Results Deaths 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. Conclusions Certain 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.

https://www.nejm.org/doi/pdf/10.1056/NEJMoa060357

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

The thermal ergonomics of firefighting reviewed.

Coronary heart disease (CHD) is responsible for 45% of on-duty deaths among United States firefighters. We sought to identify occupational and personal risk factors associated with on-duty CHD death. We performed a case-control study, selecting 52 male firefighters whose CHD deaths were investigated by the National Institute for Occupational Safety and Health. We selected two control populations: 51 male firefighters who died of on-duty trauma; and 310 male firefighters examined in 1996/1997, whose vital status and continued professional activity were re-documented in 1998. The circadian pattern of CHD deaths was associated with emergency response calls: 77% of CHD deaths and 61% of emergency dispatches occurred between noon and midnight. Compared to non-emergency duties, fire suppression (OR = 64.1, 95% CI 7.4–556); training (OR = 7.6, 95% CI 1.8–31.3) and alarm response (OR = 5.6, 95% CI 1.1–28.8) carried significantly higher relative risks of CHD death. Compared to the active firefighters, the CHD victims had a significantly higher prevalence of cardiovascular risk factors in multivariate regression models: age ≥ 45 years (OR 6.5, 95% CI 2.6–15.9), current smoking (OR 7.0, 95% CI 2.8–17.4), hypertension (OR 4.7, 95% CI 2.0–11.1), and a prior diagnosis of arterial-occlusive disease (OR 15.6, 95% CI 3.5–68.6). Our findings strongly support that most on-duty CHD fatalities are work-precipitated and occur in firefighters with underlying CHD. Improved fitness promotion, medical screening and medical management could prevent many of these premature deaths.

/pdf/firefighters-and-on-duty-deaths-from-coronary-heart-disease-2now7n1kfq.pdf

Firefighters and on-duty deaths from coronary heart disease: a case control study

http://1rxflr7bsmg1aa7h24arae91.wpengine.netdna-cdn.com/wp-content/uploads/sites/2/2015/02/AJH-BPemergencyresponders.pdf

Blood Pressure in Firefighters, Police Officers, and Other Emergency Responders

Law enforcement is a high-stress occupation that is prone to increasing the prevalence and incidence of cardiovascular disease. Epidemiological studies suggest that police officers and related public safety personnel have an increased risk of cardiovascular morbidity and mortality. Currently employed police personnel have a high prevalence of traditional risk factors, including hypertension, hyperlipidemia, metabolic syndrome, cigarette smoking, and a sedentary lifestyle. Obesity may be more common in police officers compared with civilians, whereas diabetes is present less frequently. Law enforcement personnel are also exposed to occupation-specific risk factors that include sudden physical exertion, acute and chronic psychological stress, shift work, and noise. Workplace programs to promote the health and fitness of police officers are commonly lacking, but can be an effective means for reducing cardiovascular risk. Physicians should be familiar with the essential job tasks required for police officers to determine whether the individual is fit for duty. Governmental agencies have established strategic goals to reduce cardiovascular complications and improve the health and wellness of public safety personnel.

Cardiovascular disease and risk factors in law enforcement personnel: a comprehensive review.

Firemen's reaction to alarm was investigated with a pulse rate and ECG analysis. The frame of reference was the psychophysiological alarm reaction and its relation to psychosomatic diseases. ECG and pulse rate measurements were recorded continuously from 22 first-string firemen. According to an exercise stress test, the subjects were healthy, but not more fit than a sedentary population. High pulse rates occurred during the alarm due to vigorous movement to the trucks. No anticipatory pulse rate rise occurred as the firemen approached the fire. Non-pathological ECG deviations were found 13 subjects although no abnormalities were found in the same subjects during exercise test. Different firefighting practices, environment, selection, and training might explain the differences between the findings of the present investigation and those of other recent studies.

Olli Korhonen

Papers

Firefighters' reaction to alarm, an ECG and heart rate study.