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(Reuters Health) – A recent study suggests that most firefighters who die from cardiac arrest show narrowing of the heart arteries or structural damage in their heart.
When firefighters suddenly become unable to work, it puts their lives at risk. Researchers note in the Journal of the American Heart Association that it can also put lives in danger because it is about saving people from burning buildings or extinguishing flames.
Despite this obvious risk, research to date has failed to understand why so many firefighters killed at work die of cardiac arrest rather than fire-related injuries.
"Fire department statistics have long indicated that sudden cardiac events are the leading cause of death in service for firefighters," said study leader Denise Smith. Research shows that firefighters are more likely to suffer a heart event after being a firefighter than when they were on duty, said Smith, who heads the First Responder health and safety laboratory at Skidmore College in Saratoga Springs. New York.
To see why these heart-related deaths occur, researchers examined autopsy data from 627 firefighters between the ages of 18 and 65, who died between 1999 and 2014, including 276 heart cases and 351 trauma cases.
Surprisingly, less than one in five heart cases was fatal, Smith said via email.
Instead, 82% of those who died had signs of coronary heart disease – narrowing of the heart arteries – or enlarged hearts.
The study found that the risk of sudden cardiac death was multiplied by six or that the risk of sudden death was at the origin of a heart attack, while a coronary artery narrowed to 75% was associated with a nine-fold increase in heart rate. risk.
Although the study does not reveal whether firefighter work could improve the likelihood of heart disease, several aspects of the work could explain this connection, Smith said.
Exposure to smoke, soot and chemicals in the air, as well as sleep disturbances and high levels of work stress could contribute to heart problems, Smith said.
It is unclear whether the risk of heart disease among firefighters is higher or lower than that of other people working in different fields. "However, research clearly shows that the stress of firefighting – intense muscular work, thermal stress, activation of the sympathetic nervous system and exposure to smoke – can trigger a cardiac event. in people with an underlying disease, "Smith said.
One of the limitations of the study is that autopsies do not have uniform descriptions of heart disease or criteria for defining an enlarged heart, the authors note. The researchers also lacked data on some risk factors for heart disease such as smoking or hypertension.
Still, the findings offer further evidence of the dangers of stressful and physically demanding jobs for people with underlying heart conditions, noted Dr. Stefanos Kales, a researcher at Harvard Medical School and at the not involved in the US. study.
"Essentially, for people who have developed underlying heart disease, it is dangerous to perform heavy work, especially in stressful situations that cause a rush of epinephrine and related hormones. that challenge the cardiovascular system ".
"Therefore, although firefighter screening is traditionally focused on coronary heart disease (heart risk factors and stress tests), it should also include an echocardiogram to identify cardiac enlargement, a wall thickness Kales said.
SOURCE: bit.ly/2OkfJeI Journal of the American Heart Association, Online September 5, 2018.
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