Sudden cardiac death (SCD) has been the leading cause of on-duty death (ODD) in the fire service over the past several decades, accounting for 51.6% of all ODDs in 2019. The primary factors that contribute to SCD among firefighters are overexertion and stress, and SCD is most likely to occur during fire suppression and alarm response. When an emergency occurs, firefighters are alerted/awoken by loud mechanical bells. Thishigh noise level may induce a stress response triggering a cardiovascular event. In fact, "high levels ofenvironmental noise fuel cardiac risk" by stimulating the amygdala and inflaming the arteries. While othercompanies have attempted to modernize alerting systems, they failed to address the problem of stressfulalarms because they focus on alerting "stations" not individual firefighters. A significant need exists to developa less stressful alerting system for firefighters. The objective for this SBIR Phase I R43 research study is todevelop a commercially viable Fire Fighter Alerting System (FFAS) comprised of proprietary wearables andoptional bed shakers called BunkAlerts. Collectively "personal alerting devices," the wearables and BunkAlertsenhance the alerting process for firefighters by replacing jarring audible alarms with tactile alerts delivered tothe firefighter's wrist. This alternative approach is designed to significantly decrease tachycardic responsesassociated with legacy alerting systems. Meeting this need has the potential to reduce firefighter ODDs andimprove the quality of life for the 15.4 million firefighters around the world. The feasibility of EaseAlert's FFASis reinforced by preliminary data collected during field testing with six (6) fire departments in three (3) stateswhere EaseAlert's prototype FFAS ("Gen 1") successfully delivered over 10,000 alerts to firefighters called toan emergency with no calls missed. The potential for our FFAS to reduce stress and SCD risk amongfirefighters is supported by preliminary data which shows that: 1) noise triggers a startle response and 2) tactilealerts are associated with positive valence and high arousal. The proposed research will be accomplished withtwo aims: Aim 1 - develop a commercially viable FFAS and Aim 2 - determine the effectiveness of the FFAS inreducing cardiac reactivity and improving sleep. EaseAlert will leverage the Gen 1 FFAS as a foundation fordeveloping its Gen 2 FFAS outlined in Aim 1. Aim 2 will test two study hypotheses in a within-subjects pilotclinical trial design: (H2.1) that EaseAlert will result in a significant reduction in the stress response to alarmscompared to traditional auditory alerting systems, and (H2.2) EaseAlert will result in a significant improvementin sleep efficiency. Upon successful completion of Phase I, our Gen 2 FFAS and pilot trial will demonstratetechnical merit and feasibility for Phase II. Phase II will conduct a large randomized parallel groups clinical trialpowered to examine the physiological and psychological effects of this innovative alerting system alongsidelonger-term outcomes for important biological markers such as cortisol (stress) and c-reactive protein(inflammation) in addition to sleep outcomes and psychological functioning.
Public Health Relevance Statement: Project Narrative
Sudden cardiac death (SCD) is the leading cause of on-duty death in the US Fire Service with alarm response
being the second-most prevalent cause of SCD. EaseAlert's Fire Fighter Alert System can reduce SCD by
circumventing the traditional alert system with an alternative system that leverages vibrotactile alerts via wrist-
worn wearables. This novel alerting approach can result in controlled arousal that will significantly reduce
cardiovascular reactivity, in addition to improving the sleep and quality of life of firefighters and other
emergency response personnel.
Project Terms:
