On March 29, 2005, a 26-year-old male career Fire Fighter/Paramedic (FF/P) worked an overtime shift as the driver of Station #3's ambulance. The shift lasted 9½ hours, 0700 to 1630 hours, during which time the ambulance responded to three medical emergencies. Shortly after his shift ended, the FF/P started his typical 5-mile jog as part of the Fire Department (FD) physical fitness program. After jogging about ½ mile, he reportedly felt a pop in his chest and a tingling in his legs which made it impossible to run and difficult to walk. An ambulance was summoned, and transported him to the local emergency department, where a dissecting aortic aneurysm was diagnosed. He was transferred via helicopter to a referral medical center for surgical repair. After 15 hours of surgery, the FF/P died in the operating room. The death certificate was completed and the autopsy conducted by the County Medical Examiner who listed the immediate cause of death as "Aortic dissection and its sequelae" with "Hypertensive cardiovascular disease" being another significant condition. It is possible that the heavy lifting during his shift initiated the tear of the aorta. It is also possible that his jogging put additional torque on his aorta resulting in the tear, or that the jogging may have extended the dissection. NIOSH investigators, however, cannot definitively determine whether these events initiated or exacerbated the FF/P's aortic dissection. It is unlikely the following recommendations could have prevented the FF/P's death. Nonetheless, NIOSH investigators offer these to improve the FD's safety and health programs: 1. Conduct exercise stress tests only on FFs at increased risk for CAD. 2. Discontinue routine annual electrocardiograms (EKG) unless medically indicated. 3. Discontinue annual screening chest X-rays (CXR) unless medically indicated. 4. Restart the FD's screening program for tuberculosis (TB). 5. Phase-in an annual physical performance (physical ability) evaluation to ensure fire fighters are physically capable of performing the essential job tasks of structural fire fighting.
Region-6; Cardiac-function; Cardiovascular-disease; Cardiovascular-function; Cardiovascular-system-disease; Cardiovascular-system-disorders; Fire-fighters; Medical-examinations; Medical-screening; Heart; Physical-stress; Physical-fitness; Emergency-responders; Cardiovascular-system; Cardiovascular-system-disorders; Medical-monitoring