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CHD, increased heart mass raise risk for cardiac death in firefighters
Firefighters who died from cardiac-related causes had increased heart mass and CHD, which were independently linked to increased risk for cardiac death, according to a study published in the Journal of the American Heart Association.
“Firefighters face many dangers, but the greatest risk is from underlying cardiovascular disease in combination with the physiological strain that the work places on the firefighter,” Denise L. Smith, PhD, Tisch Distinguished Professor and director of the first responder health and safety laboratory at Skidmore College in Saratoga Springs, New York, said in a press release. “Medical screening is necessary to establish that a firefighter is healthy enough to do this strenuous work.”
Researchers analyzed autopsy data from 627 firefighters aged 18 to 65 years who died from duty-related causes between 1999 and 2014. Women were excluded from the study.
Duty-related fatalities included illness from a stroke or sudden cardiac event within 24 hours of emergency response or training activity. Data that were reviewed included anthropometric and cardiac findings, BMI, job classifications and years of service. Causes of death were classified as noncardiac (n = 351; mean age, 39 years) and cardiac (n = 276; mean age, 49 years). Cardiac causes of death included cardiomegaly (defined as heart weight > 450 g)/left ventricular hypertrophy (defined as LV wall thickness 1.2 cm), cardiomyopathies, primary arrhythmia and valvular disease.
In patients who died from cardiac-related causes, 81.9% were caused by CHD and cardiomegaly/LV hypertrophy.
Compared with the control group, patients who died from cardiac causes had higher instances of cardiomegaly, severe coronary artery stenosis and LV hypertrophy (P < .001 for all).
Strong independent predictors of cardiac death were coronary artery stenosis of at least 75% (OR = 9.3; 95% CI, 5.3-16.1), cardiomegaly (OR = 6.1; 95% CI, 3.6-10.4) and prior MI (OR = 6.2; 95% CI, 3.4-11.3).
“These findings indicate that screening for CHD, cardiac enlargement and structural heart damage should be considered for firefighters,” Smith and colleagues wrote. “Moreover, taking actionable measures to mitigate the risk of cardiac death following identification of any of these conditions is imperative to reduce duty-related cardiac deaths in the fire service.” – by Darlene Dobkowski
Disclosures: Smith reports she is a consultant in cases involving medical evaluations and firefighter fatalities. Please see the study for all other authors’ relevant financial disclosures.