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Skidmore professor to study cardiac deaths of firemen

Inquiry may enhance screening for at-risk firefighters

Friday, August 8, 2014
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— Acting Albany Fire Department Lt. Theodore “Teddy” Abriel had already fought one fire and was climbing the stairs of a Lincoln Square high-rise to fight another during the late afternoon on Feb. 19, 2007.

After carrying roughly 75 pounds of gear up six flights of steps, the 44-year-old veteran firefighter of two decades battled the apartment blaze for almost a half-hour before collapsing. Fellow firefighters pulled him to a stairwell to resuscitate him, but he never regained consciousness.

The married father of four never had a history of heart trouble and had even passed a required physical exam the previous year. Yet his cause of death was ruled a heart attack spurred by stress and overexertion, according to the U.S. Fire Administration.

Denise Smith, a professor of exercise science at Skidmore College, has researched the cause-and-effect of cardiac deaths among firefighters for years, but her recent work with Dr. Stefanos Kales of Harvard Medical School led to a curious discovery that might one day help firefighters avoid cardiac events like the one that felled Abriel. Reviewing autopsy records of firefighters who died in the line of duty in 2010, Smith and Kales discovered only 15 percent had evidence of a blockage. In contrast, 80 percent of the cases they reviewed showed signs of an enlarged heart.

“It was striking even with our own hypothesis,” she said Thursday.

Their work will now expand to more than a decade of records compiled by the National Fallen Firefighters Foundation in an effort to find new methods of screening and preventing fatal cardiac events — the leading cause of death for firefighters. The work was awarded a $1.43 million research grant through the U.S. Department of Homeland Security, which will give Smith the funding she needs to conduct the three-year study.

“The Skidmore team has been a national leader in documenting the cardiovascular strain associated with firefighting,” said U.S. Rep. Paul Tonko, D-Amsterdam, who helped secure the grant. “The research done at Skidmore with this support can be employed not just locally to keep our emergency responders safe in the line of duty, but across the entire nation.”

So far this year, heart attacks or cardiac arrest were listed as the cause of death in 30 of 55 fatalities nationwide among firefighters who were either on duty or had recently finished a shift, according to figures compiled by the U.S. Fire Administration. Among the three fatalities listed for New York, two resulted from cardiac events.

Smith, who conducts fatality investigations for the U.S. Department of Labor’s Occupational Safety & Health Administration, started to notice a pattern in some of the listed heart attack cases she was probing. While she often couldn’t find evidence of a blockage, she started seeing many cases in which the fallen firefighter had an enlarged heart.

“The first couple of times, I thought it could be coincidental,” she said. “But after 10 or so, I started paying closer attention.”

Firefighters are often subjected to strenuous conditions that can lead to cardiac events. Turnout gear can add upward of 50 pounds of weight and, while designed to protect them from temperatures in excess of 1,000 degrees, that gear can also trap body heat.

Poor conditioning has also been pegged for contributing to fatal cardiac events. Donald Collins, a 62-year-old Schenectady firefighter who suffered a heart attack while operating a pumper truck at an arson fire in April 1996, prompted some members of the City Council to question fitness standards at the department.

But while proper health is important in firefighters, Smith believes there is more to identifying those who are risk. She said the evidence uncovered so far suggests firefighters are suffering from fatal arrhythmia — possibly more commonly than anyone previously suspected.

“This will be the most significant project to date, in terms of improving firefighter safety,” she said.

 
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