Association Between Atrial Fibrillation and Occupational Exposure in Firefighters Based on Self-Reported Survey Data.

Background Exposure to inhaled smoke, pollutants, volatile organic compounds, and polycyclic aromatic hydrocarbons in the firefighting environment has been associated with detrimental respiratory and cardiovascular effects, making firefighters a unique population with both personal and occupational risk factors for cardiovascular disease. Some of these exposures are also associated with development of atrial fibrillation. We aimed to study the association of atrial fibrillation and occupational exposure in firefighters. Methods and Results A cross-sectional survey was conducted between October 2018 and December 2019. Data were gathered electronically and stored in a secure REDCap database through Louisiana State University Health Shreveport. Firefighters who were members of at least 1 of 5 preselected professional organizations were surveyed via electronic links distributed by the organizations. The survey queried the number of fires fought per year as a measure of occupational exposure, as well as self-reported cardiovascular disease. A total of 10 860 active firefighters completed the survey, of whom 93.5% were men and 95.5% were aged ≤60 years. Firefighters who fought a higher number of fires per year had a significantly higher prevalence of atrial fibrillation (0-5 fires per year 2%, 6-10 fires per year 2.3%, 11-20 fires per year 2.7%, 21-30 fires per year 3%, 31 or more fires per year 4.5%; P<0.001). Multivariable logistic regression showed that a higher number of fires fought per year was associated with an increased risk of atrial fibrillation (odds ratio 1.14 [95% CI, 1.04-1.25]; P=0.006). Conclusions Firefighters may have an increased risk of atrial fibrillation associated with the number of fires they fight per year. Further clinical and translational studies are needed to explore causation and mechanisms.

Physiological determinants of the candidate physical ability test in firefighters.

The purpose of this study was to examine the relative importance of physiological characteristics during firefighting performance, as assessed by the Candidate Physical Ability Test (CPAT). Subjects included career and volunteer firefighters aged 18-39 (N = 33). Upper- and lower-body strength, muscle endurance, lower body muscle power, body composition analysis, aerobic capacity, anaerobic fitness, and the heart rate (HR) and blood pressure response to stair climbing were assessed to determine the physiological characteristics of the subjects. To quantify firefighting performance, the CPAT was administered by members of the fire service. Absolute and relative mean power during the Wingate anaerobic cycling test (WAnT), relative peak power during the WAnT, and absolute maximal oxygen uptake (VO2max) were significantly higher in those who passed the CPAT (N = 18), compared to those who failed (N = 15; p < 0.01). Mean power during the WAnT, fatigue index during WAnT, absolute VO2max, upper body strength, grip strength, and the HR response to stair climbing were significantly related to CPAT performance time (p < 0.01). Absolute VO2max and anaerobic fatigue resistance during WAnT best predicted CPAT performance (Adj. R2 = 0.817; p < 0.001). Performance on the ceiling breach and pull was the only CPAT task that was not significantly related to the physiological characteristics assessed. Measures of anaerobic and cardiovascular fitness best predict overall CPAT performance, and individual task performance. Remedial programs aimed at improving firefighting performance should target anaerobic and aerobic fitness qualities.