CHICAGO — Fire does not kill firefighters nearly as often as do their own hearts.
According to the United States Fire Administration, in 2009, 48 percent of on-duty firefighters died from a heart attack, 31 percent from trauma, 6 percent from asphyxiation, and 2 percent from burns. So far this year, the USFA has reported 25 on-duty firefighter fatalities. Of those, 56 percent have died from heat attacks, 28 percent from trauma, 4 percent from asphyxiation, and 4 percent from burns.
In response, the Department of Homeland Security has decided to throw $2 million into researching one solution to the heart attack/heat stroke problem: aspirin.
Last week, the DHS awarded the Illinois Fire Service Institute (part of the University of Illinois at Urbana-Champaign) a Fire Prevention & Safety Research and Development grant of $999,801 to study how effectively aspirin reduces the number of heart attacks among firefighters on and off the line of fire duty.
“We continue to see clots and clot formation – even in younger firemen,” said Brad Bone, the fire fighting program director at the institute, who has been researching firefighter heart attacks since 1991. “We know exercise helps. Getting acclimated to wearing gear helps. Hydration helps. But we’ve never gone as far as to look at aspirin therapy.”
Most heart attacks occur from a buildup of plaque on the inner walls of the coronary arteries. A section of the plaque breaks open, causing a blood clot to form. If the clot becomes large enough to cut off a significant amount of blood flow through the artery, a heart attack happens. Firefighters, straining under the weight of their heavy gear and extinguishing fires through intense heat, are susceptible to intense bouts of heat stress, even if they are in fairly good health, Bone said.
To be sure, there have been numerous medical studies identifying aspirin as a blood thinner, blood-clot deterrent, and, ultimately, a potential heart-attack-preventer. But the point of the IFSI study is to provide guidelines as to how – and if – fire departments should instruct their firefighters to take aspirin regularly. Should they be taking one a day? Or a high dose just before heading into the fire?
Over the next three years, the IFSI, led by research scientist Dr. Gavin Horn, will conduct long-term and acute aspirin therapy tests on 20 firefighters over the age of 40. The three-year study will involve a 14-day test of 20 firefighters over 40. Bone, a registered nurse and former firefighter, said the institute will recruit firefighters throughout Illinois and bordering states. Scientists from U of I’s Kinesiology and Community Health department, Skidmore College in New York, Carle Hospital Occupational Medicine, and Christ Clinics will collaborate on the grant.
“We’re making progress,” he said. “This is going to take a lot of in-depth research and it will be expensive.”
This grant was made possible because of the Federal Emergency Management Agency’s Assistance to Firefighters Grant Program. Under this DHS program, grants are awarded to fire departments across the nation to improve their ability to protect the public and firefighters from fire-related emergencies.
In 2009, Congress appropriated a total of $565 million under the Homeland Security Appropriations Act to the AFG Program. Under the guidelines, at least 5 percent of the fund must support fire prevention and safety activities – in a “coordinated effort to strengthen homeland security preparedness.”
All applicants for FP&S grants in 2009 have been competing for a pool of $35 million.
The University of Pittsburgh won a $1 million grant nine months ago to conduct its own aspirin-and-heart-attacks-among-firefighters study. Research began early last month.
Unlike the Illinois study, this one should be completed by June 2011. And it’s strictly a lab study, with all variables controlled. Rather than testing firefighters in their working conditions, the Pittsburgh research group will test 160 firefighters (ages 18 to 49) after they’ve run on treadmills in a lab heated to 100 degrees Fahrenheit.
Dr. David Hostler, who has been at the University of Pittsburgh for nine years and is one of the lead researches on the study, aims to prove if aspirin taken by firefighters prevents platelets from becoming sticky when body temperature rises intensely. His lab will also be testing the effectiveness of daily low doses vs. acute high doses.
“This is descriptive research,” Hostler said. “We explain the problem and start moving for intervention.”
After $2 million in research, that’s the goal: To reduce heart-related fatalities among U.S. firefighters.
Thus far, FEMA has given out seven research grants for 2009. The rest will be doled out until the money runs out, or by Sept. 30. Then it will be time to apply for 2010 grants.
