Firefighters are more likely to die from a sudden cardiac event than from any other cause, according to a study released in 2006 by the National Fire Protection Association (NFPA).
Paul Schroeder, a volunteer firefighter for more than two decades and a hospital community health educator at Robert Wood Johnson University Hospital (RWJUH), Rahway, New Jersey, says that the physical and mental stresses of the job, along with the fact that many firefighters dont pay enough attention to health and wellness, set the stage for heart disease.
Typically, end-of-the-year statistics for firefighter deaths show that 50% to 60% of all deaths are attributable to cardiovascular disease and stress, Schroeder says. In firefighting, you can go from not doing anything to doing quite a bit in a few
minutes, so heart rate, breathing, and blood pressure can elevate quickly. In addition, although many firefighters receive physical examinations when they first join the department, many departments dont make it mandatory for firefighters to have an annual physical. As a result, many men and women fall through the cracks.
When the local fire chief at Cranford Fire Department received a grant to develop a wellness program for firefighters, Schroeder saw it as an opportunity for Robert Wood Johnson University Hospital to join forces with the station.
Schroeder worked with Kathleen Jaeger, RN, C, BSN, COHN-S, who is a certified occupational health nurse specialist and manager of Employee Health, Adult Medical Clinic, and Community Health Education at RWJUH. They started it in December 2006, and more than 30 firefighters participated in this year-long wellness program.
Meeting healthcare needs
The hospital, according to Jaeger, provided a physician and use of its laboratory and diagnostic testing capabilities. Firefighters workup included hepatitis B vaccine administration, baseline medical lab testing (CBC, chemistry profile), a prostate exam, a PSA on those whose results were over 40, lipid profile, urinalysis, EKG, pulmonary function test, chest X-ray, and physical examination.
The hospitals nutritionist contracted to deliver four inservice programs at the firehouse, educating firefighters about nutrition and heart-healthy eating. She met one-on-one with participating firefighters at the hospital to assess their nutritional needs and create a healthful nutrition plan.
A fitness trainer consulted with the fire department on new equipment for a fitness room, which was funded by the grant. The trainer performed one-to-one physical assessments and designed an exercise regimen for each firefighter, Jaeger says. Now, instead of being sedentary at the firehouse while waiting for a call, the volunteers have a workout room and some extra guidance.
The next step, Jaeger says, is to retest participants and compare blood lipids and other findings a year later. The fire chief, she says, noticed that firefighters were eating healthier meals at least in the beginning of the wellness program.
Firefighters are taking advantage of the fitness room, according to Jaeger, and three of them, including Schroeder, have participated in personal fitness training programs to facilitate it at the station, in the absence of the contracted trainer.
Although he does not have data about the effectiveness of the program yet, Schroeder says it was worthwhile for the firefighters to have medical checkups. It had been years since many had seen a physician or gone through a physical exam, he says. Overall, the program offered valuable information, and many volunteers have taken what theyve learned to heart and are changing their lifestyles.
Spread the word
Schroeder has brought his message on the road, organizing a community health education program for firefighters throughout the state. Attendees have learned about cardiovascular risk factors, stress management, nutrition, and the need for and challenges of implementing wellness programs at fire departments.
Certainly, there are a lot of departments in this area that Id like to work with on health and wellness.
I hope it will come to that; its something that all firefighters have to be made aware of, Schroeder says.
Nurses who learn that their patients are or have been firefighters should know that often firefighters are at increased risk for heart disease. Schroeder says these patients might need smoking cessation counseling, testing to assess their cardiac health, and education about how to live healthier lifestyles. Jaeger adds, Stress management is an essential part of the whole health picture.