While it’s no secret that firefighters are at increased risk for cardiovascular health issues, the causes of those issues aren’t often discussed.  

February is American Heart Month, making it the perfect time to talk about one of the main causes of firefighter LODDs.  

From particulates to heat stress, firefighters face unique challenges that increase the risk of cardiac issues. While these causes don’t have easy fixes, PPE and proper cleaning can go a long way toward lessening firefighter cardiac health risks.  

Health Starts Before the Fire 

Heart health starts before you ever get on the fireground.  

Cardiovascular disease is the most common cause of death in the United States, affecting millions of Americans every year. That means that most firefighters are already at risk, even without the increased risk of firefighting.  

So beyond the gear and stresses of the fireground, it’s important for firefighters to pay attention to their physical health.  

As Andy Starnes of Insight Training says, “We have to be constantly working on ourselves, taking care of ourselves, and it doesn't get any easier as you age.” 

He highlights the importance of regular checkups. Sudden cardiac death is often the first symptom of coronary heart disease, taking many firefighters by surprise. Health checkups are often the only way to spot heart issues before they become lethal.  

Starnes also highlights other issues that can cause excess risk. From controllable risks like dehydration (“the majority of firefighters are reporting to duty already dehydrated and I'm the world's worst because I love to drink coffee”) and uncontrollable risks like location (“My friends in Texas, Florida, Louisiana and Arizona, God bless them in the summertime”), firefighters need to be aware of everything that can affect their heart health. 

But even a firefighter in perfect physical condition is still at risk for overexertion. That’s because of the unique environment of the fireground and the nature of firefighting. 

How Heat Stress Affects Heart Health 

The number one cause of LODDS for firefighters is overexertion and stress. Overexertion can cause a range of deadly conditions, but most often causes heart attacks and other cardiac problems.  

Overexertion can mean a lot of things, but is most closely associated with heat stress. When you work hard on the fireground, your core temperature rises and puts strain on your whole body, especially your heart.  

Thankfully, firefighters can reduce their risk of heat stress and overexertion on the fireground. The key is understanding the causes of heat stress and taking steps to mitigate those causes.  

One of the main causes of heat stress is a lack of sweat evaporation. Turnout gear encapsulates you in layers of fabric. Historically, that fabric hasn’t been breathable. That means the heat and sweat inside your turnout gear has nowhere to go.  

If sweat can’t evaporate, it can’t cool you down. That leads to rising core temperatures.  

Study after study has shown that firefighters are extremely likely to face increases in core temperatures. Even small increases can cause problems like brain fog and can affect hearing and balance.  

But the more core temperature increases (and in firefighters core temperatures increase in a matter of minutes), the more likely that significant problems like cardiac events will occur.  

Increased core temperature causes elevated heart rates and also increase the risk for irregular heartbeats (known as AFib). That extra strain on the heart can be deadly. 

All of that means firefighters should work to lower their risk of heat stress and increased core temperatures, especially firefighters with greater health risks.   

While firefighting will always involve tough work in hot conditions, firefighters can take advantage of new equipment and techniques to lower their risks.  

New PPE advances, like AeroFlex turnouts from Fire-Dex, offer enhanced breathability with VaporLite Panels and AeroVent Technology. The VaporLite Panels, a breathable three-layer composite system, target heat-trapping areas, allowing sweat to evaporate efficiently. AeroVent Technology uses strategically placed vents in the armpits and inner thighs to enhance airflow, helping firefighters regulate body temperature and reduce heat stress risks. 

It’s also important to wear the right gear for the right job. Turnouts aren’t necessary for most non-structural calls, so take the opportunity to wear lighter alternative PPE. That means you’ll be less likely to overheat on your other calls. It will leave you much more prepared for structural calls if you’re not overexerting yourself on other calls.  

How Fireground Particulates Affect Heart Health

While most firefighters are aware of how particulates on the fireground can lead to increased cancer risks, fewer are aware of how particulates can also increase the risk of cardiac events. 

Firefighters are routinely exposed to dangerous contaminants on the fireground, such as Polycyclic Aromatic Hydrocarbons (PAHs). Those materials can be breathed in or enter the body through skin contact.  

Studies have shown that some fireground contaminants can lead to increased risk of AFib and other cardiac issues, even after short exposures.  

That highlights the need for particulate-blocking PPE, proper donning and doffing, as well as effective cleaning and maintenance.  

PPE should include particulate blocking hoods that provide additional protection against skin contact. Studies have shown that a properly engaged SCBA not only decreases the risk of breathing in dangerous contaminants, but also creates a seal around the jacket and prevents particulates from getting inside and onto the skin at the jacket/pant interface.  

For cleaning, fire departments should work to follow NFPA guidelines. These minimize the risk of contaminants staying on gear and increasing exposure. Proper cleaning and maintenance are critical for reducing the risk of contamination and keeping your gear functional.  

Decreasing contaminant exposure not only reduces your risk for cancer and heart problems, but also the other firefighters and family members you come into contact with.  

Heart Health Is a Team Effort 

For firefighters, taking heart health seriously isn’t an option.  

But tackling heat stress and fireground contamination can’t happen individually. It takes a whole department to commit to firefighter health.  

From little steps like drinking water to big steps like implementing an NFPA 1851 program, departments must take action to protect against serious heart health problems.  

Fire-Dex is committed to firefighter health and safety, which is why our gear is designed to be the lightest and most breathable on the market. We continually push the envelope of material science and gear design to make the best turnouts and alternative PPE on the market. We also work closely with our sister organization Gear Wash to help departments maintain their gear.  

Everything we do is to help you serve your community and be healthy doing it. Try our gear today and see how Fire-Dex is tackling heart health at the source.