The Federal Emergency Management Agency (FEMA) has awarded the University of Arizona a $1 million grant to study the risk of sudden death from cardiovascular disease in firefighters, part of the “2007 Assistance to Firefighters Grant Project.” 

Half of all line-of-duty (or “on the job”) deaths for firefighters are due to sudden, severe cardiovascular incidents such as heart attacks, even though firefighters tend to be a healthy group as a whole since strength and fitness are required for the job.  “For many firefighters we don’t have a really good way to determine who is at higher risk of sudden death due undiagnosed cardiovascular disease”, said Dr. Jeff Burgess, Principal Investigator of this grant and associate professor at the University of Arizona Mel and Enid Zuckerman College of Public Health (MEZCOPH).    Dr. Burgess is shown at right.

Standard risk factors such as age, high blood pressure and family history can be used to help screen those more likely to die suddenly, but firefighters with no symptoms of heart disease and who may not possess these well-known risk factors might still be in danger.  This two-year, grant-funded study will look at improved screening methods to find hidden cardiovascular disease in firefighters and to identify risk factors while fighting fires for those at risk of sudden death by heart attack.  The research will also look for possible ways to reduce a firefighter’s risk of heart attack through workplace modifications such as by using special cooling gloves after the fire. 

Pathways To Heart Attacks

Heart attacks usually occur after a chain of physical events.  A series of events that researchers can trace before a fatal heart attack occurs is called a pathway.  The pathways that lead to a fatal heart attack usually involve events culminating in a clot forming in the arteries supplying the heart.  This causes damage to the heart when blood flow is restricted to a part of the heart muscle.  Activation of these pathways may not affect most people, but can be devastating to those at highest risk.  Researchers will compare markers in the blood of the firefighters before and after fighting fires to determine which work factors have the greatest effect on activation of these pathways.   To accomplish this, the study has three different areas of investigation, outlined below.

I. Finding Hidden Cardiovascular Disease in Firefighters

Five hundred Phoenix and Tucson firefighters without known heart disease will be evaluated using non-invasive tests to look for early thickening of the walls of their blood vessels.  The goal is to find early evidence of atherosclerosis, a chronic inflammatory response in the walls of arteries or hardening of the arteries which in the heart can lead to sudden death.   The results of the study will be reviewed by a group of experts from the Fire Protection Research Foundation of the National Fire Protection Association to determine how to best use the new information to improve firefighter medical surveillance.

II. Cardiovascular Risks while Firefighting

The study will measure exposures, including components of smoke, physical stress and heat, that firefighter encounter while responding to structural or other fires.  As the firefighters work, researchers will monitor their exposures to inhaled pollutants for a prescribed period of time.   Their heart rate and body temperature will also be measured.   Blood samples will be collected before and after the firefighting to look for changes in blood markers associated with injury to blood vessels and other pathways involved in heart attacks. 

III. Using Cooling Gloves during Rehabilitation

The study will look at a way to modify the workplace for firefighters which might help prevent activation of pathways that could lead to a fatal heart attack.  As an example, firefighters endure a tremendous amount of heat stress while fighting a fire.  Special cooling gloves will be worn by firefighters to lower their body temperature during the rehabilitation period at the fire scene, when firefighters rest and recuperate from their exertion.  The effectiveness of reducing core body temperature after a fire in preventing changes in pathways that can lead to a heart attack will be studied.

Protecting Firefighters at the University of Arizona

This grant’s success draws on a long history of research into protecting firefighters by MEZCOPH faculty and the University of Arizona:

• Dr. Wayne Peate works on the detection and prevention of disease and injuries in firefighters with the Tucson Fire Department
• Dr. Kelly Reynolds has studied the presence of the Methicillin-Resistant Stapheococcus Aureus (MRSA) bacteria in Tucson fire stations.
• Dr. Jeff Burgess has worked on various projects over the past fifteen years with the Tucson, Phoenix and Seattle fire departments. 

“I’m very excited about this opportunity.  It is an honor to work with firefighters to help create the safest possible workplace for an inherently dangerous profession,” said Dr. Burgess, who is also the Director of the Community, Environment and Policy (CEP) Division at the College, which is dedicated to teaching, service and research on the many different areas of public health policy and environmental and community health.

Assistant Professor Renee Anthony, PhD, CIH, CSP, also performs research that helps to protect firefighters.  She studied air-purifying canisters for use during the overhaul phase to minimize the exposure to dangerous chemicals.  (See page 13 of the April, 2008, edition of the MEZCOPH Dean's Report.)

One of Only Five Grants Greater Than $1 Million

This grant is one of only five $1 million Fire Prevention and Safety (FP&S) grants recently awarded by FEMA for fiscal year 2008.  The FP&S grants are part of FEMA's Assistance to Firefighters grants, which help firefighters and other first responders obtain equipment, training, and other resources needed to protect the public and emergency personnel from fire and related hazards.

Grant Participants

The researchers at the University of Arizona and others who will be involved in this study are:

• Dr. Jeff Burgess, MD, MPH,  Associate Professor for the Mel and Enid Zuckerman College of Public Health (MEZCOPH), and Division Director of the MEZCOPH Community, Environment and Policy (CEP) Division
• Eyal Shahar, MD, MPH, Professor at MEZCOPH specializing in epidemiology of cardiovascular disease
• Wayne Peate, MD, MPH, Associate Professor at MEZCOPH
• MEZCOPH academic research professionals and staff including Sally Littau, MT(ASCP) CLS(NCA) and Margaret Kurzius-Spencer, MS
• MEZCOPH students
• Dr. Joseph Mills, a vascular surgeon at the University of Arizona College of Medicine
• Dr. Richard Gerkin, a Phoenix cardiologist
• Members of the Tucson Fire Department
• Members of the Phoenix fire Department
• The National Fire Protection Association

Research Updates

As Dr. Burgess' work progresses, in a few months this site will be updated with news, images, and research findings periodically.  Please bookmark this web page and check back!

News Coverage of This Story

•"UA gets grant to study heart attacks in firefighters," an article about this research in the Phoenix Republic (on azcentral.com),

•"UA Receives $1 Million FEMA Grant to Study Firefighters' Risk of Sudden Death from Cardiovascular Disease," on the FireRescue1 web page.

•"UofA studies sudden heart disease in firefighters," by Alyssa Aalmo, posted on December 2, 2008.  Zonie Report web page.

•"UA Receives $1 Million FEMA Grant to Study Firefighters’ Risk of Sudden Death from Cardiovascular Disease," Arizona Health Sciences Center web pages.

•"UA Receives $1 Million FEMA Funding," article in the December 2008 edition of Advances, the UA College of Medicine newsletter.

Please send comments about this web page to L. McKibben.

This page last updated on January 12, 2008.

The 2008 issue of the MEZCOPH Dean's Report has an article
about this research and refers to this web page.