Firefighter heart presumption retirements in Massachusetts 1997-2004.

Abstract

"Heart Presumption" legislation is common throughout North America. We sought to study Massachusetts firefighters retiring with heart disability awards. 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. 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. Our study supports calls for improved cardiovascular prevention and risk reduction strategies among firefighters.