be conducted."
It helps, Warpeha said, that Chief Dennis Edwards is a proponent of the program who volunteers for the fitness assessment himself.
"He does really well," Warpeha said. "I think that's how the culture gets created."
Nonetheless, Haney said he sometimes has to use his persuasive skills to get all of the available slots filled by firefighters willing to be assessed.
One thing the firefighters can be assured of, Warpeha said, is that the results of the assessment won't be used against them. Two of the students go over the results with the firefighter at the end of each assessment, and the exercise physiology department stores the data so comparisons can be made at the next assessment. But an individual's results are never shared with the Fire Department or the city. All Hohenstein receives as an aggregate report so she can see how the firefighters (or at least those who participate) are doing on average.
The firefighters participating in the assessment are part of a change that needs to be accelerated among firefighters, said Esbensen, who began his career as a volunteer firefighter in Eden Prairie in 1986.
"That's all a matter of our culture," he said. "So we have to change that, and we have to make it OK for firefighters to be working out. We have to encourage that, and we have to create environments so it becomes the culture that we stay in good shape.
"Because our lives literally depend upon it."
What Minnesota spends
The Minnesota Firefighters Initiative is asking the state Legislature for an additional $5.5 million in support for Minnesota firefighters.
It sounds like a lot, acknowledged George Esbensen, the organization's president. But he points to data from the Minnesota Center for Fiscal Excellence that shows the state's per-household spending on fire protection is $218 - 45th in the nation. (Rhode Island, the No. 1 state, spends $794 per household.)
If Minnesota spent another $15 million per year, it would rank 44th, Esbensen said. It would take $100 million in additional spending to reach 40th.
"We're so far behind the curve," he said. "It's an embarrassment for the state of Minnesota the way we provide for our firefighters."
Firefighter help line
The number for firefighters to call for peer support is (888) 784-6634. For more information, visit mnfireinitiative.com.