Understanding firewomen’s fit problems with their coats and pants and its impact on mobility and safety

Abstract

BACKGROUND:

Inadequately fitting turnout coats and pants hamper mobility and safety of firewomen. Previous research has established that firewomen are dissatisfied with their turnout coats and pants. Yet, there has been minimal in-depth research into the specific fit problems and consequences of these problems on the workplace health of firewomen.

OBJECTIVE:

The researchers sought to uncover common fit problems firewomen have with turnout coats and pants, and their impact on mobility and safety while performing work.

METHODS:

The researchers performed a qualitative analysis of in-depth interviews of 35 firewomen.

RESULTS:

The study illuminated specific fit problems firewomen have with their turnout coats and pants. These fit challenges include challenges with the overall proportions of the turnout coats and pants as well as issues of length and how the turnout coats and pants fit around their body (circumference), leading to concerns about mobility and safety.

CONCLUSIONS:

This study builds an understanding of specific fit problems on the ability of firewomen to do their challenging work in a safe and stress-free manner. Firewomen’s protective apparel should protect and empower all firewomen. To adequately protect firewomen, manufactures should prioritize the implementation of these findings to improve the safety and mobility that firewomen’s turnout coats and pants offer them.

Keywords

Turnout gear firefighter protective equipment

1 Introduction

Both male and female structural firefighters wear turnout gear [1] to protect them from thermal exposures [2, 3] cuts and abrasions [4]. Firewomen are less satisfied with the fit and function of their protective turnout coats and pants than their male counterparts [5 –9]. Nearly 40%of firewomen surveyed have problems with ill-fitting turnout coats and pants [5]. Appropriate fit is essential to the safety, protection, mobility, and comfort of turnout ensembles [6 , 10]. Turnout gear that is too tight can restrict movement, while gear that is too loose inhibits firefighter’s mobility and make them more likely to sustain injuries [3 , 6–8]. There has been minimal in-depth research into the specific fit problems and consequences of these problems on the workplace health of firewomen [9, 11]. Therefore, in this study, we seek to increase in-depth knowledge of common fit problems firewomen have with turnout coats and pants, and related mobility and safety consequences. By interviewing active firewomen, these issues were explored. Findings may be used to improve the fit, function, safety, and comfort of firewomens’ turnout coats and pants.

1.2 Background: Firewomen’s minority status and access to properly fitted gear

Only 8%of the 1,115,000 career and volunteer firefighters in the United States are women [12]. A higher percentage of firewomen (82%) than firemen (63%) serve in volunteer roles [5], and volunteer firefighters report less satisfaction than career firefighters with their protective turnout coats and pants [6 –9]. The gender gap in the firefighting occupation has resulted in institutional barriers for firewomen, including poor uniform fit and design. Turnout gear has traditionally been designed using a male-focused “unisex” sizing system, which results in inadequate fitting turnout gear for firewomen [13].

Sizing systems should account for all bodies found in the population [14, 15]. Adult women are shaped differently than men and are typically smaller than men in terms of overall height and weight [5]. Firewomen have a lower waist-hip ratio than men, and a smaller waist, thigh circumference, calf circumference, ankle circumference, and inseam length measurements than firemen [8]. Accordingly, the NFPA 1971 standard specifies body measurement locations (chest, sleeve, waist, and inseams) and the range of measurements to be covered by each size for both men and women [16]. Nonetheless, most turnout coats and pants are developed based on male body measurements, and there is a lack of consideration for female proportion and size [6 –8]. Some manufacturers offer women’s cut coats and pants [5, 11]. However, due to the small purchasing pool, it is considered a custom product that is more expensive than standard men’s coats and pants [3, 11]. Some departments still provide gear without consideration of body type, resulting in improperly fitting gear, which puts firewomen at risk for injury [17]. Only 42%of firewomen world-wide had female-specific personal protective equipment (PPE) available to them, with that number dipping to 25%for North American firewomen [9]. While fit dissatisfaction may be attributed to wearing men’s gear, it is interesting to note that only 11.5%of firewomen who used female-specific PPE were satisfied with it [9], indicating a lack of understanding of firewomen’s fit and sizing needs.

1.3 Current literature and existing gaps: Fit of firewomens’ turnout coats and pants

FEMA has called for research to understand firewomens’ fit and sizing needs for turnout gear [11]. However, firewomen-focused research is limited. Past studies include a 2013 focus-group based study that included 22 U.S. firewomen [6], a 2014 survey-based study that included 314 female structural firefighters from the USA and Canada [7], a 2016 study of 9 firewomen [8], and a 2019 large scale survey of firewomens’ health issues [9]. Survey-based firefighter studies [7, 21] do not provide detailed information about PPE fit and sizing needs. Extant qualitative studies of firefighters provide more detail, but either have a small sample size [8 , 22–24], or were not focused on the fit of PPE [5 , 17].

1.4 Fit of firewomen’s turnout coats and pants

Incorrect garment proportions are a cause of firewomen’s fit dissatisfaction with their PPE. Gear is generally too long to fit firewomen’s bodies when the circumference measurements are correct [6]. Proportion problems with the coats include having oversized shoulders, neckline, and sleeves when the fit in the chest of the coat is appropriate on a firewoman [7]. Pants that fit firewomen correctly in the hip are oversized around the waist and legs [7]. Pants that fit in the waist or inseam are often uncomfortable in the hips [7]. Firewomen’s pants are tight at the hips, but baggy at the waist and through the legs (thigh, knee, calf, and ankle), corresponding to their proportional differences with men [8]. Additional knowledge of fit problems in specific garment areas from a larger sample is needed to produce gear that meets firewomens’ needs.

1.5 Effect of the fit of firewomen’s turnout coats and pants on mobility

Firewomen’s work requires them to complete a wide range of movements efficiently including bending, carrying equipment, checking under objects for people, reaching overhead, walking, [6, 7] and extreme limb movement (e.g., stair climbing, ladder operation, crawling, and duck walking, in which firefighters crouch low but with their knees off the floor) [7]. Poorly fitted protective clothing affects firefighters’ ability to perform work tasks [3].

Firewomen are less satisfied than firemen with coat length for walking, bending, extreme limb movement, and reaching overhead [7]. Firewomen have significantly lower satisfaction than firemen with the chest fit of the turnout coat [7]. Tightness in the chest of firewomen’s jackets restricts their arm movements [7]. Bulkiness in jacket shoulders makes it difficult for firewomen to reach up [7]. Jacket collars that are too stiff make it difficult for firewomen to bend or rotate their necks [7], and they have issues with the pocket placement on the coats.

Firewomen have significantly lower satisfaction with the fit in the legs, length of the pants, crotch length, fit in the hips, fit in the waist, and placement of cargo pockets than firemen while walking and bending [7]. The bulkiness of pant legs makes it difficult for firewomen to step up or bend over and pick things up [8]. Firewomen report the pant crotch to be too low, impeding their leg movement mainly when crawling through windows and buildings, getting down on their knees and climbing ladders [6], ladder operations, walking, and climbing [7]. Furthermore, it is difficult for firewomen to don their pants quickly due to tightness in the hips [7]. Poorly placed cargo pockets negatively affect their ability to move through tight spaces or climb [6, 7]. More specific knowledge of the interaction of fit problems in specific garment areas and firewomens’ mobility is needed to improve the fit and function of their gear.

1.6 Effect of the fit of firewomen’s turnout coats and pants on safety

Ill-fitting turnout ensembles can contribute to injury risk by adding impediments to body movement (extra weight and bulk), which adds to physical strain and fatigue [6 , 9]. The excess bulk of the gear can result in increased physical exertion and heat stress [6]. Between 9–23%of firewomen reported work-related musculoskeletal injuries, including upper and lower limb and back injuries [9]. For example, coats that are too long increase the risk that the hem can be caught on the SCBA when performing tasks such as ascending or descending ladders [7]; however, shorter coat lengths ride up and expose skin to fire [7]. Further, firewomen are more likely to sustain injuries caused by a slip or trip (16%of injuries) as compared to all firefighters (13%) [18]. Pants that are too low in the crotch and that have poor fit in the hips restrict lower body movement and negatively impact firewomen’s safety on slippery and unstable fire grounds [7]. Overall, mobility and safety are interconnected concepts. Gear that inhibits mobility endangers firewomen [6, 7]. More specific knowledge is needed about fit-related mobility and safety issues of firewomen is necessary so that manufacturers may improve their offerings. In turn, firewomen may have safer and more ergonomic PPE.

1.7 Approaches to manage fit problems

Since the majority of firewomen wear sized-down versions of men’s turnout coats and pants, they must use various approaches to adapt to the ill-fitting garments [11]. One example being firewomen’s reliance on suspenders to keep their pants up [6], causing avoidable issues like shoulder pain [6]. Firewomen tend to alter their turnout coats and pants more than their male counterparts do, but they typically have a difficult time receiving help when dealing with poorly-fitted turnout coats and pants [8, 19]. More in-depth knowledge of firewomens’ approaches to managing fit problems is needed to uncover and correct problems with their current gear.

Overall, firewomen must have turnout coats and pants that fit their body because fit plays a significant role in the ability of firefighters to perform their jobs safely [11]. Yet, there is a lack of in-depth knowledge of firewomens’ specific fit problems and the consequences of these issues on the workplace health of firewomen. Therefore, the research questions that guided this study were:

How do firewomen perceive the fit of their turnout coats and pants?

What specific fit problems firewomen perceive of their turnout coats and pants?

How do firewomen perceive the effect of the fit of their turnout coats and pants on their mobility in performing work?

How do firewomen perceive the effect of the fit of their turnout coats and pants on their safety in performing work?

What approaches are firewomen taking to manage problems associated with fit?

2 Method

2.1 Study design

Various researchers have identified the importance of human factors research and user input through qualitative data in the design process of protective systems [22 , 24–26]. Therefore, a qualitative one-on-one interview approach was adopted to collect data from firewomen. This method optimizes individuals’ personal knowledge and perspectives to gain an understanding of meanings associated with individuals’ experiences related to the context of interest [27]. For this particular study, firewomen’s perceptions of fit and experiences of wearing turnout coats and pants were studied.

2.2 Firewoman selection

This study was designed to collect data at an international female firefighting professional development conference, in May 2018. Attendees represented career and volunteer firewomen and rescue personnel from 48 U.S. states and 11 countries, at all stages of their career. This particular conference was selected as a firewoman recruitment venue to (a) reach an “information-rich” sample in a targeted, time-efficient manner and (b) recruit firewomen who were committed to and interested in improving the way they do their jobs. Potential firewomen walking through the vendor fair portion of the conference were invited verbally to participate in the study. Inclusion criteria included women who were 18 years and older and involved in firefighting as their professional or volunteer career. Each firewoman was assigned a non-identifying numeric code. All interviews were audio-recorded and the interview audio files were named with the same code. Firewoman names were not recorded, to protect privacy. Interviews were continued until a point of redundancy [36] and data saturation was achieved with 35 interviews. Data collection methodology was approved by participating universities’ Institutional Review Boards (IRB) and conference organizers to ensure the protection of human firewomen. All 35 firewomen reviewed and signed the informed consent to participate in this study.

2.3 Data collection

Interviews began with demographic questions asking about the firewoman’s age, ethnic background, length of firefighting career, firefighting status, type of firefighting, location of service, and type of environment protected. The next part of the interview continued with questions specific to the turnout coat –such as (a) brand, size, and gender of coat worn, (b) length of service of the coat, (c) what is worn under the coat, (d) feelings of protection (e) injuries caused by the fit of the coat, (f) purchasing and size selection process for the coat, and (g) modifications made to the fit of the coat. Then, firewomen were asked to describe challenges with the fit of specific sections of the coat, based on a reference image provided during the interview: (a) neck, (b) shoulders, (c) upper arm/armhole, (d) chest/bust/back, (e) hip, (f) jacket bottom, (g) waist/stomach, (h) sleeve length, and (i) sleeve fit/circumference. Finally, firewomen were asked: “When you put on your turnout coat, what does it mean to you or how does it make you feel?” Except for the demographic questions, all questions were repeated concerning the turnout pants. Specific sections of the pants addressed included: (a) crotch area, (b) thigh region, (c) knee, (d) ankle area, (e) shin region, and (f) hip. At the end of the interview, firewomen were asked, “What have we not talked about, that you think is important in relation to turnout gear?”

2.4 Data analysis

The recorded interviews were transcribed verbatim. Transcripts were analyzed through a coding process using the constant comparison approach [29]. First, a preliminary list of codes and definitions were developed based on the literature. The five researchers who conducted the interviews were trained and tested on the application of codes to a selected transcript. Researchers met in person and discussed differences in coding and refined the coding categories and definitions. Using the refined codebook, the researchers coded a second selected transcript. Interrater reliability of 98%was achieved which exceeded the recommended threshold of 85 to 90%[30]. Interrater reliability was calculated by dividing the number of correctly coded segments by the total number of segments. Each of the researchers was assigned seven transcripts to independently code. The refined codebook was entered into Dedoose® qualitative data analysis software (QDAS). Transcripts were imported into the software and coded to add rigor to the coding process and enhance qualitative research validity [31]. QDAS tools were used to assist with the axial coding by searching the data to identify frequently occurring codes in the data for each type of garment (e.g. coat, pant) as well as frequent co-occurrences among codes (e.g. fit, coat, sleeve, and length). This led to the identification of key themes in the data [32]. For example, Theme 2: Coat Fit—Length included excerpts that were coded with “physical fit,” “coat,” and “length”. Subthemes were identified under each theme by part. For example, Theme 2: Coat Fit—Length had subthemes of “body”, “sleeve”, and “collar”. Coded excerpts related to each theme were retrieved, stored in a document, and analyzed to answer the research questions.

3 Results

3.1 Firewoman demographics

Thirty-five firewomen were interviewed and the interviews ranged from six to forty minutes in length. The participants represented fifteen U.S. states from all geographical regions as well as one firewoman each from Australia and the United Kingdom. Fourteen (40%) of the participants in the study were career firewomen, three (9%) were volunteer firewomen, three reported (9%) that they held both career and volunteer positions, and fifteen (43%) did not report their roles (Table 1). This differs from the national average, where almost eighteen percent of firewomen are career [12]. Nine firewomen held leadership roles. The most-reported firefighting specialty was structural (n = 16, 46%) followed by wildland (n = 7, 20%), and proximity (n = 1, 3%), which is in line with data reported by the Bureau of Labor Statistics [33]. Seven firewomen reported more than one specialization type.

Table 1
Subjects’ roles, age, and race or ethnicity as compared to the firefighter population

Study subjects Firefighter population

N %of total Female %of total All

Roles

Career 14 40.0% 35.0%¹

Volunteer 3 8.6% 65.0%¹

Reported both career and volunteer 3 8.6% X

Not reported 15 42.9% X

Total 35 100.0% 100.0%¹

Age range

16-19 0 0.0% 3.0%¹

20-29 3 8.6% 21.0%¹

30-39 7 20.0% 28.0%¹

40-49 16 45.7% 26.0%¹

50-59 9 25.7% 16.0%¹

60 and over 0 0.0% 6.0%¹

Total 35 100.0% 100.0%¹

Race or ethnicity

White 23 65.7% 83.5%²

Black/African American 6 17.1% 7.6%²

Asian 0 0.0% 1.2%²

Other: Puerto Rican 1 2.9% 2.6%²

Two or more races 0 0.0% 4.0%²

American Indian, Native Hawaiian 2 5.7% 1.1%²

Hispanic, Latino, or Spanish 3 8.6% X

Total 35 100.0% 100.0%²

	Study subjects	Firefighter population
Roles
Career	14	40.0%	35.0%¹
Volunteer	3	8.6%	65.0%¹
Reported both career and volunteer	3	8.6%	X
Not reported	15	42.9%	X
Total	35	100.0%	100.0%¹
Age range
16-19	0	0.0%	3.0%¹
20-29	3	8.6%	21.0%¹
30-39	7	20.0%	28.0%¹
40-49	16	45.7%	26.0%¹
50-59	9	25.7%	16.0%¹
60 and over	0	0.0%	6.0%¹
Total	35	100.0%	100.0%¹
Race or ethnicity
White	23	65.7%	83.5%²
Black/African American	6	17.1%	7.6%²
Asian	0	0.0%	1.2%²
Other: Puerto Rican	1	2.9%	2.6%²
Two or more races	0	0.0%	4.0%²
American Indian, Native Hawaiian	2	5.7%	1.1%²
Hispanic, Latino, or Spanish	3	8.6%	X
Total	35	100.0%	100.0%²

¹ Jahnke S [17]. ² Data USA: Firefighters [35]. X = Data not available.

The average age of the sample was 42.2 years old, which is older than the average age (35.4 years old) of firewomen in the U.S. [12]. Sixty-six percent of firewomen interviewed (n = 23) were between the ages of 30 and 49 years old, representing a slight increase in this age category compared to the overall U.S. firefighting population (51%) [12]. Fifty-one percent of firefighters were between the ages of 30 and 49 years old [12]. The race and ethnicity of firewomen interviewed were more diverse than the overall population [12]. See Table 1 for detailed age ranges and race or ethnicity of the participants.

The experience of the firewomen ranged from 3.5 to 29 years of service with an average of 18 years of service. Eight firewomen (23%) did not provide their tenure. This average is slightly higher than previously reported figures, but generally within the range of average years of service [12 , 34]. In their study of 54 firefighters in four states in the U.S., Park, Park, Lin, and Boorady [22] report that the average length of active service for firefighters in their sample was 8.5 years –9.8 years. These reports of the average length of service are supported by older data from N = 1,692 firefighters in the Pacific Northeastern U.S. whose average tenure was 7.3 years –12.3 years of service [34].

Through the data analysis of the interview responses, eight themes were identified: 1.) Coat Fit - Circumference, 2.) Coat Fit - Length, 3.) Coat Mobility Issues, 4.) Coat Safety Issues, 5.) Pant Fit - Circumference, 6.) Pant Fit - Length, 7.) Pant Mobility Issues, and 8.) Pant Safety Issues. The frequency of these fit-related themes are summarized in Table 2 (coats) and Table 3 (pants). In the following sections, the themes are presented and discussed. Excerpts that convey each theme are presented in Table 4 (coats) and Table 5 (pants).

Table 2

Turnout coat fit: Frequency and percentage of code co-applications to excerpts by theme and subtheme

	Total excerpts related to coat fit	%Total of excerpts related to coat fit	Neutral responses		Positive responses		Negative responses
			N	%	N	%	N	%	Total
Theme 1: Coat Fit - Circumference	51	44%	2	4%	6	12%	43	84%	100%
Chest	13	11%	0	0%	0	0%	13	25%
Hips	12	10%	1	2%	2	4%	9	18%
Waist	9	8%	1	2%	0	0%	8	16%
Shoulders	5	4%	0	0%	2	4%	3	6%
Sleeves	4	3%	0	0%	1	2%	3	6%
Neck	3	3%	0	0%	1	2%	2	4%
Overall	3	3%	0	0%	0	0%	3	6%
Across back	2	2%	0	0%	0	0%	2	4%
Theme 2: Coat Fit - Length	31	26%	0	0%	11	35%	20	65%	100%
Body	18	15%	0	0%	8	26%	10	32%
Sleeve	10	9%	0	0%	3	10%	7	23%
Collar	3	3%	0	0%	0	0%	3	10%
Theme 3: Coat Mobility Issues	18	15%	0	0%	8	44%	10	56%	100%
Body	6	5%	0	0%	2	11%	4	22%
Shoulders	3	3%	0	0%	1	6%	2	11%
Sleeves	3	3%	0	0%	2	11%	1	6%
Hips	2	2%	0	0%	0	0%	2	11%
Overall	2	2%	0	0%	2	11%	0	0%
Chest	1	1%	0	0%	1	6%	0	0%
Across back	1	1%	0	0%	0	0%	1	6%
Theme 4: Coat Safety Issues	17	15%	1	6%	3	18%	13	76%	100%
Body	10	9%	1	6%	3	18%	6	35%
Sleeve	2	2%	0	0%	0	0%	2	12%
Collar	2	2%	0	0%	0	0%	2	12%
Chest	1	1%	0	0%	0	0%	1	6%
Hips	1	1%	0	0%	0	0%	1	6%
Pockets	1	1%	0	0%	0	0%	1	6%
Total
Total coat	117	100%	3	3%	28	24%	86	74%	100%

Table 3

Turnout pant fit: Frequency and percentage of code co-applications to excerpts by theme and subtheme

	Total excerpts related to pant fit	%Total of excerpts related to pant fit	Neutral responses		Positive responses		Negative responses
			N	%	N	%	N	%	Total
Theme 5: Pant Fit - Circumference	25	35%	5	20%	6	24%	14	56%	100%
Waist	9	13%	2	8%	1	4%	6	24%
Thigh	5	7%	3	12%	0	0%	2	8%
Calf	4	6%	0	0%	3	12%	1	4%
Hips	3	4%	0	0%	1	4%	2	8%
Bottom hem opening	3	4%	0	0%	1	4%	2	8%
Crotch	1	1%	0	0%	0	0%	1	4%
Theme 6: Pant Fit - Length	27	38%	4	15%	3	11%	20	74%	100%
Inseam	15	21%	4	15%	2	7%	9	33%
Crotch length/rise	10	14%	0	0%	0	0%	10	37%
Kneepad placement	2	3%	0	0%	1	4%	1	4%
Theme 7: Pant Mobility Issues	9	13%	1	11%	0	0%	8	89%	100%
Crotch length/rise	5	7%	0	0%	0	0%	5	56%
Inseam	3	4%	0	0%	0	0%	3	33%
Waist	1	1%	1	11%	0	0%	0	0%
Theme 8: Pant Safety Issues	10	14%	1	10%	1	10%	8	80%	100%
Crotch length/rise	5	7%	0	0%	0	0%	5	50%
Inseam	2	3%	0	0%	0	0%	2	20%
Waist	1	1%	1	10%	0	0%	0	0%
Bottom hem opening	1	1%	0	0%	0	0%	1	10%
Overall	1	1%	0	0%	1	10%	0	0%
Total
Total pant	71	100%	11	15%	10	14%	52	71%	100%

Table 4

Summary of physical fit issues of turnout coat organized by garment length and circumference problems

Problem	Area	Summary	Representative excerpt
Circumference	Chest		Too loose: “I mean for me the issue is getting one that’s large enough to fit my chest, but then isn’t enormous” (Participant 15); Too tight: “Interviewer: Oh, you can’t flex your arms back? Participant 31: No, because it’s tight. It’s just flat, straight across. There’s no give. And when you have boobs, then that’s uncomfortable.”
	Waist		“Just remember we got boobs. My coat don’t go down so then it’s all loose and whatever up there [waist and abdomen]. My coat stops at the waist” (Participant 10).
			“And in waist it’s too big. It’s too wide” (Participant 3).
	Hip		“So, you know we wear our radios under. And most of the time, I have the anti-sway strap. If we catch a fire, I’ll hook it to the rest of the belt so it makes it longer so it goes under my coat. It doesn’t touch the end of my coat. But the male is tighter than the female. I guess the female one I have flares out a little bit, and the male one is straight so it kind of grabs that radio. Just the way that it makes the radio stay right on your hip is just kind of uncomfortable, and then it’s [hard] to move. I like to be able to move easily” (Participant 34).
	Shoulders		“I have to go bigger in the shoulders. So, it ends up being too big in the chest area. Because the shoulders have to be a little bigger” (Participant 3).
	Neck		The neck, sometimes it won’t close, because I’m small in the neck and the waist, but my shoulders are broad. So even though I get a broad one, it gets small here. So, I’d rather it be a little bigger. So, I can have it close better.” (Participant 3)
	Sleeves		“I feel a little bit restricted because of the way the coat fits. The sleeves are long but, the pit comes down a little bit low. When I reach forward and stuff, I’m fine. As far as hands overhead tight, it’s very restrictive. That’s why I made them give me a different sized coat so that I could maneuver” (Participant 32).
Length	Body		“The jacket would come all the way down here, which would mean when I’m trying to climb the ladder, it would just [pull]. It was a safety issue for sure, and that’s when I requested for a shorter jacket” (Participant 19).
	Sleeve		“I want to feel safe. And that’s why especially the sleeve length is not good because if they slip down and then you lose grip... It’s the safety.” (Participant 1).
	Overall proportions	Relationship between length and circumference	“To get one that was long enough for me in the arms and in the legs, I had to go up a size, which was then much too big around my waist and chest” (Participant 13).
			Too loose: “It’s probably a little bit bigger than I need, but it needed to be bigger for my chest, so the rest of it’s kind of bigger around” (Participant 32).

Table 5

Summary of physical fit issues of turnout pants organized by garment length and circumference problems

Problem	Area	Summary	Representative quotes
Circumference		Waist/hip	“The waist is so unfitted I have to use suspenders to keep them up. When you’re crawling and making sure that they don’t fall down. They get heavy. When they get wet, they get heavier” (Participant 21).
			“If I don’t have the belt that’s attached to them totally buckled, they will fall all the way down” (Participant 34).
	Thigh, knee, calf	Bulkiness in the pant leg	“You end up almost having to lift your leg to move. So instead of just being able to just sort of move” (Participant 15).
	Hem opening	Too tight to easily go over boot	Participant 3 said, “My pants are so tight, they get stuck in there. So, I have to make sure that after every dress-up rehearsal, or after every fire, I push my pants all the way down... I have to actually pull them in. Put some effort into it, yes. Unfortunately.”
Length	Crotch		“The issue I find with them is the crotch. There ends up being just a lot of fabric from here up, so when you try to move, you’re like the Pillsbury Dough Boy” (Participant 15).
			“The crotch comes way down... so, then it’s a lot harder to crawl and stuff because you’re restricted, because it affects how you bend. Because it’s pulling as you’re trying to bend. Because this was loose, it gets pulled down here, when the crotch is here, you can’t move much” (Participant 32).
	Inseam	Pant inseam so long they drag or short enough to come up over the boot	Too long: “The length is a problem. You’d pull them up so high, so they weren’t dragging on the floor. So, the length of the pants can be [an issue], especially for shorter girls. You had to just yank right up to maybe your boobs. It would cut you off in the crotch.” (Participant 1)
			Too long: ““Like every single pair of male pants it’s too big, it’s always too big but in my turnouts it’s not really an issue. It doesn’t play significant role.” (Participant 20).
			Too short: Participant 26 explained, “they fit okay in the body but the sleeves are short and the pants come up to here. And, I bend my knee up and the cuff comes up over my boot. That’s not safe.”
	Knee		“Okay. So, we’ve got the length of the pants, which is number one. So, they’ve all got knee patches in them. So that, they never meet your knees because this part is normally longer in a man, I think. And so, they make them for me. They’re basically meant for men. I know they call them unisex. But that would be wrong” (Participant 1).

3.2 Physical fit challenges of turnout coats and pants for firewomen

The firewomen in this study felt that their firefighter turnout coat and pants were not made for female bodies and therefore had problems getting turnout coats and pants that fit their bodies. Physical fit issues manifested through challenges with the overall proportions of the turnout coats and pants as well as issues of length and how the turnout coats and pants fit around their body (circumference). These fit problems were related to concerns about having the mobility to perform their work and safety.

3.2.1 Turnout coat length and circumference

Theme 1: Coat circumference challenges: As evidenced in Table 2, 44%of the total coded excerpts were related to firewomen’s experiences with turnout coats being both too tight, particularly around their chest, hips, and neck areas while being too loose around their waist, shoulder and sleeve. For example, “If you get it to fit your boobs, then it’s too big. And I see it [this] with a whole heap of the girls” (Participant 1). Other women had coats that were too tight in the chest: “I feel like sometimes my chest is tight when I zip it up” (Participant 16). Other gender-related proportion comments included: “They [do] not fit women so if you’ve got big boobs, they can fit really tight here and then be really loose [at the hip]. And then if you get [the coat] longer, then the arms get longer... And I know that there’s bigger girls who have to get an extremely large coat to fit into it. But then everything else doesn’t match” (Participant 1)”

Many of the excerpts (18%) mentioned that the hip of the coat was too tight. Firewomen attributed tightness in the hips to coats being designed for men instead of for women: “Then sometimes the hips, girls have more hips than guys do. So, it will be super loose here, but then the bust and the hip area it’s like ugh” (Participant 6) and “... it doesn’t fit because I mean, women have hips and [these] coats are not as wide in the hips sometimes” (Participant 34).

In the interviews, the firewomen also discussed the fit of the shoulders. These fit problems were usually related to getting the garment to fit another body circumference, but then the coat not fitting the shoulders. Alternatively, if the shoulders fit, other areas did not. Excerpts from three firewomen (3%) mentioned problems with the fit of their coat in the neck—one was too big, and the others were too small. When discussing sleeve fit, one participant stated, “The sleeves are very bulky. Wide, very wide” (Participant 27).

Theme 2: Coat length challenges: Twenty-six percent of the total coded excerpts were related to coat length, of which 32%of these excerpts were negative experiences with the body of the coat being too long. The excess length caused problems with climbing ladders, climbing into the truck, and other work-related movements. One participant stated, “It was very, very long. They’re like, ‘Oh, well you’re supposed to be able to see your nameplate underneath your air pack,’ and I’m like, ‘I don’t care about that. I want to be able to bend over and pick something up off the ground” (Participant 25). In contrast, another participant explained how the correct length of her coat helped her to do work-related tasks easily, “My department measured us for that. So, my length is okay. And what they chose to do [is go] just past the waist. Which is nice because then when you bend down, the coat doesn’t get stuck or limit you . . . you can squat down, whereas if you go with a coat that’s too long, you try and duck walk or something and it really limits your ability to do things” (Participant 31). The firewomen also expressed concern over the sleeve lengths being too long. A few firewomen or 10%of the excerpts related to coat length addressed the collar was too high. This caused discomfort and rubbing on the chin.

3.2.2 Turnout pant length and circumference

Theme 5: Pant circumference challenges: In Table 3, over 35%of the total coded excerpts were related to how the pants fit around the firewomen’s waist, thigh, hips, and other circumference measurements. Many women, (24%of pant fit circumference excerpts) had challenges with the waist of their pants too big. They attributed this to the pants being made for men’s body shapes instead of women’s, stating that the pants were the same measurement at the waist as at the hip: “The waist is, not how [it is] on women’s pants [where] the waist here is, the circumference is less than where your hip bone is. It’s straight from the hip up.” This, in turn, required the women to wear belts or suspenders to keep their pants from falling. For one participant, who did own pants made for women, this was not necessary as the pants fit properly at her waist. Firewomen also cited proportion issues in selecting pants: “To get where my hips fit in the pants, I had to choose the bigger waistline” (Participant 21).

Some firewomen indicated that the thighs and calves of their pants were too big (12%of pant circumference excerpts); however, a larger number of participants indicated that the pants fit fine in these two areas (24%of pant circumference excerpts). Three firewomen explicitly addressed how the pant legs at the hem were very tight over the boot, which contributed to issues when preparing to don the boots and pants. For example, “When I put them over my boots . . . my pants are so small, but the length is long. It’s hard for me to press them all the way down. It takes me a long time to put them over my boots” (Participant 3).

Theme 6: Pant length challenges: Thirty-eight percent of the total excerpts were related to pant length. Firewomen had the most problems with crotch/rise length (37%were negative responses), inseam length (33%were negative responses) and kneepad placement (4%were negative responses). Poor fit in the crotch was due to an excess of distance between the waist and crotch of the pants, whereby the crotch of their pants was too low. When the crotch of pants is lower than the natural crotch it can restrict movement. For example, Participant 10 explained, “The crotch is too low. So, every time I step up in the truck, I’m having to grab my crotch, pull it up where I can step up high enough to get on the truck.” Another participant explained that the crotch of the pants is “very uncomfortable when you’re trying to climb a ladder or trying to pick up your leg to reach a step that’s a little high (Participant 19).” She goes onto explain that the reason she has issues with the crotch is that, “it’s made for men (Participant 19).”

Of the excerpts related to inseam length, four excerpts conveyed issues of pant inseam length being too short, and when working, the pant leg would come up over the boot. Participant 32 shared her experience with short pants, “if the pant comes up above my ankle, then to me that’s too short because that exposes me to additional heat and other things when I’m in a fire. Especially if I have to crawl around or do anything like that. I had them give me longer pants. I’m not going to get burnt” And, “There is one thing that bugs me, is I don’t know if the pant is too short for me or if everybody has this problem, but if we’re crawling or anything, it just rides up” (Participant 16).

On the other hand, five excerpts relayed issues with pant inseams being too long. This caused problems while working, as in this quote: “I have issues. The bottom of the pants gets tucked underneath my boots while I’m walking because they’re too long” (Participant 29). And, as mentioned previously, for a few firewomen, the knee padding was too low.

3.2.3 Garment proportions

Many fit problems were interrelated, indicating that firewomen had challenges getting coats and pants that matched their bodies’ proportions. A proportion is the relationship of one garment dimension to another. One example of clothing proportion is how big the waist is compared to the hip (for a particular garment size). To get a garment to fit one body dimension, then another dimension would not fit. Participant 25 explained, “They don’t have a lot of female-oriented gear. I’m a fairly average size person in general, but I have a very long torso but wider hips, so I need a shorter coat to make sure I don’t literally catch when I’m bending down. To get a longer coat you always have to get a wider chest, which I don’t necessarily need, [then] the sleeves will end up being too long. They’re not tailored to female bodies at all.” Accordingly, firewomen felt like the coats they had to choose from fit either their chest and torso or their arm length, but could not find coats that had a good fit in both body locations. There were also problems with the pants being proportioned for men’s bodies, instead of women’s bodies. For example, “They have to be big enough to go around my butt. And even though they measure, they can still end up with a huge waist (Participant 26).” Participant 1 articulated problems with the positioning of the pockets and kneepads incorrectly on their body, “[you have to] yank [the pants] up so that they meet in the right spot. And lots of the girls would have [the manufacturer] sew things padding or soft material into the inner lining so that their knees are protected because if you’re in a fire, you don’t want it [your knees touching directly] on the ground. Some of our old pants used to have big pockets above the knee patch. So, they would fill their pockets with soft stuff because their pockets would fall down to their knees.”

3.3 Themes 3, 4, 7, and 8: Mobility and safety issues related to garment fit

There were 54 combined excerpts related to mobility and safety issues of the coat and pants. Of these excerpts, 72%were negative responses regarding the mobility and safety experiences of firewomen with their turnout coat and pants. The physical fit of the turnout coat and pants had a direct impact on mobility and the firewomen’s ability to perform work-related tasks. Participant 20 was upset at how poor fitting PPE were making their work more difficult, “Some women that I talk to they just make it work, you know. That’s unacceptable. That’s absolutely unacceptable because it makes doing the job far more difficult . . . It’s just really difficult to do your job when things don’t fit... it’s already difficult as it is.” The firewomen identified several work-related tasks that were made more difficult because of the physical fit of the turnout coats and pants. These tasks, listed from most-mentioned to least-mentioned, were crawling (mentioned 11 times), bending over (mentioned 10 times), walking (6 mentions), raising arms (4 mentions), squatting down (4 mentions), and climbing (3 mentions).

In addition to the prior discussion about specific length and circumference problems, the firewomen explained how poorly fitting garments can lead to safety issues. For example, “the jacket would come all the way down, which would mean when I’m trying to climb the ladder, it would just... the same thing. It was a safety issue for sure, and that’s when I requested for a shorter jacket” (Participant 19); And, “you can’t move around a whole lot. Sometimes, if it’s too bulky or too long, it really prohibits you from moving correctly. It gets stuck on your straps or the bottle and all that kind of stuff. It just is uncomfortable and just annoying. I’m always tugging and pulling” (Participant 6). This quote speaks to the issue of mobility problems caused by poorly fitting coats leading to distraction from work tasks. In addition, problems with the length of the pant lead to concerns with safety. Pants that were too short could pull up when climbing a ladder, exposing firewomen to fire. “I bend my knee up and the cuff comes up over my boot. That’s not safe.” (Participant 26) Pants that were too long could cause a hazard when walking. “I have issues. The bottom of the pants gets tucked underneath my boots while I’m walking because they’re too long.” (Participant 29). Firewomen were also aware of the importance of correctly fitting coats and pants on their safety. The right space between the body and turnout coats and pants should be maintained as in these quotes: “[I] don’t want hot contact points, where it’s pulling on you, because that’s where you burn most” (Participant 30).

It should be noted that the firewomen, in ten excerpts, reported positive or neutral experiences issues related to mobility and their turnout coat and pants. For example, Participant 22 reported that when wearing her coat, “I’m able to move and do those things that I need to do.” For another participant, she did observe that the pant crotch was long, but she, “can move with it (Participant 9)”. For the few firewomen who did have better fitting garments, they equated that with comfort: “It’s a much better fit than my backup gear. It’s a much more comfortable fit.... It doesn’t feel as weighted down as the other gear” (Participant 22). When firewomen found something that fit them well, they were elated, as Participant 21 exclaimed, “The one I have now, I ordered it again. I love it!”

3.4 Approaches to managing problems associated with fit

The firewomen interviewed in this study detailed a range of approaches to manage problems associated with fit. The simplest approach was a “make it work,” mentality. Participant 25, who is quoted above as having pants so long that they got caught under her boot was told to, “to just deal with it”. She eventually had [to] send her pants back to the manufacturer for repair. Any modifications to turnout coats and pants must go back to the manufacturer or otherwise certified professional because of federally regulations [5]. Instead of being reactive to the problem, the fire department could have proactively shortened the pants, improved her fit and ability to work, and likely circumvented the need to send the pants for repairs. Participant 20 finds this mentality “unacceptable”, she stated, “Some women that I talk to they just make it work, you know. That’s absolutely unacceptable.”

The most common strategy to get turnout coats and pants sized large enough or long enough to allow mobility and provide adequate protection was to order a size larger, however as mentioned previously, this strategy led to the garments being out of proportion. The firewomen relied on suspenders and belts to manage loose-fitting pants. However, these accessories were not a cure-all for a poor fit. The firewomen noted that they had to shorten the suspenders as short as they would go and for some firewomen, this was still not enough to raise the crotch of the pants to a level that did not inhibit movement. For example, Participant 16 explained, “They adjust, but I have to pull them as tight as they’ll go, ‘cause they’re so long. So, mine are all the way pulled tight.” Six other firewomen went on to detail similar occurrences with the suspenders. To cope with long sleeves, Participant 1 rolled her sleeves up, but that was “a safety issue.”

In the best possible scenario, the fire department works with the manufacturers to customize the fit of the turnout coats and pants for the firewomen. Participant 32 explained, “they do that for us so that it would fit us individually.” From the interviews, it appears that in most cases, the manufacturers were modifying existing inventory held either at the manufacturer’s warehouse or with fire stations to fit the firewomen. Participant 15 noted that in her department, “if it needs to be modified, our department is good about sending it back to the manufacturer and having it shortened or whatever.”

The range of modifications included adding or removing length in the coat body and sleeve and pant inseam. They also added “flare” on the coat for more room around the hips. One participant, who has several years of experience, knows that she needs the manufacturer to add ease around her hips, “Whenever I get a new coat, they have to add gussets to the sides in order for me to be able to fit [in the hips] and fit everywhere else. I have hips; manufacturers don’t make them for big hips. Because I’ve been doing it [this for] so long, I just say okay well this is my last set... I always know that I need to add at least two-inch gussets on each hip” (Participant 20).

Although having the turnout coats and pants customized to fit each firewoman is the best strategy to ensure a good fit, some firewomen still did not end up with turnout coats and pants that fit well. For example, Participant 5 explained, “Even though I got it altered and had it shortened and [added] the hip flare, it’s bagging in areas where it shouldn’t be bagging and it’s tight in areas where it shouldn’t be tight, across my chest and stuff like that.” Also, Participant 23 explained, “they supposedly custom-made one for me once, but there was a limit to how custom it could go. So, they made it as short as they could.” Although customizing the turnout coats and pants is ideal, not all fire municipalities go to this level to help individualize fit for firewomen. Furthermore, some women who need alterations can’t or don’t have it done, while others have garments “customized” for their body shape, but the results are still less than perfect. Overall, there are many improvements to be made to turnout coats and pants to fit firewomen.

In moving forward, the firewomen had recommendations to help improve firefighter turnout coats and pants fit for women. The firewomen felt that garments should be offered in a greater variety of proportional configurations and, in particular, to fit women’s’ bodies. One participant had worn turnout coats and pants created specifically for women. The turnout coats and pants were a pilot program by a manufacturer. Unfortunately, this type of turnout coats and pants was not continued. Participant 32 compared her experience of the pilot program turnout coats and pants to her traditional turnout coats and pants:

“they had that were the, what they call the “B-fit”, or they’re classified B, was more structured to a woman’s body so things were in the right places. They rode at the waist, not on the hip. The patches on the knees were higher, your crotch was higher. Loose, but higher. Even with the coat, everything was in the right place so, I had all kinds of movement that I don’t have with the gear I have now. I have an excess of material and I can’t do as much as I could with it in the other gear. It makes a huge difference.”

4 Discussion and implications

Through interviews of 35 firewomen, this study provides in-depth detail of fit problems at specific garment locations, as well as the mobility and safety problems caused by these fit problems. Because of the level of detail, the findings are actionable. Whereas past studies [6 –9] alluded to firewomen’s mobility and safety issues due to poor fit, the study gives in-depth information about the issues and provides actionable items on how to address the issues outlined in this research.

4.1 Physical fit challenges of turnout coats and pants for firewomen

The qualitative findings of this study support that firewomen have challenges acquiring turnout coats and pants that fit their bodies. This expands upon previous findings of women’s low satisfaction with their turnout coats and pants [5–7 , 9], by identifying specific common fit issues with firewomen’s turnout coats and pants. In contrast to previous studies [1 , 28], this study focuses specifically on women, includes in-depth interviews (rather than surveys) to understand the causes and effects of these fit problems, and includes a much larger number of interviews than previous qualitative studies. Manufacturers should consider these findings in developing new turnout coats and pants that better fit female bodies.

4.1.1 Turnout coat length and circumference

4.1.1.1. Coat circumference challenges: Previous studies indicate that firewomen’s fit problems with turnout coat circumferences include oversized neckline [7], extra fabric at the shoulders and upper chest [6], shoulders that are too wide or big [7], chest circumference being too tight and restrictive [7], sleeves that are too wide at the upper arm [7], and coat sleeve cuffs that are too wide [7]. Results of the current study confirm these findings and add new findings of circumference problems with tightness at jacket hips and looseness at jacket waist. Findings indicate that the most problematic areas for firewomen with their coat circumferences are tightness at the chest and hips, and looseness at the waist. These circumference problems support the relationship between firewomen’s fit problems and wearing coats designed for firemen’s body proportions [5, 7]. Coats appropriately proportioned to firewomen’s bodies need to be developed and made available to firewomen.

4.1.1.2. Coat length challenges: Previous studies indicate that firewomen’s fit problems with turnout coat lengths include collars that are too high [7], coat sleeves that are too long [6, 7], and coat length that is too long [7]. These three problem areas were confirmed by the findings of this study. Of these three, coat length was most frequently mentioned. Interestingly, 44%of those mentions of coat length were positive and 56%were negative. Positive mentions were related to being measured for an appropriate length coat, while negative mentions were about coats that were too long and impaired mobility. These findings reinforce the importance of appropriate length coats being made available to firewomen.

4.1.2 Turnout pant length and circumference

4.1.2.1. Pant circumference challenges: Previous studies indicate that firewomen’s fit problems with turnout pant circumferences include too large in the waist [6 –8], too small in the hips [7, 8], the crotch is bulky [7], too large in the thigh [8], too large at the knee [8], too large at the calf [8], and too large at ankle [8]. However, some firewomen reported pants being too tight on boots [7]. These problem areas were confirmed by the current study. The greatest problem for firewomen was that their pants were too large at the waist. To get a pant that fit their hips, many women had to choose a size that was too big for their waist. This circumference problem is related to firewomen wearing pants designed for firemen’s body proportions [5 , 8], where the waist and hips are similar in circumference [5, 8]. The frequency of this problem emphasizes the urgency for pants appropriately proportioned to firewomen’s bodies to be developed and made available to firewomen.

The next three most problematic areas with pant circumference were at the hips, thigh, and bottom hem. For the thigh, findings indicate a mix of neutral and negative fit assessments. Fit at the hips and the bottom hem had both positive and negative responses. These mixed findings indicating further research is need to understand firewomen’s perceptions. Pant manufacturers should consider the dimensions of the boots firewomen wear when specifying the leg openings of pants. This may require them to undertake a modified process in developing the measurement differences (grade) between the sizes offered.

4.1.2.2. Pant length challenges: Previous studies indicate that firewomen’s fit problems with turnout pant lengths include inconvenient pocket placement [6, 7], excess length [6, 8], the crotch of the pants is too low [6, 7], and inappropriate location of knee pad [7, 8]. In the current study, crotch length was the most frequently mentioned pant length problem, reiterating its importance and mirroring Park and Langseth-Schmidt’s findings of male and female body proportion difference in the waist-to hip-distance [8]. The length of the pants from the crotch to the waist was often too long, inhibiting their ability to walk and climb ladders, similar to previous findings [6, 7]. The second most mentioned pant length problem area was pant inseam length, with almost equal numbers of too long and too short. Manufacturers need to offer pants in a greater variety of lengths. Contrary to previous studies indicating problems with kneepad locations [7, 8], only one excerpt in this study negatively mentioned kneepads. This may be an area for future anthropometric research.

4.1.3 Garment proportions

Previous studies have implied interrelated fit issues because the proportions of the turnout gear do not reflect firewomen’s body proportions [6 –8]. Results of the current study also reflect this and provide more insight into key body relationships that should be considered when refining turnout gear fit for firewomen. Previously alluded to in this discussion, the chest: waist ratio, the coat body length: sleeve length ratio, and the waist: hip ratio were all problematic when trying to size turnout coats and pants. Furthermore, the crotch length of the pants were all too long for the firewomen in this study, reflecting a male-oriented crotch length proportion. When firewomen are sized for turnout coats and pants that fit one body dimension (often their largest circumference measurement), they often do not fit in another body region because the existing sizing systems used by manufacturers do not correlate to the body proportions of firewomen. To remedy this issue, sizing standards inclusive of firewomen are needed that reflect an understanding of firewomen’s body proportions. The proportions of the major circumference areas of coats and pants need to be offered in combinations that fit female bodies, as current combinations do not meet their needs. Primarily, the turnout coats and pants should be manufactured and offered to firewomen in proportional configurations to fit firewomen’s bodies. This requires a comprehensive study of the anthropometrics of firewomen as well as making such knowledge being publicly available to manufacturers. Manufacturers, instead of relying on their experience and intuition, can adapt to the updated turnout coats and pants sizing and fit information.

4.2 Mobility and safety issues related to garment fit

Previous studies indicate that fit problems can lead to mobility and safety problems [7], resulting in workplace injuries like exposure [18], overexertion [9], musculoskeletal injuries [18, 23], and slips and trips [18]. Park et al. [22] noted that the interface between the turnout garments and other equipment was a major contributor to reduce mobility, comfort, and safety. Results of the current study also reflect these findings and add new findings regarding specific tasks that are problematic due to poor fit such as climbing, crawling, bending over, raising their arms, and walking. The firewomen in this study report that the length of the sleeves got in the way of secure handholds and long coats that catch on their SCBA or other equipment led to slip and fall injuries. Furthermore, the firewomen reported that short pant inseams left their legs exposed when they bent their knee, and pants that were too long got caught under their boots when walking.

The firewomen in this study expressed concern that the poor fit of their turnout coat and pants made their work activities harder than if the garments were to fit them well. As one of the firewomen noted, poor fit of the turnout coats and pants makes the job “far more difficult” and can be a distraction from work tasks because they were constantly “tugging and pulling” at their coats and pants to be able to move. The fit of the turnout coats and pants becomes a safety issue when ill-fitting garments distract or stop the firewomen from performing their work safely. These findings should provide justification for turnout gear manufacturers to rectify fit issues for firewomen. Manufactures of turnout gear should prioritize the implementation of these findings to improve the fit, and thereby the mobility and safety of turnout coats and pants to adequately protect firewomen. Additionally, manufacturers should offer female-specific options as the same bulk rates as male-specific or “unisex” options. Furthermore, regulating bodies, such as the NFPA should enforce recently updated standards that state men’s and women’s sizes should be accomplished by unique patterns based on key body locations and presented in this study. None of these changes can happen without the support of regulating bodies. Their roles are important and should include making updates on turnout coats and pants sizing information and promoting public accessibility of such information and providing other stakeholders with strong support in adopting a wider range of sizes and customization of turnout coats and pants.

4.3 Approaches to managing problems associated with fit

Previous research shows that there is a lack of responsiveness to fit issues of firewomen even though a fire department may recognize the importance of the fit of turnout coats and pants [5, 11]. And therefore, the findings of this study detail how firewomen manage problems associated with turnout coat and pant fit. In this study, the firewomen ordered larger sized garments to fit their widest body measurement and used accessories (belts or suspenders) to help hold up baggy and out of proportion garments. These two approaches are fixes that only somewhat ameliorate the fit problems.

The most comprehensive way the firewomen in this study to managed fit problems was to alter turnout coats and pants. The most common modifications included adding ease at the hips, adding or removing length in the jacket sleeve, adjusting the pant inseam, and removing length in the jacket torso. Alterations to fit each firewoman, is highly demanded and applauded by firewomen, but this approach is restricted. Any modifications to turnout coats and pants must go back to the manufacturer or otherwise certified professional because of federally regulations [5]. Not many fire departments are responsive to such need, and not every manufacturer provides this service [9]. Even with access to customization, firewomen are limited to the level of customization. In this study, the firewomen reported that most gear that is customized to them is existing inventory that is modified to fit their measurements.

Overall, a multifaceted process is needed for achieving turnout coats and pants fit satisfaction for firewomen. This process calls for efforts from all stakeholders, including but not limited to researchers in the field of PPE sizing and fit, manufacturers, fire departments, makers of related regulations and policies, as well as firewomen themselves. Fire departments should take on a proactive approach to address size issues for firewomen and work with manufacturers to customize the fit of the turnout coats and pants to each firewoman to recognize the diversity of body shapes and proportions. Firewomen can also actively and proactively work with other stakeholders to help them obtain a better understanding of their body shapes and proportions, which will result in a better sizing system matching their needs.

5 Conclusion

Through the qualitative analysis of in-depth interviews of 35 firewomen, the study illuminated specific fit problems firewomen have with their turnout coats and pants. Further, this study builds an understanding of these fit problems on the ability of firewomen to do their challenging work in a safe and stress-free manner. These fit challenges include challenges with the overall proportions of the turnout coats and pants as well as issues of length and how the turnout coats and pants fit around their body (circumference), leading to concerns about mobility and safety.

6 Limitations and future work

As with nearly all research, this study has limitations that should be addressed through future research. For example, the fact that participants were attendees at a conference led to some demographic differences from the general firewomen population, notably, the firewomen in this study represented a higher percentage of career firefighters than volunteer firefighters. This difference may have led to an underreporting of fit problems and related mobility and safety problems, as volunteer firefighters report less satisfaction than career firefighters with their protective turnout coats and pants [6 –9]. Therefore, future research is needed to adequately capture volunteer firewomen’s fit issues with their turnout gear.

Furthermore, this study focused on firewomen because they are underrepresented in the literature and have greater dissatisfaction than firemen with their coats and pants when doing job-related movements [7]. However, firemen have also indicated fit dissatisfaction with their coats and pants [1, 7] and negative mobility impacts [8 , 24]. One of the participants in the current study also mentioned that some men with very large pectoral muscles also have the same experience stating, “they have the same challenges I do” and so she thinks it would be great if turnout coats and pants manufacturers offered, “an alternate option” because it “would be helpful.” Thus, firemen may experience some of the same fit, mobility, and safety issues with their turnout coats and pants. Therefore, additional research is needed to understand the specific fit problems of firemen. Such findings would clarify additional causes of fit problems, beyond gear designed for male rather than female body proportions.

Also, the process by which firefighters select the size of their turnout gear should also be critically evaluated, but was outside of the scope of this paper. Proper size selection practices, including dynamic fit testing, as suggested by Stull and Stull [13], should also be studied to bring to light fit issues associated with inaccurate fitting and measurement techniques that could be contributing to poor fitting turnout gear.

Although this current research contributes valuable knowledge about fit problems firewomen have with turnout coats and pants, and the impact of poor fit on mobility and safety, there is much more work to be done to ensure that firewomen have access to properly fitted gear. Fellow researchers should find the in-depth qualitative findings presented in this study to be a strong foundation for further investigation into this topic. Likewise, manufactures may find the findings presented in this study useful to justify female-specific gear that has improved fit to adequately protect firewomen. Overall, this study illuminated specific fit problems firewomen have with their turnout coats and pants including challenges with the overall proportions of the turnout coats and pants as well as issues of length and how the turnout coats and pants fit around their body (circumference). These fit problems should be addressed to ensure that firewomen can do their challenging work in a safe and stress-free manner.

Conflict of interest

None to report.

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Data USA. Data USA: Firefighters - Search [Internet]. Available from: https://datausa.io/profile/soc/firefighters

	Study subjects		Firefighter population
	N %of total Female		%of total All
Roles
Career	14	40.0%	35.0%¹
Volunteer	3	8.6%	65.0%¹
Reported both career and volunteer	3	8.6%	X
Not reported	15	42.9%	X
Total	35	100.0%	100.0%¹
Age range
16-19	0	0.0%	3.0%¹
20-29	3	8.6%	21.0%¹
30-39	7	20.0%	28.0%¹
40-49	16	45.7%	26.0%¹
50-59	9	25.7%	16.0%¹
60 and over	0	0.0%	6.0%¹
Total	35	100.0%	100.0%¹
Race or ethnicity
White	23	65.7%	83.5%²
Black/African American	6	17.1%	7.6%²
Asian	0	0.0%	1.2%²
Other: Puerto Rican	1	2.9%	2.6%²
Two or more races	0	0.0%	4.0%²
American Indian, Native Hawaiian	2	5.7%	1.1%²
Hispanic, Latino, or Spanish	3	8.6%	X
Total	35	100.0%	100.0%²