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NEWS FROM
CAMBRIDGE HEALTH ALLIANCE
March 19, 2009
Researchers Find Majority of Fire and Ambulance
Recruits Overweight or Obese
Boston, MA...Researchers from Boston University
School of Medicine (BUSM), Boston Medical Center, Harvard University
and Cambridge Health Alliance found that more than 75 percent of
emergency responder candidates for fire and ambulance services in
Massachusetts are either overweight or obese. The findings, which
appear online today in the journal Obesity, have significant
consequences for public health and safety.
Emergency responders (firefighters, ambulance personnel, and police)
are expected to be physically fit to perform strenuous duties without
compromising the safety of themselves, colleagues or the community.
Traditionally, these professions recruited persons of above-average
fitness from a pool of healthy young adults. However, given the
current obesity epidemic, the candidate pool is currently drawn
from an increasingly heavy American youth.
The researchers reviewed the pre-placement medical examinations
of firefighter and ambulance recruits from two Massachusetts clinics
between October 2004 and June 2007. Candidates older than 35 and
those who had failed their services' minimum criteria were excluded
from the study in order to focus only on young recruits and those
most likely to go on to gain employment as emergency responders.
Among the 370 recruits, only about 22 percent were of normal weight;
43.8 percent were overweight, and 33 percent were obese. According
to the study's results, today's young recruits are significantly
heavier than older veteran firefighters from the 1980s and 1990s.
The researchers showed that excess weight as measured by body mass
index (BMI) was associated with higher blood pressures, worse metabolic
profiles and lower exercise tolerance on treadmill stress tests.
All normal weight recruits achieved a National Fire Protection Agency's
recommended minimum exercise threshold of 12 metabolic equivalents,
while seven percent of overweight and 42 percent of obese recruits
failed to reach these criteria.
"These findings are strong evidence against the common misconception
in the emergency responder community that many of their members
have BMI's in the overweight and obese ranges simply on the basis
of increased muscle mass. Even in these young recruits we documented
a very strong association between excess BMI and an increased cardiovascular
risk profile," said senior author Stefanos Kales, MD, MPH,
FACP, FACOEM, Medical Director of Employee & Industrial Medicine
at Cambridge Health Alliance and an assistant professor at both
Harvard Medical School and Harvard School of Public Health.
"Our findings regarding recruits' excess weight have important
implications, especially when superimposed upon expected future
effects of aging and career span," said lead author Antonios
Tsismenakis, BS, MA, a second-year medical student at BUSM. "First,
cardiovascular disease and musculoskeletal injury are important
causes of morbidity and mortality in emergency responders, and excess
body fat is associated with higher risk for both. Second, because
of the nature of emergency response work, any health condition suddenly
incapacitating an emergency responder also potentially compromises
the safety of his or her coworkers and the community," he added.
"These professionals perform highly psychologically and physically
stressful work and are therefore at high risk for cardiovascular
events," added Kales. "Sudden incapacitation during duty
puts these emergency responders, as well as their colleagues and
the public, in danger. In addition to the dangers posed to public
safety, these findings have important economic implications, as
state and federal legislation exists for the awarding of benefits
to emergency responders who die or are disabled by cardiovascular
events, malignancies and work-related orthopedic problems; and the
risk of all of these are increased by obesity," explained Kales.
This study was supported in part by grant from the U.S. Department
of Homeland Security. Coauthor Burress reports serving as a treating
physician for Boston Emergency Medical Services (EMS), as a paid
evaluator in workers' compensation and disability cases, including
cases involving emergency medical technicians and firefighters,
as a paid consultant to the Commonwealth of Massachusetts Public
Employee Retirement Administration Commission (PERAC) and Human
Resource Department (HRD). Senior author Kales reports serving as
paid expert witness, independent medical examiner, or both in workers'
compensation and disability cases, including cases involving firefighters
and other public safety personnel. Kales also has funding from Respironics,
Inc and has consulted with Quasar, Inc.
Cambridge Health Alliance is an innovative, award-winning
health system that provides high quality care in Cambridge, Somerville,
and Boston's metro-north communities. It includes three hospital
campuses, a network of primary care and specialty practices, the
Cambridge Public Health Dept., and the Network Health plan. CHA
is a Harvard Medical School teaching affiliate and is also affiliated
with Harvard School of Public Health, Harvard School of Dental Medicine,
and Tufts University School of Medicine. Visit us online at www.challiance.org.
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Media Contact
Gina M. DiGravio
Boston Medical Center
Phone: 617-638-8491
gina.digravio@bmc.org
David Cecere
Cambridge Health Alliance
Phone: 617-503-8428
dcecere@challiance.org
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