“On-the-job” cardiovascular events occur relatively frequently, especially after vigorous physical activity, according to a study released in advance of the annual meeting of the American Academy of Neurology in Philadelphia.

Amna Zarar, M.D., from the Zeenat Qureshi Stroke Institute in St. Cloud, Minn., and colleagues identified on-the-job cardiovascular events among firefighters using data from the National Institute for Occupational Safety and Health for 1998 to 2012. Precipitant physical activity was categorized “light to moderate” and “vigorous.”

The researchers identified 199 on-the-job fatal cardiovascular events (167 myocardial infarctions, 12 arrhythmias, nine sudden cardiac deaths, three strokes, two cardiac tamponades, and two hypoxic brain injuries). The mean age was 49 years and more than half (56 percent) of the patients were aged younger than 50 years.

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Fifty-one of the events occurred after light to moderate activity and 148 followed vigorous activity. In 178 patients, cardiopulmonary resuscitation was performed, and in 151 of the patients, an external defibrillator was used. The mean survival was significantly shorter after light to moderate activity (285 ± 935) than after vigorous activity (998 ± 3,138; P = 0.0001).

“Knowing that these fatal heart attacks and other vascular events occur relatively frequently, fire departments and other workplaces need to be prepared to recognize these events and screen for those who may be at higher risk,” Zarar said in a statement.