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Firefighters at Risk of Cardiovascular Disease

04/06/2017

Firefighters and other first responders are on the front lines keeping communities safe and are faced with countless dangerous environments that could cause them personal bodily harm. Combating fires markedly increases the risk of cardiovascular events among firefighters: 10- to >100-fold greater risk compared with nonemergency fire department duties, as demonstrated by the research group of a Cambridge Health Alliance physician in 2007. Consistent with those findings, a recent research study from the UK found that firefighter’s physical exertion accompanied by dehydration and exposure to extreme heat may potentially injure heart muscle and trigger the formation of blood clots leading to heart attacks in vulnerable firefighters.

Last month a firefighter who served in the community of Watertown, Massachusetts passed away, the first such death since 2014, while battling a two-alarm fire inside a home. The officer was working inside the fire when he collapsed, conditions similar to those in the UK study.  Also, in March, a Chicopee, Massachusetts firefighter died during a work-out. While details have not been released, both deaths are likely related to cardiovascular issues according to experts.

In 2015, the last year with a full report, there were 90 on-duty deaths in the US Fire Service. Two-thirds were cardiovascular related:  54 heart attacks and 6 strokes. In fact, since at least the 1970’s, about 45% of firefighters, line-of-duty deaths have consistently been due to sudden cardiac death.

Stefanos Kales, MD, MPH, chief of occupational and environmental medicine at Cambridge Health Alliance, contributed an editorial based on his prior research in the American Heart Association's journal Circulation to accompany the UK paper correlating firefighters' exposure to exertion and high heat and physiologic changes increased strain on the cardiovascular system. Dr. Kales’ article explains the many reasons and circumstances why heart disease tragically claims so many first responders’ in their prime.

Dr. Kales believes that “firefighting is uniquely stressful on the cardiovascular system” and he strongly “encourages doctors to aggressively evaluate and treat cardiovascular risk factors in these invaluable public servants and, when indicated, perform additional studies (such as exercise stress testing, coronary artery calcium scans, or echocardiography) to detect subclinical atherosclerosis or cardiac enlargement.” He also urges “Massachusetts fire departments to adopt wellness/fitness programs and fire department annual medical examinations as called for by medical experts and all major national fire service organizations. These programs can save lives,” Kales said.

Read more of Dr. Kales’ research here.

Cambridge Health Alliance

Contributed By: Cambridge Health Alliance

Cambridge Health Alliance is an academic community health care system committed to serving all members of our communities. We have expertise in primary care, mental health and substance abuse, and caring for diverse and complex populations. CHA patients receive high quality care in convenient neighborhood locations, and have seamless access to advanced care through CHA’s affiliation with Beth Israel Deaconess Medical Center. With over 140,000 patients in Cambridge, Somerville Everett and Boston’s Metro North, CHA is working hard to offer the integrated services its communities need now, and in the future.