On August 20, 1998, a 58-year-old male Fire Fighter died while on light duty. He was placed on light duty by the Fire Department (FD) physician for multiple medical conditions. The death certificate, completed by the victim's personal physician, listed "acute myocardial infarction due to coronary artery disease" as the immediate cause of death and "diabetes mellitus Type II and renal failure" as other significant conditions. The following recommendations address health and safety generally. It is unlikely, however, that any of these recommendations could have prevented the sudden cardiac arrest and subsequent death of this Fire Fighter. This list includes some preventive measures that have been recommended by other agencies to reduce the risk of on-the-job heart attacks and sudden cardiac arrest among fire fighters. These recommendations have not been evaluated by NIOSH but represent published research or consensus votes of Technical Committees of the National Fire Protection Association (NFPA) or labor/management groups within the fire service. In addition, they are presented in a logical programmatic order and are not listed in a priority manner. 1. Fire fighters should have mandatory 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. 2. Exercise stress tests should be incorporated into the Fire Department's medical evaluation program. 3. Develop a mechanism to ensure compliance with the mandatory wellness/fitness program. 4. Provide fire fighters with medical evaluations and clearance to wear self-contained breathing apparatus (SCBA). 5. Perform an autopsy on all on-duty fire fighters whose death may be cardiovascular-related.