Prevalence of coronary artery disease risk factors among fire-fighters in Cape Town, South Africa

Abstract

14Background 15 Cardiovascular disease is a major cause of morbidity and on-duty mortality among fire- 16 fighters. This study investigated the prevalence of coronary artery disease (CAD) risk factors 17 among firefighters in Cape Town, South Africa. 18 Methods 19 A quantitative, cross-sectional and descriptive study design was used. A convenient sample 20 of 219 male fire-fighters with mean age 37.85±9.80 years was recruited. Eight major CAD 21 risk factors were measured. SPSS (ver. 23) was used with the Pearson correlation and 22 Kruskall-Wallis H test with the Mann Whitney test post hoc and a Bonferroni correction. 23 Results 2 24 The significance level set at p<0.05. Most fire-fighters (65.29%) were stratified as moderate 25 risk for CAD, with 21.00% as low risk, and 14.15% as high risk. A sedentary lifestyle was 26 the most prevalent CAD risk factor (51.14%), followed by obesity (45.90%). and cigarette 27 smoking (38.30%). Statistically significant correlations were found between waist 28 circumference and body mass index (BMI) (r=0.711; p<0.01), hip circumference and BMI 29 (r=0.673; p<0.01), waist circumference and waist-hip ratio (WHR) (r=0.665; p<0.01), and 30 BMI and body mass (r=0.512; p<0.01). 31 Conclusion 32 The majority of fire-fighters presented with multiple modifiable CAD risk factors. Fire 33 departments should focus on promoting education on CAD to reduce the risk of fire-fighters 34 developing heart disease. 35 36 42 of heart attacks [3], [4]. These cardiovascular events do not only happen at random, but 43 mostly occur during very physically demanding situations, such as fire suppression [4].44 Furthermore, the majority of fire-fighters who experienced these events possess one or more 45 of the following risk factors for CAD, namely, obesity, prediabetes, dyslipidemia, high blood 46 pressure (hypertension), cigarette smoking, and/or a sedentary lifestyle. The risk of heart 47 attacks among fire-fighters is dependent on many factors, including factors such as a low 3 48 level of physical activity, and chronic exposure to smoke. In addition, the high temperatures 49 present during fire suppression significantly increase physiological strain and the potential to 50 over exert the cardiovascular system [4]. 51 Many countries in Africa bear a heavy burden from cardiovascular disease, more especially 52 in sub-Saharan Africa [5]. In South Africa, the prevalence of cardiovascular disease has been 53 aggravated by an increased burden of cardiovascular risk factors, such as cigarette smoking, 54 hypertension, dyslipidemia, diabetes and sedentary lifestyles [6]. The majority of individuals 55 affected are young and at their most productive age, and constitute the largest sector of the 56 workforce, fire-fighters included [6]. 57 Many of the fire-fighters, who died on-duty, did not have an up-to-date medical evaluation 58 [2]. Hypertension, prior occlusive disease, and cigarette smoking presented as significant risk 59 factors for on-duty-death [2]. Furthermore, some of the firefighters who were ...