Lipid Profile of Firefighters Over Time: Opportunities for Prevention

Abstract

Heart disease is the primary cause of on-duty deaths in firefighters, but little is known about their lipid profile. We evaluated the lipid profile in relation to other cardiovascular disease risk factors in 321 firefighters at a baseline examination. Prospective comparisons were performed for 285 firefighters, who were enrolled in a statewide medical surveillance program, and had complete follow-up data for 4 years. The average cholesterol level in firefighters declined from 224 mg/dL at baseline (1996-1997) to 214 mg/dL at the follow-up examination (P < 0.0001). Conversely, both obesity (body mass index > or = 30; 34% versus 40%, P = 0.008) and triglycerides (> or = 200 mg/dL; 27% versus 35%, P = 0.047) increased over time. The proportion of firefighters taking lipid-lowering medications increased from 3% at baseline to 12% at follow-up (P < 0.0001). Cholesterol levels declined significantly, and treatment rates for elevated cholesterol increased over time. Despite repeated examinations, a considerable number of firefighters had persistently elevated cholesterol, and only a minority were receiving adequate treatment.

Firefighter Heart Presumption Retirements in Massachusetts 1997???2004

“…We previously reported a 33% prevalence of obesity among the professionally active control firefighters, 14 which increased to 40% 4 years later. 15 Similar cross-sectional results were also observed in a Texas cohort. 22 Additionally, Womack et al 23 found that both exercise tolerance and lean body mass were below agepredicted averages in another firefighter cohort.…”

“…We have previously shown that hypertension and dyslipidemia are often inadequately treated among professionally active Massachusetts firefighters and that uncontrolled hypertension is associated with a higher risk of adverse changes in employment status. [15][16][17] Therefore, we believe that risk factor screening alone is insufficient, and fire department medical programs should include incentives to promote more aggressive risk factor reduction. These should include measures for progressively controlling hypertension, 17,26 which is a treatable illness yet one whose failure to control accounted for almost 10% of heart retirements and most likely contributed to others.…”

Obesity and Risk of LVH and ECG Abnormalities in US Firefighters

“…8 Firefighters perform strenuous activities under stressful conditions and at the same time may have unfavorable CVD risk factor profiles. 9,10 It is well known that obesity is an established risk factor for cardiovascular disease and that it is associated with a clustering of other CVD risk factors, our group having previously reported on the relatively high prevalence of obesity among firefighters. 11,12 In addition, the medical literature strongly supports that left ventricular hypertrophy (LVH) is associated with a higher risk of cardiovascular morbidity and mortality.…”

Acute effects of firefighting on arterial stiffness and blood flow

“…1 Several studies have documented increased cardiovascular risk factors in firefighters, including high levels of obesity. [10][11][12][13][14][15] Cardiovascular risk factors have unfavorable impact on arterial function, including decreased endothelial function, 16 and increased arterial stiffness, 17 and central blood pressure (BP), 18 all of which are predictive of allcause cardiovascular mortality. 13,19 Furthermore, higher aortic stiffness is associated with increased risk for a cardiovascular event.…”