Young Massachusetts paramedic and firefighter recruits overweight or obese?

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According to a study recently published online in the journal Obesity, 75% of young Massachusetts paramedic and firefighter recruits are overweight or obese. The excuse that is often presented on the behalf of firefighters is that the added weight is from muscle mass; this is not the case according to the authors of the study. Steffanos N. Kales, M.D., M.P.H., of the Harvard School of Public Health, and colleagues, studied medical examination records of 370 firefighters and ambulance recruits that were seen during visits at two Massachusetts clinics between October 2004 and June 2007; among those seen at the clinics 43.8% were overweight (BMI of 25 to 30 kg/m2) and 33% had an even greater BMI. Researchers commenting on the findings mentioned that firefighters and emergency responders that are overweight could well put themselves in danger as well as their coworkers and the public. “We propose making BMI a vital sign during emergency responders’ medical examinations, especially as perception of ‘average weight’ is skewed higher, even among physicians,” Dr. Kales’ group said.  The following is an excerpt of an article from Medpage Today that discusses the findings more:

Already in their 20s, the average 28.5 kg/m2 BMI in these emergency responder candidates exceeded that of veteran responders in their 30s and 40s, based on a review of studies from the 1980s and 1990s.

But despite common arguments that this simply reflects greater muscle mass among recruits, the researchers showed that increasing BMI was associated with cardiovascular risk factors the same as in the rest of the population, including:

* Higher blood systolic and diastolic blood pressure (both P<0.001 for trend)
* Greater likelihood of hypertension (2.4% in normal weight, 6.2% in overweight, and 16.5% in obese, P=0.001 for trend)
* Higher total cholesterol (P=0.001 for trend)
* Greater triglyceride levels (P<0.001 for trend)
* Lower exercise tolerance and higher heart rate after three-minute step test (P<0.001 and P=0.006 for trend, respectively)

These findings were particularly worrisome because cardiovascular disease and musculoskeletal injury rank high as causes of morbidity and mortality among emergency responders, the researchers noted.

“Young recruits are expected to be at or near peak career fitness,” the researchers said.

But a substantial proportion of the recruits couldn’t meet the minimum exercise threshold proposed by the National Fire Protection Agency. Whereas all those of normal weight could reach 12 metabolic equivalents, 7% of those who were overweight and 42% of those who were obese failed this standard.

Notably, each unit increase in BMI reduced the likelihood of meeting this criterion by 54% (P<0.001).

Click here to read the rest of this article from Medpage Today

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