Heart Disease & NIOSH

Heart attacks claim 44% of fire service line-of-duty deaths nationwide. This NIOSH Study  gives a pretty solid breakdown of the problem, detailing several factors unique to the fire environment we work in. Beyond all of the normal Coronary Artery Disease (CAD) risk factors; hypertension, hip-waist ratio, insulin resistance, age, physical inactivity, and high ratio of triglycerides to HDL cholesterol, it seems that exposure to carbon monoxide, hydrogen cyanide, and particulate matter in smoke further increase the likelihood of us kicking the bucket.

“Cardiac and Cardiovascular Effects Associated with Fire Smoke

Fire smoke is complex mixture of heated gases, vapors, and particulate matter. The composition of the smoke is determined not only by the fuel source, but also by fire conditions (e.g. oxygen availability, temperature, etc.) [Kulig 1991; Levin 2005]. While hundreds of decomposition products are found, two of the more common and well known gases with cardiovascular effects are carbon monoxide and hydrogen cyanide.”

“If inhaled, carbon monoxide disrupts the blood’s transport of, and intracellular use of, oxygen [Ernst 1998]. The resulting hypoxia can cause myocardial injury [Satran 2005].”


“Like carbon monoxide, hydrogen cyanide disrupts the intracellular use of oxygen, resulting in intracellular hypoxia with cardiac manifestations [Purser 1984].”


“For example, long-term repeated exposure to elevated concentrations of particulate matter has been associated with cardiovascular mortality and the initiation/progression of atherosclerosis [Dockery 1993; Pope 2002, 2004]. In addition, short-term exposure to fine particulates has been associated with triggering heart attacks, particularly among people with pre-existing heart disease [Peters 2001; Pope 2006]. These findings have implications for the fire service given fire fighters’ exposure to fire smoke particulate matter [Treitman 1980].”

You would think that members of the fire service, being subject to all of the factors above, would generally take whatever action they could to counter the impending doom of heart disease. Unfortunately almost the exact opposite is true. What we have fostered instead is a culture of adrenaline junkies and Post Traumatic Stress cases that, off duty, fill their lives with bad food, poor sleep, alcohol, tobacco, and other indulgences often at odds with our health.

The NIOSH article does a good job of pointing out the risk factors but it tends to place blame on the departments wellness program or lack there of. It also points out in the case studies that Over half of these fire departments (61/105 or 58%) allowed the fire fighter’s personal physician to make the return-to-work determination.” citing that the use of personal physicians can be problematic because of their lack of knowledge related to the demands of the job.

While I am a fan return-to-work physicals, I do not believe that any policy or standard can take the place of personal responsibility.

By “personal responsibility” I mean each of us being responsible to know our job, know our physical/mental capacities. Be responsible for our own health, take control and reduce as many risk factors as we can. That means making the effort to improve your diet, exercise, sleep habits, and overall lifestyle. Don’t wait for someone to make it a standard or policy; don’t wait for new dietary recommendations from whatever acronym you hold sacred, AHA can’t even decide how to do CPR consistently imagine how accurate their nutritional information is.

Go to your Doc and get some blood work done, make a conscious decision to fix any issues that may arise. Look to lifestyle changes, diet, sleep, exercise, and stress regulation before you look to pharmaceuticals for solutions.  


2 Responses to Heart Disease & NIOSH

  1. Jamie Harvey says:

    I can’t say enough about how impressed I am with the Fit for Duty web site, I’m equally as impressed with your personal fitness level regarding your ‘FRAN’ video, time in 8+ min with full turnouts, that’s awesome & crazy. I can’t wait to read more of your articles especially if you have any regarding fitness for older Firefighter’s and staying healthy through retirement.

    Engineer Jamie Harvey
    Redding Fire Department

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