On February 6, 2000, a 42-year-old male Fire Fighter responded to a fire in a single-family dwelling. After ascending a 14-foot roof ladder, removing a 2-foot square section of wooden tongue-and-groove siding, further ascending up the same ladder to the roof in anticipation of performing roof ventilation, then descending to the ground, the victim had a witnessed collapse. Despite cardiopulmonary resuscitation (CPR) and advanced cardiac life support (ACES) administered on the scene and at the hospital, the victim died. The death certificate, completed by the County Coroner, listed "occlusive coronary artery disease" as the immediate cause of death due to "atherosclerotic vascular disease." Pertinent autopsy results included severe coronary artery disease, acute agonal pulmonary congestion, and pulmonary anthracosis without emphysema. 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: 1. 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; 2. Exercise stress tests should be incorporated into the Fire Departmentís medical evaluation program; 3. 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; 4. Self-contained breathing apparatus (SCBAs) should be upgraded with regard to the weight of the SCBAs and air cylinder; 5. As contained in the OSHA Revised Respiratory Protection Standard, provide fire fighters with medical evaluations to determine fitness to wear a self-contained breathing apparatus (SCBAs).