title: Obesity and cardiovascular disease risk factors in firefighters: a prospective cohort study.
abstract: OBJECTIVE
  Obesity, despite being a significant determinant of fitness for duty, is reaching epidemic levels in the workplace. Firefighters' fitness is important to their health and to public safety.
  
  
  METHODS
  We examined the distribution of BMI and its association with major cardiovascular disease (CVD) risk factors in Massachusetts firefighters who underwent baseline (1996) and annual medical examinations through a statewide medical surveillance program over 5 years of follow-up. We also evaluated firefighters' weight change over time.
  
  
  RESULTS
  The mean BMI among 332 firefighters increased from 29 at baseline to 30 at the follow-up examination (2001), and the prevalence of obesity increased from 35% to 40%, respectively (p < 0.0001). In addition, the proportion of firefighters with extreme obesity increased 4-fold at follow-up (from 0.6% to 2.4%, p < 0.0001). Obese firefighters were more likely to have hypertension (p = 0.03) and low high-density lipoprotein-cholesterol (p = 0.01) at follow-up. Firefighters with extreme obesity had an average of 2.1 CVD risk factors (excluding obesity) in contrast to 1.5 CVD risk factors for normal-weight firefighters (p = 0.02). Finally, on average, normal-weight firefighters gained 1.1 pounds, whereas firefighters with BMI > or = 35 gained 1.9 pounds per year of active duty over 5 years of follow-up.
  
  
  CONCLUSIONS
  Obesity is a major concern among firefighters and shows worsening trends over time. Periodic medical evaluations coupled with exercise and dietary guidelines are needed to address this problem, which threatens firefighters' health and may jeopardize public safety.
authors.affiliation: The Cambridge Hospital Department of Medicine, Employee and Industrial Medicine, Cambridge, MA 02139, USA.
authors.forename: Elpidoforos S
authors.initials: ES
authors.lastname: Soteriades
authors.forename: Russ
authors.initials: R
authors.lastname: Hauser
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Liarokapis
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
authors.forename: Stefanos N
authors.initials: SN
authors.lastname: Kales
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D015444:Exercise; D005390:Fires / Q000517:prevention & control; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D009790:Occupations; D012307:Risk Factors