Firefighters' blood pressure and employment status on hazardous materials teams in Massachusetts: a prospective study.
We evaluated the association between hypertension and changes in employment status in 334 hazardous materials firefighters. Firefighters were categorized by blood pressure (BP) at baseline (1996 or 1997) and subsequent follow-up examinations (1997, 1998, and 1999). They were followed up for a maximum of 4 years for possible adverse outcomes (death, placement on "injured-on-duty" status, termination of duty, resignation, retirement, or incident cardiovascular disease). In several analytic models, we found that firefighters with stage II hypertension (BP > or = 160/100 mm Hg) were consistently 2 to 3 times more likely to experience an adverse outcome compared with those with normal BP. Cox proportional-hazards regression was used to adjust for age, body mass index, smoking, cholesterol, and antihypertensive medication. In these models, the hazard ratio for stage II hypertension was 3.2 (95% confidence interval [CI], 1.50 to 7.04, P = 0.003) and for untreated stage II hypertension, it was 4.6 (95% CI, 2.08 to 10.11, P = 0.0002). Firefighters with a BP > or = 160/100 mm Hg should receive further evaluation and demonstrate improved BP control before being determined fit for duty.
Cambridge Hospital, Department of Medicine, Occupational and Environmental Health, 1493 Cambridge St, Cambridge, MA, USA. stefokali@aol.com
Stefanos N
SN
Kales
Elpidoforos S
ES
Soteriades
Stavros G
SG
Christoudias
Scott A
SA
Tucker
Michael
M
Nicolaou
David C
DC
Christiani
D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D016001:Confidence Intervals; D004651:Employment; D005260:Female; D005390:Fires; D015386:Hazardous Substances / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D016273:Occupational Exposure; D011446:Prospective Studies; D012307:Risk Factors
D015386:Hazardous Substances