The DOI matches its Crossref record; 130 of the 131 references it cites were found in a registry or an index.
Cardiovascular Disease in US Firefighters: A Systematic Review
Abstract
Cardiovascular disease (CVD) is the leading cause of on-duty death among firefighters (45% of on-duty fatalities) and a major cause of morbidity. CVD in the fire service also has adverse public safety implications as well as significant cost impacts on government agencies. Over the last decade, our understanding of CVD among firefighters has significantly improved and provides insight into potential preventive strategies. The physiology of cardiovascular arousal and other changes that occur in association with acute firefighting activities have been well-characterized. However, despite the strenuous nature of emergency duty, firefighters' prevalence of low fitness, obesity, and other CVD risk factors are high. Unique statistical approaches have documented that on-duty CVD events do not occur at random in the fire service. They are more frequent at certain times of day, certain periods of the year, and are overwhelmingly more frequent during strenuous duties compared with nonemergency situations. Moreover, as expected on-duty CVD events occur almost exclusively among susceptible firefighters with underlying CVD. These findings suggest that preventive measures with proven benefits be applied aggressively to firefighters. Furthermore, all fire departments should have entry-level medical evaluations, institute periodic medical and fitness evaluations, and require rigorous return to work evaluations after any significant illness. Finally, on the basis of the overwhelming evidence supporting markedly higher relative risks of on-duty death and disability among firefighters with established coronary heart disease, most firefighters with clinically significant coronary heart disease should be restricted from participating in strenuous emergency duties.
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“These physical and psychological stressors encountered every working shift have been shown to lead to increased risk for major health conditions such as cardiovascular disease, cancer, and depression [7,8,9].”
From The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review (2024) · cites this paper as [9]
Citations
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Time-Restricted Eating to Prevent and Manage Chronic Metabolic Diseases
Chaix, A., Manoogian, E. N. C., Melkani, G. C., & Panda, S. (2019) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-082018-124320 · Cited by 424
Cardiovascular Disease and Risk Factors in Law Enforcement Personnel
Zimmerman, F. H. (2012) · Cardiology in Review · doi:10.1097/crd.0b013e318248d631 · Cited by 228
Manoogian, E. N. C., Zadourian, A., Lo, H. C., Gutierrez, N. R., Shoghi, A., Rosander, A. M., Pazargadi, A., Ormiston, C. K., Wang, X., Sui, J., et al. (2022) · Cell Metabolism · doi:10.1016/j.cmet.2022.08.018 · Cited by 191
Extreme sacrifice: sudden cardiac death in the US Fire Service
Smith, D. L., Barr, D. A., & Kales, S. N. (2013) · Extreme Physiology & Medicine · doi:10.1186/2046-7648-2-6 · Cited by 180
Self-citationCardiovascular Strain of Firefighting and the Risk of Sudden Cardiac Events
Smith, D. L., DeBlois, J. P., Kales, S. N., & Horn, G. P. (2016) · Exercise and Sport Sciences Reviews · doi:10.1249/jes.0000000000000081 · Cited by 159
Self-citation
Metadata
- Authors
- Soteriades, E. S., Smith, D. L., Tsismenakis, A. J., Baur, D. M., & Kales, S. N.
- Affiliations
- Harvard University (US)
- University of Illinois Urbana-Champaign (US)
- Boston University (US)
- Cambridge Health Alliance (US)
- Corresponding author
- Soteriades, Elpidoforos S.
- Tsismenakis, Antonios J.
- Baur, Dorothee M.
- Kales, Stefanos N.
- Venue
- Cardiology in Review
- Published
- 2011-07
- Volume
- 19
- Issue
- 4
- Pages
- 202-215
- ISSN
- 1061-5377 (ISSN-L)
- OpenAlex
- W2035217542
- Cited by
- 419
- References
- 131
- Citations by year
- 2026: 17 · 2025: 26 · 2024: 38 · 2023: 44 · 2022: 37 · 2021: 30 · 2020: 39 · 2019: 34 · 2018: 29 · 2017: 16 · 2016: 17 · 2015: 18 · 2014: 33 · 2013: 21 · 2012: 15
- FWCI
- 5.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cardiology in Review (publishedVersion)
- PubMed (publishedVersion)
- Kypseli (submittedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Performance
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- cardiovascular disease, firefighters, cardiovascular risk factors, cardiorespiratory fitness, obesity, coronary artery disease, occupational health, return to work, fitness evaluation, cardiovascular arousal, CVD prevention
- MeSH terms
- Adaptation, Psychological, Cardiovascular Diseases, Dehydration, Diet, Emergency Medicine, Fires, Health Status, Hot Temperature, Humans, Hypertension, Motor Activity, Noise, Nutritional Status, Physical Fitness, Smoking, Stress, Psychological, Sympathetic Nervous System, United States, Prevalence, Occupational Exposure, Workload, Risk Assessment
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