FEMA grant to further new research on firefighter health

Denise Smith, professor of exercise science at Skidmore, has received a $1.4 million research grant from the U.S. Department of Homeland Security for a three-year clinical study to better understand the precise medical causes of sudden cardiac deaths in firefighters. A better understanding of the underlying pathological causes of a cardiac event is a critical step in designing improved medical screening and targeted treatment strategies for firefighters.

The grant, administered through the department’s Federal Emergency Management Agency via the U.S. Fire Administration, was announced Aug. 7 by Rep. Paul Tonko, who called Skidmore “a source of pride for Saratoga Springs and the entire Capital Region.” He added, “Securing awards like this from the federal government is a direct reflection of the hard work and dedication put in each day by people like Denise and her team on campus.”

Tonko continued, “The Skidmore team has been a national leader in documenting the cardiovascular strain associated with firefighting. This research topic is particularly important as approximately 50 percent of firefighter line-of-duty deaths are due to sudden cardiac events. Research done at Skidmore with this support can be employed not just locally to keep our emergency responders safe in the line of duty, but across the nation.”

The study—the largest national study investigating the precise medical cause of cardiac deaths in the fire service—is geared toward developing better screening, monitoring, and treatment options for firefighters and ultimately, the number of cardiac events. The research has the potential to improve the medical evaluation received by every firefighter in the country and ensure that medical screening and monitoring are closely matched to the risks that firefighters face.

The researchers will evaluate more than a decade’s worth of records compiled by the National Fallen Firefighters Foundation. Thus far this year, according to The Daily Gazette, heart attack or cardiac arrest was listed as the cause of death in 30 of 55 duty-related fatalities nation wide. Pilot data that was analyzed for the grant application revealed that a large portion of fallen firefighters have evidence of an enlarged heart. If confirmed, this data suggests that some firefighters should be screened for enlarged or thickened hearts.  The study will seek to identify which firefighters are at greatest risk for an enlarged heart and should receive additional screening.

Smith said, “Our study will be a critical step in helping to determine better screening and treatment options to protect our first responders. Working closely with our partners at the National Fallen Firefighters Foundation and Harvard University, we will review medical records of firefighters who lost their lives in the line of duty to determine the precise cause of death and to identify risk factors that may be detected or screened for before a tragedy occurs.”

The project is the latest in a long line of studies undertaken by Smith over more than two decades. Since 1992, with the support of grants from both government and private sources, Smith has studied the causes and magnitude of the physiological strain of firefighting—and made recommendations to policy makers about how to make that job safer for first responders.

In collaboration with Skidmore colleague Professor Pat Fehling, Smith established Skidmore's First Responder Health and Safety Lab, one of a few in the country devoted to improving firefighter health and safety. There, Smith and Fehling, with the help of student researchers, have analyzed the role of fitness in reducing cardiac strain; investigated the independent effects of heat stress and dehydration on cardiac strain; provided insight and data to manufacturers of gear and equipment; and worked with national leaders in the fire service to develop rehab policies to rehydrate and monitor firefighters at emergency sites. Smith and her colleagues have published more than 40 scientific articles on firefighter physiology and she has lectured extensively in the fire service. Smith currently serves on the National Fire Protection Agency Technical Committee on Fire Service Occupational Safety and Health, where her expertise helps shape the recommendations on medical evaluations for firefighters.

Smith hopes her newest project will lead to significant improvements in firefighter screening and decrease fatalities by clarifying key scientific and medical questions regarding sudden cardiac death in this unique occupational group.