On February 10, 1998, a 50-year-old male Driver/Operator responded to a motor-vehicle fire. After stretching a 50-foot section of 5-inch supply hose to a hydrant and returning to the Engine to retrieve handtools, the victim had a witnessed collapse. Despite cardiopulmonary resuscitation (CPR) and advanced cardiac life support (ACLS) administered on the scene and at the hospital, the victim died. The autopsy, performed by the Deputy Chief Medical Examiner, showed a large heart (cardiomegaly) and only moderate coronary artery disease (CAD). The death certificate, completed by the County Coroner, listed "Myocardial infarction" as the immediate cause of death, due to "severe atherosclerotic cardiovascular 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) reducing physical stress on fire fighters, (2) screening to identify and subsequently rehabilitate high-risk individuals, and (3) encouraging increased individual physical capacity. Issues relevant to this Fire Department include: 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; exercise stress tests should be incorporated into the fire department's medical evaluation program; fire fighters should be cleared for duty on an annual basis by a physician knowledgeable about the physical demands of fire fighting and the various components of NFPA 1582, Medical Requirements for Fire Fighters; fire fighters should be provided with medical evaluations to determine their fitness to wear self-contained breathing apparatus (SCBA). Reduce risk factors for cardiovascular disease and improve cardiovascular capacity by offering a wellness/fitness program for fire fighters. Phase in a mandatory wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity.