Wednesday, March 18, 2009

Heart Disease: An Epidemic For Firefighters

/PRNewswire/ -- H. Robert Superko, MD, principal investigator in the landmark FEMA-sponsored study of firefighters aged 40 and over conducted at Saint Joseph's Hospital in Atlanta, released preliminary findings in the world's first study of first responders at risk of suffering sudden death or other significant cardiac events. Firefighters are known to have a three hundred percent increased risk for cardiac disease as compared to other segments of the population.

"Preliminary findings show that one third of firefighters had heart disease that is unrelated to traditional risk factors, such as high cholesterol," says Dr. Superko. "Those results are astounding and point at job duties and environment as the primary determinants for early death in our country's first responders."

Dr. Superko, recognized as a leading expert on lipids, cholesterol and advanced metabolic markets and their contribution to heart disease, and his team performed a comprehensive, scientific battery of sophisticated blood and imaging tests on three hundred firefighters in Gwinnett County, Georgia. Gwinnett County first responders were identified for the study following an emotional report by Fire Chief Steve Rolader, following the sudden death of one of his firefighters from cardiac arrest while fighting a house fire.

"This wasn't the first firefighter in my department to die but I wanted to do something to make it among the last," says Chief Rolader. "This man was 53 years old, in great physical shape and he had no known symptoms of heart disease. We also had lost several newly-retired firefighters to sudden cardiac death. There had to be a way to stop it."

Study volunteers underwent a comprehensive genetic screen of more than a million genes including newly identified KIF6 (statin responsiveness gene) and 9p21 (myocardial infarction gene), advanced phenotype (blood) and imaging analyses, diet and exercise review over the year-long study. Results and explanations were presented to the groups followed by individual consultations. Complete statistical and comprehensive genetics results are expected this year.

According to Dr. Superko, stress and psychological pressures related to the job, as well as diet, exercise issues and inherent personality, interacting with a genetic predisposition to heart disease, probably have tremendous impact on the risk of heart attack in these first responders.

"Imagine being awakened from a dead sleep by a loud, shrieking siren several times during the night, responding through the rush of adrenaline, carrying a hundred pounds of equipment on your back, and meeting people at the very worst possible moments in their lives every day and you can begin to understand the toll it takes on the first responders," says Superko. "And, consider the emotional and psychological stress they encounter each day as they respond to society's most brutal moments from murders to car wrecks and death. Finally, those who serve as first responders have a mind-set and a desire to help people. They certainly bring a competitive nature to the job but also a profound desire to help and to do the best for others. All these elements create an environment that puts them at an increased risk for cardiac disease."

In response to the growing awareness to issues of diet and exercise, Gwinnett Fire Department has instituted exercise programs within local firehouses and the county now re-reimburses for fitness club memberships. The department also educates firefighters on proper diet and nutrition with one-on-one opportunities as well as "lunch and learn' programs in the station houses. And, over the years, the traditional firehouse alarm in Gwinnett stations has been replaced with softer alarms and even-voiced prompts to awaken sleeping first responders.

As a result of the study, Saint Joseph's Hospital and Dr. Superko's team implemented a two month screening program for all Atlanta first responders (firefighters, Police and EMS) regardless of age in order to provide them with some basic and advanced diagnostic tests at prices affordable to firefighters.. Several physicians are providing their services free of charge.

"There are tremendous costs associated with early deaths of our first responders in every community as we lose men and women in their 30s, 40s and 50s who are our first line of defense but who don't live to perform their jobs for very long," says Chief Rolader. "With the results of this study, we can implement programs across the country that will save lives."

Final results are expected to be submitted for presentation consideration at the annual American Heart Association meeting.

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