The Heart of the Issue: Firefighters and Cardiovascular Problems

Almost fifty per cent of firefighter fatalities in the United States are a result of heart attacks, far surpassing the next leading causes.
 

Heart attacks being the dominant killer is surprising given the depiction of firefighters in western media. Firefighters are shown fighting the elements and dealing with the heat, flames, and internal stresses that come with the territory of controlling wildfires or rushing into burning buildings. One might assume that suffocation or burns would be far higher on the list of reasons for firefighter fatalities, but they only rank third and fourth respectively. Neither come close to the rate of heart attacks deaths.

The reason why firefighters are more at risk of heart attacks and why heart attacks are the leading killer for firefighters, is likely caused by a combination of heat and overexertion.

In the article "Why do Firefighters have an Increased Risk of Heart Attacks," by Tim Newman for Medical News Today, it discusses an investigation performed in Scotland that examined the link between firefighters and heart attacks. The study concluded that "the risk of blood clotting increased in response to physical exertion and extreme temperature.” Both are conditions firefighters experience on a consistent basis. The study also found that while suppressing a fire, firefighters suffer from low blood pressure caused by dehydration and that a firefighter’s body temperature increases “on average, nearly 2 degrees Fahrenheit over 20 minutes.”

Overall the combination of dehydration, increased body temperature, and extreme heat are the likely reasons why firefighters are so at risk of cardiovascular problems.

An article written by Canadian Occupational Safety, Dr. Stefanos Kales, a professor at Harvard Medical School and editorial writer for this study said that a firefighters who appear healthy but have an unknown heart condition are the most at risk.

Another article in Fire Engineering discussed other possible reasons why firefighters are more susceptible for heart attacks, such as inconsistent sleep patterns, a lack of physical activity outside of work, and mental stress. These reasons have been linked to higher rates of heart attacks and many firefighters suffer from these problems.

Overall, firefighters should maintain a healthy fitness level and re-hydrate themselves throughout the day to reduce the risk of cardiovascular problems.

2001 is notable as a year when heart attacks were not the leading cause of death. Including the data for firefighter fatalities in both 2000 and 2001, heart attacks are surpassed as the leading cause of firefighter deaths by trauma. Trauma is defined as a death caused by collapses, impacts, falls, or vehicle collisions.
 

The reason trauma incidents were the leading killer for 2001 was because of the large number of firefighters who passed away as a result of 9/11.



Overall, 343 firefighters died trying to rescue people from the wreckage at ground zero. These deaths were all categorized as trauma incidents. Some estimates have even increased this number to over 500 fatalities, as many firefighters died of illnesses after the attack resulting from the rescue efforts. This means that the data from 2001 isn’t a representative year for the average dangers that firefighters face. Someone looking at the second chart would assess that the best way to reduce firefighter fatalities would be to reduce the risk of trauma incidents. In actuality, because so many trauma fatalities were caused by one specific incident, the best way to reduce firefighter fatalities overall would be to reduce the risk of heart attacks. Because of this reasoning, the data from 2000 and 2001 was not included in the original assessment.

Hopefully, because of research investigating the link between firefighter fatalities and heart attacks, changes can be implemented to help reduce the risk of heart attacks for first responders. The goal is to make firefighting a safer profession and to minimize the number of firefighter fatalities. Reducing the risk of heart attacks should be the first step to accomplishing this goal.