Analysis: The heart of firefightingBy ED SUSMAN
WEST PALM BEACH, Fla., March 21 (UPI) -- When firemen are putting out blazes, their risk of dying from a heart attack is as much as 100 times greater than when they are hanging around the firehouse waiting for an alarm to ring."We think the combination of psychological stressors and the physical stressors take a toll on the fireman's heart when he is actually fighting a fire," Stefanos Kales, assistant professor of medicine at the Harvard School of Public Health told United Press International.
Kales and his colleagues scrutinized records of the Federal Emergency Management Agency on the causes of deaths of firemen, estimating the amount of time they spend in any one activity and correlating that with heart disease-related deaths.
"We estimated that about 1 percent to 5 percent of the time, firefighters are suppressing blazes, yet that is the time when 32.1 percent of the heart disease deaths occur," Kales said.
Many previous studies have found a relationship between heavy exertion and heart attack deaths, Kales said, noting snow-shoveling deaths of men.
He said that when a firefighter goes into battle he carries heavy gear, he suffers from heat stress from both the fire and his protective clothing, and he is exposed to toxic gases and particulate matter in addition to climbing ladders and stairs and lugging high pressure hoses. On top of those physical stressors are the mental stress of entering a dangerous situation --the "fight or flight" adrenalin boost.
Kales said that the risk of dying while suppressing a fire, depending upon what analysis is used, is 12.1 to 136 times higher when compared with having a fatal heart attack during non-emergency duties.
Kales also found that among all cardiovascular deaths suffered by firemen, 13.4 percent occurred while responding to an alarm, 17.4 percent when returning from an alarm, 12.5 percent during training exercises, 15.4 percent while performing non-emergency duties, 9.4 percent while performing emergency medical services or non-fire emergency services.
"Our study shows that firemen should -- from the time they are recruited until the time they retire from the force -- have cardiovascular risk reduction training and activities." Kales said. "It is also important that physicians who treat firefighters make them aware of the potential risks involved in their jobs if there are cardiovascular concerns."
The researchers looked at 11 years of data kept by the government on deaths among firefighters, excluding the more than 300 deaths that occurred in the terrorist attacks of Sept. 11, 2001.
During that time 1,144 firefighters died, and 449 of those deaths were classified as being caused by coronary heart disease.
Kales said that 144 of the deaths occurred while the firefighter was actively attempting to suppress a fire. Another 138 deaths occurred while on the way to a fire or returning from a call.
"This study shows that cardiovascular disease is an important cause of mortality among firefighters," commented Neil Coplan, associate director of cardiovascular medicine at Lenox Hill Hospital in New York. "Fire departments need to be vigilant in performing yearly physical examinations among their firefighters, and should attempt to reduce risk factors by engaging the firemen in physical activity, proper diet and encouraging smoking cessation."
Coplan told UPI that fire departments also need to make sure that if possible cardiovascular issues are discovered, these problems are promptly evaluated.
In an editorial accompanying Kales' research, Linda Rosenstock, dean of public health, and John Olsen, chairman and professor of public health epidemiology at the University of California, Los Angeles, concurred:
"The implications of this study for firefighters is clear. Modifiable risk factors, whether or not they are related to occupation, should be aggressively addressed." They suggested mandatory annual medical examinations, annual physical performance examinations and implementation of wellness and physical fitness programs aimed at reducing cardiovascular risk factors.
Copyright 2007 by United Press International. All Rights Reserved.