Firefighters’ Silent Killer: Heart Disease

February is American Heart Month and there is perhaps no better time to focus on a concerning statistic for American firefighters: cardiac fatalities are the leading cause of death among all firefighters, and represent nearly 50 percent of on-duty deaths.

While it might seem common sense that a firefighter’s duties are particularly hard on the body, it is a bit more surprising that many firefighters are unknowingly suffering from underlying cardiovascular disease.

In fact, new research in Journal of the American Heart Association shows that a large percentage of firefighters who died from cardiac arrest also showed signs of atherosclerotic and hypertensive heart disease at autopsy, undoubtedly contributing to their chances of a fatal cardiac event.

Lifestyle Challenges

So what are the factors in a firefighter’s life that make heart disease such a common risk?

While the job of a firefighter – especially when it comes to fire suppression – is extremely physical, the shift work and busy lifestyle can also hamper the opportunities for regular, proactive exercise. Surprisingly, studies show that the obesity rate for firefighters is in the range between 73-88 percent, actually higher than the general population. And even more concerning are recent studies reflecting that the number of “severely obese” firefighters is rising, with one in 10 firefighters falling into this category.

Studies point to lifestyle factors like shift work and sleep disruption as directly contributors to obesity. Additionally, poor eating habits around the firehouse – like snacking on high carbohydrate snacks or higher fat meals – add to the challenges. In response, organizations like Food on the Stove have formed to specifically support healthier eating habits in firehouses. Operated by firefighters, the organization utilizes certified nutrition therapists to provide tools and resources for supporting healthier lifestyles, heart healthy eating practices, and fitness activities.

Pushing Your Body to Its Limits

The connection between on-duty deaths and heart disease stem from the body’s reaction to stress and exertion, specifically when it relates to fire suppression. According to a recent article by Fire Engineering citing numerous scientific studies, the risk of a heart attack in unhealthy firefighters increases anywhere from 10-100 times compared to performing non-emergency tasks. Additionally, even though active fire fighting makes up only approximately one to five percent of a firefighters’ total time on the job, 32 percent of fatal cardiac events occur either during or after participation in active fire suppression.

Studies have shown that during a fire suppression activity, a fire fighter’s resting heart rate nearly doubles, core body temperature rises at least 2ºF, systolic blood pressure rises, and tension and anxiety increase. Additionally, blood platelet and coagulation properties increase dramatically and remain elevated for hours after the fire, suggesting what causes so many fatal heart attacks during and after fire suppression activities.

Additionally, the common experience of sleep interruption and being woken from a deep sleep has been linked to elevated heart rates and symptoms of chronic stress exposure. Other studies suggest a connection between heart disease and shift work, specifically working in a night shift setting. While some people appear to more easily adapt to shift schedules, others experience problems sleeping and a wide range of health problems including heart problems.

Knowing the Enemy is Half the Battle

So while it seems that firefighters have the deck stacked against them when it comes to increased risk factors, the good news is that, according to the American Heart Association (AHA), is that the risk of heart disease can be greatly reduced by simple lifestyle changes.

A key element is the very first step: schedule a physical and have all your key vitals recorded. This is the easiest way to identify any red flags that may be silently damaging your health. Then, you can focus on the AHA’s “Life’s Simple 7.”

1. Manage Your Blood Pressure: Nearly half of American adults have high blood pressure and don’t know it, due to the fact that there are very few symptoms. Reducing your blood pressure helps reduce the strain on your heart, arteries, and kidneys, which keeps you healthier longer. Tips for reducing blood pressure include eating a well-balanced diet that’s low in salt, limiting alcohol, enjoying regular physical activity, managing stress, and maintaining a healthy weight.
2. Control Cholesterol: High cholesterol contributes to plaque, which can clog arteries and lead to blockages, heart disease, and stroke. Again, healthier lifestyle choices, diet, and weigh management can all help improve cholesterol readings.
3. Reduce Blood Sugar: Most of the food we eat is turned into glucose (or blood sugar) that our bodies use for energy. Over time, high levels of blood sugar can damage your heart, kidneys, eyes and nerves. Many studies show that lifestyle changes, such as losing weight, eating healthy and increasing physical activity, can dramatically help manage proper blood sugar levels.
4. Get Active: Living an active life is one of the most rewarding gifts you can give yourself and those you love. Daily physical activity increases your length and quality of life, and can most definitely help you do your job as a firefighter more efficiently.
5. Eat Better: A healthy diet is one of your best weapons for fighting cardiovascular disease. When you eat a heart-healthy diet, you improve your chances for feeling good and staying healthy. It can be challenging to eat healthy at the station, but helping your crew stay healthier can benefit your overall outcomes and help save lives on your own team.
6. Lose Weight: Losing extra pounds reduces the burden on your heart, lungs, blood vessels, and even skeleton. Obesity in the firehouse can mean underperformance, more missed work days, and increase injuries. Losing weight not only helps you look better, but perform your job more effectively and for more years.
7. Stop Smoking: Cigarette smokers have a higher risk of developing cardiovascular disease. In the 1990s, the rate of smoking with firefighters was around 50 percent; today, studies show it’s in a much lower range between 7 to 13 percent. Quitting smoking can be a real challenge, but the benefit to your health is undeniable.

A firefighter’s job is undoubtedly dangerous enough with the obvious and present dangers faced with each entry into a fire suppression activity. However, the silent killer of cardiac disease appears to have a much greater impact than most would imagine. With focused, active efforts and a shift to focusing more on firefighter health, the number one threat to today’s firefighters can be greatly reduced.