The Prevalence of Cardiovascular Disease Risk Factors and Obesity in Firefighters

Obesity is associated with increased risk of cardiovascular disease (CVD) mortality. CVD is the leading cause of duty-related death among firefighters, and the prevalence of obesity is a growing concern in the Fire Service. Methods. Traditional CVD risk factors, novel measures of cardiovascular health and a measurement of CVD were described and compared between nonobese and obese career firefighters who volunteered to participate in this cross-sectional study. Results. In the group of 116 men (mean age 43 ± 8 yrs), the prevalence of obesity was 51.7%. There were no differences among traditional CVD risk factors or the coronary artery calcium (CAC) score (criterion measure) between obese and nonobese men. However, significant differences in novel markers, including CRP, subendocardial viability ratio, and the ejection duration index, were detected. Conclusions. No differences in the prevalence of traditional CVD risk factors between obese and nonobese men were found. Additionally, CAC was similar between groups. However, there were differences in several novel risk factors, which warrant further investigation. Improved CVD risk identification among firefighters has important implications for both individual health and public safety.

[1]  L. London,et al.  Contamination of rural surface and ground water by endosulfan in farming areas of the Western Cape, South Africa , 2003, Environmental health : a global access science source.

[2]  Moyses Szklo,et al.  Coronary calcium as a predictor of coronary events in four racial or ethnic groups. , 2008, The New England journal of medicine.

[3]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2011 update: a report from the American Heart Association. , 2011, Circulation.

[4]  J. Danesh,et al.  C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis , 2010, The Lancet.

[5]  A. Hofman,et al.  Association Between Arterial Stiffness and Atherosclerosis: The Rotterdam Study , 2001, Stroke.

[6]  M. Pollock,et al.  Practical Assessment of Body Composition. , 1985, The Physician and sportsmedicine.

[7]  Acute effects of firefighting on cardiac performance , 2012, European Journal of Applied Physiology.

[8]  Stefanos N. Kales,et al.  Cardiovascular Disease in US Firefighters: A Systematic Review , 2011, Cardiology in review.

[9]  D. Webb,et al.  Increased central pulse pressure and augmentation index in subjects with hypercholesterolemia. , 2002, Journal of the American College of Cardiology.

[10]  Rongwei Fu,et al.  C-Reactive Protein as a Risk Factor for Coronary Heart Disease: A Systematic Review and Meta-analyses for the U.S. Preventive Services Task Force , 2009, Annals of Internal Medicine.

[11]  Y. Arad,et al.  Objectives Background Methods Results Conclusions , 2022 .

[12]  M. Gail,et al.  Cause-specific excess deaths associated with underweight, overweight, and obesity. , 2007, JAMA.

[13]  Ingvar Holmér,et al.  Classification of metabolic and respiratory demands in fire fighting activity with extreme workloads. , 2007, Applied ergonomics.

[14]  I. Kawachi,et al.  Obesity and cardiovascular disease risk factors in firefighters: a prospective cohort study. , 2005, Obesity research.

[15]  R. D'Agostino,et al.  Concept and usefulness of cardiovascular risk profiles. , 2004, American heart journal.

[16]  Wesley M Theurer,et al.  Association of Body Mass Index and Health Status in Firefighters , 2002, Journal of occupational and environmental medicine.

[17]  R. Kronmal,et al.  Coronary calcium predicts events better with absolute calcium scores than age-sex-race/ethnicity percentiles: MESA (Multi-Ethnic Study of Atherosclerosis). , 2009, Journal of the American College of Cardiology.

[18]  C. Christophi,et al.  The Obesity Epidemic and Future Emergency Responders , 2009, Obesity.

[19]  P. Greenland,et al.  Coronary artery calcium score and risk classification for coronary heart disease prediction. , 2010, JAMA.

[20]  Krishnarao Tangella,et al.  Effect of Live-Fire Training Drills on Firefighters’ Platelet Number and Function , 2011, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[21]  David B Allison,et al.  Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. , 2004, Circulation.

[22]  Irwin Feuerstein,et al.  Coronary calcium independently predicts incident premature coronary heart disease over measured cardiovascular risk factors: mean three-year outcomes in the Prospective Army Coronary Calcium (PACC) project. , 2005, Journal of the American College of Cardiology.

[23]  R. Detrano,et al.  Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. , 2004, JAMA.

[24]  L Soleo,et al.  Effect of shift work on body mass index: results of a study performed in 319 glucose-tolerant men working in a Southern Italian industry , 2003, International Journal of Obesity.

[25]  Claude Bouchard,et al.  Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: Executive summary , 1998 .

[26]  David C Christiani,et al.  THE NEW ENGLAND JOURNAL OF MEDICINE , 1977, The Lancet.

[27]  R. Kronmal,et al.  Multi-Ethnic Study of Atherosclerosis: objectives and design. , 2002, American journal of epidemiology.

[28]  C. Christophi,et al.  Firefighters' physical activity: relation to fitness and cardiovascular disease risk. , 2011, Medicine and science in sports and exercise.

[29]  W. Siri Body composition from fluid spaces and density: analysis of methods. 1961. , 1993, Nutrition.

[30]  Claude Bouchard,et al.  Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. , 1998, WMJ : official publication of the State Medical Society of Wisconsin.

[31]  D L Smith,et al.  Effect of strenuous live-fire drills on cardiovascular and psychological responses of recruit firefighters , 2001, Ergonomics.

[32]  J L Bilzon,et al.  Characterization of the metabolic demands of simulated shipboard Royal Navy fire-fighting tasks , 2001, Ergonomics.

[33]  P. Thompson,et al.  ACSM's Guidelines for Exercise Testing and Prescription , 1995 .

[34]  Richard B. Devereux,et al.  Central Pressure More Strongly Relates to Vascular Disease and Outcome Than Does Brachial Pressure: The Strong Heart Study , 2007, Hypertension.

[35]  David C Christiani,et al.  Firefighters and on-duty deaths from coronary heart disease: a case control study , 2003, Environmental health : a global access science source.

[36]  H. Bøggild,et al.  Shift work, risk factors and cardiovascular disease. , 1999, Scandinavian journal of work, environment & health.

[37]  M. Crilly,et al.  Indices of cardiovascular function derived from peripheral pulse wave analysis using radial applanation tonometry: a measurement repeatability study , 2007, Vascular medicine.

[38]  D. Levy,et al.  Prediction of coronary heart disease using risk factor categories. , 1998, Circulation.

[39]  T. Nelson,et al.  Cardiorespiratory fitness and the metabolic syndrome in firefighters. , 2009, Occupational medicine.

[40]  N Gledhill,et al.  Characterization of the physical demands of firefighting. , 1992, Canadian journal of sport sciences = Journal canadien des sciences du sport.

[41]  P. Lemon,et al.  The human energy cost of fire fighting. , 1977, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[42]  Denise L. Smith,et al.  Impact of excess body weight on arterial structure, function, and blood pressure in firefighters. , 2009, The American journal of cardiology.

[43]  S. Kales,et al.  Predictors of on-duty coronary events in male firefighters in the United States. , 2008, The American journal of cardiology.

[44]  D. Christiani,et al.  Correlates of body mass index in hazardous materials firefighters. , 1999, Journal of occupational and environmental medicine.

[45]  C. Tsioufis,et al.  Subendocardial viability ratio as an index of impaired coronary flow reserve in hypertensives without significant coronary artery stenoses , 2012, Journal of Human Hypertension.

[46]  S. Kales,et al.  The Prevalence of Overweight, Obesity, and Substandard Fitness in a Population-Based Firefighter Cohort , 2011, Journal of occupational and environmental medicine.

[47]  W. Franke,et al.  Prevalence of Cardiovascular Disease Risk Factors in Volunteer Firefighters , 2009, Journal of occupational and environmental medicine.

[48]  R. Detrano,et al.  Quantification of coronary artery calcium using ultrafast computed tomography. , 1990, Journal of the American College of Cardiology.

[49]  P S Gartside,et al.  Risk factors for coronary heart disease among firefighters in Cincinnati. , 1996, American journal of industrial medicine.

[50]  Thomas Weber,et al.  Arterial Stiffness, Wave Reflections, and the Risk of Coronary Artery Disease , 2004, Circulation.

[51]  Allen J. Taylor,et al.  Outcomes in the Prospective Army Coronary Calcium (PACC) Project Heart Disease Over Measured Cardiovascular Risk Factors: Mean Three-Year Coronary Calcium Independently Predicts Incident Premature Coronary , 2005 .

[52]  Mark A. Hlatky,et al.  ACCF/AHA 2007 Clinical Expert Consensus Document on Coronary Artery Calcium Scoring By Computed Tomography in Global Cardiovascular Risk Assessment and in Evaluation of Patients With Chest Pain , 2007 .

[53]  K. Flegal,et al.  Prevalence and trends in obesity among US adults, 1999-2008. , 2010, JAMA.

[54]  Lemon Pw,et al.  The human energy cost of fire fighting , 1977 .

[55]  Jonathan G Goldin,et al.  Assessment of Coronary Artery Disease by Cardiac Computed Tomography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiolog , 2006, Circulation.

[56]  A. Mokdad,et al.  Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. , 2003, JAMA.

[57]  Yasmin,et al.  Normal vascular aging: differential effects on wave reflection and aortic pulse wave velocity: the Anglo-Cardiff Collaborative Trial (ACCT). , 2005, Journal of the American College of Cardiology.

[58]  T. Olds,et al.  Relationship between adiposity and body size reveals limitations of BMI. , 2006, American journal of physical anthropology.