Associations of Employment Factors With Cardiovascular Disease in a National Sample of US Firefighters: Findings From the National Health Interview Survey.

Abstract

We explored whether employment factors were associated with prevalent cardiovascular disease (CVD) in a nationally representative sample of US firefighters. In the National Health Interview Survey, we estimated associations using survey-weighted multivariable logistic regression models. Firefighters employed for 20 or more years (vs <10 years) had higher odds of coronary heart disease (CHD) and composite CVD. After controlling for covariates, associations attenuated but remained statistically significant for CHD (odds ratio = 7.23; 95% confidence interval, 1.65 to 31.8) but not composite CVD (odds ratio = 1.18; 95% confidence interval, 0.39 to 3.60). Marginally significant and higher odds of composite CVD was observed for firefighters employed in large (100 or more employees) versus small (1 to 24 employees) departments. Firefighters' already elevated risk of CHD compounds markedly with tenure, particularly after 20 years. Associations were independent of age, sex, private insurance status, and body mass index.