On January 21, 2003, at approximately 2045 hours, a 50-year-old male career Captain was lifting weights and walking on a treadmill in his fire station's exercise room when he experienced chest pains. After alerting his crew members, medical treatment for angina was begun. When his chest pain persisted and he became increasingly ill, he was loaded into an ambulance and transported to the hospital by in-house ambulance personnel. Despite being given advance life support (ALS) in the ambulance, he went into cardiac arrest and cardiopulmonary resuscitation (CPR) was begun. ALS measures were continued inside the emergency department (ED) for 18 minutes until he was pronounced dead and resuscitation measures were stopped. The death certificate listed "acute myocardial infarction" due to "atherosclerotic coronary artery disease" as the immediate cause of death. The autopsy listed "coronary atherosclerosis" followed by "stenosis, thrombosis, chronic myocardial infarct, subacute myocardial infarcts, acute myocardial infarct, and acute ischemic change" as the cause(s) of death. The following recommendations address some general health and safety issues. 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 selected 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 fire service labor/management groups: 1) Ensure that fire fighters are cleared for duty by a physician knowledgeable about the physical demands of fire fighting and the various components of NFPA 1582; 2) Although unrelated to this fatality, the Fire Department should consider these additional recommendations based on safety and economic considerations. Provide mandatory annual medical evaluations to ALL fire fighters consistent with NFPA 1582 to determine their medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others; 3) Consider incorporating exercise stress tests into the Fire Department's medical evaluation program; 4) Provide fire fighters with medical evaluations and clearance to wear SCBA; 5) Phase in a mandatory wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity; 6) Perform an annual physical performance (physical ability) evaluation; 7) Discontinue lumbar spine x-rays as a screening test administered during the pre-placement medical evaluation.
Region-7; Fire-fighters; Cardiovascular-disease; Cardiovascular-function; Cardiovascular-function-tests; Cardiovascular-system; Cardiovascular-system-disease; Cardiovascular-system-disorders; Medical-examinations; Medical-monitoring; Medical-screening; Physical-capacity; Physical-examination; Physical-exercise; Physical-fitness; Physical-stress