On April 22, 2004, a 56-year-old male volunteer Lieutenant (LT) responded to a fire in the city community center. After donning his turnout gear, the LT walked toward the pumper when he suddenly collapsed. Ambulance service paramedics on the scene provided immediate treatment. Despite cardiopulmonary resuscitation (CPR) and advanced life support (ALS) performed by the paramedics and hospital emergency department (ED) personnel, the LT died. The death certificate, completed by the County Coroner, listed "acute myocardial infarction" due to "viral endocarditis" as the cause of death. No autopsy was performed. The NIOSH investigator concluded the physical stress of responding to the structure fire and the LT's underlying dilated cardiomyopathy contributed to his sudden cardiac death. NIOSH investigators offer the following recommendations to prevent similar incidents or to address general safety and health issues: 1. Provide pre-placement and annual medical evaluations to ALL fire fighters to determine their medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others. 2. Consider conducting exercise stress tests for male fire fighters over the age of 45 years with two or more risk factors for coronary artery disease. 3. Ensure that fire fighters are cleared for duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582, Standard on Comprehensive Occupational Medicine Program for Fire Departments. 4. Phase in a mandatory wellness/fitness program for fire fighters to reduce risk factors for cardiovascular disease and improve cardiovascular capacity. 5. Perform an annual physical performance (physical ability) evaluation to ensure fire fighters are physically capable of performing the essential job tasks of structural fire fighting. 6. Perform an autopsy on all on-duty fire fighter fatalities.
Region-4; Cardiac-function; Cardiovascular-disease; Cardiovascular-function; Cardiovascular-system-disease; Cardiovascular-system-disorders; Fire-fighters; Medical-examinations; Medical-screening; Occupational-health-programs; Safety-measures; Safety-practices; Safety-education; Viral-diseases; Viral-infections