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 F2010-04, 2010 May; :1-12
On December 29, 2009, a 24-year-old male career fire fighter (FF) participated in the mandatory Fire Department (FD) physical fitness program while on duty. The FF lifted weights for over 1 hour, ran on the treadmill for 2.3 miles in approximately 12 minutes, and then paused the treadmill's timer. Shortly thereafter, a crew member entered the exercise room and found the FF unresponsive, lying on the treadmill. Despite cardiopulmonary resuscitation (CPR) and advanced life support delivered on scene, in the ambulance, and in the hospital's emergency department (ED), the FF died. An autopsy was conducted by the local hospital pathologist. That autopsy report noted that the FF possibly experienced a fatal cardiac arrhythmia and that hypoglycemia may have contributed to his death, but that "Overall, there is no definite anatomic cause of death." The Office of the Chief Medical Examiner listed the cause of death as "Undetermined" on their investigation report and on the death certificate. NIOSH investigators agree with these assessments, but consider the diagnosis of hypoglycemia unlikely; even if the FF had hypoglycemia, it is very unlikely that it contributed to his death. The more likely scenario is a fatal cardiac arrhythmia possibly triggered by the heavy physical exertion during fitness training. NIOSH investigators offer the following recommendations to address general safety and health issues. It is unlikely, however, that any of these recommendations could have prevented the FF's collapse and subsequent sudden cardiac death. 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. 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. Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of a Fire Department medical evaluation program.