Emergency Duties and Deaths from Heart Disease among Firefighters in the United States

Abstract

BackgroundHeart disease causes 45% of the deaths that occur among U.S. firefighters while they are on duty. We examined duty-specific risks of death from coronary heart disease among on-duty U.S. firefighters from 1994 to 2004. MethodsWe reviewed summaries provided by the Federal Emergency Management Agency of the deaths of all on-duty firefighters between 1994 and 2004, except for deaths associated with the September 11, 2001, terrorist attacks. Estimates of the proportions of time spent by firefighters each year performing various duties were obtained from a municipal fire department, from 17 large metropolitan fire departments, and from a national database. Odds ratios and 95% confidence intervals for death from coronary heart disease during specific duties were calculated from the ratios of the observed odds to the expected odds, with nonemergency duties as the reference category. ResultsDeaths from coronary heart disease were associated with suppressing a fire (32.1% of all such deaths), responding to an alarm (13.4%), returning from an alarm (17.4%), engaging in physical training (12.5%), responding to nonfire emergencies (9.4%), and performing nonemergency duties (15.4%). As compared with the odds of death from coronary heart disease during nonemergency duties, the odds were 12.1 to 136 times as high during fire suppression, 2.8 to 14.1 times as high during alarm response, 2.2 to 10.5 times as high during alarm return, and 2.9 to 6.6 times as high during physical training. These odds were based on three estimates of the time that firefighters spend on their duties. ConclusionsCertain emergency firefighting duties were associated with a risk of death from coronary heart disease that was markedly higher than the risk associated with nonemergency duties. Fire suppression was associated with the highest risk, which was approximately 10 to 100 times as high as that for nonemergency duties.

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“…Their episodic intense work, combined with those health risks, contribute to myocardial infarctions being the leading cause of on duty death [9]. Healthy lifestyles are of additional importance because firefighters' risk of cancer is increased [10].…”

Pathoanatomic Findings Associated With Duty‐Related Cardiac Death in US Firefighters: A Case–Control Study

“…Prior research has identified occupational16, 17 and individual5, 6, 12 factors associated with an increased risk of cardiac death in the fire service. Careful analysis of autopsy data offer the opportunity to better understand the underlying pathoanatomic features associated with SCD.…”

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“…The combination of cardiovascular, thermal and psychological stresses which are routinely experienced may trigger cardiac events. Fire suppression activities increase the risk of suffering from a cardiac event by 10-100 times compared to non-firefighting duties (Kales et al 2007). This risk is further exacerbated by underlying health issues, such as obesity and hypertension (Kales 2007, Kales 2009, Geibe et al 2008.…”

“…Fire suppression activities increase the risk of suffering from a cardiac event by 10-100 times compared to non-firefighting duties (Kales et al 2007). This risk is further exacerbated by underlying health issues, such as obesity and hypertension (Kales 2007, Kales 2009, Geibe et al 2008. The high incidence of myocardial infarction makes cardiac strain experienced by firefighters a major concern Yang et al 2013).…”