Occupational Health

Analytical models and big data may be used to evaluate the relationship between key leading indicators of health and safety (H&S) and their downstream lagging indicators. Lagging indicators are being considered that include: 1) Eye injuries; 2) Hand injuries; 3) Sprains and strains of the ankle, knee, shoulder or back; and 4) Fractures and amputations. Using data provided by our industry partners, we employ machine learning (ML) methods to examine underlying relationships. This work includes two phases: Phase 1 involves data collection and discovery of leading indicators using both exploratory and confirmatory statistical approaches. Phase 2 involves developing a proof of concept predictive model for each lagging indicator and assessing a variety of ML approaches. Classifier accuracy will be evaluated against subject expert baselines as well as H&S outcomes. The leading indicators and predictive technologies developed in this work will serve as a foundation to augment existing training programs and control hierarchies and develop proactive performance dashboards for next-generation H&S management systems.   Seed funding has been provided by the new School of Mining & Mineral Resources to begin this project.

In this project, we extended our training resources with new materials that focus on accessible, app-based technologies to improve instruction and coordinate outcomes assessment for trainers serving contractors and small mine operators. The three aims of this project included the following: Aim 1: Provide app-based resources to enhance training for belt conveyor safety, electrical hazards, and accidents with powered haulage. Aim 2: Increase operators' capability to evaluate health and safety outcomes using a light weight, app-based reporting tool coupled with cloud-based tracking and assessment. Aim 3: Grow a supportive online community for contractors and small operators to share and discuss health and safety training materials, practices, and outcomes. This project was funding by the Mine Safety & Health Administration. 

This program developed a framework for on-demand access to training materials and instruction, coupled with cloud-based tracking and assessment, to augment the training capacity of contractors and small mine operators. The three specific aims of this project included the following: 1) Provide an online community repository of active learning resources with new materials for conveyor maintenance, powered haulage, and electrical hazards; 2) Enhance the instructional design and delivery capabilities of trainers through online tutorials and programs; and 3) Deploy a technology-enabled assessment framework to evaluate training competency and track worker safety and health outcomes.  This project was funded by the Mine Safety & Health Administration. 

Women firefighters have high rates of post-traumatic stress disorder, increases in certain cancers, and adverse reproductive outcomes compared to women in the general population. However, the lack of sufficient information on the causes of and mechanisms leading to these occupationally related illnesses limits the creation of effective interventions. The goal of this project is to evaluate stress, cancer risk, and reproductive toxicity in women firefighters and to develop, beta test, and assess the feasibility of a peer support intervention. This project was funded by the Federal Emergency Management Agency. 

Firefighters are exposed to many harmful materials and conditions while fighting fires. These hazardous exposures put them at risk for damaging health effects, including those that may negatively impact female reproductive health. Anti-müllerian hormone (AMH) can be used as a measure of ovarian reserve, or the quantity of eggs in the ovaries. Exposure to harmful substances has been shown to decrease AMH. We will measure the AMH levels of female firefighters and compare them to the AMH levels of females who are not firefighters. The AMH measurements will be done using dried blood spots (DBS). We believe that the AMH levels will be lower in firefighters compared to non-firefighters. Also, we believe that those who have been firefighters for longer than others will have lower AMH. This project is receiving federal funding. 

This project aims to determine if the Predicted Heat Strain (PHS) model accurately estimates core temperature (Tc) in underground miners at the Resolution Copper Mine (RCM). In addition to assessing the validity of the PHS model, measures of physiological changes that predict heat strain (heart rate, hydration and body temperature) will be explored. These measures will be analyzed for correlations among the predicted/measured heat strain and specific physiological measures, which may lead to more efficient and effective heat strain prevention. This project is funded through the University of Arizona' s RDI Accelerate for Success Award.  Moe Momayez, PhD, is also a collaborator on this project. 

Exposure to per- and polyfluoroalkyl substances (PFAS) in the general population has been linked to cancer, elevated cholesterol, altered immune and endocrine response, respiratory disease, and reproductive toxicity. However, PFAS exposures and health effects in firefighters are not well understood. The goal of this project is to gather further evidence on PFAS exposure in firefighters and develop best practice recommendations to reduce firefighter PFAS exposure. This project is funded by the Federal Emergency Management Agency.

he objective of this proposal is to improve mining safety and health training in the western United States to support efforts to reduce mining injuries, illnesses, and fatalities. Building on our past NIOSH miner training (U60) grants, we are using a competency-based framework to integrate health and safety training for miners, trainers, and managers. This study is funded by the National Institute for Occupational Safety and Health.  Award Years:  2017 - 2020 2020 - 2023

Exposures to diesel particulate matter in underground mining often exceed existing standards. Alternative fuel blends are being employed to reduce exposures to miners, yet there is inadequate information on how these fuels change emission exposures and the resulting health effects. This study compares exposures and toxicity from the use of diesel and alternative fuels in underground mines. This study is funded by the National Institute for Occupational Safety and Health. 

The overarching goal of this work is to research multi-disciplinary approaches to the analysis of significant changes in time series measurements, relevant for occupational health scenarios, by incorporating contemporary methods from the fields of sensor development and data analytics.  Significant changes in environmental (e.g., particulate matter, chemical hazards) and physiological measurements (e.g., heart rate, core body temperature) can be viewed retrospectively to assess the significance of an intervention, or prospectively which can lead to technologies for real-time feedback mechanisms or alert systems to prompt implementation of controls.  This interdisciplinary and translational project also aims to increase the diffusion of innovation of methodologies for analysis of dependent data into the practice of occupational health.   This project is funded by the National Institute for Occupational Safety and Health. 

The goal of this study is to formally evaluate if a community health worker intervention can effectively reduce workplace exposures in marginalized small businesses to hazardous chemicals. Through face-to-face encounters, this study will increase the capacity of workers with limited education, literacy, and computer skills to understand workplace hazards and effective control options to reduce exposures and prevent occupational disease. This project was funded by the National Institute of Environmental Health Sciences.

The goal of this study is to learn about how work-demands and sleep affect mood and lifestyle choices. More specifically, we are interested in understanding how pre-shift sleep and the 911 calls received effect daily emotions, activity patterns, and caffeine intake. Information from this study may be used to develop wellness programs for 911 telecommunicators. Collaborators on this project include Graciela Silva from the College of Nursing and W.D. Scott Killgore from the College of Medicine.

Fire and Emergency Services (EMs) departments have marked variation in injury rates based on national and local policies, training, and traditions.  International partnerships and comparative studies therefore provide ideal mechanisms to identify cost-effective safety and health interventions.  The major goal of this project was to conduct international policy-related research on safety and health programs for fire/EMS. The host institutions included the London Fire Brigade (LFB) in the United Kingdom (UK) and the Paris West suburb division of the Service d’Aide Médicale Urgente/Service Mobile d’Urgence et Reanimation and the Service de Santé et de Secours Médical Haute-Corse du Service Départemental d'Incendie et de Secours in France. The study had to major focuses. The first was to evaluate the frequency and distribution of firefighter injuries and illnesses over the last 10 years in the UK and French partners and assess how specific previously implemented safety and health interventions changed injury and illness patterns and costs. None of the data collected in this evaluation included personal identifiers.The second was for this evaluation to lead to the formation of a roadmap for future EU and US fire/EMS safety and health policy and program development. This project was done within a six-month sabbatical and was sponsored by the Fulbright-Schuman grant program. 

Abstract not available. 

Migrant farmworkers in northwestern Mexico, a vulnerable population lacking in surveillance and resources, are subjected to strenuous working conditions including extreme heat and high pesticide exposures.The objective of this pilot study was to assess if there are differences in pesticide exposure as a function of heat stress and hydration levels in summer versus winter seasons. The specific goals of this project were to: 1)determine the association between internal and external permethrin exposure by exposure route during winter and summer; 2) determine the difference in heat stress and hydration levels in winter and summer; and 3) compare the relationship between heat stress and hydration levels with permethrin exposure in summer versus winter season. Samples were collected from 10 individuals working on a large grape farm; ten working during the winter season and the same ten individuals during the summer season. Personal air and dermal wipe samples from farmworkers conducting similar tasks during winter and summer were collected and analyzed for permethrin. Urine samples were analyzed for a permethrin metabolite, creatinine and specific gravity. Skin and core temperatures were administered to determine hydration levels, and standardized observational assessments were conducted to record: water intake, clothing, personal protective equipment, and job tasks for determining metabolic rate. This project resulted in a better understanding of the interaction between heat stress and pesticide exposure. This data will be used to conduct a larger study and design interventions for reducing pesticide exposure under extreme heat conditions.

Polybrominated diphenyl ethers (PBDEs):  A series of PBDEs will be measured at trace levels (ng/g lipid weight) in breast milk provided by volunteers.  Breastmilk collection:  Participants will provide breastmilk samples (100 ml ideally) within chemically clean, 120 ml foil-wrapped glass jars, prepared by the University of Arizona (UA) or certified by the UA to be free of target chemicals within the sensitivity of the methods applied.  Several collection sessions may be required to fill each jar.  The samples will then be refrigerated and frozen when collection is completed (volume met).  Participants are advised to minimize skin contact with the jar (lip and lid) and to minimize the possibility of contamination by skin, hair, or dust.   Once received by the UA, samples will be stored at -20ºC until analysis. Polybrominated diphenyl ether analysis: The analytical approached follows methods successfully applied by the State of California and the US Centers for Disease Control and Prevention (CDC). The UA team is currently conducting research using Enhanced Matrix Removal (EMR) protocols that have been specifically developed to allow for lipid removal without loss of analyses and have been applied numerous times for analysis of trace organic chemicals in milk. In general, the EMR tubes contain a mixture of solid-phase extraction (SPE) sorbents and MgSO4, that will absorb the matrix material and excess water. Our team will only apply EMR upon successful performance evaluation that demonstrates equivalency, or better, to previously published work using the method Instrumental analysis will be performed using gas chromatography (GC) with mass spectrometric detection (GC-MS).  PBDEs will be separated using a DB-5MS column (15 m x 0.25 mm I.D. x 0.1um film thickness, Agilent J&W, USA).

Prenatal exposure to organophosphorus pesticides (OPs) has been associated with a wide range of adverse childhood outcomes [1]–[7]. However, most of these studies rely on OP biomarkers in the general population. These biomarkers disproportionately reflect non-toxic dietary ingestion of metabolites and cannot distinguish between parent pesticides. Exposure metrics that use agricultural pesticide applications may overcome these limitations, but such studies are limited to California. We propose to prepare Arizona’s Pesticide Use Registry as a resource for future studies of exposure to pesticides and childhood health outcomes, and to enhance exposure assessment by incorporating birth certificate-reported farmworker occupation into analyses. Farmworkers are at higher risk of pesticide-associated health risks due to occupational exposures, but farmworkers are difficult to identify and are highly transitory. Thus, we also propose a pilot study of prenatal exposure to OPs and preterm birth among farmworkers to assess the feasibility of this approach for future studies. The National Institute for Occupational Safety and Health and the University of California, Davis fund this project. 

Problem Statement and Justification: Mining remains a dangerous profession.  Risk management is a cyclical process of identifying operations or activities at high risk for injuries, redesigning operating procedures to reduce risks, implementing these changes and evaluating their effectiveness.  Internationally, risk management is a legal requirement in many countries, but in the U.S. safety and health regulations are generally compliance-based.  Establishment of risk management in Australian mines has been associated with significant reductions in lost-time injuries, and, in preliminary studies, progressive U.S. mines have also reduced injuries after instituting formal risk management programs.  Impact of the Research: Our goal is to determine the effectiveness of risk management interventions in reducing injuries and economic costs in the U.S. mining industry.  The proposed research will: identify risk management best practices for U.S. mining operations including determination of the effect of overall risk management programs and component parts on injury rates and return on investment (ROI); develop business cases to help move industry to adopt these interventions; identify critical risks and controls for industry use; and share these resources through a dedicated website.  Objective(s) and Research Approach: Our project objectives are to: 1) Evaluate current risk management implementation in the U.S. mining industry; 2) Determine intervention ROI and risk management best practices; and 3) Share risk management tools through a dedicated website.  We will work with U.S. mine sites with extensive risk management expertise representing both metal and coal sectors.  A risk management survey/data collection tool for scoring overall program implementation and individual risk management interventions will be developed.  The survey results will be combined with retrospective longitudinal analysis of company internal data and Mine Safety and Health Administration (MSHA) reported injury claims to determine the effectiveness of implemented risk management interventions.  We will also evaluate the costs of program implementation, including direct and indirect program costs and the resulting changes in injury costs.  Risk management intervention best practices will be identified by reduction in injury rates and positive ROI.

The purpose of this project is to develop and test a framework for establishing a long-term firefighter multicenter prospective cohort study focused on carcinogenic exposures and effects.  The specific aims are to: 1) Establish an oversight and planning board to provide study oversight, foster communication among fire organizations and help develop a long-term funding plan; 2) Create and test a cohort study data coordinating center and harmonized survey data protocols; 3) Develop and evaluate an exposure tracking system paired with quantitative exposure data to construct a firefighter carcinogen exposure matrix; and 4) Create a biomarker analysis center and evaluate the association between cumulative firefighter exposures and epigenetic effects. Relevance: Cancer is a leading cause of fire service morbidity and mortality, and a recent National Institute for Occupational Safety and Health (NIOSH) study demonstrated an excess mortality rate for cancer in firefighters compared with the general population (Daniels et al., 2014).  Firefighters are exposed to multiple carcinogens in the workplace through skin contamination and inhalation.  However, we currently do not understand which individual exposures are responsible for cancer in firefighters, the mechanisms by which these exposures cause cancer, or effective means of reducing exposures.  Since cancer has a long latency period, biomarkers are also needed that can measure the effects of carcinogen exposure well before the development of cancer, when interventions to prevent disease could be effective.  Development of a large (>10,000 firefighter) multicenter firefighter cancer prospective cohort study will address these needs, but the framework for such a study needs to be first developed and tested among a smaller initial set of fire service partners.  Methods: The study will build on recent and developing firefighter cancer prevention studies in Arizona, Florida and Massachusetts, adding volunteer and combination fire departments.  1) An Oversight and Planning Board will be established by the Fire Protection Research Foundation (FPRF) in association with the National Fallen Firefighter Foundation (NFFF) Fire Service Occupational Cancer Alliance (FSOCA) to provide oversight of the study through collaboration among fire service organizations, academia, and government agencies, and develop a long-term funding and sustainability plan.  2) A Data Coordination Center will design, develop and evaluate a framework for a multicenter prospective cohort study of firefighters and cancer risk, including standardized participant survey data collection tools and analysis protocols sufficient to address the short- and long-term study objectives as well as linkage with long-term outcome data including cancer development.  3) An Exposure Assessment Center will develop a carcinogen exposure matrix using information gleaned from self-reported and quantitative exposure measurements to provide improved occupational exposure data for comparison with epigenetic outcomes and eventual cancer outcomes.  Carcinogen exposures associated with specific fire types and job tasks will be evaluated across fire departments through exhaled breath monitoring and analysis of urine for absorbed contaminants, providing information to guide exposure reduction strategies.  4) The Biomarker Analysis Center will carry out pilot studies of epigenetic markers of cancer effect and cancer risk comparing firefighters with a range of cumulative exposures and non-firefighter controls.  For these purposes, blood and buccal cells will be collected during annual medical surveillance evaluations.  Anticipated outcomes: The proposed research will: establish the framework necessary for the subsequent development of a large multicenter cohort study of cancer in the fire service; advance our understanding of firefighter exposures to carcinogens; and help identify biomarkers of carcinogen effect and cancer risk.

Purpose and Aims: The purpose of the proposed research is to identify effective methods of reducing firefighter exposure to carcinogens and associated toxic effects through completion of the following specific aims: 1) Evaluate exposure to carcinogens throughout the work shift; 2) Measure biomarkers of carcinogenic effect in relation to workplace exposures; and 3) Within a risk management framework, test the effectiveness of interventions to reduce fire service carcinogen exposure and effects. Relevance: Cancer is a leading cause of fire service morbidity and mortality.  Exposure to carcinogens occurs through skin contamination, through the lungs when respiratory protection is not worn during all phases of fire suppression and overhaul, and through inhalation during standby, operation of apparatus and off-gassing of equipment.  In addition to fire smoke, diesel exhaust exposure can occur from operation of apparatus at the fire ground and in the station.  Since cancer has a long latency period between exposure and disease onset, measurements are needed that can determine the effectiveness of new interventions on a much shorter time interval.  Methods: Exposure to particulates and volatile chemicals will be measured at the fireground and in-transit.  Diesel particulate matter monitoring during responses and in the fire station will also be completed.  Blood and urine collected during annual medical surveillance evaluations and post-fireground activities will be analyzed for chemical contaminants.  Biomarkers of carcinogenic effect will also be analyzed pre- and post-exposure, and evaluated for association with measured chemical contaminants.  The extent to which firefighter chemical exposures and biomarkers of effect can be reduced by following risk management steps will be determined.  Anticipated outcomes: The proposed research will identify carcinogenic exposures throughout the fire shift and measure the effectiveness of interventions designed to reduce cancer risks. 

Purpose and Aims: We propose to research the effectiveness of proactive risk management-based training, administrative, and technological interventions to improve vehicle operation and reduce emergency services vehicle crashes (ESVCs) in career, combination, and predominantly volunteer fire departments through completion of the following aims: 1) Evaluate risks and design and implement interventions to reduce ESVCs; 2) Measure program effectiveness and economic return; and 3) Develop and disseminate model guidance materials for vehicle-related program interventions.  Relevance: ESVCs and being struck by vehicles are the second leading cause of U.S. firefighter fatalities, averaging approximately 20 each year.  An average of approximately 16,000 firefighter ESVCs and over 1,100 associated injuries are reported annually. Methods: A proactive risk management framework will be employed to tailor vehicle-related program interventions and test their effectiveness in three fire departments: Chicago (IL), Prince William County (VA) and Stayton (OR).  Interventions will incorporate appropriate use of information from fire apparatus vehicle data recorders (VDRs), and additional interventions will be considered, including but not limited to increasing training, revising protocols for emergency and non-emergency response, and increasing supervisor responsibility for ESVCs.  The effectiveness of the interventions will be assessed using a combination of VDR data and ESVC frequency, process evaluation measures, and economic return on investment.  A Fire Protection Research Foundation advisory panel will review the study interventions, assist in evaluation and dissemination of the study results, inform applicable NFPA standards, and guide development of web-based model templates for training, evaluation and vehicle operation-related standard operating procedures (SOPs).  Anticipated Outcomes: Proactive risk management-based interventions will result in improved driving and reduced ESVCs and related firefighter injuries and fatalities.  

Economic evaluation of the global costs of injury for Newmont Mining, including factors such as age, workers compensation structure, health system, injury, and production. Eric Lutz was a contributor on this project but has since left the University of Arizona. 

Eric Lutz was a contributor on this project but has since left the University of Arizona. 

This project involved an Occupational Exposure Assessment and Inflammatory Biomarker Evaluation of diesel versus bio-diesel emissions, specifically in underground mining. This project was funded by the National Institute for Occupational Safety and Health. 

Abstract not available.  Eric Lutz was a contributor on this project but has since left the University of Arizona. 

Investigating Respiratory Protection for Firefighters Assessment of CBRN Canisters during Firefighter Overhaul in live fire exposure assessment in partnership with Northwest Fire Department.

Abstract not available. 

The Exposure Science and Risk Assessment Center (ESRAC) Find more information at https://esrac.arizona.edu/

The goal of this project was to respond to the data request regarding healthcare workforce information. Research for this project was conducted through survey design and implementation, data cleaning/scrubbing, data manipulation, statistical analysis, data reporting. This project trained public health graduate students in health care workforce analysis. This project received 90% FTE from July 2012 to June 2013. Joe Tabor was a contributor on this project but has since left the University of Arizona.

Exposures to diesel particulate in underground mining often exceed existing standards. A known carcinogen, diesel emissions have also been linked to a broad range of respiratory and cardiovascular health effects, both acute and chronic. Biodiesel blends are being employed to reduce these exposures, yet there was no information on whether this increases, decreases or fails to change the toxicity to miners of equipment emissions.  Some studies suggest a greater toxicity from biodiesel use. This study helped determine the health consequences of the use of biodiesel fuel blends in the underground mining setting. Using a cross-over experimental design alternating use of diesel and 50% biodiesel/diesel blend (B50) fuels, mining and mineral engineering students operated a load-haul-dump vehicle in an underground mine will be monitored for exposure to contaminants and health effects. Respirable dust, elemental carbon, black carbon, nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), aldehydes, and polycyclic aromatic hydrocarbons (PAHs) were sampled from the mine to determine exposure with the use of each fuel type. Spirometry, symptoms, sputum, blood, urine, exhaled breath, ultrasonography, and other sample types were collected on all subjects pre- and post-exposure to track the health effects of each fuel type. The paired differences in pre- and post-exposure biomarkers of effect were then compared for exposures to diesel and B50 biodiesel. Project work was funded by an NIH grant. 

This project helps define curricular needs in occupational/preventive medicine. Focusing on occupational medicine as an example, the project will use a work sampling technique complemented by questionnaires and focus groups to define the actual work activities and skills used. For work sampling, participants will report activity/ task/ task element for a series of 15-minute work samples. The project will include local, regional, and national samples. Multifaceted participant recruitment methods will create a broad-based sample, including self-identified medical providers of worker care who are not members of organizations. Organized "guidance groups" will guide the project, assist interpretation of data, and facilitate meaningful dissemination. Analyses will be both descriptive and address specific questions, such as determining the impact of formal education and evaluating whether occupational preventive medicine is a homogeneous field or composed of distinct subgroups. Improved understanding of the actual activities of occupational health professionals and the specific skills they utilize will facilitate improving service delivery, creating competency-based educational systems, and making effective use of educational resources. Project funds come from the National Institutes of Health. 

Research R01. Includes significant focus on randomized trial of 3 training methods. Also includes methods development for IR imaging. This project is a research R01 grant. The project work has a significant focus on randomized trial of 3 training methods. Research also includes methods development for IR imaging. Grant funding came from the Centers for Disease Control (CDC) and NIOSH. 

This project focuses on work with farmers in rural communities for the promotion of safe animal practices to prevent infectious agent spread. Rural communities involved are located in Arizona. This project is a part of a subcontract. Project funding comes from the United States Department of Agriculture's Agriculture and Food Research Initiative (USDA - AFRI). 

National Institute for Occupational Safety and Health 2009 - 2013 PI (0-0.15 FTE support), Project: “Implementing Risk Management Strategies to Prevent Injuries among Firefighters” $1,352,731

Each year there are more than one-half million occupational illnesses reported in the United States. Eight of the ten occupational health and safety objectives set forth in the DHHS Healthy People 2020 initiative are issues addressed by the industrial hygiene profession. Clearly, occupational illness is a major public health priority that must be addressed by trained professionals capable of understanding and solving the underlying problems creating these illnesses. The purpose of the University of Arizona's Industrial Hygiene Program is to provide Master's level graduate training in the core occupational safety and health area of Industrial Hygiene. This program was funded by the National Institute for Occupational Safety and Health, or NIOSH. 

Firefighters have a high risk of injuries due in part to the need to perform strenuous activities in a dynamic environment.  Risk management involves the creation and application of standard operating procedures for all processes with significant health and safety risks. Due to past success in implementing risk management using a regulatory approach, the focus of this project was to apply a tailored risk management intervention to reduce injuries in firefighters. These risk management strategies aimed at reducing the incidence of injury were employed for three job-specific tasks within the fire service associated with a high frequency of injury and severity, including physical exercise, the lifting of patients, and fire ground protocols. The intervention consisted of scoping sessions to identify hazards, analysis, and characterization of the risks associated with each job task, an introduction of a set of clear control measures including department-wide training, and a provision of gap analysis identifying the potential need for additional or a combination of intervention strategies. In order to assess for significant change in injury rates over time following each focused intervention strategy, historical data from the Phoenix Fire Department was used. This data was compared to a period of seven years of historical data. Finally, an evaluation of protocol adherence among injured and uninjured firefighters was conducted to determine the success of the risk management strategies. This project was supported by a FEMA Assistance to Firefighters Grant Program for Fire Prevention and Safety. 

This project was funded by the Federal Emergency Management Agency. Total funding amounted to $1,000,000 for this project. 

This project was primarily a development in partnership with NIOSH and MSHA. Eric Lutz was a contributor on this project but has since left the University of Arizona. 

Abstract not available.  Eric Lutz was a contributor on this project but has since left the University of Arizona. 

Mining biodiesel emission and exposures was an R01 Submission. Eric Lutz was a contributor on this project but has since left the University of Arizona. 

Carotid intima-media thickness (CIMT) is a measure of the extent of atherosclerosis present in an individual, and increasing CIMT is associated with a higher likelihood of future cardiac events such as heart attacks. A higher ratio of total cholesterol (TC) over high-density lipoprotein cholesterol (HDL-C) is associated with increased CIMT. Statin therapy is generally well-tolerated and has been shown to reduce the risk of future cardiac events in individuals with cardiac risk factors, even in the absence of hypercholesterolemia (TC ≥ 240 mg/dl), and has also been shown to reduce CIMT in high-risk individuals.  However, firefighters without hypercholesterolemia rarely receive statin therapy. The goal of this project was to determine if this treatment prevents progression of CIMT in firefighters and improves other cardiovascular disease risk factors. This was done by conducting a two-year randomized interventional trial of statin therapy in firefighters with high TC/HDL-C. Phoenix area firefighters who had a TC/HDL-C ratio ≥ 5.0 and were not taking statin therapy were eligible for participation and 124 were selected. Then, half of these people were randomly assigned to receive 10 mg of rosuvastatin per day for two years and the other half were followed over this same period as a control group. CIMT and other biomarker measurements were taken at the beginning, 12-month mark, and 24-month mark of this study. This project was part of a FEMA Assistance to Firefighters Grant Program.