Firefighters at Increased Risk of Heart Attack

While it’s accepted that firefighting is a dangerous profession, it’s less well-known that heart disease accounts for about 40% of firefighters’ deaths while on duty. The New England Journal of Medicine carries a report of an analysis of the deaths of all on-duty firefighters between 1994 and 2004, except for those associated with the terrorist attacks on September 11, 2001 . Data came from reports made available by the US Fire Administration. The odds of death from coronary heart disease within 24 hours of fighting a fire were between 10 and 100 times higher than during non-emergency duties, such as cat rescues. Clearly the stress involved in firefighting – both psychological and physical – was largely responsible, but further analyses showed that lack of physical fitness was probably partially to blame. While there are strict fitness tests for entry to the firefighter service, as well as physical training periods allocated, there’s little doubt that over the years firefighters lose their physical fitness.

The on-duty deaths that were due to coronary heart disease occurred at these times: 32% associated with fire fighting, 17% returning from an alarm, 13% during physical and emergency drill training, 9% responding to non-fire emergencies (e.g. cat rescues), and 15% doing non-emergency work.

An accompanying editorial in the journal points out that the risk of death in the firefighters increased with age, and emphasized that the stress of firefighting alone was not the cause; they were virtually all due to underlying coronary disease. “ Firefighters enter the workforce particularly healthy, but they do not necessarily maintain that attribute over time. There is ample evidence that firefighters are not immune to the hazards of overeating and inadequate regular exercise.” The editorialists go on to urge implementation of wellness and fitness programs to reduce cardiovascular risk factors, with annual physical performance evaluations. That’s good advice, and not just for firefighters!