Measures of cardiovascular risk in wildland firefighters (WFFs)

Authors' Names

MD ZAHID HASAN, University of Montana, MissoulaFollow

Presentation Type

Oral Presentation

Category

STEM (science, technology, engineering, mathematics)

Abstract/Artist Statement

Measures of cardiovascular risk in wildland firefighters (WFFs)

Purpose: As the population across the western United States grows, and as fires increase in size and intensity, an increasing number of wildland firefighter operations are needed to protect vulnerable communities. WFFs are involved directly or indirectly in fire suppression activities and have high exposure to smoke and other risk factors including fine particulate matter (PM2.5), carbon monoxide (CO), and volatile organic compounds (VOCs). These exposures affect respiratory health, cardiovascular health, and oxygen-carrying capability. Notably, cardiovascular health is implicated in a huge percentage of sudden deaths of WFFs both on and off the job. Several studies in this worker population have focused on acute health outcomes, but little is known about the long-term health risks among this group. We aim to test the hypothesis that WFFs have higher lifetime cardiovascular risk compared to a non-WFF comparison population A better understanding of cardiovascular risk among WFFs can inform prevention strategies to benefit the long-term health of this worker population.

Method: We will characterize cardiovascular risk among WFFs from medical screening examinations conducted by the Department of Interior Medical Screening Program (DOI MSP) between 2014 and 2018. Specifically, we will apply the measures of Body Mass Index (BMI), total cholesterol, smoking, blood pressure, blood glucose to calculate a cardiovascular risk score. The measures of every specific variable related to cardiovascular health and the cumulative risk scores among WFFs will be compared to the cardiovascular risk factors and score of NHANES population. For every specific continuous variable related to cardiovascular health, we will conduct two-sample t-test. Then we will conduct two binomial proportion test ( if nπ(1-π)≥5 for both groups) or fisher’s exact test (if nπ(1-π)groups) based on the overall cumulative cardiovascular health score to measure the significance of difference of cardiovascular health between these two population.

Originality: The findings from this study will help to understand the existing short and long-term health cardiovascular health risks among WFFs. From this assessment, we can then explore the association between the occupational history of WFFs and the cardiovascular risks and better estimate lifetime CVD risks. This study can also inform the design of a cohort study to reduce the mortality by diseases associated with the WFFs’ occupation and increase occupation-friendly safety measures. This study will be among the very first to explore the long-term health impacts of wildland firefighting in such a comprehensive way.

Significance: The increasing number of wildland firefighters each year calls for more attention on the health and wellbeing impacts of working in this profession. With a better understanding of the cardiovascular health of WFFs, firefighting agencies can take steps to reduce risk, benefiting the long-term health of WFFs.

Mentor Name

Dr. Curtis Noonan

Personal Statement

Personal Statement When any wildfire occurs, wildland firefighters are the first and only responders to suppress it. They go through the worst part of wildfire. Even with their huge contribution to society and the country, their short and long-term health concerns have been neglected and are not still known completely. Also, the increased respiratory diseases and higher on-spot cardiac arrest among wildland firefighters suggest that scientists should explore that area more critically. In this study, we will try to understand a complete scenario of cardiovascular health of WFFs to increase the existing knowledge and help the policymakers to develop future interventions. Till now, most of the research related to WFFs, deal with short-term health impact like respiratory problems. But we very little know about the long-term health impact of wildland firefighting. One of the aspects of long-term effect is cardiovascular health of wildland firefighters. We will measure cardiovascular health using the cardiovascular health indexes provided by Lloyd-Jones et al., (2010). This health indexes include body mass index (BMI), total cholesterol, diet, physical activity, smoking, blood pressure, blood glucose to measure overall cardiovascular health. This study will be among the very first attempt to explore their such long-term impact of wildland firefighting in such comprehensive level. The population of the United States as well as all over the world is increasing and the number of houses, towns, cities adjacent to the forest land is increasing. This requires an increasing number of wildland firefighter operations to protect vulnerable communities. The increasing number of wildland firefighters each year calls for more attention on the health and wellbeing impacts of working in this profession. During a wildfire, firefighters are exposed to gases, VOC, and small particulate matter (PM2.5) which have acute and chronic effects on their respiratory and cardiovascular health along with other aspects of the body. Many of the on-spot death of WFFs occurs due to cardiac issues resulting from excessive heat during the wildfire. With a better understanding of the cardiovascular health of WFFs, we can make take steps to reduce risk, benefiting the long-term health of WFFs. To perform well on the job, WFFs must stay healthy and fit throughout the year. Cardiovascular health is one of the indicators of whether they are physically fit or not. A better understanding of this aspect will help policymakers address new interventions to improve/help WFFs to make them healthier. The Incident Qualifications and Certification System (IQCS) data includes variables related to occupational history such as total operational period during their lifetime. Exploring those variables will be a novel way to understand how much they are exposed. Subsequently linking the outcome with the overall cardiovascular health measured from medical screening data will also serve as a novel way to measure the association of occupational history and long-term health impact. Because of those reasons mentioned above, this work has the capability to qualify to be considered for a "Best of GradCon" award.