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Heart disease in Firefighters
Yesterday I asked an old friend of mine, the retired Deputy Chief of the Portland, ME Fire department, to comment on the article about heart disease in Firefighters.
I was curious to hear his opinion, in particular in regards to changes that have occurred since 1999. Meanwhile, I reviewed data about Fire incidence:
I. Improved Fire protection and prevention standards have resulted in a steady decline in fires in the US:
II. As a result, Fire departments around the US have switched a large portion of their work to EMT services.
Nationwide Fire Department Provision of Emergency Medical Service, 2005-2007 Annual Averages:
- EMS services 44%
- EMS service and advanced life support, 15%
- No EMS services, 41%
Nonetheless, as this has not yet resulted in a decline in cardiac deaths, we reviewed what factors in his opinion may continue to play a role. This is what resulted from that conversation:
- Stress (as emphasized in my slide about Alarms and heart rates)
- While the “Air packs” theoretically provide up to an hour of Oxygen, a firefighter, with 40 lbs of equipment, who has just run up 6 flights of stairs may well use up the supply in much less time than an hour
- The “macho effect” certainly plays a role in the kind of person attracted to this profession and may lessen the use of air packs to a minimum
Improved survival from heart disease may well become noticeable in the next 10 years, when the switch to EMT services has had a chance to influence the survival statistics. Will combining EMT services with Firefighting prove equally hazardous to the Heart Health of Firefighters?
Time will tell. Please let me know what you think,
Ask Doctor T. Blog
My father was recently hospitalized with a pericardial effusion and atrial fib/flutter with a rate of 160. Rate was decreased over 24 hours to 110-115 on amiodarone and diltiazem. His cardiologist wanted to perform a chemical stress test. (He had a negative cardiac cath 2 years prior). My father felt that he was unable to tolerate the test, so he...