Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T10:43:05.815Z Has data issue: false hasContentIssue false

Prevalence of Risk Factors for Coronary Artery Disease in Pennsylvania (USA) Firefighters

Published online by Cambridge University Press:  18 December 2015

Brian L. Risavi*
Affiliation:
Department of Emergency Medicine, University of Pittsburgh Medical Center-Hamot, Erie, PennsylvaniaUSA
Jason Staszko
Affiliation:
Department of Emergency Medicine, Columbia St. Mary’s Hospital, Milwaukee, WisconsinUSA
*
Correspondence: Brian L. Risavi, DO, MS, FACEP FAAEM, University of Pittsburgh Medical Center-Hamot Department of Emergency Medicine 201 State Street Erie, Pennsylvania 16550 USA E-mail: [email protected]

Abstract

Introduction

Firefighting is a physically demanding profession. Heart disease remains the number one killer of firefighters. Many firefighters have multiple risk factors, putting them at risk for sudden cardiac events. The purpose of this study was to describe the prevalence of risk factors for heart disease in a convenience sample of Pennsylvania (USA) firefighters.

Methods

A convenience sample of 160 firefighters in western Pennsylvania had height, weight, waist circumference, blood pressure, and body mass index (BMI) assessed, and then were surveyed to measure their knowledge of cardiovascular risk factors. Data analysis included subgroup comparisons of age, BMI, waist circumference, and exercise for their impact on health risks in the study cohort. In particular, the researchers were interested in understanding whether the knowledge of risk was associated with lower measures of risk.

Results

Eighteen firefighters (4%) reported a history of coronary artery disease (including stents/interventions). In this group, 69% to 82% correctly identified age, hypertension (HTN), high cholesterol, smoking, obesity, sedentary lifestyle, and family history as risk factors for coronary artery disease. Fourteen percent were smokers, 41% had HTN, 38% had pre-HTN with only 12% receiving treatment, and 13.5% were treated for high cholesterol. Fifty-eight percent exercised regularly.

Conclusions

While a majority of firefighters were able to identify risk factors for coronary artery disease, many could not. Eighteen (4%) had a history of coronary artery disease, including interventions. Many had several of the risk factors indicated, which highlights the need for an organized national approach to address the medical screening/evaluation, nutrition, and exercise components of firefighter fitness.

RisaviBL, StaszkoJ. Prevalence of Risk Factors for Coronary Artery Disease in Pennsylvania (USA) Firefighters. Prehosp Disaster Med. 2016;31(1):102–107.

Type
Brief Report
Copyright
© World Association for Disaster and Emergency Medicine 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Kales, SN, Soteriades, ES, Christophi, CA, Christiani, DC. Emergency duties and deaths from heart disease among firefighters in the United States. N Engl J Med. 2007;356(12):1207-1215.CrossRefGoogle ScholarPubMed
2. Donovan, R, Nelson, T, Peel, J, Lipsey, T, Voyles, W, Israel, RG. Cardiorespiratory fitness and the metabolic syndrome in firefighters. Occup Med. 2009;59(7):487-492.CrossRefGoogle ScholarPubMed
3. Karter, MJ Jr, Molis, JL. Fire Fighter Injuries–2005. Quincy, Massachusetts USA: National Fire Protection Association; 2006.Google Scholar
4. Glueck, CJ, Kelley, W, Wang, P, Gartside, PS, Black, D, Tracy, T. Risk factors for coronary heart disease among firefighters in Cincinnati. Am J Ind Med. 1996;30(3):331-340.CrossRefGoogle ScholarPubMed
5. Elsner, KL, Kolkhorst, FW. Metabolic demands of simulated firefighting tasks. Ergonomics. 2008;51(9):1418-1425.Google Scholar
6. Centers for Disease Control and Prevention. Men and heart disease fact sheet. http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_men_heart.htm. Published April 30, 2015. Accessed July 21, 2015.Google Scholar
7. Byczek, L, Walton, SM, Conrad, KM, Reichelt, PA, Samo, DG. Cardiovascular risks in firefighters: implications for occupational health nurse practice. AAOHN J. 2004;52(2):66-76.Google Scholar
8. Soteriades, ES, Smith, DL, Tsismenakis, AJ, Baur, DM, Kales, SN. Cardiovascular disease in US firefighters: a systematic review. Cardiol Rev. 2011;19(4):202-215.Google Scholar
9. Yang, J, Teehan, D, Farioli, A, Baur, DM, Smith, D, Kales, SN. Sudden cardiac death among firefighters ≤45 years of age in the United States. Am J Cardiol. 2013;112(12):1962-1967.Google Scholar
10. Geibe, JR, Holder, J, Peeples, L, Kinney, AM, Burress, JW, Kales, SN. Predictors of on-duty coronary events in male firefighters in the United States. Am J Cardiol. 2008;101(5):585-589.CrossRefGoogle ScholarPubMed
11. Yoo, HL, Franke, WD. Prevalence of cardiovascular disease risk factors in volunteer firefighters. J Occup Environ Med. 2009;51(8):958-962.CrossRefGoogle ScholarPubMed
12. Moore-Merrell, L, Zhou, A, McDonald, S, Fisher, E, Moore, J. Contributing factors to firefighter line-of-duty death in the United States. http://vdfp.virginia.gov/government_affairs/non_vdfp_studies/Contributing_Factors_to_Firefighte_%20Line-of-Duty_Death-Merrill.pdf. Accessed April 9, 2014.Google Scholar
13. National Fire Protection Association. NFPA 1582 Standards in Firefighter Health and Wellness. Quincy, Massachusetts USA; 2008.Google Scholar
14. Kales, SN, Soteriades, ES, Christoudias, SG, Christiani, DC. Firefighters and on-duty deaths from coronary heart disease: a case control study. Environ Health. 2003;2(1):14.Google Scholar
15. US Department of Health and Human Services. Federal Occupational Health Guidelines. https://foh.hhs.gov/NYCU/hypertension.asp. Accessed June 16, 2014.Google Scholar
16. National Heart, Lung, and Blood Institute (NHLBI). Overweight and Obesity. http://www.nhlbi.nih.gov/health/health-topics/topics/obe/. Accessed April 9, 2014.Google Scholar
17. The Morning Call. Volunteer fire departments could get more money under bill. http://articles.mcall.com/2013-10-26/news/mc-pa-volunteer-firefighters-20131026_1_volunteer-firefighters-fire-commissioner-edward-mann-fewer-firefighters. Published October 26, 2013. Accessed July 28, 2015.Google Scholar
18. Smith, DL, Barr, DA, Kales, SN. Extreme sacrifice: sudden cardiac death in the US Fire Service. Extrem Physiol Med. 2013;2(1):6.Google Scholar
19. Kales, SN, Tsismenakis, AJ, Zhang, C, Soteriades, ES. Blood pressure in firefighters, police officers, and other emergency responders. Am J Hypertens. 2009;22(1):11-20.CrossRefGoogle ScholarPubMed
20. Smith, DL, Manning, TS, Petruzzello, SJ. Effect of strenuous live-fire drills on cardiovascular and psychological responses of recruit firefighters. Ergonomics. 2001;44(3):244-254.CrossRefGoogle ScholarPubMed
21. Leiba, A, Baur, DM, Kales, SN. Exercise-induced hypertension among healthy firefighters−a comparison between two different definitions. J Am Soc Hypertens. 2013;7(1):40-45.Google Scholar
22. Mittleman, MA, Maclure, M, Tofler, GH, Sherwood, JB, Goldberg, RJ, Muller, JE. Triggering of acute myocardial infarction by heavy physical exertion. Protection against triggering by regular exertion. Determinants of Myocardial Infarction Onset Study Investigators. N Engl J Med. 1993;329(23):1677-1683.CrossRefGoogle ScholarPubMed
23. Willich, SN, Lewis, M, Löwel, H, Arntz, HR, Schubert, F, Schröder, R. Physical exertion as a trigger of acute myocardial infarction. Triggers and Mechanisms of Myocardial Infarction Study Group. N Engl J Med. 1993;329(23):1684-1690.CrossRefGoogle ScholarPubMed
24. Albert, CM, Mittleman, MA, Chae, CU, Lee, IM, Hennekens, CH, Manson, JE. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med. 2000;343(19):1355-1361.Google Scholar
25. Jahnke, SA, Poston, WS, Haddock, CK, Jitnarin, N. Obesity and incident injury among career firefighters in the central United States. Obesity. 2013;21(8):1505-1508.Google Scholar
26. Poston, WS, Haddock, CK, Jahnke, SA, Jitnarin, N, Tuley, BC, Kales, SN. The prevalence of overweight, obesity, and substandard fitness in a population-based firefighter cohort. J Occup Environ Med. 2011;53(3):266-273.Google Scholar
27. Scanlon, P, Ablah, E. Self-reported cardiac risks and interest in risk modification among volunteer firefighters: a survey-based study. J Am Osteopath Assoc. 2008;108(12):694-698.Google ScholarPubMed
28. Soteriades, ES, Hauser, R, Kawachi, I, Liarokapis, D, Christiani, DC, Kales, SN. Obesity and cardiovascular disease risk factors in firefighters: a prospective cohort study. Obes Res. 2005;13(10):1756-1763.Google Scholar
29. U.S. Department of Health and Human Services. Healthy People 2010. http://healthypeople.gov/2010/redirect.aspx?url. Accessed April 9, 2014.Google Scholar
30. Clark, S, Rene, A, Theurer, WM, Marshall, M. Association of body mass index and health status in firefighters. J Occup Environ Med. 2002;44(10):940-946.Google Scholar
31. Haddock, CK, Jitnarin, N, Poston, WS, Tuley, B, Jahnke, SA. Tobacco use among firefighters in the central United States. Am J Ind Med. 2011;54(9):697-706.CrossRefGoogle ScholarPubMed
32. Superko, HR, Momary, KM, Pendyala, LK, et al. Firefighters, heart disease, and aspects of insulin resistance: the FEMA Firefighter Heart Disease Prevention study. J Occup Environ Med. 2011;53(7):758-764.Google Scholar
33. Wilson, PW, D’Agostino, RB, Levy, D, Belanger, AM, Silbershatz, H, Kannel, WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837-1847.Google Scholar
34. Libby, P, Theroux, P. Pathophysiology of coronary artery disease. Circulation. 2005;111(25):3481-3488.Google Scholar
35. Schoenfeld, B, Dawes, J. High-intensity interval training: applications for general fitness training. Strength Cond J. 2009;31(6):44-46.Google Scholar
36. Kemi, OJ, Wisloff, U. High-intensity aerobic exercise training improves the heart in health and disease. J Cardiopulm Rehabil Prev. 2010;30(1):2-11.CrossRefGoogle ScholarPubMed
37. Powell, KE, Thompson, PD, Caspersen, CJ, Kendrick, JS. Physical activity and the incidence of coronary heart disease. Annu Rev Public Health. 1987;8:253-287.Google Scholar
38. Reid, EL, Morgan, RW. Exercise prescription: a clinical trial. Am J Public Health. 1979;69(6):591-595.Google Scholar
39. Jahnke, SA, Poston, WS, Haddock, CK, Jitnarin, N. Injury among a population based sample of career firefighters in the central USA. Inj Prev. 2013;19(6):393-398.Google Scholar
40. Poston, WS, Haddock, CK, Jahnke, SA, Jitnarin, N, Day, RS. An examination of the benefits of health promotion programs for the national fire service. BMC Public Health. 2013;13:805.Google Scholar
41. Durand, G, Tsismenakis, AJ, Jahnke, SA, Baur, DM, Christophi, CA, Kales, SN. Firefighters’ physical activity: relation to fitness and cardiovascular disease risk. Med Sci Sports Exerc. 2011;43(9):1752-1759.Google Scholar
42. Jahnke, SA, Poston, WS, Jitnarin, N, Haddock, CK. Health concerns of the US fire service: perspectives from the firehouse. Am J Health Promot. 2012;27(2):111-118.CrossRefGoogle ScholarPubMed
43. United States Fire Administration. Emerging Health and Safety Issues in the Volunteer Fire Service. FA-317/March 2008. http://www.usfa.fema.gov/downloads/pdf/publications/fa_317.pdf. Accessed April 9, 2014.Google Scholar
Supplementary material: File

Risavi and Staszko supplementary material

Appendix 1

Download Risavi and Staszko supplementary material(File)
File 20.5 KB