If you could find out whether you’re at increased risk for heart disease, would you want to know? Would you want to receive comprehensive genetic screening, the results of which could show that you need to make some drastic changes—now—to save your life?
That’s the decision firefighters in Gwinnett County (Ga.) Fire & Emergency Services were faced with when they agreed to participate in a landmark FEMA-sponsored study of firefighters ages 40 and over conducted by Robert Superko, MD, a leading expert on heart disease.
On May 6, one of the groups in the study was due to receive their individual results, and I was there to watch it happen. It was a profound experience; no one in the room could help reflecting on their own health, and what they would do if they were handed similar information.
Guess What? You’re At Risk
It’s widely known that heart disease is the No. 1 killer of firefighters. In fact, firefighters have a 300 percent increased risk for cardiac disease as compared to other segments of the population. So even if you eat right, exercise fanatically and keep your cholesterol low, you’re at risk simply because you’re a firefighter.
According to Dr. Superko, an individual can have a genetic predisposition that increases the risk of coronary heart disease. Environmental issues, such as an unhealthy diet or working in a hazardous environment (burning building), can then exacerbate the problem. During the briefing, Clinical Research Coordinator Catherine Skrifvars commented that firefighters do an extremely good job of taking care of others, but often don’t take care of themselves. “Hopefully the study findings will give them the tools they need,” she says.
Those tools come from a comprehensive battery of blood and imaging tests that Dr. Superko and researchers from Saint Josephs Hospital performed on 300 firefighters in Gwinnett County. Over the period of 1 year, study volunteers underwent a screening of more than a million genes; advanced phenotype (blood) and imaging analyses; and a diet and exercise review. Results and explanations were presented to the groups, followed by individual consultations.
Eventually, Superko would like to create a firefighter “chip” that would contain those genes identified in the study to increase the risk of heart disease. The chip could be compared against a firefighter’s genetic makeup to identify increased risk.
Return on Investment
Gwinnett County Fire Chief Steven Rolader began the May 6 briefing by noting the impact the study had already made. Rolader said that six firefighters’ lives had been saved, either directly or indirectly, by the study—before the results had even been released! The focus on cardiac issues in the organization has caused many department members to take a hard look at their own health and make some important, life-altering changes.
The final recommendations of the study will be released after the American Heart Association accepts the findings. Superko would like to have the manuscript of the study available when the findings are presented.
The next step: Obtain funds to develop a National Firefighter Registry, where blood and DNA from firefighters would be stored and tested to determine their current risk of heart disease. Each year, firefighters would submit the results of a health screening that would record whether they’ve had a heart attack, developed hypertension or any number of cardiac-related issues. Data analysis would then be performed to determine if certain areas or environmental factors are increasing the risk for certain populations. Note: A similar registry could be established to identify cancer risk.
Facing It Head-On
Returning to the question I started out with, if such a study came to your department, would you volunteer? Are you ready for the results of tests that might indicate your heart health is compromised?
Such knowledge carries a burden of action, but Gwinnett County’s Assistant Chief of Operations Bill Myers points out that it’s also liberating. “The results of this study allow firefighters to be in command and control of their own health,” he says. “The third-greatest killer of firefighters is a lack of situational awareness on the fireground. A lack of personal situational awareness can also lead to premature death.”