Cardiovascular Disease in Firefighters

Informational Research Essay Research & Writing Health Sciences ENG 1121 Cardiovascular Disease in Firefighters

Firefighting uses techniques and equipment to extinguish fires, protect and limit damages to valuables, assist in other emergencies and ultimately save lives. The main basis in firefighting is to extinguish the fire by removing one or more of the three components that causes combustion, which are: heat, oxygen or fuel. The modernization of industrialized life has required firefighters to become more trained and physically fit to operate existing technologies and protection against prominent health hazards.

In this essay, I will be discussing the three long term health risks of Firefighters: high-stress, cardiovascular risks, and cardiovascular disease associated with firefighting. There are many factors that contribute to the risk of cardiovascular disease in firefighters. “The trend over the last 20 years for percent of deaths due to some form of cardiovascular disease has ranged from approximately 35% to 53% of all deaths”, (Pendergast, 2004, p. 6) in firefighter fatalities. CVD affects the cardiovascular system; hindering the normal functions of the heart, brain and other vital organs.

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In most instances, ischemia and hypoxemia are the main causes of CVD. Ischemia is the insufficient blood flow in providing adequate oxygenation to vital organs, thus, in turn, causes hypoxemia (low blood oxygen) and tissue hypoxia. When tissue hypoxia occurs in the heart, arrhythmia (fibrillation of the heart) is likely to occur, followed by a myocardial infraction. In some cases, ischemia does not need to be a contributing factor for CVD, for example, anemia (lack of healthy red blood cells) may be more prevalent than ischemia.

Due to the amount of risk factors researched, risk factors were categorized into three parts; Personal (advancing age, gender, underlying health conditions, hypertension, smoking, sleep disorders, obesity and lack of exercise), workplace factors (exposure to toxic emissions, heat stress, physical exertion and noise exposure), and Physical & Psychological stressors (work environment factors, environmental hazards and psychological stress). Out of all the personal factors listed, smoking, obesity and lack of exercise seem to be the more prevalent factors to increase firefighter’s susceptibility to CVD.

Smoking in general has always been used by the public as a way to cope with stress. Being that firefighting is one of the most stressful jobs in North America, smoking is likely to be a coping mechanism for firefighters, thus, adding the CVD risk by twofold. “Smokers have been shown to have elevated carbon monoxide levels in their blood and this is known to lead to chronic artery obstruction. ” (Pendergast, 2004, p. 23) Additional factors are, obesity and a lack of exercise. “The prevalence of obesity and high total cholesterol levels were higher in firefighters, relative to the general population. (Byczek, 2004, p. 67) The physical and hazardous demands for firefighting requires a high level of physical fitness, as well as physical strength and agility.

Furthermore, they must wear heavy personal protective equipment and carry tools through intense heat. At any scene, there’s always a level of danger that the firefighters keep in mind. Dangers include the possibility of exposure to toxic materials and gases. “Self-contained breathing apparatus use has reduced, but not eliminated chemical exposures including carbon monoxide, particulates and other toxicants. (Kales, 2004, p 68) Exposure to high levels of carbon monoxide reduces oxygen delivery to the heart. When attacking a fire, heat stress and physical exertion are two of the most common factors that contribute to CVD risk. “Heat stress and fluid losses can result in decrease in the cardiac output despite sustained tachycardia. ” (Kales, 2003) Blood flow decreases as the body attempts to cool down by expanding the capillaries, allowing more blood to surface to the dermis. This action cause low pressure, while the heart struggles to compensate by beating rapidly.

Firefighters are stressed by their own station environment, their protective gear, their officers and leaders, current management style, coworkers, and the stress of leaving their family and loved ones during natural and manmade disasters. ” (Shantz, 2002 p3) Stress plays a crucial CVD risk factor, yet, there are two distinct types of stress that affects firefighters. Work environment factors affect firefighters psychologically; whereas environmental hazards cause physical stress. Traumatic events of critical incidents are experienced by everyone at least one time in their lives.

After an incident, people may experience strong emotional and physical reactions. These reactions are quite common and may take weeks or months to recover. But with firefighters, traumatic events are more common, and emotional aftershocks tend to build up overtime without given time to “rest up”. When left untreated, it cause post-traumatic disorder, which can play a significant role in the risk of CVD. Environmental hazards are the hazards that affect firefighters physically by situations on the fire ground.

Hazards include heat stress and intense physical exertion. A combination of heat stress amd excessive physical strain causes an inadequate oxygenation of the blood, the body releases erythropoietin to create more red blood cells, in turn, counteracts the inadequacy of oxygen in the blood. This homeostasis reaction cause polycythemia when the firefighter is at rest. Polycythemia is a blood disorder that causes blood flow to decrease due to an increase of red cell production. Symptoms include weakness, fatigue, headache, itching, joint pain and dizziness.

The prevalence of high stress in firefighters has been found to be directly co-related to the cardiovascular risks that are prominent in firefighting activities. Men and woman in firehouses across North America; paid, on-call and career, endure many different forms of occupational stress. Yet, the lack of physical fitness among firefighters is the leading cause of cardiovascular disease.

References

• Byczek, L. , Walton, S. , Conrad, K. , Reichelt, P. , & Samo, D. (2004). Cardiovascular risks in firefighters: implications for occupational health nurse practice. AAOHN Journal, 52(2), 66-76.
• Kale, S. N. Soteriades, E. S. , Christoudias, S. G. , & Christiani, D. C. (2003, September). Firefighters and on-duty deaths from coronary heart disease: a case control study.
• Boston, MA: The Cambridge Health Alliance. Retrived, March 28, 2013 from http://www. ehjournal. net/content/2/1/14 Pendergast, D. A. (2004). The leading cause of death of American firefighters in the 21st century: a study of the impact of occupational stress on cardiovascular disease.
• East Derry Fire Department. Shantz, M. C. (2002). Effect of work related stress on firefighter/paramedic. Eastern Michigan University School of Fire Staff and Command.Retrived, March 28, 2013 from http:// http://www. emich. edu/cerns/downloads/papers/FireStaff/Stress,%20Fitness,%20Wellness/Effect%20of%20Work%20Related%20Stress%20on%20the%20Firefighter%20Paramedic. pdf
• Staley, J. A. , Weiner, B. , & Linnan, L. (2011). Firefighter fitness, coronary heart disease, and sudden cardiac death risk.
• American Journal Of Health Behavior, 35(5), 603-617. Sweeney, P. (2012). Firefighters at risk ~ The negative effects of stress and trauma on the human spirit. The Sweeney Alliance, 19. Retrived from http://sweeneyalliance. org/grievingbhindthebadge/firefighters-at-risk/

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