Think firefighters and emergency medical technicians (EMTs) are in tip-top shape? Not necessarily, according to a new study published today in the journal Obesity. Researchers found that 77 percent of emergency responder recruits in Boston are either overweight or obese, a result they say is likely similar in other cities and towns.

"Both firefighters and EMTs have pretty significant risks of cardiovascular events [such as heart attacks] as a result of the physical demands of the job…They are also at risk for musculoskeletal injuries," says study co-author Antonios Tsismenakis, a medical student at Boston University School of Medicine. Carrying additional pounds magnifies these risks, he adds. "If an emergency responder goes down," he says, "that has potential implications for his or her colleagues, and for you and me."

Tsismenakis and his colleagues studied the medical records of firefighter and EMT recruits (322 men and 48 women between the ages of 18 and 35). The researchers looked at each recruit's body mass index (BMI) -- a weight-to-height ratio that is used to estimate a person's body fat content -- as well as other health markers such as blood pressure and cholesterol levels.

They found that three (1 percent) recruits were underweight, 83 (22 percent) were normal weight, 162 (44 percent) were overweight, and 122 (33 percent) were obese. Those who were overweight and obese also had significantly higher blood pressure and cholesterol, meaning they faced a higher risk of stroke and heart disease.

Tsismenakis says the findings have nationwide implications: "Massachusetts has the second lowest prevalence of obesity in the general population, which is where the recruits come from," he says, "so we can expect it's as bad or worse in the rest of the country."

Carrying extra body weight not only makes it harder to climb ladders or carry injured people, it also increases one's risk of suffering knee, back, shoulder and other musculoskeletal injuries, says study co-author Stefanos Kales, an occupational medicine specialist at Harvard School of Public Health. He adds that people with higher BMI's are also more likely than their leaner counterparts to suffer from heart disease, especially as they age, noting that if, say, an ambulance driver has a heart attack behind the wheel or a firefighter suffers a stroke while trying to pull someone from a burning building, it puts the entire community at risk.

Firefighters and EMTs are required to have passed medical and physical fitness tests to be hired, but the researchers say the requirements are too easy. The EMT's in the study had to pass a three-minute aerobic step test, and firefighters were required to run on a treadmill for as long as they could with increasing speed and incline (all study participants passed these tests). Firefighters in Massachusetts and many other states are required to take an additional Physical Abilities Test (PAT), in which they demonstrate, among other things, that they can carry cumbersome hoses and break down doors. The researchers did not follow the firefighters through this second round of testing, but Kales says the passing rate is about 95 percent.

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