Firefighters and On-Duty Deaths from Coronary Heart Disease: A Case Control Study

Details

• Personal Author:
  Christiani, David C. ; Christoudias SG ; Kales SN ; Soteriades ES
• Description:
  Coronary heart disease (CHD) is responsible for 45% of on-duty deaths among United States firefighters. We sought to identify occupational and personal risk factors associated with on-duty CHD death. We performed a case-control study, selecting 52 male firefighters whose CHD deaths were investigated by the National Institute for Occupational Safety and Health. We selected two control populations: 51 male firefighters who died of on-duty trauma; and 310 male firefighters examined in 1996/1997, whose vital status and continued professional activity were re-documented in 1998. The circadian pattern of CHD deaths was associated with emergency response calls: 77% of CHD deaths and 61% of emergency dispatches occurred between noon and midnight. Compared to non-emergency duties, fire suppression (OR = 64.1, 95% CI 7.4-556); training (OR = 7.6, 95% CI 1.8-31.3) and alarm response (OR = 5.6, 95% CI 1.1-28.8) carried significantly higher relative risks of CHD death. Compared to the active firefighters, the CHD victims had a significantly higher prevalence of cardiovascular risk factors in multivariate regression models: age >or= 45 years (OR 6.5, 95% CI 2.6-15.9), current smoking (OR 7.0, 95% CI 2.8-17.4), hypertension (OR 4.7, 95% CI 2.0-11.1), and a prior diagnosis of arterial-occlusive disease (OR 15.6, 95% CI 3.5-68.6). Our findings strongly support that most on-duty CHD fatalities are work-precipitated and occur in firefighters with underlying CHD. Improved fitness promotion, medical screening and medical management could prevent many of these premature deaths. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Case Reports Demography Emergencies Emergency Responders Firefighters Mortality Occupational Diseases Occupational Exposure Occupational Health Safety Sex Characteristics

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• Keywords:
  Author Keywords: Coronary Heart Disease Case-studies Coronary Heart Disease Risk Demographic-characteristics Disease-prevention Diseases Emergency-responders Emergency-response Emergency Medical Service Fire-fighters Fire-fighting Fire Department Fire Suppression Heart Hypertension Mathematical-models Models Mortality-data Mortality-rates Occupational-diseases Occupational-hazards Occupational-health Sex-factors

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• ISSN:
  1476-069X
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; OSHA Region 1
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  14
• Volume:
  2
• NIOSHTIC Number:
  nn:20029197
• Citation:
  Environ Health 2003 Nov; 2:14
• Contact Point Address:
  Stefanos N. Kales, MD, MPH, Cambridge Hospital, Department of Medicine, Occupational and Environmental Health, 1493 Cambridge Street, Cambridge, MA 02139
• Email:
  skales@challiance.org
• Federal Fiscal Year:
  2004
• NORA Priority Area:
  Research Tools and Approaches: Health Services Research
• Performing Organization:
  Harvard University, Department of Environmental Health, Boston, Massachusetts
• Peer Reviewed:
  True
• Start Date:
  19980930
• Source Full Name:
  Environmental Health: A Global Access Science Source
• End Date:
  20020929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:76dabd88b8935df6fd2f0e967f6b54bd94ec00f4e732fcd18ec581d19c2684beebb75fbe8cc34bca47f8533905612df025d1a699e65f9ffb15ec90e3a690ebf8
• Download URL:
  https://stacks.cdc.gov/view/cdc/190236/cdc_190236_DS1.pdf
• File Type:
  [PDF - 635.27 KB ]