Firefighters' heart attack risk soars at the scene

Bill Dedman Investigative reporter • Profile • E-mail

BOSTON — Firefighters face a much higher risk of death from heart attack when battling a blaze — up to 100 times the normal rate — and are more likely to be struck even when they're doing less-strenuous tasks, according to a Harvard study to be published Thursday.

Heart attacks — not burns or smoke — have long been known to be the most frequent cause of firefighter deaths on the job. But the Harvard study, published in the New England Journal of Medicine, establishes the strongest link yet between coronary disease and firefighting duties by examining what firefighters were doing when they were stricken.

Looking at firefighter heart attack deaths nationwide over a decade, the researchers found that the risk of heart attack is highest when firefighters are working at a fire scene — with increased odds ranging from 10 to 100 times the normal risk of heart attack. Although firefighters spend only 1 to 5 percent of their time putting out fires, 32 percent of firefighter deaths from heart attacks occur at fire scenes, the study found.

But the chances of a heart attack also are significantly increased when firefighters are responding to an alarm, returning from an alarm, or engaging in physical training, according to the researchers from the Harvard School of Public Health, who studied 449 deaths. (See sidebar: Justice Department denies benefits claims for heart attacks.)

The study does not identify the specific causes of these job-related attacks or whether firefighters have an overall greater risk of dying from heart problems than the rest of the population, but does note the unique hazards of the profession. Not only do firefighters deal with extreme heat and exertion, they also are exposed to toxic substances and psychological stress.

Stress, conditioning seen as factors
The authors hypothesize that the risk of dying from heart disease may increase during fire suppression because of the effects of strenuous exertion on firefighters who have underlying coronary heart disease. Also, many firefighters are overweight and lack adequate physical fitness, which may be contributing risk factors, they said.

"We hope that our study will reinforce efforts in the firefighting community to improve their health and wellness programs," said Stefanos Kales, the study's lead author and assistant professor in the Department of Environmental Health at the Harvard School of Public Health.

A 2005 study by the National Fire Protection Association showed that more than 70 percent of fire departments lacked fitness and health programs. Kales' team has published previous research documenting a high prevalence of obesity among firefighters. The majority of the nation's firefighters — about 75 percent — are volunteers.

Kales also said that the researchers are hopeful that “these striking results will make physicians who care for firefighters … more cognizant of the demanding nature of this occupation and get them to be more aggressive with regard to cardiovascular risk reduction."

Earlier studies looked at heart disease rates to see whether firefighters have a greater lifetime risk of heart death than the general population. But because roughly one-third of firefighters and one-third of the general population in developed countries die of cardiovascular disease, those studies were inconclusive.

Print this Email this Blog this  IM this

MORE FROM HEART HEALTH

Heart health Section Front

Most Americans can’t spot stroke warning signs FDA rejections may mean higher bar for drugs Greater wealth tied to lower stroke risk Spit test could diagnose heart attacks Diet lowers women's heart attack rate 24 percent Key Vytorin meeting minutes created 'after fact' Meditation may boost heart health FDA: 100 deaths tied to heparin since 2007 Three rare mutations lower blood pressure Home defibrillators save lives, but so does CPR Heart health Section Front   Add Heart health headlines to your news reader: