NIOSHTIC-2 Publications Search

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

Kales SN; Soteriades ES; Christoudias SG; Christiani DC
Environ Health 2003 Nov; 2:14
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.
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; Author Keywords: Coronary Heart Disease; Emergency Medical Service; Coronary Heart Disease Risk; Fire Suppression; Fire Department
Stefanos N. Kales, MD, MPH, Cambridge Hospital, Department of Medicine, Occupational and Environmental Health, 1493 Cambridge Street, Cambridge, MA 02139
Publication Date
Document Type
Journal Article
Email Address
Funding Amount
Funding Type
Fiscal Year
Identifying No.
Grant-Number-R01-OH-003729; Grant-Number-T42-CCT-122961
Priority Area
Research Tools and Approaches: Health Services Research
Source Name
Environmental Health: A Global Access Science Source
Performing Organization
Harvard University, Department of Environmental Health, Boston, Massachusetts
Page last reviewed: April 9, 2021
Content source: National Institute for Occupational Safety and Health Education and Information Division