Firefighters' heart attack risk soars at the scene

Deaths correlated with duties
The Harvard researchers took a different tack: Looking at how much time firefighters spend on various duties. If heart attacks were caused by pre-existing conditions — not by on-the-job activities — then deaths during any firefighting duty would be proportional to the amount of time spent on that duty. But the researchers found more-than-expected deaths during firefighting as well as the other activities.

The team, led by Kales and David Christiani, a professor of occupational medicine and epidemiology in the Departments of Environmental Health and Epidemiology at Harvard, studied all on-duty firefighter deaths from 1994 through 2004, using a memorial database maintained by the U.S. Fire Administration. The researchers excluded deaths resulting from the terrorist attacks of Sept. 11, 2001, as well as those caused by medical conditions other than coronary heart disease. That left them with 449 deaths.

The researchers also estimated the average proportion of time firefighters spend on specific job duties using data from several sources, including 17 large metropolitan fire departments. That is the least-precise information in the study, the researchers said, leading to the wide range of estimates for the increased risk for each activity. Still, even using the most conservative figures, the researchers said, the increased risk is "remarkably high."

Heart attacks fell more firefighters
About 100 firefighters die on the job each year, and heart attacks cause about 45 percent of these deaths, a much higher percentage than for other public safety occupations — 22 percent of the on-the-job deaths among police officers, and 11 percent for emergency medical workers. Overall, heart attacks account for 15 percent of all deaths that occur on the job.

/ U.S. Fire Administration The decline in firefighter line-of-duty deaths in the U.S. has stalled. The number of deaths has leveled off at about 100. This chart does not include 343 firefighter deaths on Sept. 11, 2001.

The Harvard study was supported by grants from the National Institute for Occupational Safety and Health and the Massachusetts Public Employees Retirement Administration Commission.

The fire service has begun several campaigns to raise awareness among fire chiefs and firefighters to health issues, including the Heart-Healthy Firefighter Program set up by the National Volunteer Fire Council, and a joint Wellness-Fitness Task Force created by the firefighters union and chiefs association. The National Fallen Firefighters Foundation, which previously focused on the needs of surviving families, also is now involved in prevention.

Firefighter safety/fitness resources Heart Healthy Firefighter Program Wellness-Fitness Task Force National Fallen Firefighters Foundation Everyone Goes Home program

"From medical evaluations to fitness programs to diet, we are in the process of slowly impacting the incident and fatality numbers," said Deputy Chief Billy Goldfeder of Loveland-Symmes, Ohio, who is vice chairman of the safety, health and survival section of the International Association of Fire Chiefs.

“Firefighters generally love what we do — the longer we can live healthy, the longer we can continue to do the job we love."

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