Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, FACE F2009-19, 2010 Jan; :1-12
On December 31, 2008, a 54-year-old male volunteer fire fighter (FF) was dispatched to a residential fire. On scene, he stretched 200 feet of uncharged 1¾-inch hoseline to the front door of the residence, operated the engine's pump panel, and carried a portable ventilation fan to the front porch of the residence. After discussing pump panel operation with a crew member, the FF collapsed. Finding the FF unresponsive, without a pulse, and not breathing, the crew began cardiopulmonary resuscitation (CPR). Despite CPR and advanced life support (ALS) administered on scene, en route to the hospital, and at the hospital, the FF died. The death certificate, completed by the coroner, listed "cardiopulmonary arrest due to atherosclerotic cardiovascular disease" as the cause of death. No autopsy was performed. Given the FF's probable underlying heart disease, NIOSH investigators conclude that the physical stress of driver operator duties probably triggered his sudden cardiac death. The NIOSH investigators offer the following recommendations to address general safety and health issues. Had these recommended measures been in place prior to the FF's collapse, his sudden cardiac death may have been prevented. 1. Provide preplacement and annual medical evaluations to fire fighters consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 2. Incorporate exercise stress tests following standard medical guidelines into a fire department medical evaluation program. 3. Ensure fire fighters are cleared for return to 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. 4. Phase in a comprehensive wellness and fitness program for fire fighters. 5. Perform an annual physical performance (physical ability) evaluation. 6. Provide fire fighters with medical clearance to wear self-contained breathing apparatus as part of the Fire Department's annual medical evaluation program. 7. Use a secondary (technological) test to confirm appropriate placement of the endotracheal tube. 8. Perform an autopsy on all on-duty fire fighter fatalities.