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TO THE EDITOR:

The concern of Tsismenakis et al. in their article titled “The Obesity Epidemic and Future Emergency Responders” over the impact of the obesity epidemic's impact on emergency response candidates is inescapable, given their documentation of obesity's adverse impact on blood pressure, metabolic profile, and exercise tolerance (1). We have found a similar impact of obesity on maximal treadmill exercise time using the Bruce protocol, which is probably the same method as they employed. We evaluated 139 current and potential Hazmat responders (age 36.6 ± 7.8 s.d., 86% men, 91% nonsmokers). Their BMI was 27.3 ± 3.8 kg/m2, with 18% having BMI >30. We found a significant negative correlation between BMI and treadmill exercise duration (r = −0.42, P = 0.001). The 31 persons who did not complete 3 min of Stage 4 of the Bruce protocol had a mean BMI of 30.3 ± 4.6. The association between age and treadmill exercise duration was weaker (r = −0.20, P = 0.05). BMI was not related to either age (r = 0.099) or resting blood pressure immediately before treadmill exercise in our subjects.

We are not aware of direct studies on the effect of either obesity or reduced treadmill performance on the ability of first responders to respond effectively, in either simulated or actual Hazmat or fire emergencies. However, the need for such research is clear. The investigators with whom Tsismenakis collaborates have already called for greater emphasis on physical fitness among firefighters (2) in the hope of reducing the risk of on-duty cardiovascular mortality. The need for fitness extends to all emergency responders, to whom communities entrust their safety, perhaps one day their survival.

Disclosure

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  2. Disclosure
  3. REFERENCES

The authors declared no conflict of interest.

REFERENCES

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  2. Disclosure
  3. REFERENCES
  • 1
    Tsismenakis AJ, Christophi CA, Burress JW et al. The obesity epidemic and future emergency responders. Obesity (Silver Spring) 2009; e-pub ahead of print 19 March 2009.
  • 2
    Kales SN, Soteriades ES, Christophi CA, Christiane DC. Emergency duties and deaths from heart disease among firefighters in the United States. New Engl J Med 2007; 356: 12071215.