“On-the-job” Fatal Cardiovascular Events: Analysis of National Institute for Occupational Safety and Health Data (P5.120)

Objective: To identify fatal cardiovascular events that occur “on-the-job” and precipitant physical activity and cardiovascular risk factor profile of patients. Background: “On-the-job” cardiovascular events have unique attributes in regards to recognition, response, and prevention. Methods: We retrieved the investigative information regarding firefighters data associated with the fatality of firefighters using National Institute for Occupational Safety and Health ( NOISH) received by CDC from 1998 to 2012. NIOSH conducts investigations of the duty deaths including interview of crew members and the victim’s family members, Fire Department incident report, ambulance report, hospital emergency department records, death certificate, autopsy report and primary care physician records. We categorized the precipitant activity based on Metabolic Equivalent of Tasks classification into “light to moderate” and “vigorous” activity. Results: A total of 199 “on-the-job” fatal cardiovascular events were identified: myocardial infarction (n=167), arrhythmias (n=12), sudden cardiac death (n=9), stroke (n=3), cardiac tamponade (n=2), and hypoxic brain injury (n=2). The mean age (±SD) was 49 (±8) years and 56% of the patients were aged less than 50 years. The mean duration (±SD) as a fire fighter was 22 ± 10 years. Of the 199 events, 51 occurred after light to moderate activity and 148 after vigorous activity. The mean duration (±SD) of the precipitating event was59 ± 66 and 33 ± 27 minutes (p=0.0001) in those with mild to moderate and vigorous activities, respectively. CPR was performed in 178 patients and external defibrillator was used in 151 patients. The mean (±SD) survival was significantly shorter in patients who developed cardiovascular events after light to moderate activity compared with those who developed event after vigorous activity (285 ± 935 versus 998 ± 3138, p0.0001). Conclusions: “On-the-job” cardiovascular events occur relatively frequently particularly after vigorous activity and appropriate screening and preparedness is recommended. Disclosure: Dr. Zarar has nothing to disclose. Dr. Saed has nothing to disclose. Dr. Tasneem has nothing to disclose. Dr. Malik has nothing to disclose. Dr. Qureshi has nothing to disclose.