Smith, Liebig, Steward, and Fehling (2010) describe cardiovascular disease as “a pathological condition that affects the heart, blood vessels, or the clotting potential of blood”. Although cardiovascular disease is a chronic condition that progresses over the course of many years, it may transition into an acute life-threatening event in which death occurs quickly. The physiological strain of firefighting coupled with underlying cardiovascular disease may be the lethal combination causing a sudden cardiac event in firefighters. In order to prevent a sudden cardiac event, we must understand the physiological effects of firefighting and the risk factors for cardiovascular disease (Smith, Liebig, Steward, & Fehling, 2010).
Risk Factors for Cardiovascular Disease
The American Heart Association (2011) lists the following risk factors for cardiovascular disease:
Risk Factors Beyond Our Control
Age — A large percentage of people who die from coronary artery disease are over age 65. The risk for firefighters increases over age 45. In 2009, 34 of the 47 fire fighters to die from heart attack or stroke were between the ages of 35 and 60 (USFA, 2009).
Gender — Men are more likely to die as a result of heart disease than women.
Family History — Individuals may be predisposed to cardiovascular disease based on family history.
Major Risk Factors We Can Control
Tobacco Smoke — The Surgeon General identifies smoking as the leading preventable cause of disease and deaths in the United States. Smoking increases blood pressure, decreases tolerance to exercise and increases the risk of blood clots.
High Blood Cholesterol — Excess cholesterol in the blood can build up in the walls of arteries leading to heart disease.
High Blood Pressure — High blood pressure increases the workload of the heart, causing cardiac muscle to thicken and become stiffer.
Sedentary Lifestyle — Lack of physical activity can have a negative impact on heart health directly and it can also lead to other risk factors such as obesity, high blood pressure, elevated cholesterol levels and diabetes.
Obesity — Obese individuals are likely to develop heart disease even in the absence of other risk factors. Lack of exercise and poor nutrition are both lifestyle choices that lead to obesity.
Diabetes — Significant risk factor causing damage to blood vessels (AHA, 2011).
It is estimated that firefighters have a 300% increased risk for cardiac disease compared to other segments of the population. Dr. H. Robert Superko conducted a FEMA sponsored study of firefighters in Gwinnett County, Georgia. The study was prompted by the sudden death of a 53 year-old firefighter who suffered a cardiac arrest while fighting a house fire. Superko (2011) found that the stress and psychological pressures related to the job, poor nutrition, lack of exercise, and inherent personality traits, combined with a genetic predisposition to heart disease may have a tremendous impact on the risk of sudden cardiac death in firefighters (Superko, 2011).
Risk Factor Assessment
How many of the risk factors above apply to you or someone on your crew? We each need to take responsibility for our health. The decision to make lifestyle changes is a personal one. You have to make that choice for yourself. Understanding your risk for cardiovascular disease is a vital part of improving your health and reducing your risk of sudden cardiac death.
Next week we will discuss some other strategies to prevent sudden cardiac death in firefighters and we will issue our TACFIT Fire Fighter Call To Action.
American Heart Association. (2011, May 13). Risk factors and coronary heart disease. Retrieved from http://www.americanheart.org/presenter.jhtml?identifier=4726
Heart Scan Services. (2011, May 16). Landmark FEMA study: Heart disease is an epidemic for firefighters. Retrieved from http://heartscanservices.com/police.php
Smith, D., Liebig, J., Steward, N., Fehling, P. (2010) Sudden Cardiac Events in the Fire Service: Understanding the Cause and Mitigating the Risk. Skidmore College.
United States Fire Administration (USFA). (2009). Firefighter fatalities in the United States in 2009. Emitsburg, MD.