Firefighters are at increased risk for cardiovascular events, which cause almost half of firefighter line-of-duty deaths. As an EMS provider, know what to look for when treating firefighters, encourage your fellow public safety colleagues to get screened for cardiovascular disease, and take steps in your own fitness and health to stay response ready.
By Michele Ice, contributor to In Public Safety
Firefighters are tough, but so are the challenges we face day after day in modern firefighting. It is crucial every firefighter understands the risks of the job so we can maintain optimal health to provide the best care for our communities. The reality is, cardiovascular events cause almost half of all on-duty firefighter deaths each year. The leading causes of firefighter injuries are overexertion, stress and medical issues.
The personal health and safety choices we make impact our entire department, our families, and our communities. It’s up to you, as the firefighter, to stay on top of your health by attending annual health screenings including cardiac heart scans, bloodwork tests, stress tests, prostate screenings, skin cancer screenings, and so on. Some departments have made it a priority to offer yearly firefighter physicals through the NFPA 1582. This measure can help detect any medical issues early, but firefighters also need to make conscious decisions to improve their health as their lives depend on it!
Risks to firefighter health
There are several factors that put firefighters more at risk than the regular citizen:
- Harsh work environments with excessive heat and dense, toxic smoke.
- Extreme physical challenges while wearing 70lbs of equipment.
- Thermoregulatory demands and risk of hyperthermia during firefighting tasks.
- Long hours and shift work can lead to sleep deprivation.
As a result of the physical demands on their bodies, firefighters may develop obesity, hypertension, diabetes and high cholesterol. They may also turn to unhealthy habits such as smoking or using tobacco products and excessive alcohol consumption.
Studying cardiovascular risks to firefighter health
In 2013, several firefighters from the Cobb County (Ga.) Fire and Emergency Services, among other firefighters, participated in a study on “Cardiovascular and Chemical Exposure Risks in Modern Firefighting.” The study was conducted through partnerships and collaboration between the Illinois Fire Service Institute, UL Firefighter Safety Research Institute, National Institute for Occupational Safety and Health, Globe Manufacturing Company, and U.S. Department of Homeland Security Federal Emergency Management Agency Assistance to Firefighters Grants Program.
The researchers realistically, yet safely, recreated firefighting tasks within a controlled environment to assess cardiovascular risk factors. They used modern building materials and room contents and employed real firefighters who executed common tactics, techniques, and procedures of entry, search, extinguishment, ventilation and overhaul.
The results indicated that exterior firefighting (e.g., ladders, pumping, ventilation, etc.) took the greatest toll on the firefighter’s pulse, blood pressure and body temperature. Interior firefighting and search and rescue did not have as major of an impact on these issues. This study is a valuable step toward helping firefighters and their departments better understand and address the current hazards in modern firefighting.
Cardiovascular disease took one of our own
On Mar. 12, 2018, Cobb County Fire and Emergency Services suffered our first line-of-duty death in more than 26 years. This wasn’t a case of “Oh, I saw that coming.” This was a vibrant, athletic and healthy woman who was only 44 years old.
Firefighter Stacey Boulware was at the top of her career. She had been a firefighter for more than 19 years, served on our Hazardous Materials team for more than 10 of those years, and she was an avid tennis player and ballroom dancer. According to her sister, her only medical issue was recent high cholesterol that she was trying to treat through diet and exercise.
So what happened to Stacey on that Monday in March? She had successfully completed her yearly Physical Agility Test (PAT) at our training center earlier that morning, returned to service, and responded to a motor vehicle crash with injuries followed by a cardiac arrest call. When Stacey was driving the rescue vehicle back to the station, she started getting agitated and told her paramedic partner that she wasn’t feeling well. After her crew hooked her up to a heart monitor and was getting ready to start an IV, Stacey went into cardiac arrest. They did as much as anyone could, giving her the right care and treatment, but Stacey had suffered a 100 percent blockage in her artery, and was pronounced deceased at a local hospital.
How could this happen to a healthy firefighter? We may never know the answer, but the incident has changed our department. On weekends, some crews in Stacey’s battalion concentrate on gear workouts at the station in memory of her. She was always pushing herself to be the best firefighter and always worked out with her crew. Firefighters need to stress the importance of healthy foods, healthy habits and strength and cardiovascular training. If we work together as a team, we can protect our communities, live long and healthy lives, and enjoy our retirements.
Early detection has saved lives
After Stacey’s death, I reached out to a local doctor who provides NFPA 1582 firefighter physicals to local departments. He was sorry to hear about Stacey’s death and said ALL firefighters should have cardiac heart scans to check for excessive plaque buildup in arteries and for other issues. Most insurance companies will not cover this, but we were able to call around the metro-Atlanta area and get discounted scans for our firefighters.
Out of the 150 scans that I know were carried out, two firefighters were saved by early detection of heart valve disorders and one firefighter was diagnosed and operated on for early pancreatic cancer. Even though Stacey is no longer with us, she is still saving lives.
As I’ve worked on this article, firefighters began contacting me to share their “cardiac stories.” It is scary how many stories there are out there, but I’ve heard the same message multiple times: “If my story can help prevent or postpone this happening to someone else, then please share it.”
One of the firefighters saved by a heart scan is only 45 years old, works out every day, and thought he was in great health. He completed his heart scan and then went to work out like normal. Three days later, his doctor’s office called and said he needed to see a cardiologist ASAP. The heart scan showed he had an aortic aneurysm, which involved his ascending aorta as well as the aortic root. He immediately had open heart surgery to repair his heart. Paying the $99 out of pocket for the scan had literally saved his life. His cardiologist told him that the condition usually doesn’t show any warning signs before rupturing. He strongly encourages all firefighters over the age of 40 to go have a heart scan.
Last, but not least, in 2015, I received the dreaded call from my husband’s fire chief. While on duty, he had started experiencing chest pain and, after 26 years as a paramedic, he knew it was the “real deal.” He asked his partner to get the Nitro spray and baby aspirin and treated himself. He was able to make it back to the fire station to get his officer/paramedic and they transported him to the hospital. After having a heart catheter done, they were able to determine that he had a 95 percent blockage to his left anterior descending artery (a widow maker heart attack). They were able to successfully place a stent and he immediately started feeling better.
How did this happen? Though hee still attended his routine annual NFPA 1582 physicals, my husband had untreated hypertension, untreated high cholesterol, and high triglycerides.
Firefighters are solely responsible for their own health, diet and exercise. The NFPA physicals are crucial for early detection, but firefighters still need to follow up with a primary care doctor annually.
Reducing risk of cardiovascular disease
So how can we decrease risk of cardiovascular diseases and line-of-duty deaths among firefighters? Every department and every firefighter must:
- Make health and fitness as much of a priority as tactical training (e.g., mayday, VEIS, hose streams).
- Promote team/crew accountability for fitness by working out as a group and encouraging each other.
- Make small, positive changes to nutrition and hydration (e.g., have one less soda or energy drink a day, one extra glass of water a day, or add more fruit and vegetables to your diet).
- Consider yourselves “Fire Rescue Athletes” and strive to be in the best shape of your lives.
- Include cardiovascular exercises in your workouts: jogging, brisk walking, cycling, stair climbing, rope skipping, aerobics, cross country skiing, swimming, rowing, etc.
Firefighters love to help others and are dedicated to saving lives, so now it’s time to take care of ourselves and our crews so we can be “firefighter ready” when the alarm sounds! If we’re not ready to do our best, how can we protect our communities?
About the author
Michele Ice has been a firefighter for over 25 years with Cobb County (Ga.) Fire and Emergency Services. She is currently assigned as firefighter II at Truck Company 13 in West Cobb. Michele is also a CPR/first aid instructor, Community Emergency Response Team (CERT) Instructor, child safety seat technician instructor, hazardous materials technician, Firefighter Cancer Support Network state director, Critical Incident Stress Management (CISM) state team member, Fire Explorer advisor and on the GEMA Incident Management Type III Team.
She is a wife and mother of two (Denver, 18; and Brooke, 20). Both her husband and daughter are career firefighters with Cherokee County (Ga.) Fire and EMS, and her son is a fire explorer. To contact the author, email IPSauthor@apus.edu. To receive more articles like this in your inbox, please sign up for In Public Safety’s bi-monthly newsletter.
