The effectiveness of health interventions in cardiovascular risk reduction among emergency service personnel.

PURPOSE The physical demands and hazards associated with emergency service work place particular stress on responders' cardiovascular systems. Indeed, cardiovascular disease (CVD) is a significant problem for emergency service personnel. Although it may be difficult to alter the cardiovascular health hazards associated with the work environment, it is possible for personnel to control their modifiable CVD risk factors, cardiovascular fitness levels and subsequently, reduce their CVD risk. This review aimed to determine the effectiveness and methodological quality of health interventions designed to mitigate CVD risk in emergency service personnel. METHODS A literature search of electronic journal databases was performed. Sixteen relevant studies were assessed for methodological quality using a standardised assessment tool. Data regarding the effectiveness of each intervention were extracted and synthesised in a narrative format. RESULTS Fifteen studies were rated 'Weak' and one study was rated 'Strong'. Interventions which combined behavioural counselling, exercise and nutrition were more effective in improving cardiovascular health than nutrition, exercise or CVD risk factor assessment-based interventions alone. Further, CVD risk factor assessment in isolation proved to be an ineffective intervention type to reduce CVD risk. CONCLUSION Combined interventions appear most effective in improving the cardiovascular health of emergency service personnel. Accordingly, fire and emergency service agencies should consider trialling multifaceted interventions to improve the cardiovascular health of personnel and avoid interventions focused only on one of nutrition, exercise or CVD risk factor assessment. However, as most studies were methodologically weak, further studies of a higher methodological quality are needed.