"We need to start thinking about the people the same way. The biggest asset you have is the people."

Dr. Sara Jahnke has spent nearly twenty years studying firefighter health. She directs the Center for Fire, Rescue and EMS Health Research at NDRI-USA, she is president of Science to the Station, and she sits on the board of the National Fallen Firefighters Foundation. She was also raised by a fire chief, from kindergarten through her senior year of high school, which is the part that explains the rest.

She calls herself a full-time nerd. She's actually the person connecting nearly everyone working on this problem.

In this conversation, she walks through what the research says now, and some of it is not what the fire service assumes. Firefighting was re-evaluated by the International Agency for Research on Cancer and classified as a known carcinogen, and she explains what that process looks like from the inside and why it changes what is possible in legislation. Shift work carries its own classification. Sleep consistency, not just sleep quantity, turns out to be an independent risk factor for illness and death. Elevated blood pressure raises your risk of a cardiac event on the fireground twelvefold.

But she is just as interested in what is going right. Smoking rates in the fire service are now lower than the military and lower than the general population, and she argues the mechanism was peer pressure, crews deciding this is not who we are. Divorce rates for men in the fire service came back lower than the general population across forty-three departments from Maine to Guam, a result her analytics team ran repeatedly because nobody believed it. For women in the fire service, the same data came back high, and she says so plainly.

Greg and Sara get into sleep, nicotine pouches, shift schedules, start times, why "cleared for duty" is not the same as healthy, and what a department actually owes the people who work for it. Amy asks the questions that pull all of it out of the echo chamber.

Sara also talks about 360 Responder Health, Medical and Safety, the clinic model she built with Kepra Jack and Denise Smith, and about Science to the Station 2026 in Kansas City, November 3rd through 5th, the gathering she still calls Nerdstock.

This episode is dedicated to Firefighter/EMT Mark Mansfield, Overland Park Fire Department, end of watch April 6, 2002.