Cardiac Risk Greatest While Firefighters Fighting Flames

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It's not easy for a firefighter to pay close attention to cardiac risk factors such as high blood pressure, Kales acknowledged. "It is hard in any population," he said. "Most firefighters are men, and men in general do not like to go to a doctor. And they might be concerned that, in medical screening, something could be found that would not make them eligible for a job they love to do."

The solution is to have concern for cardiac fitness become an integral part of that job, Kales said. "Health and fitness should be part of a firefighter's culture from the beginning, when he becomes a recruit," he said.

The study does not say that firefighters are at an unusual risk of cardiac death, said Dr. Linda Rosenstock, dean of the University of California, Los Angeles, School of Public Health and former head of the U.S. National Institute for Occupational Safety and Health, who wrote an accompanying editorial.

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"They are a healthy workforce," Rosenstock said. "The overall risk is about the same as for other work populations."

But fighting a fire is not ordinary work, she said. "We've known for a couple of decades that when you have underlying cardiac disease and are put under stress, you are likely to have a cardiac event," Rosenstock said. "It is a clustering phenomenon. We can learn from this study to try to put into effect the best protection firefighters can have in this situation."

The first protective measure is "the same as for the rest of us, to keep as heart-healthy as can be," she said. "Also we have to protect against certain exposures that are unique to firefighting." Protection is needed against particulates and carbon monoxide, toxic products of combustion, both during and immediately after a fire, Rosenstock said.

"We have made progress over the past 20 years in such things as respiratory protection," she said.

More information

Read more about firefighter fatalities at the National Institute for Occupational Safety and Health.

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