Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2018


Doctor of Nursing Practice (DNP)

Primary Advisor

Cathie E. Guzzetta, PhD, RN, FAAN


Background: Firefighters across the United States face high fatality rates in the line of duty of which many are likely related to preventable cardiovascular risk factors.

Objectives: To assess differences in firefighter cardiovascular-related versus unavoidable occupational-related fatalities by career status, age, smoking, obesity, and hypertension.

Methods: We used an exploratory, comparative secondary data analysis design. We extracted data from a national database of deceased firefighters over 14 years. Variables extracted were career status, age, smoking, obesity, and hypertension as well as the reason for death while on duty (i.e., cardiovascular-related or unavoidable occupational-related death). Data were analyzed using Chi-Square to compare cardiovascular-related versus unavoidable occupational-related fatalities among the variables with significance set at 0.05.

Results: In a sample population of 984 deceased firefighters nationwide, we found that career versus volunteer position status (χ2 = 1.14, p=0.56) did not significantly affect cardiovascular- related fatality outcomes compared to unavoidable occupational-related outcomes. Significantly more firefighter with increased age (χ2 = 176.16, p<0.001), who smoked (χ2 = 10.91, p=0.001), had increased BMI (χ2 = 10.91, p=0.001), specifically obesity (χ2 =13.14, p<0.001), and hypertension (χ2 =84.42, p<0.001), had cardiovascular-related fatalities compared to those with unavoidable occupational-related fatalities.

Conclusions: Our study demonstrated significant differences related to increased age, smoking, increased BMI, obesity, and hypertension in relation to increased cardiovascular fatalities in firefighters compared to unavoidable occupational-related fatalities. Our findings support the development of cost-effective nurse-practitioner (NP) led preventative health programs aimed at reducing cardiovascular-related fatalities in the fire service.

Open Access


Available for download on Thursday, April 16, 2020