U.S. Department of Homeland Security Award Number EMW-2013-FP-00749
P.I. Denise L. Smith Ph.D; Skidmore College
Purpose & Relevance: Firefighters suffer the highest occupational cardiovascular disease (CVD) proportionate mortality—45% of on-duty deaths—of any occupational group. However, developing strategies to reduce these tragedies is hampered because the exact pathophysiologic mechanisms of these fatalities are poorly understood. The purpose of this study is to retrospectively analyze the most complete set of firefighter autopsies and accompanying medical records ever made available in order to evaluate the pathoanatomic (medical) causes of sudden cardiac death (SCD) and the underlying medical conditions of the victims, and to identify the most effective preventive strategies.
Methods: We will partner with the National Fallen Firefighters Foundation (NFFF) to review records from fatalities from the year 2000 to the present and retrieve relevant information about cause of death (from autopsies), CVD risk factors and underlying medical conditions (from medical records). We will use a retrospective case-control study design to compare the cardiovascular deaths with firefighters who died from non-cardiac causes (traumatic fatality controls, and also compare SCD victims to occupationally-active, age-matched career firefighter controls). The case-control study designs with statistical adjustments, such as matching for age and other covariates, will offer high scientific and epidemiologic rigor, as well as sufficient statistical power.
Anticipated Outcomes: (1) rigorously identify medical risk factors and underlying causes independently associated with on-duty SCD death in firefighters, and (2) develop comprehensive preventive strategies based on targeted, evidence-based recommendations for screening, periodic monitoring and treatment modalities to decrease SCD in the Fire Service.
