’s Health Beat-July, 2002

Mary Jane Dittmar
Fire Engineering/

Heart Disease Still a Leading Caust of Firefighter Deaths

In 2001, there were 99 firefighter line-of-duty deaths (excluding the deaths that occurred at the World Trade Center). Significantly, fewer than half of these deaths occurred while the firefighters were on the fireground. In fact, this has been the case in seven of the past 10 years, according to the National Fire Protection Agency (NFPA).

In its report on 2001 firefighter fatalities, the NFPA noted that, as in recent years, heart attacks caused by overexertion or stress killed the greatest number of firefighters, 40, among these 99 firefighters. Twelve of the heart attacks struck while the firefighters were on the fireground. Firefighters in their 50s died at twice the average rate of the general population, and those in their 60s at four times the average rate.

Another 25 percent of deaths among this group occurred while the firefighters were traveling to or from fires or other emergencies, according to the NFPA. Twenty-seven of these firefighters died from being struck by an object or by coming in contact with an object. Seventeen vehicle crashes are included in this figure.

In view of these statistics, Rita Fahy, Ph.D., manager of NFPA fire databases and systems, prevention efforts must involve not just training and equipment but also techniques that will help firefighters to stay in shape and to better cope with stress.

Recently, the American Heart Association (AHA) updated its guidelines for prevention heart attacks and strokes. It recommends that physicians routinely assess patients for general risk of cardiovascular disease beginning at the age of 20 and that they calculate the risk of developing cardiovascular disease in the next 10 years for people age 40 and older or individuals with multiple risk factors.

Looking at recent line-of-duty death statistics, we are beginning to see deaths attributed to cardiovascular conditions among firefighters in their thirties. Therefore, it may be a good idea to evaluate at the time of hiring a firefighter’s cardiovascular health. In this way, any underlying condition or risk factors can be detected and monitored, if necessary. The information could also be used to assess any changes that may occur in subsequent tests.

“Risk factor screening,” says the AHA, includes the recording of blood pressure, body mass index, waist circumference, and pulse at least every two years and a cholesterol profile and glucose testing at least every five years beginning at age 20.

For people age 40 and older, or anyone with two or more risk factors, a “global risk estimation” should be done. It combines information from all existing risk factors to determine an individual’s percentage risk for developing cardiovascular disease in the next 10 years.

Other AHA recommendations for preventing heart attacks and strokes include the following:

  • Avoid exposure to tobacco smoke (including second-hand smoke).
  • Maintain blood pressure below 140/90 mm Hg. It should be below 130/85 mm Hg for people with kidney damage or heart failure and below 130/80 mm Hg for people with diabetes.
  • Follow an overall healthful eating pattern.
  • Maintain a cholesterol level appropriate for your individual risk.
  • Engage in at least 30 minutes of moderate-intensity physical activity on most (preferably all) days of the week.
  • Achieve and maintain desirable weight.
  • Maintain a normal fasting blood glucose level below 110 mg/dL.
Has your department implemented any programs aimed at preventing heart disease? What is its policy on medical physicals? Send comments to me at

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