Associations of employment factors with cardiovascular disease in a national sample of U.S. firefighters: findings from the National Health Interview Survey

Background We explored whether employment factors were associated with prevalent cardiovascular disease (CVD) in a nationally representative sample of U.S. firefighters. Methods In the National Health Interview Survey, we estimated associations using survey-weighted multivariable logistic regression models. Results Firefighters employed for 20 or more years (versus <10 years) had higher odds of coronary heart disease (CHD) and composite CVD. After controlling for covariates, associations attenuated but remained statistically significant for CHD (OR = 7.23, 95% CI:1.65,31.8) but not composite CVD (OR = 1.18, 95% CI:0.39,3.60). Marginally significant and higher odds of composite CVD was observed for firefighters employed in large (100-or-more employees) versus small departments (1-24 employees). Conclusions Firefighter’s already elevated risk of CHD compounds markedly with tenure, particularly after 20 years. Associations were independent of age, sex, private insurance status and body mass index.