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This article appeared in The Home News Tribune.
December 5, 2006
Battling a Silent Fire: Heart Disease is the Leading Killer of Firefighters
By Kathleen Jaeger, RN
Cranford firefighter Andy Stratton can name several area firefighters who’ve died on the job in the past few years. Their deaths were not from burns or smoke inhalation, not from collapsed roofs or caved-in floors, but from heart attack.
“Heart attack is the leading killer of firefighters,” said the 40-year-old father of two. As he spoke, Stratton and fellow firefighters at the Cranford Fire Department were getting their blood drawn as part of an on-going health screening and fitness program through Robert Wood Johnson University Hospital at Rahway. While the program includes other important health screenings, its focus is on preventing heart attacks among Cranford’s firefighters.
Firefighting has one of the highest occupational fatality rates in the United States with about 100 lives lost per year. The program with Robert Wood began because sudden cardiac death, including heart attack and other heart-related events, have consistently been the leading cause of on-duty firefighter deaths, accounting for about 43 percent of deaths from 1995 to 2004, according to the National Fire Protection Association.
The Centers for Disease Control and Prevention noted that from 1994 to 2004, 610 volunteer and 368 career firefighters died while on duty. Half of the deaths among the volunteers were caused by heart attacks. For career firefighters, 39 percent were caused by heart attacks.
It’s not clear whether heart disease deaths in firefighters are work-related, but there are a number of occupational factors that could bring on a coronary event. Firefighting includes long sedentary stretches followed by heavy exertion for long periods of time. Firefighters react immediately to alarms, going from “zero to 100 miles an hour” in just a few minutes, according to Stratton.
During a fire, firefighters work at near maximal heart rates while wearing more than 50 pounds of protective equipment, as well as tools, sometimes for long periods of time. Heat stress and fluid losses can result in decreases in cardiac output, and while self-contained breathing apparatus reduces exposure to toxic substances, it does not eliminate them.
Many fires departments in New Jersey provide an initial physical exam before entering the service, but few monitor firefighters’ health while on the job. Departments also don’t require veterans to maintain the physical standards required of new hires. Also, there is high prevalence of obesity and high cholesterol among firefighters.
The National Fire Protection Association recommends fire departments conduct annual medical evaluations and exercise stress tests for those with multiple coronary artery disease risk factors, but most firefighters don’t receive this testing.
“To get this kind of evaluation would cost a fortune and the money just isn’t there due to budget constraints,” Cranford Fire Chief Leonard Dolan III said of the program with Robert Wood Johnson at Rahway. Chief Dolan worked for several years to obtain a Federal Fire Act grant to cover the cost of a wellness program for his department.
The Cranford program is thanks to a $211,000 grant that includes a complete physical exam with a lipid profile, EKG, chest X-ray, pulmonary function, as well as personal and group meetings with a dietitian to learn how to prepare heart healthy meals and snacks. The chief, along with Cranford volunteer fire fighter Paul Schroeder, who is also a respiratory therapist at the hospital, and the hospital’s employee health staff, created the basics of the program.
One important piece of the program is the services of a personal trainer to help devise individual fitness plans for the firefighters. The plans will not only help with cardiovascular fitness, but the prevention of stress and strain injuries, also common among firefighters. The Cranford Fire Department has a weight training room, but some firefighters “are better about using it than others,” the chief observed.
The health assessment is mandatory for the department’s 29 career firefighters and voluntary for its 20 volunteers. Chief Dolan has assured the firefighters their careers will not be at risk if the screenings detect problems.
“This program will show us where the red flags are and, hopefully, we can do something about them,” Dolan said.
Kathleen Jaeger, RN, BSN, C, COHN-S is manager of the employee health, adult clinic and community health education programs at Robert Wood Johnson University Hospital at Rahway.
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