Cost-effectiveness of workplace wellness to prevent cardiovascular events among U.S. firefighters

Abstract

Background: The leading cause of death among firefighters in the United States (U.S.) is cardiovascular events (CVEs) such as sudden cardiac arrest and myocardial infarction. This study compared the cost-effectiveness of three strategies to prevent CVEs among firefighters. Methods: We used a cost-effectiveness analysis model with published observational and clinical data, and cost quotes for physiologic monitoring devices to determine the cost-effectiveness of three CVE prevention strategies. We adopted the fire department administrator perspective and varied parameter estimates in one-way and two-way sensitivity analyses. Results: A wellness-fitness program prevented 10% of CVEs, for an event rate of 0.9% at $1440 over 10-years, or an incremental cost-effectiveness ratio of $1.44 million per CVE prevented compared to no program. In one-way sensitivity analyses, monitoring was favored if costs were < $116/year. In two-way sensitivity analyses, monitoring was not favored if cost was ≥ $399/year. A wellness-fitness program was not favored if its preventive relative risk was >0.928. Conclusions: Wellness-fitness programs may be a cost-effective solution to preventing CVE among firefighters compared to real-time physiologic monitoring or doing nothing.

Fitness Fights Fires: Exploring the Relationship between Physical Fitness and Firefighter Ability

“…For all regressions, Age and BMI, while not significantly correlated to firefighting ability in this sample, were retained as predictors due to previous evidence suggesting their inverse impact on exertion task ability [2]. Given previous literature highlighting the importance of cardiovascular fitness in firefighters [8][9][10][11][12], estimated VO 2max was entered at the second level, followed by muscular endurance. It is important to note that the three indices of muscular endurance (i.e., YMCA bench press, 60 s sit-up and push-ups) were retained as only moderate relationships existed among each of the variables within this data set (see Tables 3 and 4).…”

“…Some of these modifiable risk factors include obesity, high blood pressure, smoking status, poor nutrition, poor hydration, and lack of physical activity and physical fitness [8,9]. Indeed, recent research has begun to examine the relationship between physical fitness and the likelihood of experiencing a cardiac incident among firefighters and these findings suggest that many of the modifiable risk factors can be targeted to prevent cardiac incidents among firefighters [8][9][10][11][12].…”

Educational and Mandatory Fitness Standards in the Firefighting Profession

“…The evidence that SCD is the leading cause of on-duty deaths among firefighters is well documented 10 , as is the research that coronary artery disease is one of the three contributing factors in SCD. The two other contributors to SCD, genetics and heart structural damage, are detectable through cardiac screening that is required at the entry-level for firefighters and firefighter trainees 11 .…”

Building a culture of workplace wellness: Perspectives from Philippine organizations

“…A study in Australia reported that productivity loss due to alcohol use is about $AUD 3.6 billion annually (Pidd, Roche, & Fischer, 2015). A study among firefighters reported that a wellness-fitness program prevented 10% of cardio vascular events (CVE) and resulted in savings of $1.44M per CVE (Patterson, Smith, & Hostler, 2016). Company investments in employee health are likewise associated with lower absenteeism, increased job satisfaction, improved productivity and a more positive corporate image (Lee, Blake, & Lloyd, 2010).…”