Fire Fighter Suffers Heart Attack During Training and Later Dies - Kansas
Death in the Line of Duty…A summary of a NIOSH fire fighter fatality investigation
F2015-02 Date Released: July 31, 2015
Executive Summary
On January 22, 2015, a 49-year-old male career fire fighter (FF) participated in air management training during his 24-hour shift as part of the fire department (FD) respiratory protection program. The FF, wearing full turnout gear and self-contained breathing apparatus (SCBA) (on-air) completed one evolution lasting about 10 minutes without incident. After removing his SCBA and turnout gear, he sat on the engine’s tailboard and told his battalion chief (BC) that he “was just a little winded.” About 5 minutes later, the FF stated “his chest was hurting.” Dispatch was notified as crewmembers noted the FF’s clammy skin and a weak and irregular pulse. An electrocardiogram (EKG) revealed changes consistent with an acute myocardial infarction (heart attack), and the FF was transported to the local hospital’s emergency department (ED). In the ED, an acute heart attack was confirmed and the FF was taken emergently to the cardiac catheterization lab for coronary angiography and angioplasty. While in the cardiac catheterization lab, the FF suffered cardiac arrest. Despite resuscitation efforts for over 20 minutes, the FF died at 2145 hours.
The death certificate listed “MI [myocardial infarction] – acute due to “occlusion of LAD [left anterior descending] on cath [catheterization]” as the cause of death. Due to findings in the cardiac catheterization lab, no autopsy was performed. Given the FF’s underlying heart disease, NIOSH investigators concluded that the physical stress of the air management training triggered his heart attack, which resulted in his sudden cardiac death.
Key Recommendations
- Provide annual medical evaluations to all fire fighters consistent with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, to identify fire fighters with risk factors for coronary heart disease (CHD)
- Perform symptom-limiting exercise stress tests (ESTs) on firefighters at increased risk for CHD and sudden cardiac events.
The following recommendations would not have prevented the FF’s death, but NIOSH investigators include them to address general safety and health issues:
- Discontinue routine ESTs on asymptomatic fire fighters with no risk factors for CHD
- Perform candidate and member physical ability evaluations
- Discontinue routine protein specific antigen (PSA) testing
- Conduct annual respirator fit testing
- Install diesel exhaust source capture systems in fire stations.
The National Institute for Occupational Safety and Health (NIOSH), an institute within the Centers for Disease Control and Prevention (CDC), is the federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. In 1998, Congress appropriated funds to NIOSH to conduct a fire fighter initiative that resulted in the NIOSH Fire Fighter Fatality Investigation and Prevention Program which examines line-of-duty-deaths or on duty deaths of fire fighters to assist fire departments, fire fighters, the fire service and others to prevent similar fire fighter deaths in the future. The agency does not enforce compliance with State or Federal occupational safety and health standards and does not determine fault or assign blame. Participation of fire departments and individuals in NIOSH investigations is voluntary. Under its program, NIOSH investigators interview persons with knowledge of the incident who agree to be interviewed and review available records to develop a description of the conditions and circumstances leading to the death(s). Interviewees are not asked to sign sworn statements and interviews are not recorded. The agency’s reports do not name the victim, the fire department or those interviewed. The NIOSH report’s summary of the conditions and circumstances surrounding the fatality is intended to provide context to the agency’s recommendations and is not intended to be definitive for purposes of determining any claim or benefit.