On June 17, 1999, a 50-year-old male Fire Fighter responded to a fire in a three-story structure. After assisting with laddering the building, removing plywood from windows and doors, and connecting his Truck to a water supply, the victim suffered a collapse which was witnessed by a paramedic who saw the Fire Fighter in apparent distress. Despite cardiopulmonary resuscitation (CPR) and advanced life support (ALS) on scene and at the hospital, the victim died. The death certificate and the autopsy, completed by the County Coroner, listed "arteriosclerotic cardiovascular disease" as the immediate cause of death. Other agencies have proposed a three-pronged strategy for reducing the risk of on-duty heart attacks and cardiac arrests among fire fighters. This strategy consists of (1) minimizing physical stress on fire fighters; (2) screening to identify and subsequently rehabilitate high risk individuals; and (3) encouraging increased individual physical capacity. The following issues are relevant to this fire department: Fire Fighters should have annual medical evaluations to determine their medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others. Reduce risk factors for cardiovascular disease and improve cardiovascular capacity by phasing in a mandatory wellness/fitness program for fire fighters.