Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, FACE F2009-24, 2009 Dec; :1-9
On July 6, 2009, a 28-year-old male volunteer fire fighter trainee (the Trainee) responded to a debris fire. At the scene, he assisted in stretching a 1¾-inch handline as other fire fighters extinguished the fire. The Trainee reported to the driver/operator that he had a severe headache and difficulty breathing. As the driver/operator called for the Fire Chief, the Trainee collapsed. Crew members assessed the Trainee, began cardiopulmonary resuscitation (CPR), and called an ambulance. Despite advanced life support on-scene and during transport to the local hospital's emergency department (ED), the Trainee died. The death certificate, completed by the coroner, and the autopsy, completed by the forensic pathologist, listed "atrial septal aneurysm" as the cause of death. NIOSH investigators conclude that the Trainee's underlying medical condition, possibly triggered by the physical exertion involved in responding to the call and stretching the fire hose, caused his death. Given the cause of death, it is unlikely Fire Department (FD) policies or procedures could have prevented the death of this Trainee. Therefore, the following recommendations address general health and safety issues to reduce the risk of on-the-job cardiovascular events among fire fighters at this and other fire departments across the country. 1. Provide preplacement and annual medical evaluations to all fire fighters. 2. Perform a preplacement and an annual physical performance (physical ability) evaluation. 3. Ensure fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. 4. Phase in a comprehensive wellness and fitness program for fire fighters. 5. Provide fire fighters with medical clearance to wear self-contained breathing apparatus (SCBA) as part of the Fire Department's medical evaluation program.