Hostname: page-component-848d4c4894-pftt2 Total loading time: 0 Render date: 2024-06-06T20:43:09.646Z Has data issue: false hasContentIssue false
  • English
  • Français

Differences in Cardiovascular Health Metrics in Emergency Medical Technicians Compared to Paramedics: A Cross-Sectional Study of Emergency Medical Services Professionals

Published online by Cambridge University Press:  29 April 2019

Rebecca E. Cash ,
Remle P. Crowe ,
Julie K. Bower ,
Randi E. Foraker  and
Ashish R. Panchal
Rebecca E. Cash*
Affiliation:
National Registry of Emergency Medical Technicians, Columbus, OhioUSA Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OhioUSA
Remle P. Crowe
Affiliation:
National Registry of Emergency Medical Technicians, Columbus, OhioUSA Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OhioUSA
Julie K. Bower
Affiliation:
Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OhioUSA
Randi E. Foraker
Affiliation:
School of Medicine, Institute for Informatics, Washington University in St. Louis, St. Louis, MissouriUSA
Ashish R. Panchal
Affiliation:
National Registry of Emergency Medical Technicians, Columbus, OhioUSA Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OhioUSA Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OhioUSA
*
Correspondence: Rebecca E. Cash, MPH, NRP 6610 Busch Blvd Columbus, Ohio 43229 USA E-mail: rcash@nremt.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Emergency Medical Services (EMS) professionals face high physical demands in high-stress settings; however, the prevalence of cardiovascular health (CVH) risk factors in this health care workforce has not been explored. The primary objective of this study was to compare the distribution of CVH and its individual components between a sample of emergency medical technicians (EMTs) and paramedics. The secondary objective was to identify associations between demographic and employment characteristics with ideal CVH in EMS professionals.

Methods:

A cross-sectional survey based on the American Heart Association’s (AHA; Dallas, Texas USA) Life’s Simple 7 (LS7) was administered to nationally-certified EMTs and paramedics. The LS7 components were scored according to previously described cut points (ideal = 2; intermediate = 1; poor = 0). A composite CVH score (0-10) was calculated from the component scores, excluding cholesterol and blood glucose due to missing data. Multivariable logistic regression was used to estimate odds ratios (OR; 95% CI) for demographic and employment characteristics associated with optimal CVH (≥7 points).

Results:

There were 24,708 respondents that were currently practicing and included. More EMTs achieved optimal CVH (n = 4,889; 48.8%) compared to paramedics (n = 4,338; 40.6%). Factors associated with higher odds of optimal CVH included: higher education level (eg, college graduate or more: OR = 2.26; 95% CI, 1.97-2.59); higher personal income (OR = 1.26; 95% CI, 1.17-1.37); and working in an urban versus rural area (OR = 1.31; 95% CI, 1.23-1.40). Paramedic certification level (OR = 0.84; 95% CI, 0.78-0.91), older age (eg, 50 years or older: OR = 0.65; 95% CI, 0.58-0.73), male sex (OR = 0.54; 95% CI, 0.50-0.56), working for a non-fire-based agency (eg, private service: OR = 0.68; 95% CI, 0.62-0.74), and providing medical transport service (OR = 0.81; 95% CI, 0.69-0.94) were associated with lower odds of optimal CVH.

Conclusions:

Several EMS-related characteristics were associated with lower odds of optimal CVH. Future studies should focus on better understanding the CVH and metabolic risk profiles for EMS professionals and their association with incident cardiovascular disease (CVD), major cardiac events, and occupational mortality.

Cash RE, Crowe RP, Bower JK, Foraker RE, Panchal AR. Differences in cardiovascular health metrics in emergency medical technicians compared to paramedics: a crosssectional study of Emergency Medical Services professionals. Prehosp Disaster Med. 2019;34(3):288–296.

Keywords

cardiovascular healthEmergency Medical Servicesemergency medical techniciansparamedics
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 34 , Issue 3 , June 2019 , pp. 288 - 296
Copyright
© World Association for Disaster and Emergency Medicine 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Benjamin, EJ, Blaha, MJ, Chiuve, SE, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146–e603.10.1161/CIR.0000000000000485CrossRefGoogle ScholarPubMed
Folsom, AR, Yatsuya, H, Nettleton, JA, et al. Community prevalence of ideal cardiovascular health, by the American Heart Association definition, and relationship with cardiovascular disease incidence. J Am Coll Cardiol. 2011;57(16):1690–1696.CrossRefGoogle ScholarPubMed
Lloyd-Jones, DM, Hong, Y, Labarthe, D, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic impact goal through 2020 and beyond. Circulation. 2010;121(4):586–613.10.1161/CIRCULATIONAHA.109.192703CrossRefGoogle ScholarPubMed
Bambs, C, Kip, KE, Dinga, A, et al. Low prevalence of “ideal cardiovascular health” in a community-based population: the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study. Circulation. 2011;123(8):850–857.CrossRefGoogle Scholar
Djousse, L, Petrone, AB, Blackshear, C, et al. Prevalence and changes over time of ideal cardiovascular health metrics among African-Americans: the Jackson Heart Study. Prev Med. 2015;74:111–116.CrossRefGoogle ScholarPubMed
Garcia-Hermoso, A, Ramirez-Velez, R, Ramirez-Campillo, R, Izquierdo, M. Relationship between ideal cardiovascular health and disability in older adults: the Chilean National Health Survey (2009-10). J Am Geriatr Soc. 2017;65(12):2727–2732.10.1111/jgs.15139CrossRefGoogle Scholar
Gonzalez, HM, Tarraf, W, Gouskova, N, et al. Life’s Simple 7’s cardiovascular health metrics are associated with Hispanic/Latino neurocognitive function: HCHS/SOL results. J Alzheimers Dis. 2016;53(3):955–965.CrossRefGoogle ScholarPubMed
Kales, SN, Soteriades, ES, Christophi, CA, Christiani, DC. Emergency duties and deaths from heart disease among firefighters in the United States. N Engl J Med. 2007;356(12):1207–1215.CrossRefGoogle ScholarPubMed
Soteriades, ES, Smith, DL, Tsismenakis, AJ, Baur, DM, Kales, SN. Cardiovascular disease in US firefighters: a systematic review. Cardiol Rev. 2011;19(4):202–215.CrossRefGoogle ScholarPubMed
Drew-Nord, DC, Hong, O, Froelicher, ES. Cardiovascular risk factors among career firefighters. AAOHN J. 2009;57(10):415–422.10.1177/216507990905701004CrossRefGoogle ScholarPubMed
Maguire, BJ, Hunting, KL, Smith, GS, Levick, NR. Occupational fatalities in Emergency Medical Services: a hidden crisis. Ann Emerg Med. 2002;40(6):625–632.CrossRefGoogle ScholarPubMed
Crowe, RP, Bower, JK, Cash, RE, et al. Association of burnout with workforce-reducing factors among EMS professionals. Prehosp Emerg Care. 2018;22(2):229–236.CrossRefGoogle ScholarPubMed
Bentley, MA, Crawford, JM, Wilkins, JR, Fernandez, AR, Studnek, JR. An assessment of depression, anxiety, and stress among nationally certified EMS professionals. Prehosp Emerg Care. 2013;17(3):330–338.CrossRefGoogle ScholarPubMed
Studnek, JR, Bentley, M, Crawford, JM, Fernandez, AR. An assessment of key health indicators among Emergency Medical Services professionals. Prehosp Emerg Care. 2010;14(1):14–20.CrossRefGoogle ScholarPubMed
Gormley, MA, Crowe, RP, Bentley, MA, Levine, R. A national description of violence toward Emergency Medical Services personnel. Prehosp Emerg Care. 2016;20(4):439–447.CrossRefGoogle ScholarPubMed
Brown, WE Jr., Dickison, PD, Misselbeck, WJ, Levine, R. Longitudinal Emergency Medical Technician Attribute and Demographic Study (LEADS): an interim report. Prehosp Emerg Care. 2002;6(4):433–439.CrossRefGoogle ScholarPubMed
Millar, MM, Dillman, DA. Improving response to web and mixed-mode surveys. Public Opin Quart. 2011;75(2):249–269.10.1093/poq/nfr003CrossRefGoogle Scholar
Sinclair, M, O’Toole, J, Malawaraarachchi, M, Leder, K. Comparison of response rates and cost-effectiveness for a community-based survey: postal, internet and telephone modes with generic or personalized recruitment approaches. BMC Med Res Methodol. 2012;12:132.CrossRefGoogle ScholarPubMed
Schmuhl, P, Van Duker, H, Gurley, KL, Webster, A, Olson, LM. Reaching Emergency Medical Services providers: is one survey mode better than another? Prehosp Emerg Care. 2010;14(3):361–369.CrossRefGoogle Scholar
Hosmer, DW, Lemeshow, S, Sturdivant, RX. Applied Logistic Regression. Third Edition. Hoboken, New Jersey USA: Wiley; 2013.10.1002/9781118548387CrossRefGoogle Scholar
Kulshreshtha, A, Vaccarino, V, Judd, SE, et al. Life’s Simple 7 and risk of incident stroke: the reasons for geographic and racial differences in stroke study. Stroke. 2013;44(7):1909–1914.CrossRefGoogle ScholarPubMed
Rasmussen-Torvik, LJ, Shay, CM, Abramson, JG, et al. Ideal cardiovascular health is inversely associated with incident cancer: the Atherosclerosis Risk in Communities study. Circulation. 2013;127(12):1270–1275.CrossRefGoogle ScholarPubMed
Kim, JI, Sillah, A, Boucher, JL, Sidebottom, AC, Knickelbine, T. Prevalence of the American Heart Association’s “ideal cardiovascular health” metrics in a rural, cross-sectional, community-based study: the Heart of New Ulm Project. J Am Heart Assoc. 2013;2(3):e000058.CrossRefGoogle Scholar
Ogunmoroti, O, Utuama, O, Spatz, ES, et al. Trends in ideal cardiovascular health metrics among employees of a large healthcare organization (from the Baptist Health South Florida Employee Study). Am J Cardiol. 2016;117(5):787–793.CrossRefGoogle Scholar
Robbins, JM, Petrone, AB, Carr, JJ, et al. Association of ideal cardiovascular health and calcified atherosclerotic plaque in the coronary arteries: the National Heart, Lung, and Blood Institute Family Heart Study. Am Heart J. 2015;169(3):371–378.10.1016/j.ahj.2014.12.017CrossRefGoogle ScholarPubMed
Unger, E, Diez-Roux, AV, Lloyd-Jones, DM, et al. Association of neighborhood characteristics with cardiovascular health in the Multi-Ethnic Study of Atherosclerosis. Circ-Cardiovasc Qual. 2014;7(4):524–531.CrossRefGoogle ScholarPubMed
Younus, A, Aneni, EC, Spatz, ES, et al. A systematic review of the prevalence and outcomes of ideal cardiovascular health in US and non-US populations. Mayo Clin Proc. 2016;91(5):649–670.CrossRefGoogle ScholarPubMed
Shay, CM, Ning, H, Allen, NB, et al. Status of cardiovascular health in US adults: prevalence estimates from the National Health and Nutrition Examination Surveys (NHANES) 2003–2008. Circulation. 2012;125(1):45–56.CrossRefGoogle ScholarPubMed
Smith, DL, Fehling, PC, Frisch, A, et al. The prevalence of cardiovascular disease risk factors and obesity in firefighters. J Obes. 2012;2012:908267.CrossRefGoogle ScholarPubMed
Soteriades, ES, Hauser, R, Kawachi, I, et al. Obesity and cardiovascular disease risk factors in firefighters: a prospective cohort study. Obes Res. 2005;13(10):1756–1763.CrossRefGoogle ScholarPubMed
Poston, WS, Haddock, CK, Jahnke, SA, et al. The prevalence of overweight, obesity, and substandard fitness in a population-based firefighter cohort. J Occup Environ Med. 2011;53(3):266–273.CrossRefGoogle Scholar
Banes, CJ. Firefighters’ cardiovascular risk behaviors. Workplace Health Saf. 2014;62(1):27–34.Google ScholarPubMed
Eastlake, AC, Knipper, BS, He, X, Alexander, BM, Davis, KG. Lifestyle and safety practices of firefighters and their relation to cardiovascular risk factors. Work. 2015;50(2):285–294.Google ScholarPubMed
Williams, I, Valderrama, AL, Bolton, P, et al. Factors associated with emergency medical services scope of practice for acute cardiovascular events. Prehosp Emerg Care. 2012;16(2):189–197.CrossRefGoogle ScholarPubMed
Supplementary material: File

Cash et al. supplementary material

Cash et al. supplementary material 1

Download Cash et al. supplementary material(File)
File 18 KB