Firefighters and On-duty Deaths From Coronary Heart Disease: A Case Control Study

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Firefighters and On-duty Deaths From Coronary Heart Disease: A Case Control Study

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Title: Firefighters and On-duty Deaths From Coronary Heart Disease: A Case Control Study
Author: Christoudias, Stavros G; Kales, Stefanos Nicholas; Soteriades, Elpidoforos S.; Christiani, David C.

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Citation: Kales, Stefanos N, Elpidoforos S Soteriades, Stavros G Christoudias, and David C Christiani. 2003. Firefighters and on-duty deaths from coronary heart disease: a case control study. Environmental Health 2: 14.
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Abstract: Background: Coronary heart disease (CHD) is responsible for 45% of on-duty deaths among United States firefighters. We sought to identify occupational and personal risk factors associated with on-duty CHD death. Methods: We performed a case-control study, selecting 52 male firefighters whose CHD deaths were investigated by the National Institute for Occupational Safety and Health. We selected two control populations: 51 male firefighters who died of on-duty trauma; and 310 male firefighters examined in 1996/1997, whose vital status and continued professional activity were re-documented in 1998. Results: The circadian pattern of CHD deaths was associated with emergency response calls: 77% of CHD deaths and 61% of emergency dispatches occurred between noon and midnight. Compared to non-emergency duties, fire suppression (OR = 64.1, 95% CI 7.4–556); training (OR = 7.6, 95% CI 1.8–31.3) and alarm response (OR = 5.6, 95% CI 1.1–28.8) carried significantly higher relative risks of CHD death. Compared to the active firefighters, the CHD victims had a significantly higher prevalence of cardiovascular risk factors in multivariate regression models: age ≥ 45 years (OR 6.5, 95% CI 2.6–15.9), current smoking (OR 7.0, 95% CI 2.8–17.4), hypertension (OR 4.7, 95% CI 2.0–11.1), and a prior diagnosis of arterial-occlusive disease (OR 15.6, 95% CI 3.5–68.6). Conclusions: Our findings strongly support that most on-duty CHD fatalities are work-precipitated and occur in firefighters with underlying CHD. Improved fitness promotion, medical screening and medical management could prevent many of these premature deaths.
Published Version: doi://10.1186/1476-069X-2-14
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC293431/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:8000902

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