On January 28, 2006, a 49-year-old male Fire Fighter (FF) responded to a fire in a three-story dwelling. While performing "wet down" overhaul inside the structure, the FF collapsed. Cardiopulmonary resuscitation (CPR) and advanced life support (ALS) were begun and the FF was transported to the hospital. Despite medical treatment for approximately 47 minutes on the scene and at the hospital, the FF died. The death certificate and the autopsy (completed by the City Medical Examiner) listed "arteriosclerotic cardiovascular disease (CVD)" as the immediate cause of death and "hypertensive cardiomyopathy" as a significant condition. The NIOSH investigator concluded that the physical stress of conducting fire suppression, coupled with the FF's underlying CVD, contributed to the FF's sudden cardiac death. The NIOSH investigator offers the following recommendations to prevent similar incidents and to address general safety and health issues: 1. Provide mandatory annual medical evaluations to all fire fighters consistent with the National Fire Protection Association (NFPA) Standard 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, to determine their medical ability to perform duties without presenting a significant risk to the safety and health of themselves or others. 2. Consider exercise stress tests for fire fighters at increased risk for coronary artery disease (CAD). 3. Develop a wellness/fitness program for fire fighters to reduce risk factors for CVD and improve cardiovascular capacity. 4. Ensure endotracheal tubes do not become dislodged during patient treatment, transfer, and transport. 5. Discontinue routine pre-employment/pre-placement exercise stress test for applicants, unless the applicants are at increased risk for CAD. 6. Discontinue routine screening chest x-rays for HazMat units unless medically indicated. 7. Ensure fire fighters wear self-contained breathing apparatus (SCBA) when working in a potentially hazardous atmosphere, including overhaul operations.
Region-3; Fire-fighters; Emergency-responders; Cardiovascular-system-disease; Cardiovascular-system-disorders; Cardiovascular-disease; Medical-examinations; Medical-screening; Physical-fitness; Cardiovascular-system; Medical-monitoring; Cardiac-function; Cardiovascular-function; Respiratory-protective-equipment; Respiratory-protection; Personal-protective-equipment; Personal-protection