ABSTRACT
Background: Over 45% of firefighter deaths are attributable to sudden cardiac death related to coronary artery disease (CAD), with many of these deaths attributed to comorbidities. The purpose of the study is to determine the prevalence of coronary artery disease (CAD) risk factors in firefighters in the City of Cape Town (CoCT).
Design and Methods: The study used a quantitative, cross-sectional and descriptive design. A total of 124 full-time firefighters were conveniently recruited between September and November 2019 from the City of Cape Town Fire and Rescue Service.
Results: The most prevalent CAD risk factors among firefighters were hypertension (33.1%), obesity (37.1%), cigarette smoking (39.5%) and dyslipidaemia (40.3%). A total of 41.9% of firefighters were categorized as low-risk, 54.8% as moderate-risk, and 3.2% as high-risk for CAD.
Conclusion: The majority of firefighters had at least one CAD risk factor, with older males having the highest prevalence of multiple CAD risk factors. Compared to other regions of the world, the (CoCT) firefighters have higher prevalence of dyslipidaemia and cigarette smoking. Preventative behavioural strategies and education on CAD should be promoted to mitigate the development of CAD.
REFERENCES
Smith DL, Fehling PC, Frisch A, et al. The prevalence of cardiovascular disease risk factors and obesity in firefighters. J Obes 2012;2012:908267. DOI: https://doi.org/10.1155/2012/908267
Seyedmehdi SM, Attarchi M, Cherati AS, et al. Relationship of aerobic fitness with cardiovascular risk factors in firefighters. Work 2016;55:155-61. DOI: https://doi.org/10.3233/WOR-162375
Durand G, Tsismenakis AJ, Jahnke SA, et al. Firefighters’ physical activity: relation to fitness and cardiovascular disease risk. Med Sci Sports Exerc 2011;43:1752-9. DOI: https://doi.org/10.1249/MSS.0b013e318215cf25
Gendron P, Lajoie C, Laurencelle L, Trudeau F. Cardiovascular disease risk factors in Québec male firefighters. J Occup Environ Med 2018;60:e300-6. DOI: https://doi.org/10.1097/JOM.0000000000001309
Wolkow A, Netto K, Langridge P, et al. Cardiovascular risk screening of volunteer firefighters. In: Proceedings of Bushfire CRC & AFAC 2012 Conference Research Forum. 2012.
Martin ZT, Schlaff RA, Hemenway JK, et al. Cardiovascular disease risk factors and physical fitness in volunteer firefighters. Int J Exercise Sci 2019;12:764-76.
Smith DL, Barr DA, Kales SN. Extreme sacrifice: Sudden cardiac death in the US Fire Service. Extreme Physiol Med 2013;2:1-9. DOI: https://doi.org/10.1186/2046-7648-2-6
Jitnarin N, Poston WS, Haddock CK, et al. Tobacco use pattern among a national firefighter cohort. Nicotine Tob Res 2015;17:66-73.
Savall A, Charles R, Binazet J, et al. Volunteer and career French firefighters with high cardiovascular risk epidemiology and exercise tests. J Occup Environ Med 2018;60:E548-53. DOI: https://doi.org/10.1097/JOM.0000000000001426
Soteriades ES, Kales SN, Liarokapis D, et al. Lipid profile of firefighters over time: Opportunities for prevention. J Occup Environ Med 2002;44:840-6. DOI: https://doi.org/10.1097/00043764-200209000-00006
American College of Sports Medicine. ACSM Guidelines for Exercise Testing and Prescription, 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2018. p. 44-89.
American College of Sports Medicine. ACSM Guidelines for Exercise Testing and Prescription, 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2013. p. 27-31.
Byczek L, Walton SM, Conrad KM, et al. Cardiovascular risks in firefighters: Implications for occupational health nurse practice. AAOHN J 2004;52:66-77. DOI: https://doi.org/10.1177/216507990405200205
Wolkow A, Hons B, Netto K, et al. Coronary heart disease risk in volunteer firefighters in Victoria, Australia. Arch Environ Occup Health 2014;69:112-20. DOI: https://doi.org/10.1080/19338244.2012.750588
Gendron P, Lajoie C, Laurencelle L, Trudeau F. Cardiovascular disease risk in female firefighters. Occup Med 2018;68:412–4. DOI: https://doi.org/10.1093/occmed/kqy074
Padela AI. American Muslim health disparities: The state of the Medline. J Health Dispar Res Pract Lit 2015;8:1-9.
Soteriades ES, Kales SN, Liarokapis D, Christiani DC. Prospective surveillance of hypertension in firefighters. J Clin Hypertens (Greenwich) 2003;5:315–20. DOI: https://doi.org/10.1111/j.1524-6175.2003.02058.x
Eastlake AC, Knipper BS, He X, et al. Lifestyle and safety practices of firefighters and their relation to cardiovascular risk factors. Work 2015;50:285–94. DOI: https://doi.org/10.3233/WOR-131796
Damacena FC, Batista TJ, Ayres LR, et al. Obesity prevalence in Brazilian firefighters and the association of central obesity with personal, occupational and cardiovascular risk factors: a cross-sectional study. BMJ Open 2020;10:1–10. DOI: https://doi.org/10.1136/bmjopen-2019-032933
Choi BK, Schnall P, Dobson M. Twenty-four-hour work shifts, increased job demands, and elevated blood pressure in professional firefighters. Int Arch Occup Environl Health 2016;89:1111–25. DOI: https://doi.org/10.1007/s00420-016-1151-5
Choi B, Dobson M, Schnall P, Garcia-Rivas J. 24-hour work shifts, sedentary work, and obesity in male firefighters. Am J Ind Med 2016;59:486–500. DOI: https://doi.org/10.1002/ajim.22572
Mehrdad R, Movasatian F, Momenzadeh AS. Fitness for work evaluation of firefighters in Tehran. Acta Medica Iranica 2013;51:265–9.
Santora LJ, Pillutla P, Norris T, et al. Coronary calcium scanning independently detects coronary artery disease in asymptomatic firefighters: A prospective study. J Cardiovasc Comput Tomogr 2013;7:46–50. DOI: https://doi.org/10.1016/j.jcct.2012.07.003
Glueck CJ, Kelley W, Gupta A, et al. Prospective 10-year evaluation of hypobetalipoproteinemia in a cohort of 772 firefighters and cross-sectional evaluation of hypocholesterolemia in 1,479 men in the National Health and Nutrition Examination Survey I. Metabolism 1997;46:625-33. DOI: https://doi.org/10.1016/S0026-0495(97)90004-4
Smith DL, Graham E, Stewart D, Mathias KC. Cardiovascular disease risk factor changes over 5 years among male and female US firefighters. J Occup Environ Med 2020;62:398-402. DOI: https://doi.org/10.1097/JOM.0000000000001846
Nor N, Lee CJ, Park KS, et al. The risk of mortality and cardiovascular disease is increased in firefighters with elevated blood pressure compared to the general population. J Hypertension 2019;37:e11. DOI: https://doi.org/10.1097/01.hjh.0000570476.35662.28
Soteriades ES, Hauser R, Kawachi I, et al. Obesity and risk of job disability in male firefighters. Occup Med 2008;58:245–50. DOI: https://doi.org/10.1093/occmed/kqm153
Reinberg AE, Smolensky MH, Riedel M, et al. Do night and around-the-clock firefighters’ shift schedules induce deviation in tau from 24 hours of systolic and diastolic blood pressure circadian rhythms? Chronobiol Int 2017;34:1158-74. DOI: https://doi.org/10.1080/07420528.2017.1343833
Jang TW, Jeong KS, Ahn YS, Choi KS. The relationship between the pattern of shift work and sleep disturbances in Korean firefighters. Int Arch Occup Environ Health 2020;93:391–8. DOI: https://doi.org/10.1007/s00420-019-01496-3
Choi BK, Steiss D, Garcia-Rivas J, et al. Comparison of body mass index with waist circumference and skinfold-based percent body fat in firefighters: adiposity classification and associations with cardiovascular disease risk factors. Int Arch Occup Environ Health 2016;89:435-48. DOI: https://doi.org/10.1007/s00420-015-1082-6
Leary DB, Takazawa M, Kannan K, Khalil N. Perfluoroalkyl Substances and metabolic syndrome in firefighters: A pilot study. J Occup Environ Med 2020;62:52–7. DOI: https://doi.org/10.1097/JOM.0000000000001756
Clark S, Rene A, Theurer WM, Marshall M. Association of body mass index and health status in firefighters. J Occup Environ Med 2002;44:940-10. DOI: https://doi.org/10.1097/00043764-200210000-00013
Muegge CM, Zollinger TW, Song Y, et al. Barriers to weight management among overweight and obese firefighters. J Occup Environ Med 2020;62:37-45. DOI: https://doi.org/10.1097/JOM.0000000000001751
Jahnke SA, Poston WSC, Haddock CK, et al. The health of women in the US fire service. BMC Womens Health 2012;12:39. DOI: https://doi.org/10.1186/1472-6874-12-39
Yoo HL, Franke WD. Prevalence of cardiovascular disease risk factors in volunteer firefighters. J Occup Environ Med 2009;5:958–62.
Lima E de P, Assunção AÁ, Barreto SM. [Smoking and occupational stressors in firefighters, 2011].[Article in Portuguese]. Rev Saude Publica 2013;47:897-904.
Cohen HW, Zeig-Owens R, Joe C, et al. Long-term cardiovascular disease risk among firefighters after the World Trade Center disaster. JAMA Network Open 2019;2:e199775. DOI: https://doi.org/10.1001/jamanetworkopen.2019.9775
Burgess JL, Kurzius-Spencer M, Gerkin RD, et al. Risk factors for subclinical atherosclerosis in firefighters. J Occup Environ Med 2012;54:328–35. DOI: https://doi.org/10.1097/JOM.0b013e318243298c
Jitnarin N, Poston WS, Haddock CK, et al. Tobacco use pattern among a national firefighter cohort. Nicotine Tob Res 2015;17:66–73. DOI: https://doi.org/10.1093/ntr/ntu131
Coker RH, Murphy CJ, Johannsen M, et al. Wildland firefighting: Adverse influence on indices of metabolic and cardiovascular health. J Occup Environ Med 2019;61:E91-4. DOI: https://doi.org/10.1097/JOM.0000000000001535