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Emergency duties and deaths from heart disease among firefighters in the United States.

Authors
Kales-SN; Soteriades-ES; Christophi-CA; Christiani-DC
Source
N Engl J Med 2007 Mar; 356(12):1207-1215
NIOSHTIC No.
20031747
Abstract
Background: Heart disease causes 45% of the deaths that occur among U.S. firefighters while they are on duty. We examined duty-specific risks of death from coronary heart disease among on-duty U.S. firefighters from 1994 to 2004. Methods: We reviewed summaries provided by the Federal Emergency Management Agency of the deaths of all on-duty firefighters between 1994 and 2004, except for deaths associated with the September 11, 2001, terrorist attacks. Estimates of the proportions of time spent by firefighters each year performing various duties were obtained from a municipal fire department, from 17 large metropolitan fire departments, and from a national database. Odds ratios and 95% confidence intervals for death from coronary heart disease during specific duties were calculated from the ratios of the observed odds to the expected odds, with nonemergency duties as the reference category. Results: Deaths from coronary heart disease were associated with suppressing a fire (32.1% of all such deaths), responding to an alarm (13.4%), returning from an alarm (17.4%), engaging in physical training (12.5%), responding to nonfire emergencies (9.4%), and performing nonemergency duties (15.4%). As compared with the odds of death from coronary heart disease during nonemergency duties, the odds were 12.1 to 136 times as high during fire suppression, 2.8 to 14.1 times as high during alarm response, 2.2 to 10.5 times as high during alarm return, and 2.9 to 6.6 times as high during physical training. These odds were based on three estimates of the time that firefighters spend on their duties. Conclusions: Certain emergency firefighting duties were associated with a risk of death from coronary heart disease that was markedly higher than the risk associated with nonemergency duties. Fire suppression was associated with the highest risk, which was approximately 10 to 100 times as high as that for nonemergency duties.
Keywords
Fire-fighters; Emergency-response; Mortality-data; Mortality-rates; Heart; Cardiovascular-system-disease; Cardiovascular-system; Fire-fighting; Physical-capacity; Physical-fitness; Training; Job-analysis; Risk-factors
Contact
Stefanos N. Kales, MD, MPH, The Cambridge Health Alliance, Employee Health and Industrial Medicine, Lee B. Macht Building, Room 427, 1493 Cambridge Street, Cambridge, MA 02139
CODEN
NEJMAG
Publication Date
20070322
Document Type
Journal Article
Email Address
skales@challiance.org
Funding Amount
1549642
Funding Type
Grant
Fiscal Year
2007
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-T42-CCT-122961
Issue of Publication
12
ISSN
0028-4793
Source Name
New England Journal of Medicine
State
MA
Performing Organization
Harvard School of Public Health
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