Massachusetts: Researchers say overweight fire, ambulance recruits disconcerting

More than 75 percent of emergency responder candidates for fire and ambulance services in Massachusetts are either overweight or obese, according to a study.

Researchers said the findings raise concerns about the health and safety implications these professions may face.

Traditionally, emergency responders -- firefighters, ambulance personnel and police -- are recruited from a pool of healthy young adults of above-average fitness. However, researchers for the study said that given the current obesity epidemic, the candidate pool is increasingly drawn from heavy American youth.

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The study, published in Obesity journal, was conducted by Boston University School of Medicine, Boston Medical Center, Harvard University, and the Cambridge Health Alliance. The researchers reviewed the preplacement medical examinations of firefighter and ambulance recruits from two Massachusetts clinics. Among the 370 recruits, only about 22 percent were of normal weight, 43.8 percent were overweight, and 33 percent were obese. Excess weight, as measured by body mass index, was associated with higher blood pressure, worse metabolic profiles, and lower exercise tolerance on treadmill stress tests.

"Our findings regarding recruits' excess weight have important implications, especially when superimposed upon expected future effects of aging and career span," said Antonios Tsismenakis, lead author of the study and medical student at BUSM.

"First, cardiovascular disease and musculoskeletal injury are important causes of morbidity and mortality in emergency responders, and excess body fat is associated with higher risk for both. Second, because of the nature of emergency response work, any health condition suddenly incapacitating an emergency responder also potentially compromises the safety of his or her coworkers and the community," he added.

Stefanos Kales, medical director at the Cambridge Health Alliance and assistant professor at Harvard Medical School, said that because these workers perform highly stressful jobs, they are at a higher risk for cardiovascular events.

"In addition to the dangers posed to public safety, these findings have important economic implications, as state and federal legislation exists for the awarding of benefits to emergency responders who die or are disabled by cardiovascular events, malignancies, and work-related orthopedic problems; and the risk of all of these are increased by obesity," he said.

June 8, 2009

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