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The Effect of Mandatory Fitness Requirements on Cardiovascular Events: A State-by-State Analysis Using a National
Dillon J Dzikowicz1,2,3, Sankalp Babarao Saoji4, Wai Cheong Tam5
1School of Nursing, University of Rochester.
Insights
Volunteer firefighters face higher cardiovascular event risks. While fitness standards aim to reduce these, their effectiveness varies, highlighting the need for targeted health promotion in this group.
Area of Science:
- Occupational Health
- Public Health
- Cardiology
Background:
- Cardiovascular events are the leading cause of death for on-duty firefighters.
- Existing fitness standards for firefighters lack uniformity across different roles and states.
- Investigating cardiovascular event rates is crucial for improving firefighter safety.
Purpose of the Study:
- To examine the incidence of cardiovascular events among firefighters across various states.
- To compare cardiovascular event rates based on firefighter type (career, volunteer, wildland).
- To analyze the impact of state-specific fitness standards on cardiovascular event rates.
Main Methods:
- Utilized publicly available data from the United States Fire Administration.
- Analyzed cardiovascular death rates by firefighter type and state.
- Compared states with differing fitness standard mandates (California, Tennessee, New York).
- Employed descriptive statistics and trend analysis.
Main Results:
- Volunteer firefighters experienced the highest rate of cardiovascular events (60.6%).
- Volunteer firefighters had significantly higher odds of cardiovascular events compared to wildland firefighters.
- New York reported the most cardiovascular events, predominantly among volunteers.
- California observed a downtrend in volunteer firefighter fatalities post-fitness standard legislation, while Tennessee showed no effect.
Conclusions:
- Volunteer firefighters are at a significantly higher risk for cardiovascular events compared to career and wildland firefighters.
- Mandatory fitness standards for volunteers did not consistently demonstrate a benefit in preventing fatalities.
- There is a critical need for nurses to actively promote cardiovascular health among volunteer firefighters.
Background:
Cardiovascular events are known to be the leading cause of death among on-duty firefighters. Implementing fitness standards may help reduce the incidence of cardiovascular deaths; however, standards vary between firefighter type and states. We aimed to investigate the rate of cardiovascular events among firefighters across states.
Methods:
Using publicly available data from the United States Fire Administration, we explored the rates of cardiovascular deaths between firefighter type (e.g., career, volunteer, and wildland) and state. Specifically, we examined rates of cardiovascular deaths between California and Tennessee, which have fitness standards for all firefighters, and New York, which does not have fitness standards for volunteer firefighters. We used descriptive statistics and trend analysis to examine the data.
Findings:
Most cardiovascular events occur among volunteer firefighters (60.6%, n = 877). Volunteer firefighters had 7.5 (95% CI = [4.8, 11.7], p < .001) greater odds of cardiovascular events compared to wildland firefighters, who had the lowest incidence of cardiovascular events (1.7%, n = 24). New York reported the most cardiovascular events (n = 161), primarily among volunteer firefighters (73.9%, n = 119). After the passage of legislation mandating fitness standards in California, a downtrend in the number of volunteer firefighter fatalities is observed. However, a null effect was observed in Tennessee after the passage of similar fitness standards as in California.
Conclusions/Applications To Practice:
Volunteer firefighters are significantly more likely to die of a cardiovascular event than career and wildland firefighters, both of which have stricter fitness standards. However, the effect of legislation mandating stricter fitness standards among volunteers did not produce a clear benefit for preventing fatalities. Nurses need to promote cardiovascular health among volunteer firefighters.
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