This is the last column in a series devoted to addressing the number-one killer in firefighters: heart disease. Previously, we discussed why firefighters are at a higher risk of cardiac death, why firefighters with underlining cardiovascular disease are at the most risk of suffering a cardiac...
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This is the last column in a series devoted to addressing the number-one killer in firefighters: heart disease. Previously, we discussed why firefighters are at a higher risk of cardiac death, why firefighters with underlining cardiovascular disease are at the most risk of suffering a cardiac line-of-duty death (LODD), and we reported on obesity in firefighters and increasing awareness of non-specific symptoms of cardiovascular disease.
The presence of cardiac risk factors in firefighters also can be used to predict other cardiovascular diseases such as blocked arteries in the carotid arteries of the neck leading to stroke or in the legs leading to pain and amputations. Earlier, we discussed how identifying firefighters with cardiac risk factors through annual exams and implementing risk-factor reduction strategies can reduce firefighters' overall risk of cardiac death. This column will cover implementing a comprehensive medical program to address all aspects of cardiovascular health.
Annual exams are only one component to a medical program. It is an important first step to identify firefighters at risk and to start medical interventions to help control cardiac risk factors. This will allow firefighters at risk to follow-up with their doctors to monitor their cardiac risk factors and adjust the therapeutic regimens accordingly. Larger departments with occupational physicians may opt to have their firefighters follow up with the department physicians, ensuring continuity of care. This approach ensures that firefighters will receive the follow-up they need.
Smaller departments with fewer resources may recommend that their firefighters see their own doctors for further management of cardiovascular disease risk factors. The individual firefighter must schedule their own doctors' visits and be compliant with risk-factor reduction strategies regardless of who manages the condition. Firefighters must show up for appointments, follow lifestyle recommendations and take their medications as prescribed. Fire department leadership may motivate firefighters to comply with all of the above if the seriousness of non-compliance is conveyed. If you don't follow the plan, you are at higher risk for becoming suddenly incapacitated at a fire. You may be jeopardizing yourself as well as your fellow firefighters.
Volunteer firefighters may only serve if physically fit. There is no legal right to perform firematic duty if not medically qualified. The physically demanding job requirements cannot be ignored and the law says one must be capable of the tasks to participate. Use the information provided in this series of columns to impress on your firefighters the importance of following these recommendations.
A comprehensive medical program includes lifestyle modifications. Lifestyle adjustments are the first step to reducing important cardiac risk factors such as high blood pressure and cholesterol levels. Lifestyle adjustments include eating a heart-healthy diet and performing cardiovascular exercise.
A heart-healthy diet consists of a low-fat, low-sodium diet rich in whole grains, fruits and vegetables. Anyone who has been around the fire service knows that firehouse meals are not always the lightest. However, one study demonstrated that firefighters were unsure of the components of a heart-healthy diet and a majority of the firefighters wanted to know more about it. We recommend having a registered dietitian give a lecture at the firehouse with handouts on heart-healthy diet information as a good first step. The dietitian may critique the current menu and provide sample meal plans to improve the firehouse diet.