Full Breakdown
Firefighter On-Duty Deaths Linked to Enlarged Hearts, Study Finds
By Drooid · · How we work
Core Findings
A new analysis of federal records covering more than 3,400 on-duty firefighter deaths from 1990 through 2025 shows that cardiac arrest and heart attacks account for roughly 43 % of those fatalities. Among the cardiac cases, clogged arteries were present in 57 % while an enlarged heart muscle mass was identified in 79 %. The study also reports that the odds of a heart-related death for firefighters have risen by over 2 % each year, even as the corresponding odds for the general U.S. population have fallen by more than 1 % annually.
Health-Screening Implications
Researchers say routine medical examinations for firefighters may overlook hypertrophic heart conditions that develop from the intense physical training required for the job. The senior researcher, Dr. Alan Kwans, an assistant professor of cardiology at Cedars-Sinai Medical Center, suggested that national firefighter health guidelines should be revised to incorporate screening for excess heart muscle mass. Dr. Susan Cheng, chair of cardiology at Cedars-Sinai, echoed the need for updated protocols, noting that the underlying reasons firefighters are predisposed to this condition remain unclear and warrant further investigation.
Expert Commentary
Dr. Kwans emphasized that early identification of treatable heart conditions is essential to reducing on-duty fatalities. Dr. Cheng highlighted the study’s contribution to a growing body of evidence that cardiac events are a leading cause of death among firefighters and called for continued research to inform prevention strategies.
Verbatim Quotes
- “Identifying heart conditions when they can be treated is key to addressing these new findings,” — Kwan
- “This trend suggests that prevention of on-duty cardiac death has not kept pace with other domains of firefighter safety,” — Kwan
Data & Statistics
- Total on-duty firefighter deaths examined: >3,400 (1990-2025).
- Percentage of deaths that were heart-related: 43 %.
- Share of cardiac cases involving clogged arteries: 57 %.
- Share of cardiac cases involving enlarged heart muscle mass: 79 %.
- Annual increase in odds of heart-related death for firefighters: >2 % per year.
- Annual decrease in odds of heart-related death for the general public: >1 % per year.
The findings, released in late October 2026 in *JACC: Advances*, underscore a growing occupational health gap and suggest that updated cardiac screening could be a critical step toward improving firefighter safety.