tailieunhanh - NEJM CARDIOVASCULAR DISEASE ARTICLES - Part 4

Bệnh tim gây ra 45% số ca tử vong xảy ra giữa các nhân viên cứu hỏa của Hoa Kỳ trong khi họ đang thi hành công vụ. Chúng tôi kiểm tra thuế cụ thể nguy cơ tử vong từ bệnh tim mạch vành trong số các nhân viên cứu hỏa vụ Mỹ từ 1994 đến 2004. | The new ENGLAND JOURNAL of MEDICINE ESTABLISHED IN 1812 MARCH 22 2007 VOL. 356 NO. 12 Emergency Duties and Deaths from Heart Disease among Firefighters in the United States Stefanos N. Kales . . Elpidoforos S. Soteriades . . Costas A. Christophi . and David C. Christiani . . abstract background Heart disease causes 45 of the deaths that occur among . firefighters while they are on duty. We examined duty-specific risks of death from coronary heart disease among on-duty . firefighters from 1994 to 2004. methods We reviewed summaries provided by the Federal Emergency Management Agency of the deaths of all on-duty firefighters between 1994 and 2004 except for deaths associated with the September 11 2001 terrorist attacks. Estimates of the proportions of time spent by firefighters each year performing various duties were obtained from a municipal fire department from 17 large metropolitan fire departments and from a national database. Odds ratios and 95 confidence intervals for death from coronary heart disease during specific duties were calculated from the ratios of the observed odds to the expected odds with nonemergency duties as the reference category. results Deaths from coronary heart disease were associated with suppressing a fire of all such deaths responding to an alarm returning from an alarm engaging in physical training responding to nonfire emergencies and performing nonemergency duties . As compared with the odds of death from coronary heart disease during nonemergency duties the odds were to 136 times as high during fire suppression to times as high during alarm response to times as high during alarm return and to times as high during physical training. These odds were based on three estimates of the time that firefighters spend on their duties. From the Cambridge Health Alliance Harvard Medical School Cambridge MA . the Department of Environmental Health .