Risk of Cardiovascular Disease in American Firefighters: An Intervention Is Warranted

Cardiovascular disease (CVD) is the most common cause of job-related mortality among firefighters in the United States. Although age, family history, and work environments cannot be controlled, other predictors are modifiable. If solutions are to be implemented, it is important to know which health parameters are responsible for the elevated CVD risk in this population. PURPOSE: To examine the cardiovascular health of California firefighters. METHODS: We measured physiological CVD risk factors in 35 firefighters from Northern California. Assessments were age, anthropometry, blood lipids, blood pressure, and blood glucose. Risk factors were summed according to the American College of Sports Medicine guidelines. We evaluated the frequency of individual risk factors and used regression analyses (logistic, negative binomial, and linear as appropriate) to test the effect of age on risk. RESULTS: Firefighters were 33.5 ± 11.8 years old, had a body mass index (BMI) of 26.6 ± 3.4, body fat percent (BF%) of 21.2 ± 6.0%, waist circumference (WC) of 90.3 ± 10.4 cm, and waist-hip ratio of 0.87 ± 0.10. Systolic blood pressure (SBP) was 122.5 ± 8.0 mmHg, diastolic pressure (DBP) was 78.1 ± 10.3 mmHg, fasted blood glucose (FBG) was 98.5 ± 14.3 mg/dL, LDLs were 128.9 ± 40.1 mg/dL, HDLs were 31.6 ± 12.5 mg/dL, triglycerides were 116.8 ± 90.3, and the average number of risk factors was 1.8 ± 1.2. There were 32 firefighters (91.4%) with ≥ 1 risk. The proportion of at-risk firefighters for each variable was: lipid profile (77.1%), obesity (65.7%), FBG (37.1%), blood pressure (34.3%), and age (14.3%). Most of the lipid profile was met by low HDLs (65.7% of all firefighters). Age was a significant predictor of BMI (p=0.001), BF% (p=0.003), WC (p=0.001), and waist-hip ratio (p=0.047), but not SBP (p=0.553), DBP (p=0.590), FBG (p=0.961), HDLs (p=0.369), LDLs (p=0.593), or triglycerides (p=0.688). Increased age significantly predicted an increased number of CVD risk factors (p=0.003). CONCLUSION: As firefighters advanced in age, they experienced elevations in CVD risk, mostly as a consequence of increasing adiposity. Weight loss interventions aimed at improving lipid profile, blood glucose, and blood pressure may help reduce job-related CVD mortality in American firefighters