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Career Firefighter Candidate Dies from Heat Stroke while Performing Firefighter Essential Function Course – Alabama

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Death in the Line of Duty…A summary of a NIOSH fire fighter fatality investigation

F2020-03 Date Released: April 4, 2020

Executive Summary

On June 17, 2019, at 0800, a career firefighter candidate (Candidate) reported for duty to begin the second week of recruit training school. The first task of the day was to complete the consumption course which consisted of 10 firefighting tasks completed in full gear and breathing from self contained breathing apparatus (SCBA). Each task is done twice and two SCBA bottles are used. If the second SCBA bottle is exhausted before completing the course, then a recruit is to remove the mask mounted regulator (MMR) and complete the course. The consumption course started at approximately 0840. The Candidate reached the 10th task, the dummy drag, just before 0900. During that task, the Candidate exhausted the SCBA bottle, removed the MMR, and stated they were unable to continue. Fellow recruits assisted with taking off his gear down to the bunker pants and assisted the Candidate to seating in the rehab area. Within minutes the Candidate went into cardiac arrest, cardiopulmonary resuscitation (CPR) was started, and the candidate was transported to the local emergency department (ED). Despite resusitative efforts, the Candidate did not survive the incident and was pronounced dead at 1002.

The autopsy report lists the cause of death as “probable heat stroke.” The Candidate’s core temperature on arrival to the ED was 103.8°F. The ambient temperature on June 17, 2019 between 0830 and 0900 was 81°F with a relative humidity of 65% resulting in a heat index of 84°F [weather underground]. ED notes indicate the candidate experienced a heat related illness during training the previous week but recovered with rest and intravenous (IV) fluids. National Institute for Occupational Safety and Health (NIOSH) investigators concluded that the Candidate’s physical exertion associated with the consumption course produced heat stress that could not be managed by the body’s normal regulatory mechanisms.

Key Recommendations

To prevent injury and death resulting from heat stress associated with emergency operations and training, NIOSH investigators offer the following recommendations.

  • Provide preplacement and annual medical evaluations consistent with National Fire Protection Association (NFPA) 1582.
  • Medical evaluations should be performed by a provider familiar with the physical and psychological demands of firefighting.
  • Fire Department/Training Center policy and procedure should address heat exposure topics related to unacclimatized firefighters, and medical monitoring during training and emergency operations.
  • Review policy on return-to-work medical evaluations as the candidate had a heat-related illness the previous week during training that required medical attention.

Read the full report