A Cross-Sectional Examination of 10-Year Atherosclerotic Cardiovascular Disease Risk Among US Firefighters by Age and Weight Status

Comparative analysis of the health status of military police officers and firefighters: a cross-sectional study in the State of Paraná, Brazil

OBJECTIVES

To evaluate the health-condition of military police officers and firefighters. To identify risk factors for not being medically ready for duty.

DESIGN

Cross-sectional study.

SETTING

Data were extracted from medical records during annual periodic health assessments of police officers and firefighters serving with the military police in Paraná, Brazil.

PARTICIPANTS

6621 police officers (5927 men and 694 women) and 1347 firefighters (1257 men and 90 women) who underwent health assessments between July 2018 and June 2019 were analysed. Pregnant women were excluded.

OUTCOME MEASURES

Data included variables such as sex, age, anthropometric measurements, lifestyle, comorbidities and laboratory tests. Multiple logistic regression was used to estimate the probability of not being medically ready for active duty.

RESULTS

Overall, police officers had worse health status than firefighters and greater prevalence of overweight and obesity, regardless of sex. Musculoskeletal diseases were the most commonly reported disease by police officers and firefighters of both sexes. Among men, hypertension was the second most prevalent disease, followed by psychiatric diseases and dyslipidaemia. Among women, psychiatric diseases were the second most prevalent. Male police officers ≥40 years old presented the highest probability of not being considered ready for duty (40.1%). The probability of male police officers between the ages of 31 and 40 not being ready was similar to that for male firefighters >40 years old. There was a higher chance of not being medically ready professionals with diseases such as diabetes mellitus (OR 2.95, 95% CI 1.97 to 5.03), dyslipidaemia (OR 2.65, 95% CI 1.96 to 3.58), hypertension (OR 2.29, 95% CI 1.85 to 4.70), high total cholesterol (OR 2.16, 95% CI 1.93 to 2.42), and heart disease (OR 2.13, 95% CI 1.32 to 3.45).

CONCLUSIONS

There was a high prevalence of chronic diseases and modifiable cardiovascular risk factors among police officers and firefighters. Healthy protective measures should be offered frequently, particularly to police officers at an earlier age.

Characteristics of Hazardous Substances Extracted from Laundry Water for Fire Protection Suit Exposed to Fire

(1) Background: It is well known that various toxic substances, including carcinogens, are generated at the fire scenes, so it is very important for firefighters to wear comprehensive personal protective equipment. The extent of the type and amount of harmful substances contained in the washing water of fire protection suits (FPS) exposed to fire scenes have not yet been confirmed. The purpose of this study is to evaluate the characteristics of harmful substances contained in wash water extracted from FPSs exposed to fire. (2) Methods: The study design was a simulation-based experimental study. To evaluate the degree of contamination exposure of FPSs, 10 sets of fire suits were classified into four groups as follows: newly supplied, field use, one fire exposure, and two consecutive fire exposures. In the experimental environment, after exposing three to four groups of FPSs to residential fire conditions. they were sealed in a plastic bag in the experimental space. The washing water for FPSs was extracted through manual washing in the order of Groups 1 to 4, and 24 items were analyzed according to the water pollution process test standards. (3) Results: According to the results of the FPS laundry analysis, the concentration of acrylonitrile in laundry was higher when exposed to fire twice than when exposed to fire once. Moreover, there was a dose–response relationship, and the risk of cumulative toxicity was shown. Naphthalene and diethylhexyl phthalate (DEHP) were detected to be high in the washing water of Group 3 FPSs exposed to incomplete combustion fire. Of the 24 items that were analyzed for in the water, four item exceeded the standard for sewage discharge facilities in accordance with the Water Environment Conservation Act. Copper and its compounds exceeded the standards by 3.4 times, antimony 4.8 times, acrylonitrile 26.0 times, and DEHP 4.1 times, respectively. (4) Conclusions: Therefore, when removing FPSs after firefighting activities, care should be taken to avoid contaminating the skin. In addition, facilities that wash FPS that have been exposed to a fire scene must have a sewage treatment and purification facility. However, if emergency decontamination of FPSs is conducted at the fire scene, the concentration of toxic substances contained in laundry can be reduced. In the case of large-scale fire, there is a risk of water pollution near the fire scene, so it is necessary to prepare a national countermeasure. The results of this study can be applied to the revision of regulations related to the building of the fire departments, reduction of water pollution, and water environment policy.

Retrospective Longitudinal Evaluation of Male Firefighter's Body Composition and Cardiovascular Health

OBJECTIVE

Describe firefighter body composition and cardiovascular health as a function of age.

METHODS

217 male firefighters with 1922 distinct evaluations over 23-years were included in this retrospective analysis. The firefighters had their height, mass, six-site skin-fold, blood pressure, and resting heart rate measured annually. Linear mixed models were used to analyze the effect of age. Significance was set to P < 0.05.

RESULTS

With each 1-year increase in age, mass (0.42 kg, P < 0.001), body mass index (0.13 kg m-2, P < 0.001), body fat percentage (0.18%, P < 0.001), fat mass (0.25 kg, P < 0.001), and fat free mass (0.15 kg, P < 0.001) increased. Systolic blood pressure (-0.09 mm Hg, P = 0.263), diastolic blood pressure (0.05 mm Hg, P = 0.308), and resting heart rate (0.07 beats min-1, P = 0.291) did not change.

CONCLUSIONS

Interventions to maintain healthy body composition are critical to reduce sudden cardiovascular related death risk.

Low testosterone and cardiometabolic risks in a real-world study of US male firefighters

Low serum total testosterone (TT) is associated with increased cardiovascular risk and metabolic derangements, with fatty liver (FL) emerging as an additional cardiometabolic threat. We investigated the associations between TT and cardiometabolic (CM) health in 298 US male firefighters. Cross-sectional data from occupational health examination were analyzed. TT was categorized as low (< 264 ng/dL), borderline (264-399 ng/dL), and reference (400-916 ng/dL). Conventional CM risk factors were compared among TT categories, and between firefighters with and without FL. 81% of firefighters were obese/overweight; almost 40% had FL. In the low-TT group, only 3.1% had normal BMI, while 78.1% had FL. The low-TT group had a worse CM profile, independently of age and BMI, and a fourfold higher adjusted odds of having FL. FL was associated with lower TT, regardless of age, BMI and HbA1c. Having a FL, HbA1c ≥ 5.7% or triglycerides ≥ 150 mg/dL increased the odds for low-TT by 4.1, 2.7 and 6.6 times, respectively. These real-world data reveal strong associations between low-TT and CM risk factors and support a call for action towards screening for low-TT and FL, regardless of age, BMI or dysmetabolic conditions in firefighters. Recognizing cardiometabolic risks in firefighters provides an opportunity to lessen cardiovascular diseases burden.

Differences in 5-year weight change between younger and older US firefighters

BACKGROUND

Research consistently finds that, on average, firefighters gain weight over time and some data indicate that younger firefighters are more likely to gain weight than older firefighters. The purpose of this study was to estimate the 5-year weight change among younger and older US firefighters.

METHODS

Data from two occupational medical exams separated by 5 years (2009-2016) were examined from a cohort of US career firefighters in Virginia (males, n = 589; females, n = 67). The cohort was grouped into two age categories (< 45 years and ≥ 45 years). Weight change subgroups were Loss (decrease of > 3% body weight), Stable (within ±3% body weight) and Gain (increase of > 3% body weight). Multinomial logistic regression models and linear regression models were conducted to examine differences in the probability of being in a particular weight change category, weight change overall and by weight change category between younger and older firefighters.

RESULTS

At baseline, 25 and 35% of younger (< 45 years) and older (≥ 45 years) were obese, respectively. Younger firefighters gained significantly (P < 0.05) more weight (3.0 ± 0.2 kg) than older firefighters (0.8 ± 0.5 kg). Younger firefighters were more likely to gain weight (53% versus 39%) and less likely (10% versus 20%) to lose weight as compared to older firefighters. Smaller weight gains were associated with age and BMI with the smallest increases observed in overweight and obese firefighters ≥45 years of age.

CONCLUSIONS

Health care providers should be attentive to weight gain, even among young non-obese firefighters, and counsel firefighters to avoid the additive risks of being older and heavier. In addition, weight loss/management programs should be promoted in the fire service to encourage healthy body weight and to prevent unhealthy weight gain among both young and old firefighters alike.