Heart disease deaths among firefighters

Validation of a cardiorespiratory fitness assessment for firefighters

Currently, a submaximal protocol is used to measure cardiorespiratory fitness in firefighters by estimating their true aerobic capacity (V[Combining Dot Above]O2max); however, this submaximal test has not been cross-validated among firefighters. Thirty firefighters (85% male, 15% female), completed the submaximal protocol and the maximal (Bruce) treadmill protocol on separate occasions. Pearson's correlation analyses between the submaximal and Bruce protocol revealed a significant moderate positive correlation (r = 0.635, p = 0.005). The range of mean V[Combining Dot Above]O2max values and SDs produced from the submaximal and maximal protocols varied greatly (35.4-50.9 vs. 28.6-58.4 ml·kg·min, and SD of 3.91 vs. 7.22, respectively). The submaximal V[Combining Dot Above]O2 test underestimated the true V[Combining Dot Above]O2max in the majority of firefighters (72.4%) and overestimated the true V[Combining Dot Above]O2max in the remainder of firefighters. Participants with a higher body fat percentage were more likely (p = 0.0157) to have an overestimated true V[Combining Dot Above]O2max than those with a lower-body fat percentage. Our results indicate the current submaximal V[Combining Dot Above]O2 test used to measure cardiorespiratory fitness in firefighters is an improvement over previous protocols. However, our findings also show that the accuracy of this submaximal test for predicting the true V[Combining Dot Above]O2max in firefighters is questionable, and may not identify firefighters who possess substandard cardiorespiratory fitness, particularly in those with a higher percentage of body fat. Thus, the results of this study indicate that improvements to the current Fire Service Joint Management, Wellness & Fitness Initiative (WFI) V[Combining Dot Above]O2 assessment is still needed to accurately reflect the true V[Combining Dot Above]O2max of individual firefighters.

Implementation of the first wellness-fitness evaluation for the Dallas Fire-Rescue Department

More than 100 firefighters lose their lives in the line of duty each year; many of these deaths are caused by cardiovascular events and underlying coronary heart disease. In addition, firefighters are at higher-than-normal risk of developing certain types of cancer. To improve health and fitness among its firefighters, the Dallas Fire-Rescue Department developed and implemented an annual wellness-fitness program in 2008. The program detected and addressed medical issues including coronary disease, hypertension, high triglyceride levels, high cholesterol, high blood glucose levels, and hematuria. Prostate, thyroid, breast, kidney, and bladder cancers were also detected. By identifying these issues, engaging the firefighters' personal physicians, and recommending individualized treatment plans, this program may have extended lives and improved the quality of life for the firefighters.

Carbon monoxide poisoning in Jerusalem: epidemiology and risk factors

OBJECTIVES

To describe the epidemiology of carbon monoxide (CO) poisoning in Jerusalem and identify risk factors for such poisoning.

DESIGN

A retrospective descriptive analysis of patients with CO poisoning who presented to the Hadassah hospitals in Jerusalem from 1994 to 2006.

PATIENTS

All patients with suspected CO poisoning were examined and those with confirmed cases [carboxyhemoglobin (COHb) level >5%] were included. Sources of exposure, seasonal variation, and demographic characteristics were analyzed.

RESULTS

There were 292 patients (49% males) with 40 family clusters that accounted for 149 patients (51%); 230 patients (79%) presented during the winter months. All but one had unintentional CO intoxication. The main sources of exposure were faulty gas heaters (n = 135), fire (n = 102), and other residential heating systems (n = 40). The estimated annual incidence of CO poisoning decreased from 6.45 per 100,000 in 1994-2000 to 3.53 per 100,000 in 2001-2006. High-risk intoxication (COHb level >25%) occurred in 84 patients (29%). Factors associated with severe intoxication were male gender, individual patients (compared with those in clusters), and faulty gas heaters (compared with other sources).

CONCLUSIONS

Males exposed to CO may have a more severe intoxication. The lower risk in patients presenting in clusters could be explained by the assumption that severe presentation in one patient alerts the others who are less severely affected. The implementation of safer standards for residential heating systems and CO detectors together with the public education may explain the decline in the incidence of CO poisoning.