Risk Factors for Fire Fighter Cardiovascular Disease

Fire Protection Research Foundation report: "Risk Factors for Fire Fighter Cardiovascular Disease - Executive Summary" (PDF, 247 KB)
Author: Jeffrey L. Burgess, MD, MS, MPH, Mel and Enid Zuckerman College of Public Health, University of Arizona
Date of issue: September 2010

Foreword

This "Executive Summary" contains the abstract and conclusions of a full study report conducted and led by The University of Arizona. The Fire Protection Research Foundation has provided advisory services in support of this study, including the administration of guidance provided by a panel of subject-matter-experts, and assisting with the dissemination of project results. The full study results will be published in peer-reviewed journals. For additional information, please contact Dr. Burgess at The University of Arizona, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Avenue, P.O. Box 245163, Tucson, Arizona 85724.

This study evaluates the use of carotid IMT as a medical surveillance tool in firefighters, measures the acute effects of fire suppression on biomarkers associated with heart attacks and tests an active cooling method during firefighter rehabilitation. Sudden cardiac deaths account for 44% of the line of duty deaths in firefighters, and generally occur in firefighters with underlying cardiovascular disease, many of whom have been previously asymptomatic, and fire suppression carries the highest risk for on-duty firefighter cardiac deaths. Current screening tests are not adequate to identify firefighters at high risk of an on-duty cardiovascular event.

This overall study is comprised of the following three components:

1) Over 500 Phoenix and Tucson area firefighters with at least 5 years of firefighting service and without known cardiovascular disease underwent carotid IMT to determine the extent of early atherosclerotic disease. Data on traditional risk factors as well as new biomarkers were collected and analyzed to determine their ability to predict the presence of carotid IMT thickening in this population.

2) The effects of fire suppression on acute measures of systemic inflammation and cardiac function were evaluated in over 50 firefighters at baseline and post-exposure. The contribution of exposure to smoke contaminants and elevation in core body temperature were assessed.

3) In an interventional trial, more aggressive cardiac rehabilitation in 25 firefighters using forearm immersion in cold water at the fire scene, in comparison to 25 firefighters going through standard rehabilitation, was tested to determine the effectiveness in reducing core body temperature and adverse cardiovascular effects.

The Research Foundation expresses gratitude to the study author Jeff Burgess, MD, MPH, and his research team at the University of Arizona, Mel and Enid Zuckerman College of Public Health. The Foundation appreciates the partnership support of the Phoenix Fire Department, Tucson Fire Department, Northwest Fire Department and all others that contributed to this research effort, especially the fire service personnel that directly participated in the data collection efforts. The Foundation expresses gratitude to the members of the Project Technical Panel for their helpful guidance, and special thanks are expressed to the U.S. Department of Homeland Security, AFG Research & Development Grants, for providing the funding for this project through the University of Arizona.

The content, opinions and conclusions contained in this Executive Summary are solely those of the authors.

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