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Predictors of on-duty coronary events in male firefighters in the United States.

Authors
Geibe-JR; Holder-J; Peeples-L; Kinney-AM; Burress-JW; Kales-SN
Source
Am J Cardiol 2008 Mar; 101(5):585-589
NIOSHTIC No.
20033673
Abstract
Coronary heart disease (CHD) accounts for 39% of "on-duty" deaths in firefighters in the United States. No studies have examined the factors that distinguish fatal from nonfatal work-associated CHD events. Male firefighters experiencing on-duty CHD events were retrospectively investigated to identify cardiovascular risk factors predictive of case fatality; 87 fatalities (death within 24 hours of the event) were compared with 113 survivors who retired with disability pensions for heart disease after on-duty nonfatal events. Cardiovascular risk factors were then examined for associations with case fatality. Predictors of CHD death in multivariate analyses were a previous diagnosis of CHD (or peripheral/cerebrovascular disease) (odds ratio [OR] 4.09, 95% confidence intervals [CI] 1.58 to 10.58), current smoking (OR 3.68, 95% CI 1.61 to 8.45), and hypertension (OR 4.15, 95% CI 1.83 to 9.44). Age < or =45 years, diabetes mellitus, and serum cholesterol level were not significant predictors of case fatality. In conclusion, previous CHD, current smoking, and hypertension are strong predictors of fatality in male firefighters experiencing on-duty CHD events. Accordingly, prevention efforts should include early detection and control of hypertension, smoking cessation/prohibition, and the restriction of most firefighters with significant CHD from strenuous duties.
Keywords
Heart; Fire-fighters; Fire-fighting; Cardiovascular-disease; Cardiovascular-function; Cardiovascular-system; Cardiovascular-system-disease; Cardiovascular-system-disorders; Risk-analysis; Risk-factors; Physical-exercise; Physical-stress; Physiological-factors; Physiological-response; Physiological-stress
Contact
Stefanos N. Kales, The Cambridge Health Alliance, Department of Environmental Health (Environmental & Occupational Medicine & Epidemiology), Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115
CODEN
AJCDAG
Publication Date
20080301
Document Type
Journal Article
Funding Type
Grant
Fiscal Year
2008
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-T42-OH-008416
Issue of Publication
5
ISSN
0002-9149
Source Name
The American Journal of Cardiology
State
MA
Performing Organization
Harvard School of Public Health
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