IAFF/IAFC Wellness-Fitness Task Force Meeting

Dr. Prezant directs all medical protocol development for both day-to-day operations and homeland security issues. He is also co-director of the FDNY World Trade Center Medical Monitoring Program and the Senior Pulmonary Consultant for FDNY. Dr. Prezant is a member of the Institute of Medicine’s Committee on Personal Protective Equipment in the Workplace, the National Fire Protection Association’s Health and Safety Committee, and the International Association of Firefighters Redmond Medical Advisory Board. He is a Professor of Medicine at the Albert Einstein College of Medicine; Director of Albert Einstein Medical School’s Pulmonary Course for medical students, and the Research Director for their Unified Pulmonary Division. Dr. Prezant responded on 9/11/01 to the World Trade Center and was present during the collapse and its aftermath. Since that day, he and Dr. Kelly (FDNY’s Chief Medical Officer at the Bureau of Health Services) have initiated a multi-million-dollar medical monitoring and treatment program for FDNY fire fighters funded by FDNY, the Centers for Disease Control and Prevention (CDC), and the National Institute for Occupational Safety and Health (NIOSH). Dr. Prezant is the Principal Investigator for the FDNY Data Coordinating Center for the WTC Medical Monitoring Program and is on the Steering Committee for the WTC Medical Monitoring Program. He served as a member of the EPA WTC Technical Advisory Committee, the NYC Dept of Health WTC Registry Scientific Advisory Board, the NYS Governor’s WTC panel, and the NYC Mayor’s medical advisory board. Dr. Prezant has written extensively on pulmonary physiology, fire fighter health and safety, and since 9/11 on the health impact of World Trade Center Collapse on NYC fire fighters and EMS rescue workers. His group was the first to describe WTC Cough Syndrome (New England Journal of Medicine 2002) and has published extensively on this subject in the CDC MMWR, American Journal of Respiratory and Critical Care Medicine, Chest and Environmental Health Perspectives. His major research interest is in determining the mechanisms responsible for accelerated decline in longitudinal pulmonary function and/or airway hyperreactivity in fire fighters after WTC exposure. Other interests are in determining the mechanisms responsible for the increased incidence of sarcoidosis in fire fighters after WTC exposure.

Dr. Jahnke has over a decade of research experience on firefighter health, she has been the Principal Investigator on ten national studies as well as dozens of studies as a co-investigator. Her work has focused on a range of health concerns including the health of women firefighters, behavioral health, risk of injury, cancer, cardiovascular risk factors, and substance use with funding from the Assistance to Firefighters Grant R&D Program, the National Institutes of Health and other foundations. She has more than 100 publications in peer-reviewed medical literature.

Owner and Clinical Director of PSCS. Dr. Ramella provides clinical oversight to our clinicians as well as treats First Responders. She brings 30 years of clinical and mental health experience to the practice and provides a wealth of knowledge to the field. She earned her PhD in Psychology and often consults with the International Association of Fire Fighters, Community Bridges and several Fire Departments in the nation.

After graduating from the University of Washington School of Medicine, Dr. Burgess completed a residency in Emergency Medicine, a Medical Toxicology fellowship, and a master’s degree in Toxicology and Industrial Hygiene at the University of Arizona, followed by an Occupational and Environmental Medicine fellowship and a Master of Public Health at the University of Washington. He returned to the University of Arizona in 1997 and is currently a Professor and Director of the Center for Firefighter Health Collaborative Research at the University of Arizona Mel and Enid Zuckerman College of Public Health. Dr. Burgess also previously worked as an Emergency Medicine physician, Medical Toxicologist and Occupational and Environmental Medicine physician. Dr. Burgess’ research has included evaluation and prevention of carcinogenic exposures to firefighters, miners, Native Americans, and populations exposed to arsenic in their water and food. Much of his recent research has involved firefighters, a group known to have increased cancer rates compared to the general population. Working in partnership with the Tucson Fire Department, his research team has identified effective interventions to reduce fireground exposures. In addition, the team has identified circulating microRNA and DNA methylation markers of increased cancer risk among firefighters. Dr. Burgess also is leading a research team that established and is now expanding the Fire Fighter Cancer Cohort Study (FFCCS), a national multicenter prospective study including exposure measurement, biomarkers of effect and cancer outcomes.

Dave is a Professor, Strength and Conditioning Coach (CSCS) and Registered Kinesiologist (RKin). He completed undergraduate degrees in electrical engineering, health studies and physical and health education at Queen’s University and received a Masters in sport biomechanics from Edith Cowan University and a doctorate in biomechanics from the University of Waterloo. His research interests include sport, exercise and occupational biomechanics, musculoskeletal health and injury prevention, movement screening, acute and long-term adaptations to exercise, firefighter wellness and fitness, and the scholarship of teaching and learning. Dave’s current research is focused on helping people prepare for the physical demands of sport, work and life, and the application of theory to practice in exercise-related settings.
Dave has taught at three academic institutions (Edith Cowan University, University of Waterloo, University of Toronto), served as the Director of Education for the Ontario Kinesiology Association and worked for 15 years as a Strength and Conditioning Coach in the United States, Australia and Canada with individuals of all ages, abilities and interests (e.g., Olympic and Professional athletes, firefighters, back pain patients). He frequently lectures on wellness, athletic performance and injury prevention, has authored several journal articles and book chapters on movement screening, assessment and exercise program design, and continues to advise numerous public and private organizations across the globe. Dave is an engaging and passionate presenter who aspires to share evidence-informed ideas that inspire, empower, and challenge individuals and organizations to redefine health, wellness and performance. This drive extends from an enthusiasm for motivating others to achieve success in their own lives and reflects a belief that education can be a powerful catalyst to facilitate positive change.

Constantine (Kosta) graduated from York University in 2009, where he obtained a Bachelor of Science in Kinesiology, and a Diploma in Athletic Therapy. During his time at York University he interned as a Strength and Conditioning Coach, working primarily with the Men’s and Women’s Soccer teams. His experiences at York University inspired him to pursue a career in coaching, and shortly upon graduating he obtained his certification as a Strength and Conditioning Specialist through the National Strength and Conditioning Association (NSCA).
Kosta has since had the great fortune to coach athletes competing at various level of sport in Canada and Internationally. Between 2009 and 2019 he has held Strength and Conditioning appointments at Toronto FC Academy, York University, University of Toronto, EXOS – Formerly Athletes Performance, the Canadian Sport Institute of Ontario, and York 9 FC. In 2016, inspired to become a better coach, he began graduate studies in the Biomechanics and Sports Medicine Lab at the University of Toronto. His graduate research examined the relationship between performance on dynamic multi-jointed movement tasks and passive range of motion. He completed his studies in 2019, earning a Masters of Science degree from the Department of Exercise Sciences.

Harrison Beeforth is a Certified Strength and Conditioning Specialist (CSCS) with the National Strength and Conditioning Association and a Registered Kinesiologist (RKin) certified by the College of Kinesiologists of Ontario. Previously a five-year varsity athlete at the University of Toronto, he graduated with a Bachelor of Kinesiology and began working as a strength and conditioning coach and sessional instructor within the University of Toronto Faculty of Kinesiology & Physical Education. He spent 7 years there before joining the Performance Redefined team in July 2021 and has since been collaborating with the IAFF to develop and implement the Fit to Thrive program for its members.

Dr. Michael G. Hamrock is a former fire fighter and department physician for the Boston Fire Department and now provides primary care to many Massachusetts fire fighters at Steward St. Elizabeth’s Medical Center in Boston, MA.

Professor Smith’s primary area of research is cardiovascular health, with a specific focus on the relationship between heat stress and cardiovascular function. A significant portion of her research focuses on the cardiovascular strain associated with firefighting activity. She has led several government-funded studies to investigate strategies to minimize the physiological strain associated with firefighting. Professor Smith has also conducted several laboratory studies designed to identify specific components of firefighting activity (work performed, heat stress, sympathetic nervous stimulation) that are responsible for specific physiological responses to the combined stress of firefighting. Professor Smith has coauthored several textbooks and has published over 60 scientific papers, primarily on firefighter cardiovascular health. She has been awarded more than 15 million dollars in research funding, with awards from FEMA-AFG, DHS S&T, NIOSH, and DoD.

Dr. Suzy Bird Gulliver is a licensed clinical psychologist and clinical researcher. Currently, she serves as Director and Chief of the Warriors Research Institute and as a Professor at the Texas A&M Health Science Center.
A native of Massachusetts, Dr. Gulliver began her academic journey in the north by attending Quinnipiac College for her Bachelor of Science degree in Psychobiology, followed by a Master’s degree in Clinical Psychology at Connecticut College. After completing her PhD in Clinical Psychology at the University of Vermont, Dr. Gulliver went on to work as a National Institute of Alcohol Abuse and Alcoholism-funded Postdoctoral Fellow at Brown University and later spent 12 years in a variety of roles at the VA Boston Healthcare System including Associate Director of Outpatient Mental Health Programs. Dr. Gulliver made her way to Texas in 2007 and served as the Director of the VA VISN 17 Center of Excellence in Waco, Texas before founding the Warriors Research Institute (WRI) within Baylor Scott & White Health in 2013.
In her spare time, Dr. Gulliver can be found riding her horses, playing with her dog, Maggie, making a Starbucks run or doing yoga.

Scott is the Peer Support Coordinator for LA County Fire. He has been a peer support mentor for 18 years and he is dedicated to helping his brothers and sisters in the fire service overcome the mental stress of firefighting.

The work environment plays an important role in worker health whether through possible exposures to job hazards or stress on the job, or through supportive social networks and opportunities to build self-esteem. There is mounting evidence that worksite cancer prevention interventions that integrate worksite health promotion and occupational health and safety are effective in promoting changes in cancer risk-related behaviors, particularly for blue-collar workers like construction workers. These workers face dual health risks through their exposures to occupational hazards and their high rates of risk-related behaviors, such as tobacco use, physical inactivity, or unhealthy diets. Dr. Caban-Martinez has demonstrated that the use of innovative worksite-based health assessments such as the lunch truck provides unique opportunities to provide workers with health promotion activities as well as collect self-report and biological data. Importantly, Dr. Caban-Martinez and his group has also observed increased levels of worker participation with this intervention model, compared to health promotion alone. Based on a synthesis of the evidence across studies, the Institute of Medicine and the National Institute for Occupational Safety and Health (NIOSH) have recommended this comprehensive approach to improving the health of workers. Dr. Caban-Martinez’s research has also included collaborations with labor unions, with whom they share a common mission to promote worker health and safety.

Dr. Schaefer Solle’s research interests focus on occupational cancer risks and improving cancer screening in underserved communities. She has played a critical role in the conception of the Firefighter Cancer Initiative (FCI), a multi-faceted project funded by the state of Florida to study firefighters’ exposure to carcinogens, examine their cancer risk, and develop methods of education about prevention and early detection. She has led multiple projects within FCI focusing on the epidemiology and cancer screening behaviors of active and retired firefighters.

Dr. Kuehl is a Professor of Medicine and Associate Director of the Human Performance Laboratory in the Division of Health Promotion and Sports Medicine at Oregon Health & Science University in Portland, Oregon. He has a Master’s degree in Exercise Physiology, a Doctorate of Public Health in Nutrition, and medical specialty board certification in Internal Medicine. He is a teacher, researcher, and primary care physician specializing in occupational medicine as it relates to improving wellness and safety in the workplace to reduce illness and injury among workers.
Dr. Kuehl is recognized for his work with first responders and law enforcement personnel and has been on the frontlines with national and international police and fire service organizations for the past two decades. He is a consultant on the physician panel for the NFPA 1500, Standard on Fire Department Occupational Safety and Health Program and NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments and a member of the physician group for the IAFF IACP Joint Wellness Fitness Initiative Task Force. In addition, Dr. Kuehl has presented the PHLAME study for the past decade at the IAFF and IAFC meetings establishing himself as a leading researcher on the economic outcomes from first responder injuries. He previously demonstrated that the PHLAME program is effective in promoting a wide range of beneficial health and safety behaviors, including reducing costs and injuries. In addition, Dr. Kuehl is the principal investigator on the NIOSH funded SHIELD study, a health and safety program for law enforcement personnel, and the Oregon DOC Study, a health promotion and protection study of Oregon Department of Correctional Officers. He has presented and published the results showing a significant increase in health behaviors including improved diet, exercise, and sleep patterns, reducing CVD risk, and reducing stress related illness and injury. Dr. Kuehl has published over 100 scientific and 200 lay articles. Below is a summary of his Oregon DOC Study.

Dr. Aisha Rivera Margarin Program Director, Occupational and Environmental Medicine Residency Johns Hopkins University

Dr. Derek Urwin, received his Ph.D. in chemistry at UCLA and has been a fire fighter for 15 years. A member of Los Angeles County, CA Local 1014, he began his fire service career with Miami-Dade Fire Rescue. He currently serves as an engineer with the Los Angeles County Fire Department. He works collaboratively with academic researchers on the Fire Fighter Cancer Cohort Study and is a member of California State Fire Training’s Behavioral Health and Cancer Awareness Curriculum Development Cadre. In addition, he has served as a live fire training and roof operations instructor with the Los Angeles County Fire Department. His doctoral research examines how carcinogenic polycyclic aromatic hydrocarbons (PAHs) found on the fire ground damage DNA.

David Bernzweig has been in the fire service for 35 years, the past 27 with the Columbus (OH) Division of Fire, where he is a battalion chief. He is the Director of Health, Safety, and EMS for the Ohio Association of Professional Firefighters and a member of several NFPA Technical Committees, including Occupational Safety and Health, Emergency Responder Health, the Correlating Committee for Protective Clothing and Equipment, and Respiratory Protective Equipment. He also serves on the InterAgency Board (IAB), and the Health and Safety Committee for the Ohio Fire Chiefs Association. In addition, Bernzweig is a Safety Officer for FEMA US&R Ohio Task Force One and a Fire Instructor for the State of Ohio. He has degrees in political science and economics from The Ohio State University.

A graduate of Georgetown University School of Medicine, Dr. Abby Morris is board-certified in psychiatry and addiction medicine with diverse experience in community mental health, substance abuse, inpatient and private practice settings. She is responsible for all inpatient care, training and future operations planning. She develops the individualized plan of care that will follow each client throughout their stay at the Center. Before her appointment to the IAFF Center of Excellence, Dr. Abby Morris was the medical director of a 24-bed inpatient facility that treated addiction and behavioral health disorders.

Dr. Stewart is the Medical Director for the Fairfax County, Virginia Public Safety Occupational Health Center (PSOHC).  The PSOHC provides a wide variety of occupational and preventive health services for a group of nearly 4500 public safety employees. Dr. Stewart is also the founder and president of Medocracy, Inc., a small business incorporated in 2002 to provide occupational medical services to government employees working in the Public Safety sector. Dr. Stewart is board certified in Aerospace Medicine and board eligible in Occupational Medicine.  Prior to assuming his current position, Dr. Stewart spent over a decade working for the National Aeronautics and Space Administration (NASA) in positions of increasing responsibility. Dr. Stewart sits on several key committees, including the NFPA 1500 Committee and the IAFF/IFC Wellness/Fitness Initiative Technical Committee

Dr. Marc Kruse is the staff psychologist for the Austin Fire Department and Austin-Travis County Emergency Medical Services. He is a licensed clinical psychologist who earned his Ph.D. from the University of Texas at Austin and completed his clinical internship at the Center for Alcohol and Addiction Studies at Brown Medical School and the Providence, Rhode Island Veterans Affairs Medical Center.
He is an Assistant Professor (Research) in the Department of Psychiatry and Behavioral Sciences in the College of Medicine at Texas A&M Health Science Center. Prior to joining the City of Austin, Marc was an investigator on multiple federally-funded research projects and directed the data management division of the Central Texas VA and VISN 17 Center of Excellence for Research on Returning War Veterans. In addition to his work with military veterans, Dr. Kruse has been involved in clinical research with firefighters and first-responders from Austin, Boston, Chicago, Dallas, Fairfax, New York, Providence, and Toronto.
The majority of Dr. Kruse’s clinical and research efforts are focused on working with trauma-exposed populations (firefighters, first-responders, military veterans) with particular emphasis on the assessment and treatment of Posttraumatic Stress Disorder (PTSD) and substance use disorders. Marc currently has two ongoing studies with Paramedics (“Job Satisfaction and Occupational Stress in Paramedics” and “Patterns of Sleep in Emergency Medical Service Providers”) and is working with collaborators to establish a multi-city, longitudinal study of behavioral health issues affecting EMS providers. His clinical practice emphasizes the use of empirically-supported treatments. Dr. Kruse joined the SAHARA Lab in the Fall of 2000, earned his M.A. in May of 2003, and his Ph.D. in August of 2008. As a graduate student under the supervision of Dr. Fromme, Marc took a lead role on multiple research projects including several alcohol administration and laboratory assessment studies as well as recruitment for “The UT Experience!” study. Marc’s dissertation was focused on the identification of factors (physiological, psychological, and social) that reliably differentiate underage drinkers who are at a greater risk for experiencing alcohol-related problems and persisting in heavy drinking patterns into adulthood from those who will naturally “mature out” of heavy drinking in response to life changes. In conjunction with Dr. Fromme, Marc developed and conducted a series of studies designed to examine the potential influence of individual differences in subjective response to alcohol on the drinking patterns of emerging adults. In particular, his research efforts centered on the development of a valid and reliable self-report measure of subjective response to alcohol that can be utilized with underage drinkers; and exploration of whether individual differences in subjective response to alcohol are unique to the pharmacological effects of ethanol or represent a general pattern of responsiveness to physiological sensations. Marc was awarded a 3 year Ruth L. Kirschstein National Research Service Award Pre-Doctoral Fellowship from the National Institute of Alcohol Abuse and Alcoholism to support his research. On a personal note, Marc lives in Georgetown, Texas (a suburb approximately 35 miles north of downtown Austin) with his wife Crystal, son Jake, daughter Katie, and two cats. Marc considers himself very fortunate to have been trained by Dr. Fromme and the other faculty in the Department of Psychology at UT and is happy to answer any questions you may have regarding the clinical psychology program at UT, working with Dr. Fromme in the SAHARA Lab, or living in Texas (both Marc and his wife are native Californians). You may feel free to contact him by e-mail at: [email protected].

Public Safety Medical is privileged to have a rich history of influencing first responder health and safety at the state and national level. Below is a timeline of our history.

OUR START
1980 – 1989
In the 1980’s, Thomas Miller, an Indianapolis firefighter, sought to establish a medical evaluation designed around the needs of firefighters due to the growing prevalence of death from heart attacks and other health issues that were becoming safety concerns. Dr. Steven Moffatt became a trusted partner to oversee and design the Indianapolis Fire Department’s medical surveillance program. Thomas Miller served as the General Secretary Treasurer of the International Association of Fire Fighters labor organization.

EARLY SUCCESS
1990 – 1999
In the 1990’s, Public Safety Medical was formed by Dr. Steven Moffatt. His practice began to detect heart disease before heart attacks, cancers in the early stages, and the injury numbers of the department began to decrease. In 1996, the International Association of Fire Fighters (IAFF) and the International Association of Fire Chiefs (IAFC) began a collaboration to design an internationally recommended health and safety program to prevent early death and disability in the fire service.

Due to Public Safety Medical’s early success, the IAFF/IAFC asked Local 416, the Indianapolis Fire Department, and Public Safety Medical to participate in that founding task force. Out of that initiative came three programs: the Candidate Physical Ability Test (CPAT), the IAFF/ACE Peer Fitness Trainer program, and the IAFF/IAFC Wellness-Fitness Initiative. In 1999, the American College of Occupational and Environmental Medicine awarded Indianapolis and Public Safety Medical with the coveted Corporate Health Achievement Award. This award recognized our efforts in improving the health and safety of Marion County public safety employees. Indianapolis was the first municipality ever to receive this award.

GROWING REPUTATION
2000 – 2010
The IAFF/IAFC Wellness-Fitness Initiative continued to grow in influence. In 2003, the National Fire Protection Association (NFPA) adjusted their 1582 standard to comply with the standards listed in this program. The National Fallen Fire Fighters (NFFF) went on to advocate for this program as well. At the same time, Public Safety Medical continued to experience fast growth. Our trusted partners increased from a handful of departments to working with over 200 public safety agencies. With a commitment to lead the fight against early death and disability, Public Safety Medical joined the medical advisory board for the IAFF John P. Redmond Foundation as well as the advisory board for the NIOSH Cardiovascular Disease Study.

PUBLIC SAFETY MEDICAL TODAY
2010’s
In the early 2010’s, Public Safety Medical began developing research partnerships with the leading researchers in public safety as a clinical extension of their great work. As a response to mental health concerns among first responders, Public Safety Medical acquired the psychological evaluations division of the Institute for Public Safety Personnel (IPSP). This acquisition was important because it created a center for both the medical and psychological evaluations. Both Public Safety Medical’s medical evaluations and IPSP’s psychological evaluations have been successfully defended in Federal Court.

2011
Public Safety Medical expanded its focus to include the health and safety of transit system drivers. We were chosen to perform the first national pilot study of rural transit drivers consisting of approximately 1000 drivers across the state of Indiana. We were also tasked with evaluating the impact of a landmark legislative change involving the medical requirements of CDL holders.

Additionally, Public Safety Medical initiated a Public Safety Cardiovascular Disease Early Detection and Prevention Program as a 3-year pilot. We have performed hundreds of coronary calcium scores in a population of 1200 firefighters over a 2-year timeframe.

2012
Public Safety Medical began serving as a consultant to the Federal Transit Administration (FTA) TRACS Committee which was charged to provide recommendations to congress regarding the safety of transit drivers in the United States. We also held our inaugural fire service wellness-fitness symposium with 150 attendees.

2013
Public Safety Medical was commissioned to create a public-safety-focused health and wellness chapter for the American College of Occupational and Environmental Medicine. This is the only physician-led organization in the United States that is dedicated to the health and safety of first responders.

2014
Public Safety Medical introduced the National Institute for Public Safety Health with a mission to provide the highest quality clinical research, education, and advocacy to maximize the health and safety of public safety personnel. Public Safety Medical was asked to serve as a technical committee member for the National Fire Protection Association’s 1582 Standard that is focused on the requirements for a comprehensive occupational medical program for public, governmental, military, private, and industrial fire departments.

2015
Public Safety Medical celebrates 25 years of service! Additionally, we held our inaugural law enforcement wellness-fitness symposium and added a new physician to our team.

FUTURE
Public Safety Medical is committed to leading the fight to improve the health and safety of public safety professionals. We have pursued and committed ourselves to becoming a national Center of Excellence for public safety medical and psychological services, and we have joined the conversation at a national level regarding public policy.