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    Firefighter Killer: Heart Disease

    Heart Disease Is Firefighters' Biggest On-Duty Death Risk

    Firefighters' Hearts

    Firefighters are like other people in one respect: Many of them have underlying heart disease. And, like so many other Americans, many firefighters have high cholesterol levels, high blood pressure, and other risk factors that put them at risk of heart disease.

    Battling fires and rescuing civilians involves sudden, extreme exertion and exposure to toxic environments. These job risks make heart disease all the more deadly for firefighters.

    "Now we provide the strongest evidence to date that specific firefighter duties -- fire suppression, alarm response, and physical training -- can trigger events in firefighters with underlying disease," Kales says.

    It's not that firefighters are having heart attacks right and left. Firefighters suffer fewer than 50 on-duty heart deaths a year, notes Linda Rosenstock, MD, MPH, dean of the University of California, Los Angeles School of Public Health.

    "We want to avoid every one of those deaths, in this work force particularly, because they put themselves at risk helping us," Rosenstock tells WebMD.

    Saving Firefighters' Lives -- and Your Life

    Understanding when firefighters are at greatest risk of heart death is the first step toward saving these lifesavers' lives.

    "There is a clustering of these events around times of peak physical activity," Rosenstock notes. "They work in tough environments, they wear heavy equipment, they are highly stressed, and they are exposed to chemical toxins that may aggravate their cardiac risk. And all of these exposures are occurring during the period when these fatal events occur."

    For all these reasons, underlying heart disease adds a huge risk to an already risky job. That's why Rosenstock recommends that all fire departments should:

    • require firefighters to undergo prehire and annual medical examinations
    • implement wellness and fitness programs to reduce heart disease risk factors
    • require annual physical performance tests for all firefighters

    Firefighters tend to be far fitter and healthier than civilians -- especially if they work full time at the job. But 70% of firefighters are volunteers.

    "The fitness requirements at entry and continuing through working life are much higher on the career side than on the voluntary side," Rosenstock says. "Very few paid firefighters continue after age 50. But the volunteer work force is older -- and with age comes added risk."

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