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. 2015 Sep-Oct;30(5):440-6.
doi: 10.1097/JCN.0000000000000165.

The Prevalence of Clinical and Electrocardiographic Risk Factors of Cardiovascular Death Among On-duty Professional Firefighters

Salah S Al-Zaiti  1 , Mary G Carey
Affiliations

The Prevalence of Clinical and Electrocardiographic Risk Factors of Cardiovascular Death Among On-duty Professional Firefighters

Salah S Al-Zaiti et al. J Cardiovasc Nurs. 2015 Sep-Oct.

Abstract

Background: Firefighters have twice as many cardiovascular deaths as police officers and 4 times as many as emergency medical responders. The etiology for this high rate of mortality remains unknown. The electrocardiogram (ECG) is a widely used tool to screen populations at risk, yet there are no available on-duty, high-resolution ECG recordings from firefighters.

Objective: We sought to evaluate the prevalence of clinical and ECG risk factors among on-duty professional firefighters during 12-lead ECG holter monitoring and exercise stress testing.

Methods: Firefighters were recruited from Surveying & Assessing Firefighters Fitness & Electrocardiogram (SAFFE) study. This descriptive study recruited firefighters from 7 firehouses across Upstate New York who completed on-duty 24-hour Holter ECG monitoring and a standard exercise stress test. All analyses were completed by a reviewer blinded to all clinical data.

Results: A total of 112 firefighters (mean [SD] age, 44 [8] years; mostly white men) completed the study. Although all firefighters were in normal sinus rhythm, more than half of them had at least 1 high-risk ECG risk factor present, including abnormal sympathetic tone (elevated heart rate, 54%), abnormal repolarization (wide QRS-T angle, 25%), myocardial scarring (fragmented QRS, 24%), and myocardial ischemia (ST depression, 24%). Most firefighters tolerated the treadmill exercise stress test well (metabolic equivalent tasks, 11.8 + 2.5]); however, almost one-third had abnormal results of stress tests that required further evaluation to rule out subclinical coronary artery disease.

Conclusions: Among on-duty professional firefighters, high-risk ECG markers of fatal cardiac events and abnormal stress test results that warrant further evaluation are prevalent. Annual physical checkups with routine 12-lead ECG can identify those who might benefit from preventive cardiovascular services.

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Conflict of interest statement

No Conflict of Interests

Figures

Figure 1
Figure 1. Resting 12-Lead ECG in a Professional Firefighter while on duty
(A) Shows the baseline ECG of 44 year-old white male at the beginning of holter monitoring; (B) Shows the ST segment changes during a response to a fire call.
Figure 2
Figure 2. Prevalence of High-Risk ECG markers among firefighters
This figure shows the prevalence of high-risk ECG markers of cardiac death among professional firefighters.
See this image and copyright information in PMC

References

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    1. Carey MG, Al-Zaiti SS, Dean GE, Sessanna L, Finnell DS. Sleep Problems, Depression, Substance Use, Social Bonding, and Quality of Life in Professional Firefighters. Journal of Occupational and Environmental Medicine. 2011;53:928–933. - PMC - PubMed
    1. Al-Zaiti S, Runco K, Carey M. Increased T-Wave Complexity Can Indicate Subclinical Myocardial Ischemia in Asymptomatic Adults. Journal of Electrocardiology. 2011;44:684–688. - PMC - PubMed

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