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Obesity Flagged Among Young Emergency Responder Applicants

Young applicants seeking to become emergency responders are a lot like the rest of us, unfortunately -- many of them are obese, according to research just published online in the journal Obesity. The work was done by researchers from the Boston University School of Medicine, Boston Medical Center, Harvard University, and Cambridge Health Alliance who found more than 75 percent of emergency responder candidates for fire and ambulance services in Massachusetts are overweight or obese. Given the problem of heart attacks among firefighters and the emphasis put on physical fitness, this is an ominous finding for public safety.

The authors said the responder candidate pool "is currently drawn from an increasingly heavy American youth." Their study viewed pre-placement medical examinations of firefighter and ambulance recruits from two Massachusetts clinics between October 2004 and June 2007. Candidates older than 35 and those who had failed minimum criteria were excluded from the study so it could focus only on young recruits and those most likely to gain employment as emergency responders. Among the 370 recruits, about 22 percent were of normal weight; 43.8 percent were overweight, and 33 percent were obese. The study found today's young recruits are significantly heavier than older veteran firefighters from the 1980s and 1990s.

All of the normal-weight recruits achieved the National Fire Protection Association's recommended minimum exercise threshold of 12 metabolic equivalents, but 7 percent of overweight and 42 percent of obese recruits did not.

"These findings are strong evidence against the common misconception in the emergency responder community that many of their members have BMIs in the overweight and obese ranges simply on the basis of increased muscle mass. Even in these young recruits, we documented a very strong association between excess BMI and an increased cardiovascular risk profile," said senior author Dr. Stefanos Kales, M.D., MPH, FACP, FACOEM, medical director of Employee & Industrial Medicine at Cambridge Health Alliance and an assistant professor at Harvard Medical School and the Harvard School of Public Health.

"Our findings regarding recruits' excess weight have important implications, especially when superimposed upon expected future effects of aging and career span," said lead author Antonios Tsismenakis, BS, MA, a second-year medical student at BUSM. "First, cardiovascular disease and musculoskeletal injury are important causes of morbidity and mortality in emergency responders, and excess body fat is associated with higher risk for both. Second, because of the nature of emergency response work, any health condition suddenly incapacitating an emergency responder also potentially compromises the safety of his or her co-workers and the community."

The study was supported in part by a grant from the U.S. Department of Homeland Security.

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