50-Year-Old Firefighter Suffers Fatal Heart Attack After Fighting Two Commercial Fires—Michigan
Death in the Line of Duty…A summary of a NIOSH fire fighter fatality investigation
F2018-14 Date Released: April 03, 2019
Executive Summary
On July 29, 2017, at approximately 1456 hours a 50-year-old career firefighter (FF) returned to the station after working a second commercial fire that day. The FF had reported to the first fire in an occupied apartment building in the late morning and performed fire suppression activities (searching for fire and looking for fire extension) and overhaul for one hour and twenty minutes. The second fire was dispatched at 1347 hours and involved a fully involved garage that extended to a vacant apartment building. The FF performed fire suppression activity (opening walls and ceiling) on the first and second floors. The FF and his squad were released from the scene at 1458 hours. Upon returning to the station, the Sergeant noticed that the FF was pale and sweating and was rubbing his upper abdomen/chest area. Upon questioning, the FF admitted that he was nauseous, had a tingling sensation in his arm, and had chest pain. The Sergeant, who is an emergency medical technician (EMT), and fellow firefighters initiated care and called for an ambulance. The paramedics arrived at 1509 hours and while they were assessing the FF, he suffered a cardiac arrest. A shock was administered and cardiopulmonary resuscitation (CPR) was initiated. The FF was loaded into the ambulance for transport to the hospital emergency department (ED). En route to the ED, additional shocks were administered, CPR was maintained, and advanced cardiac life support (ACLS) was provided. Hospital ED personnel, along with fire department (FD) personnel, continued resuscitation efforts unsuccessfully for approximately 30 minutes. The FF was pronounced dead at 1600 hours.
The death certificate and the Medical Examiner’s report listed the cause of death as myocardial infarction due to hypertensive and arteriosclerotic cardiovascular disease. The autopsy found moderate atherosclerosis of the right coronary artery and an enlarged heart with thickened ventricles and microscopic changes indicative of hypertensive cardiovascular disease. NIOSH investigators concluded that the physical exertion associated with firefighting activity triggered a myocardial infarction in an individual with underlying cardiovascular disease.
Key Recommendations
NIOSH offers the following recommendations to reduce the risk of heart attacks and sudden cardiac arrest among firefighters at this and other fire departments across the country
- Ensure that all firefighters receive an annual medical evaluation consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments
- Ensure firefighters are cleared for duty by a physician knowledgeable about the physical demands of firefighting, the personal protective equipment (PPE) used by firefighters, and the various components of NFPA 1582
- Phase in a mandatory comprehensive wellness and fitness program for firefighters
- Wear self-contained breathing apparatus (SCBA) throughout fire suppression activities, including overhaul
- Implement formal incident scene rehabilitation with fire suppression activities.