Cardiorespiratory fitness and the metabolic syndrome in firefighters.

BACKGROUND The leading cause of mortality in on-duty firefighters is sudden cardiac death. While the reason for this remains unclear, low cardiorespiratory fitness and the metabolic syndrome have been associated with increased risk of cardiovascular disease-related events. AIMS To document the levels of cardiorespiratory fitness and the metabolic syndrome, as well as to determine if there is a relationship between these variables, in firefighters. METHODS Maximal cardiorespiratory fitness was assessed using the Bruce treadmill protocol in 214 male firefighters from Colorado. As part of a comprehensive cardiovascular disease risk evaluation, each firefighter was also screened for the metabolic syndrome using the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) guidelines. RESULTS At the time of their evaluation, 32 firefighters (15%) met the NCEP/ATP III diagnostic criteria for the metabolic syndrome, and 54 firefighters (25%) failed to achieve a generally accepted minimum cardiorespiratory fitness level of 42.0 ml/kg/min. A significant inverse trend of increasing cardiorespiratory fitness with decreasing metabolic abnormalities was found (P < 0.001). CONCLUSIONS Increased levels of cardiorespiratory fitness are associated with an improved metabolic profile in male firefighters. Comprehensive cardiovascular disease risk factor management and cardiorespiratory fitness improvement are essential for firefighter health and safety.