Cardiovascular Disease in US Firefighters

Soteriades, Elpidoforos S.; Smith, Denise L.; Tsismenakis, Antonios J.; Baur, Dorothee M.; Kales, Stefanos N.

doi:10.1097/crd.0b013e318215c105

Cited by 352 publications

(374 citation statements)

References 110 publications

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“…Despite perceptions to the contrary, firefighters' behavioral profile is comparable to other workers, including unhealthy diets and lack of regular physical activity [8]. Their episodic intense work, combined with those health risks, contribute to myocardial infarctions being the leading cause of on duty death [9].…”

Section: Discussionmentioning

confidence: 99%

Worksite wellness program implementation: a model of translational effectiveness

Elliot

MacKinnon

Mabry

et al. 2012

Behav. Med. Pract. Policy Res.

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Occupational health promotion programs with documented efficacy have not penetrated worksites. Establishing an implementation model would allow focusing on mediating aspects to enhance installation and use of evidence-based occupational wellness interventions. The purpose of the study was to implement an established wellness program in fire departments and define predictors of program exposure/dose to outcomes to define a cross-sectional model of translational effectiveness. The study is a prospective observational study among 12 NW fire departments. Data were collected before and following installation, and findings were used to conduct mediation analysis and develop a translational effectiveness model. Worker age was examined for its impact. Leadership, scheduling/competing demands, and tailoring were confirmed as model components, while organizational climate was not a factor. The established model fit data well (χ 2 (9)=25.57, CFI = 0.99, RMSEA = 0.05, SRMR = 0.03). Older firefighters, nearing retirement, appeared to have influences that both enhanced and hindered participation. Findings can inform implementation of worksite wellness in fire departments, and the prioritized influences and translational model can be validated and manipulated in these and other settings to more efficiently move health promotion science to service.

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Section: Discussionmentioning

confidence: 99%

Worksite wellness program implementation: a model of translational effectiveness

Elliot

MacKinnon

Mabry

et al. 2012

Behav. Med. Pract. Policy Res.

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show abstract

“…[5][6][7] In fact, approximately 45% of firefighter line-of-duty deaths each year occur from sudden cardiac events, 7,8 accounting for the highest proportionate cardiovascular mortality of any occupational group. 5 The exact mechanisms responsible for firefighters' apparent increased risk of cardiovascular events remain largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Vascular and central hemodynamic changes following exercise-induced heat stress

et al. 2015

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This study examined the effects of moderate exercise-induced heat stress (EIHS) on vascular function, central hemodynamic load and indices of coronary perfusion. Vascular-hemodynamic measures were collected in 12 healthy men (aged 22±3 years) pre and post 100 minutes of moderate, intermittent exercise in two randomized conditions: heat stress (HS; wearing firefighter personal protective equipment (PPE)), and no heat stress (NHS; wearing a cooling shirt and equivalent PPE weight). Aortic blood pressure, reflected wave pressure (Pb), systolic (SPTI) and diastolic pressure time-integral (DPTI), and aortic stiffness were assessed before and after each condition. SPTI was significantly greater, and DPTI and Pb were significantly lower for HS-post compared to NHS-post (p<0.05). Pulse wave velocity was not different between conditions. In conclusion, EIHS does not affect aortic stiffness, but increases indices of myocardial work and reduces indices of coronary perfusion which may be related to chronotropic responses to EIHS. The mismatch between oxygen demand and oxygen supply may increase cardiac vulnerability to ischemia during strenuous work in the heat.

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“…The US National Research Council (NRC) emphasizes assessing risk for chemical and non-chemical hazards for risk-management (52). A comprehensive approach to understanding combined ORF and PRF effects could strengthen risk management at all prevention levels to promote workforce health, greater productivity, and population well-being (52)(53)(54)(55)(56). This discussion paper focuses on basic conceptual heuristic models that consider combinations of risk factors related to obesity and the occupational environment.…”

mentioning

confidence: 99%

Conceptual heuristic models of the interrelationships between obesity and the occupational environment

Pandalai¹,

Schulte²,

Miller³

2013

Scand J Work Environ Health

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Pandalai SP, Schulte PA, Miller DB. Conceptual heuristic models of the interrelationships between obesity and the occupational environment. Scand J Work Environ Health. 2013;39(3):221-232. doi:10.5271/sjweh.3363 Objective Research and interventions targeting the relationship between work, its attendant occupational hazards, and obesity are evolving but merit further consideration in the public health arena. In this discussion paper, conceptual heuristic models are described examining the role of obesity as both a risk factor and health outcome in the occupational setting.Methods PubMed was searched using specific criteria from 2000 and onwards for evidence to support conceptual models in which obesity serves as a risk factor for occupational disease or an outcome of occupational exposures. Nine models are presented: four where obesity is a risk factor and five where it is an adverse effect.Results A broad range of work-related health effects are associated with obesity including musculoskeletal disorders, asthma, liver disease, and cardiovascular disease, among others. Obesity can be associated with occupational hazards such as shift work, sedentary work, job stress, and exposure to some chemicals. Conclusion Identification of combinations of risk factors pertinent to obesity in the occupational environmentwill provide important guidance for research and prevention.Key terms cardiovascular disease; diet; endocrine disruptor; intervention study; metabolism; musculoskeletal disease; occupational health; physical activity; risk assessment.1 National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA.Correspondence to: Sudha P Pandalai, MD, PhD, National Institute for Occupational Safety and Health Centers for Disease Control and Prevention, 4676 Columbia Parkway, Cincinnati, OH 45226, Obesity is increasing worldwide with the 2009-2010 prevalence among US adults surpassing one-third (1, 2). Obesity is associated with genetic, behavioral, occupational, and environmental factors (3-5) and has significant economic impact (6). It is also associated with various health problems including musculoskeletal disorders (MSD), asthma, liver disease, and cardiovascular disease (CVD) (7-10). Moreover, neurohormonal and endocrine pathway disruption has been associated with obesity (11,12). Work factors, including sedentary work and taskrelated biomechanics, have been reported as risks for obesity (13)(14)(15). Variables such as irregular work hours/ sleep schedules, job stress, workplace absenteeism, and reduced productivity also contribute (16)(17)(18)(19).Although the related literature is growing, obesity in the occupational environment requires more study, for example, regarding low-wage workers and genes or other factors (20,21). Body mass index (BMI), a measure of obesity, varies by population, race, gender, and socioeconomic class (22)(23)(24). Genetics may account for ≥40% of the variation in BMI (25), but such estimates can depend on the variability of environ...

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Cardiovascular Disease in US Firefighters

Cited by 352 publications

References 110 publications

Worksite wellness program implementation: a model of translational effectiveness

Worksite wellness program implementation: a model of translational effectiveness

Vascular and central hemodynamic changes following exercise-induced heat stress

Conceptual heuristic models of the interrelationships between obesity and the occupational environment

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