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Firefighters and on-duty deaths from coronary heart disease: a case control study.

Authors
Kales-SN; Soteriades-ES; Christoudias-SG; Christiani-DC
Source
Environ Health 2003 Nov; 2(1):14
NIOSHTIC No.
20029197
Abstract
Coronary heart disease (CHD) is responsible for 45% of on-duty deaths among United States firefighters. We sought to identify occupational and personal risk factors associated with on-duty CHD death. We performed a case-control study, selecting 52 male firefighters whose CHD deaths were investigated by the National Institute for Occupational Safety and Health. We selected two control populations: 51 male firefighters who died of on-duty trauma; and 310 male firefighters examined in 1996/1997, whose vital status and continued professional activity were re-documented in 1998. The circadian pattern of CHD deaths was associated with emergency response calls: 77% of CHD deaths and 61% of emergency dispatches occurred between noon and midnight. Compared to non-emergency duties, fire suppression (OR = 64.1, 95% CI 7.4-556); training (OR = 7.6, 95% CI 1.8-31.3) and alarm response (OR = 5.6, 95% CI 1.1-28.8) carried significantly higher relative risks of CHD death. Compared to the active firefighters, the CHD victims had a significantly higher prevalence of cardiovascular risk factors in multivariate regression models: age >or= 45 years (OR 6.5, 95% CI 2.6-15.9), current smoking (OR 7.0, 95% CI 2.8-17.4), hypertension (OR 4.7, 95% CI 2.0-11.1), and a prior diagnosis of arterial-occlusive disease (OR 15.6, 95% CI 3.5-68.6). Our findings strongly support that most on-duty CHD fatalities are work-precipitated and occur in firefighters with underlying CHD. Improved fitness promotion, medical screening and medical management could prevent many of these premature deaths.
Keywords
Case-studies; Mortality-data; Mortality-rates; Fire-fighting; Fire-fighters; Heart; Diseases; Occupational-health; Occupational-hazards; Occupational-diseases; Demographic-characteristics; Sex-factors; Emergency-response; Mathematical-models; Models; Disease-prevention; Hypertension; Emergency-responders
Contact
Stefanos N. Kales, MD, MPH, Cambridge Hospital, Department of Medicine, Occupational and Environmental Health, 1493 Cambridge Street, Cambridge, MA 02139
Publication Date
20031106
Document Type
Journal Article
Email Address
skales@challiance.org
Funding Amount
562193
Funding Type
Grant
Fiscal Year
2004
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-003729
Issue of Publication
1
ISSN
1476-069X
Priority Area
Research Tools and Approaches: Health Services Research
Source Name
Environmental Health: A Global Access Science Source
State
MA
Performing Organization
Harvard University, Department of Environmental Health, Boston, Massachusetts
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