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 F2009-26, 2010 Jan; :1-12
On September 11, 2009, a 44-year-old male career Fire Fighter/Operator (FF/O) responded in his privately owned vehicle to a two-story structure fire. On scene while wearing full turnout gear, he connected the engine to a hydrant, assisted on a 2½-inch hoseline to protect exposures, and, after additional fire fighters arrived, operated the pump panel on the fire engine. As the FF/O went to the rear of the engine, he suddenly collapsed. The Deputy Police Chief, standing nearby, saw the FF/O collapse and notified the Fire Chief, who notified the on-scene ambulance. Ambulance paramedics treated the FF/O and transported him to the local hospital's emergency department (ED). Despite advanced life support for a total of 39 minutes (at the scene, during transport, and in the ED), the FF/O died. The death certificate and the autopsy, completed by the assistant coroner, listed "hypertensive atherosclerotic cardiovascular disease with coronary insufficiency" as the cause of death. NIOSH investigators conclude that the FF/O's underlying heart condition, coupled with the stress of responding to the alarm and performing fire suppression tasks, probably triggered either a heart attack or a cardiac arrhythmia, resulting in his sudden cardiac death. NIOSH investigators offer the following recommendations to address general safety and health issues. It is unclear if the recommended programs would have prevented the FF/O's sudden cardiac death had they been in place. 1. Provide preplacement and annual medical evaluations to all fire fighters consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 2. 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. 3. Phase in a comprehensive wellness and fitness program for fire fighters. 4. Perform an annual physical performance (physical ability) evaluation. 5. Provide fire fighters with medical clearance to wear self-contained breathing apparatus as part of the Fire Department's annual medical evaluation program. 6. Conduct annual respirator fit testing. 7. Discontinue lumbar spine x-rays as a screening test administered during the preplacement medical evaluation.