By Brian Ward
We have all known for quite some time the hazards of firefighting. These hazards include everything from the smoke we breathe to our heart rate elevating from 60 to 120 in a matter of seconds. Ask firefighters what cardiac concerns they have, and the majority of them will list several without stopping to think. The fire service as a whole has continuously addressed these concerns by distributing information and raising awareness. The most notable examples include the International Association of Fire Chief’s Fire/EMS Safety, Health, and Survival Week; the National Fallen Firefighters Foundation’s “Everyone Goes Home” program; and even Fire Engineering’s devoting one theme a year—in the December issue—to firefighter health. However, this problem remains the number one killer in the fire service. It does not quite seem to sink in unless it affects us or a colleague.
In 2003, members of the Gwinnett County (GA) Fire and Emergency Services (GCFES) received a severe blow when we suffered the loss of one of our own. While operating on the roof during a commercial structure fire, Lieutenant Bobby Patrick suffered a fatal heart attack. He was a well-respected and healthy 53-year-old firefighter with no known cardiac disease. Having his photo hanging in every firehouse and having a neighborhood elementary school named after him serve as reminders of what can happen in this occupation even when everything else is going right. No fire department wants to experience this and its impact—which reaches from the crew to the family to the morale of the entire department. In response, the GCFES Command Staff and Retired Chief Steve Rolader began establishing parameters to prevent the repeat of such an incident.
FIREFIGHTER HEART STUDY
In 2008, the GCFES received a federally funded grant for the Firefighter and Heart Disease Program Study. H. Robert Superko, MD, FACC, executive director for the Translational Research Institute and Center for Genomics and Human Health at Saint Joseph’s Hospital in Atlanta, Georgia, oversaw the research. The effort began as an attempt to develop and conduct research studies that identify patients’ genetic susceptibility to heart disease, cancer, and other chronic disease states and, most importantly, translate those findings into individualized treatment programs based on the person’s unique genetic makeup. Nicolas Chronos, MD, president of the Translational Research Institute, describes an interesting aspect of this research as being able to develop future treatment protocols that are tailored specifically for an individual’s genetic makeup and the makeup of his specific disease.
The research group was comprised of 300 volunteers over the age of 36 who performed firefighting operations. Superko and his colleagues performed a free comprehensive cardiac exam on each individual. He was looking specifically at newly identified KIF6 (statin responsiveness gene); 9p21 (myocardial infarction gene); advanced phenotype (blood); and imaging analyses, diet, and exercise review over the year-long study. Every individual received the results and a consultation with St. Joseph’s doctors and nurses. Also, any individual identified as being in the top 50 percent risk category was immediately notified.
PRELIMINARY RESULTS
After reviewing the results, Superko estimated that firefighters are at a 300 percent increased risk over the average citizen of developing cardiac disease. He said, “Preliminary findings show that one-third of firefighters had heart disease that is unrelated to traditional risk factors, such as high cholesterol. Those results are astounding and point at job duties and environment as the primary determinants for early death in our country’s first responders.” He continued, “Stress and psychological pressures related to the job, as well as diet, exercise issues, and inherent personality, interacting with a genetic predisposition to heart disease, probably have tremendous impact on the risk of heart attack in these first responders.” Superko hoped to unveil further analysis of his results at the Annual American Heart Association (AHA) meeting in November (after press time).
THREE FIREFIGHTERS SAVED
More important than any other results from this study, the study saved the lives of three firefighters. During the extensive cardiac exams, these individuals were identified as needing immediate surgical intervention. These were not long-term problems that might develop within a matter of months or years but rather hours and days. The doctors were able to prevent further heart damage and extend the lives of these individuals. This was an eye-opening experience for many people, including me. However, to look around my department and to think for just a moment that three of my fellow firefighters may not be here today is quite disturbing. The thought hits very close to home when you put it that way.
Many departments have lost firefighters to cardiac disease, as it is the most frequent cause of line-of-duty deaths in the fire service. How many other firefighters are in this same position right now but do not realize it? How many firefighters do you know who have missed enjoying retirement past their first year because of cardiac disease?
PREVENTION
Knowing these concerns and the hazards that firefighters face, the GCFES developed the Fire Fit Living Committee to aid in developing incentives and programs for employees. The incentives have included reimbursements for gym memberships, workout equipment in each station, and the monthly newsletter “The Risk Factor.” A Web page of the county Web site has been dedicated to Fire Fit Living and topics such as motivation, nutrition, resources, stress management, success stories, exercise and fitness, and health and wellness.
In addition, regular programs such as Lunch and Learn have been established. At Lunch and Learn, guest speakers cover health topics during a catered healthy snack or lunch. A Risk Management Division has been established to cover a wide array of topics and includes a certified personal trainer to offer workout and nutrition advice. In addition, several personal trainers are spread throughout the department. Another aspect of the Risk Management Division and directly related to Superko’s earlier comments is the implementation of our critical incident stress debriefing team. The team assists firefighters with reducing stress and handling the psychological demands of the occupation.
Department members are also encouraged to participate in our Annual 5-Alarm 5K run/walk and other nearby competitions. One of these competitions, Climb Atlanta, is hosted by the American Lung Association every year in downtown Atlanta. Usually several firefighters compete as a team and individually in the timed 50-story climb to the top. Last year, the number of individuals wishing to compete was overwhelming. In response, Chief Bill Myers and our command staff backfilled the stations to allow these individuals time off to compete. In addition, the entire department receives health-related materials for participating in the Fire/EMS Safety, Health, and Survival Week.
All of these items are great incentives for our employees, but the fire station is not the only place where people need to be more health conscious. In recruit school, where the minds are still impressionable, health consciousness needs to be a major focus. Physical training with regularly scheduled cardiovascular workouts and CrossFit (www.crossfit.com) exercises are also integrated into the Recruit Program. Lectures are given on proper eating habits, firefighter health issues, and achieving a more healthful lifestyle.
If you would like to start some form of a health initiative in your department, there are numerous resources available. Ask your AHA representative for information specifically for first responders. The National Volunteer Fire Council has established www.Healthy-Firefighter.com, which has incentive programs such as the Fired Up for Fitness Challenge. For additional resources, go to www.FireserviceSLT/resources.com, and scroll down to the “Health” subtitle.
THE BOTTOM LINE
The bottom line is that we need to take care of ourselves. Firefighting is dangerous enough without our adding additional hazards. Take the initiative to live a more healthful life—if not for yourself then for the individuals in your life who matter the most to you: the little ones at home, your spouse, and your family at the firehouse.
Picture the absence of three fellow firefighters from your firehouse. Would your life be altered by one of those deaths? Maybe it’s the lieutenant you respect or the driver who doesn’t need a map book or the firefighter you can always depend on to be there. How different would your life be? Take care of yourself. Start with a checkup. Eat healthy and work out a little. That’s not asking too much.
REFERENCES
“International Leader in Genomics, Predictive Medicine Joins Saint Joseph’s.” (Saint Joseph’s Hospital, December 2007). Retrieved June 7, 2009, from Http://www.stjosephsatlanta.org/news/12-03-07-Superko-joins-Saint-Josephs.html.
“Landmark FEMA Study: Heart Disease Is an Epidemic for Firefighters.” (Fire Engineering, March 2009). Retrieved August 15, 2009, from http://emberly.fireengineering.com/display_article/356530/25/none/none/HLTHS/Landmark-FEMA-study:-Heart-disease-is-an-epidemic-for-firefighter.
BRIAN WARD is a training officer in the Gwinnett County (GA) Fire and Emergency Services Career Development Division and the chairman of the Metro Atlanta Training Officers. He is a State of Georgia advocate for “Everyone Goes Home.” He has an associate degree in fire science and is pursuing his bachelor’s degree with the University of Cincinnati. He is also the founder of FireServiceSLT.com.
