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 F2014-05, 2014 Aug; :1-12
On April 5, 2013, at 0800 hours, a 57-year-old male career firefighter (FF) began his 24-hour shift. As the Acting Lieutenant for his company, the FF and his crew responded to two emergency medical calls during the day and early evening. The FF spent much of the evening in the officer's bunk room but had ice cream with a crew member before retiring for the evening at approximately 2100 hours. At 0021 hours, on April 6, the FF and his crew responded to an automatic fire alarm at a local college fraternity house. While investigating the cause of the automatic alarm activation, the FF climbed five flights of stairs in full personal protective equipment (PPE), including his self-contained breathing apparatus (SCBA). When the crew returned to the station at approximately 0045 hours, the FF complained of indigestion. The FF was last seen alive at approximately 0100 hours when he retired to his bunk room. At 0656 hours the crew was dispatched to a medical alarm, but the FF did not respond. When the crew returned to the fire house at 0715 hours, the FF was found unresponsive in his bunk room. He had no pulse, no respirations, was cool to the touch, and had signs of lividity and rigor. Per emergency medical service protocol, the FF was pronounced dead on scene. The death certificate, completed by the County Coroner, listed the cause of death as "cardiac arrhythmia, due to myocardial infarction, as a consequence of severe arteriosclerotic heart disease." The autopsy revealed severe coronary atherosclerosis with evidence of acute plaque rupture with hemorrhage; these findings are consistent with an acute heart attack. NIOSH offers the following recommendations to reduce the risk of heart attacks and sudden cardiac arrest among fire fighters at this and other fire departments across the country. 1. Perform symptom-limiting exercise stress tests on firefighters at increased risk for CHD and sudden cardiac events. 2. Perform an annual physical performance (physical ability) evaluation. 3. Phase in a mandatory comprehensive wellness and fitness program for fire fighters.