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Lipid profile of firefighters over time: opportunities for prevention
Elpidoforos S Soteriades1, Stefanos N Kales, Dimitrios Liarokapis
1Cambridge Hospital, Harvard Medical School, Massachusetts 02139, USA.
Insights
Firefighter cholesterol levels decreased over four years, but obesity and triglyceride levels increased. Despite more lipid-lowering medication use, many firefighters still had high cholesterol without adequate treatment.
Area of Science:
- Occupational Health
- Cardiovascular Disease Epidemiology
- Biochemistry
Background:
- Heart disease is a leading cause of on-duty firefighter fatalities.
- The lipid profile of firefighters and its association with cardiovascular disease (CVD) risk factors are not well understood.
Purpose of the Study:
- To evaluate the lipid profile of firefighters in relation to other CVD risk factors.
- To track changes in lipid profiles and CVD risk factors over a 4-year period in a firefighter cohort.
Main Methods:
- A prospective study involving 321 firefighters at baseline and 285 with 4-year follow-up data.
- Analysis of lipid profiles (cholesterol, triglycerides), body mass index (BMI), and medication use.
- Comparison of baseline (1996-1997) and follow-up data.
Main Results:
- Average cholesterol levels decreased significantly from 224 mg/dL to 214 mg/dL (P < 0.0001).
- Obesity (BMI ≥ 30) increased from 34% to 40% (P = 0.008).
- High triglycerides (≥ 200 mg/dL) increased from 27% to 35% (P = 0.047).
- Use of lipid-lowering medications rose from 3% to 12% (P < 0.0001).
Conclusions:
- While firefighter cholesterol levels improved and treatment rates increased, significant challenges remain.
- Obesity and triglyceride levels worsened over the study period.
- A substantial proportion of firefighters exhibited persistently high cholesterol, with inadequate treatment observed in many.
Abstract:
Heart disease is the primary cause of on-duty deaths in firefighters, but little is known about their lipid profile. We evaluated the lipid profile in relation to other cardiovascular disease risk factors in 321 firefighters at a baseline examination. Prospective comparisons were performed for 285 firefighters, who were enrolled in a statewide medical surveillance program, and had complete follow-up data for 4 years. The average cholesterol level in firefighters declined from 224 mg/dL at baseline (1996-1997) to 214 mg/dL at the follow-up examination (P < 0.0001). Conversely, both obesity (body mass index > or = 30; 34% versus 40%, P = 0.008) and triglycerides (> or = 200 mg/dL; 27% versus 35%, P = 0.047) increased over time. The proportion of firefighters taking lipid-lowering medications increased from 3% at baseline to 12% at follow-up (P < 0.0001). Cholesterol levels declined significantly, and treatment rates for elevated cholesterol increased over time. Despite repeated examinations, a considerable number of firefighters had persistently elevated cholesterol, and only a minority were receiving adequate treatment.