Firefighter Heart Presumption Retirements in Massachusetts 1997???2004

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Abstract
Objective: “Heart Presumption” legislation is common throughout North America. We sought to study Massachusetts firefighters retiring with heart disability awards. Methods: The authors conducted a retrospective review of Massachusetts firefighters: 362 receiving Heart Presumption pensions (1997–2004) and a comparison group of 310 professionally active firefighters. Results: Of retirements, 77% were due to coronary heart disease and 23% for other cardiovascular conditions. Only 42% of the retirements were related to discrete on-duty events. Fire suppression (odds ratio = 51, 95% confidence interval = 12–223) and alarm response (odds ratio = 6.4, 95% confidence interval = 2.5–17) were associated with markedly higher risks of duty-related heart retirement events than nonemergency activities. Cardiovascular risk factor prevalence was high among all retiree subgroups and significantly greater than among control firefighters in almost all cases. Conclusions: Our study supports calls for improved cardiovascular prevention and risk reduction strategies among firefighters.

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