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 F2013-18, 2013 Aug; :1-18
On March 7, 2013, a 49-year-old male career driver-engineer ("the Engineer") reported for duty at 0730 hours for his 24-hour shift. In the afternoon, the Engineer completed a 25-minute training session for an upcoming physical ability test. Approximately 25 minutes later, his engine was dispatched to a motor vehicle crash. At the scene, the Engineer was assisting the ambulance paramedics with a stretcher when he suddenly collapsed. Cardiopulmonary resuscitation (CPR) and advanced life support (ALS), including cardiac monitoring, multiple defibrillation attempts, intubation, and intravenous line placement, began immediately. Despite CPR and ALS for almost an hour on the scene, in transport, and at the hospital, the Engineer died. The death certificate and the autopsy listed "sequelae of atherosclerotic cardiovascular disease" as the cause of death. Given the Engineer's underlying cardiovascular disease, NIOSH investigators concluded that the physical exertion of the training session and the stress of responding to the motor vehicle crash most likely triggered an arrhythmia that resulted in his sudden cardiac death. NIOSH investigators offer these recommendations to strengthen the fire department's (FD's) comprehensive safety and health program and to prevent future events. 1. Modify the frequency of exercise stress tests required by the FD for annual medical evaluations. 2. Modify the formula used by the FD to estimate a fire fighter's aerobic capacity. 3. Phase in a mandatory comprehensive wellness and fitness program for fire fighters. 4. Ensure that fire fighters are cleared for 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.