Sudden Cardiac Death Among Firefighters ≤45 Years of Age in the United States

Details

• Alternative Title:
  Am J Cardiol
• Personal Author:
  Yang, Justin ; Teehan, Dennis ; Farioli, Andrea ; Baur, Dorothee M. ; Smith, Denise ; Kales, Stefanos N.
• Description:
  Sudden cardiac death (SCD) is the leading cause of death in firefighters. Although on-duty SCD usually occurs in older victims almost exclusively because of coronary heart disease, no studies have examined causation across the career span. In the present retrospective case-control study, cases of SCD in young (aged ≤45 years) firefighters from the National Institute for Occupational Safety and Health fatality investigations (n = 87) were compared with 2 age- and gender-matched control groups: occupationally active firefighters (n = 915) and noncardiac traumatic firefighter fatalities (n = 56). Of the SCD cases, 63% were obese and 67% had a coronary heart disease-related cause of death. The SCD victims had much heavier hearts (522 ± 102 g) than noncardiac fatality controls (400 ± 91 g, p <0.001). Cardiomegaly (heart weight >450 g) was found in 66% of the SCD victims and conveyed a fivefold increase (95% confidence interval [CI] 1.93 to 12.4) in SCD risk. Furthermore, hypertension, including cases with left ventricular hypertrophy, increased SCD risk by 12-fold (95% CI 6.23 to 22.3) after multivariate adjustment. A history of cardiovascular disease and smoking were also independently associated with elevated SCD risk (odds ratio 6.89, 95% CI 2.87 to 16.5; and odds ratio 3.53, 95% CI 1.87 to 6.65, respectively). In conclusion, SCD in young firefighters is primarily related to preventable lifestyle factors. Obesity entry standards, smoking bans, and improved screening and/or wellness program are potential strategies to reduce SCD in younger firefighters.
• Subjects:
  Adult Cardiovascular Diseases Case-Control Studies Death, Sudden, Cardiac Female Firefighters Humans Hypertension Hypertrophy, Left Ventricular Male Multivariate Analysis Risk Factors Smoking United States Young Adult

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• Source:
  Am J Cardiol. 112(12):1962-1967
• Pubmed ID:
  24079519
• Pubmed Central ID:
  PMC7750027
• Document Type:
  Journal Article
• Funding:
  T42 OH008416/OH/NIOSH CDC HHSUnited States/
• Volume:
  112
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d6a3b318b93d0f0a3db370585cff83f9c8f6980ed5ba8a89bb2c52cfde0dcc98
• Download URL:
  https://stacks.cdc.gov/view/cdc/99811/cdc_99811_DS1.pdf
• File Type:
  [PDF - 329.08 KB ]