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Risk Factors for Subclinical Atherosclerosis in Firefighters

Burgess, Jefferey L. MD, MS, MPH; Kurzius-Spencer, Margaret MS, MPH; Gerkin, Richard D. MD, MS; Fleming, James L. DO, MPH; Peate, Wayne F. MD, MPH; Allison, Matthew MD, MPH

Journal of Occupational and Environmental Medicine: March 2012 - Volume 54 - Issue 3 - p 328–335
doi: 10.1097/JOM.0b013e318243298c
Original Articles

Objective: Heart disease is the leading cause of firefighter line-of-duty deaths. The study objectives were to identify early atherosclerotic disease through ultrasound measurement of carotid intima-media thickness (CIMT) and risk factors predicting increased CIMT and carotid plaque.

Methods: Following ultrasound evaluation of 597 Phoenix and Tucson firefighters, logistic regression was used to identify risk factors for mean CIMT greater than 75th percentile and for carotid plaque.

Results: Age, low-density lipoprotein cholesterol (LDL-C) of 100 mg/dL or more, and high-density lipoprotein cholesterol were significant independent predictors of increased CIMT. Age, hypertension, LDL-C, and plasma soluble P-selectin were significant predictors of carotid plaque.

Conclusions: This study supports an emphasis on traditional risk factors for atherosclerotic disease in firefighters, in particular maintaining LDL-C less than 100 mg/dL. Plasma soluble P-selectin may help identify firefighters at increased risk for carotid plaque.

From the Mel and Enid Zuckerman College of Public Health (Drs Burgess and Peate, Ms Kurzius-Spencer), University of Arizona, Tucson, Banner Health Center (Dr Gerkin), and City of Phoenix Fire Department Health Center (Dr Fleming), Phoenix, Ariz; and University of California at San Diego (Dr Allison), San Diego, Calif.

Address correspondence to: Jefferey L. Burgess, MD, MS, MPH, University of Arizona Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave, Tucson, AZ 85724 (

The study was supported by FEMA grant EMW-2007-FP-01499. The authors declare no financial, consultant, institutional, or other conflicts of interest.

©2012The American College of Occupational and Environmental Medicine