Abstract
BackgroundResearch consistently finds that, on average, firefighters gain weight over time and some data indicate that younger firefighters are more likely to gain weight than older firefighters. The purpose of this study was to estimate the 5-year weight change among younger and older US firefighters.MethodsData from two occupational medical exams separated by 5 years (2009–2016) were examined from a cohort of US career firefighters in Virginia (males, n = 589; females, n = 67). The cohort was grouped into two age categories (< 45 years and ≥ 45 years). Weight change subgroups were Loss (decrease of > 3% body weight), Stable (within ±3% body weight) and Gain (increase of > 3% body weight). Multinomial logistic regression models and linear regression models were conducted to examine differences in the probability of being in a particular weight change category, weight change overall and by weight change category between younger and older firefighters.ResultsAt baseline, 25 and 35% of younger (< 45 years) and older (≥ 45 years) were obese, respectively. Younger firefighters gained significantly (P < 0.05) more weight (3.0 ± 0.2 kg) than older firefighters (0.8 ± 0.5 kg). Younger firefighters were more likely to gain weight (53% versus 39%) and less likely (10% versus 20%) to lose weight as compared to older firefighters. Smaller weight gains were associated with age and BMI with the smallest increases observed in overweight and obese firefighters ≥45 years of age.ConclusionsHealth care providers should be attentive to weight gain, even among young non-obese firefighters, and counsel firefighters to avoid the additive risks of being older and heavier. In addition, weight loss/management programs should be promoted in the fire service to encourage healthy body weight and to prevent unhealthy weight gain among both young and old firefighters alike.
Highlights
Obesity is highly prevalent among US firefighters (24– 35%) [1,2,3,4,5] and is associated with impaired work performance [6], increased risk of injury [7, 8] and dutyrelated sudden cardiac events [9]
Weight gain in older firefighters is of particular concern, given that the risk of sudden cardiac death dramatically increases with age among firefighters [23]
The 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event based on the pool-cohort equations [24] was 0.8 and 2.3% among normal versus obese 40–45 year old firefighters and 4.1 and 7.8% among normal versus obese ≥50 year old firefighters [25]
Summary
Obesity is highly prevalent among US firefighters (24– 35%) [1,2,3,4,5] and is associated with impaired work performance [6], increased risk of injury [7, 8] and dutyrelated sudden cardiac events [9]. Several longitudinal studies have shown that, on average, firefighters gain weight as they age (~ 0.5 kg/yr) [5, 18, 19] and that firefighters who gained weight over a 5year period had adverse changes in cardiovascular health. Previous studies, reporting on data from the 1980s and 1990s, suggests that while both age groups gain weight over time, younger firefighters gain more weight each year than older firefighters [18, 19]. Weight gain in older firefighters is of particular concern, given that the risk of sudden cardiac death dramatically increases with age among firefighters [23]. The purpose of this study was to estimate the 5-year weight change among younger and older US firefighters
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