Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
The Danish Cancer Society Research Center, The Danish Cancer Society, Copenhagen, Denmark.
Occup Environ Med. 2018 May;75(5):337-343. doi: 10.1136/oemed-2017-104734. Epub 2018 Jan 26.
Firefighters are exposed to multiple cardiovascular hazards, but few epidemiological studies have addressed their cardiovascular morbidity. The objective of this study was therefore to examine the incidence of cardiovascular diseases (CVD) in Danish firefighters.
We used individual historical employment records on 11.691 male Danish firefighters supplied by trade unions and fire agencies. The Supplementary Pension Fund Register was used to establish two occupational reference groups (a random sample from the male employed population and military employees). Information on CVD incidence was retrieved from the nationwide Danish National Patient Registry. SIRs and Poisson regression analyses (incidence rate ratio) were used for estimation of risks, including 95% CIs.
In comparison with the population sample, the age-adjusted and calendar time-adjusted SIR for all CVDs combined was increased in firefighters (SIR=1.10, 95% CI 1.05 to 1.15). The risk was also elevated for the most frequent outcomes, including angina pectoris (SIR=1.16, 95% CI 1.08 to 1.24), acute myocardial infarction (SIR=1.16, 95% CI 1.06 to 1.26), chronic ischaemic heart disease (SIR=1.15, 95% CI 1.06 to 1.24) and atrial fibrillation/flutter (SIR=1.25, 95% CI 1.14 to 1.36). This analysis showed the most elevated SIRs for CVD in full-time firefighters compared with part-time/volunteer firefighters. Both types of firefighters employed <15 years had an increased risk of CVD. Similar risk patterns appeared in comparisons with the military. Internal analysis supported external findings.
The risk of overall CVD, including the most frequent subtypes was modestly increased in Danish firefighters and was most elevated in full-time firefighters compared with other male employees.
消防员面临多种心血管危害，但很少有流行病学研究涉及他们的心血管发病率。因此，本研究的目的是检查丹麦消防员的心血管疾病（CVD）发病率。
我们使用工会和消防机构提供的 11691 名丹麦男性消防员的个人历史就业记录。补充养老金基金登记册用于建立两个职业参考组（男性就业人口和军人的随机样本）。CVD 发病率信息从全国丹麦国家患者登记处检索。使用 SIR 和泊松回归分析（发病率比）来估计风险，包括 95%CI。
与人口样本相比，所有 CVD 组合的年龄调整和日历时间调整后的 SIR 在消防员中增加（SIR=1.10，95%CI 1.05 至 1.15）。最常见的结局，包括心绞痛（SIR=1.16，95%CI 1.08 至 1.24）、急性心肌梗死（SIR=1.16，95%CI 1.06 至 1.26）、慢性缺血性心脏病（SIR=1.15，95%CI 1.06 至 1.24）和心房颤动/扑动（SIR=1.25，95%CI 1.14 至 1.36）的风险也升高。这项分析表明，与兼职/志愿者消防员相比，全职消防员的 CVD 的 SIR 最高。工作时间<15 年的两种消防员都有 CVD 风险增加。与军人的比较也出现了类似的风险模式。内部分析支持外部发现。
丹麦消防员的总体 CVD 风险，包括最常见的亚型，适度增加，与其他男性员工相比，全职消防员的风险最高。
