What is substantive response of the statement below?
In this article I found that the author described in sufficient detail the importance of and the role that too much or too little cortisol plays in our bodies. Cortisol, a glucocorticoid, is often referred to as the stress steroid hormone that is largely responsible for inflammation within the human body. While it is clear from the reading that cortisol release is an ongoing process with a 24-hour cycle, what is also clear is that any disruption in circadian rhythmic cycles can greatly influence the amount of cortisol being produced. If that disruption is due in large to a physiologic or psychologic stressor, the amount of produced and released cortisol by the hypothalamic-pituitary-adrenal (HPA) axis can have a lasting negative effect on the cardiovascular system and associated organ systems resulting in cardiovascular heart disease, strokes, hypertension and diabetes mellitus (Jones & Gwenin, 2020).
This topic hits close to home for me as a former firefighter/paramedic. According to the National Fire Protection Association (NFPA) in 2020 of the 48 reported firefighter line of duty deaths, 54% were determined to be caused by a medical event, stress, or overexertion. 46% of the reported deaths were reported as sudden cardiac arrest events (NFPA, 2020). I feel that this article made a compelling case for the need for in-depth studies and monitoring of firefighters and EMS workers who work 24- or 48-hour shifts. It is very common as a firefighter or EMS worker to be jarred out of a deep sleep several times during the night to respond to sometimes very stressful calls for service. What we know from the article is that cortisol can still be produced and released for several hours following the initial stressor (Jones & Gwenin, 2020). With that being said, if the human body is being subjected to multiple stressors during that assigned shift, there is no possible way for the cortisol levels to stabilize. Couple that with poor dietary habits, as most meals consist of high carbohydrate and fat contents due to the need for stored energy, and the fact while most firefighters and EMS workers find some time during their shift to exercise, many work multiple overtime shifts during any given month and when they do get a day off, it is most likely spent catching up with family and household chores.
I believe that the time has come within the fire and emergency medical services to move away from 24 or longer shifts. This article supports strongly the argument that further studies of firefighters and EMS workers is needed to establish healthy baseline levels of cortisol and for monitoring programs of those workers. As with any other physiologic disorder, early detection and early intervention is the key to success. It is time that we dive deep into the cultures of these first response services and make changes that will keep more of the employees alive and healthy so that they may continue to serve the citizens of this great country.
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