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Deputy chief suffers unwitnessed sudden cardiac death while fighting a wildland fire in steep terrain - Massachusetts.

Brown SE; Sylvain DC
Atlanta, GA: 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 99-F32, 2000 Jan; :1-9
On April 8, 1999, a 64-year-old male Deputy Chief of a paid call fire department was the first responder to a wildland fire in mountainous terrain. His initial assessment prompted him to request assistance from neighboring departments and from the State Air National Guard. Fire investigators determined that the fire was started by sparks from an abrasive saw that railroad employees were using during track repair. Fire authorities stated that similar railroad maintenance activities are a common cause of wildland fires. High winds and drought-like conditions rapidly contributed to the spread of this fire. The victim engaged in fire suppression activities for over 4 hours prior to his unwitnessed collapse. The victim was down for approximately 10 - 15 minutes when another fire fighter found him unconscious, without a pulse or respirations, on the ground next to a fire truck. The victim died despite cardiopulmonary resuscitation (CPR) and basic life support (BLS) administered by fellow firefighters and emergency medical technicians (EMTs) at the scene, and advanced life support (ALS) administered by paramedics and hospital emergency department personnel. Autopsy findings included "coronary atherosclerosis, focally severe," "extensive fibrosis in the antero-septal region of the left ventricle," "left ventricular hypertrophy," and "chronic obstructive pulmonary disease." 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. Recommendations relevant to this fire department include the following: Provide fire fighters with medical evaluations to determine their medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others; Initiate a wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity; Additionally, a recommendation for wildland fire prevention is included: Fire officials and railroads should voluntarily (a) jointly review and/or establish protocols and procedures to prevent the occurrence of fires caused by railroad work activities, and (b) prepare and/or implement a system for notification of fire officials of railroad work activities that pose a fire risk.
Fire-fighting; Smoke-inhalation; Cardiovascular-disease; Pulmonary-system-disorders; Physical-fitness; Region-1
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Field Studies; Fatality Assessment and Control Evaluation
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National Institute for Occupational Safety and Health
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division